Gladden longevity — Episode #33

Steve Reiter: Welcome to the Gladden Longevity Podcast with Dr. Jeffrey Gladden, MD, FACC, founder and CEO of Gladden Longevity. On this show, we want to help you optimize your longevity, health, and human performance with impactful and actionable information by answering three questions. How good can we be? How do we make 100 the new 30? How do we live well beyond 120?

Now, for listeners that have been hearing my voice at the beginning and the end over the last number of months, I'm Steve Reiter, technical producer of the Gladden Longevity Podcast. Dr. Gladden, I had this idea that I ran by you. I've listened to every single episode of the podcast. I was a fan of this podcast.

Dr. Jeffrey Gladden: This is sounding dangerous, Steve, I don't know, you and I.

Steve Reiter: I've listened to every single episode of the podcast. I've been a fan long before you guys became a client. I brought this idea to you. Listeners like me have heard bits and pieces of your story throughout all the episodes, but we've never really heard your story in totality. So, I wanted this chance to interview you and hear about your childhood and hear about the kind of kid you were in high school, and what got you into medicine, and your journey in medicine, and becoming a parent, and all of those things. So, Dr. Gladden, welcome to your podcast.

Dr. Jeffrey Gladden: Oh, well, hey, it's good to be here. It's good to be a guest. So, that's fun. Yeah, Steve, it's a great idea. Quite honestly, when Steve proposed this to me I thought: "Well, that's really interesting, and yeah, we should probably do that." So, great. Let's do it.

Steve Reiter: So, where'd you grow up?

Dr. Jeffrey Gladden: Well, I was born in Michigan in 1954, in Jackson, Michigan, and my parents were from Michigan. Had an older sister, actually, who passed away. Her name is Linda. We'll talk about her. At age two, we moved to Grand Rapids, Michigan and I lived there till I was seven. I was a typical boy, into cowboys. There's lots of pictures of me with hats on, guns, army, playing army, running around climbing trees, all that kind of stuff.

Steve Reiter: Were you into sports at all?

Dr. Jeffrey Gladden: Yeah, I was. I played a little bit of baseball while I was there. Threw a football around a little bit. I do have a memory of turning three years old, actually. I have another memory from being three years old where I was I out playing by a pond that was in our neighborhood, where there were polliwogs and things like that. I was out there and I would catch them in these glass jars and whatever or try to anyway. I grew up in a Christian family. My mom and dad, we went to church every Sunday, and somehow, I remember walking back from the pond and I was thinking to myself, debating the existence of God: "Does God really exist or not? Someday when I grow up, I want to become wise." 

Those are very distinct memories from being three years old. I know it probably sounds a little precocious, but quite honestly, that's been a theme for me my entire life, this idea of becoming wise. It's really been a lifelong goal, if you will. So, there were some other fun memories there too. I had good friends there. I remember ice skating on that pond one winter and falling through the ice. Nobody was with me. I got some ice skates for Christmas. I went to the pond and fell through the ice and managed to drag myself out. The pond wasn't super deep, and I was able to pull out of the ice and I went back home and my mother was unbelievably chagrined. So, that was pretty interesting.

Steve Reiter: What did your parents do?

Dr. Jeffrey Gladden: My mom was a homemaker. My dad sold life insurance and then got into estate planning later in life, really, I guess. But there's one other memory there that's important for me, which is that when I was in first grade, I used to like to walk to school and it was about eight blocks away and it was Michigan. So, even in the winter, I'd like to walk to school. It was just nice to be outside. I really enjoyed that. 

So one, my fifth birthday, actually, I had a birthday party and I had a bunch of friends over and we were laughing, carrying on, eating things and I was eating peanuts. Anyway, I choked. About three days later, I'm walking home from school and I feel so terrible. I'm asking myself: "Why did I ever tell my mom I wanted to walk to school today? Why didn't I let her pick me up?" I get home and I open the door to the house and I basically just fall face first onto the kitchen floor. My mother freaks out, of course, and so she whips me off-

Steve Reiter: You're a little young for that to be happening.

Dr. Jeffrey Gladden: Right? A little young. So, anyway, she takes me off to the doctor. They admit me to the hospital. It turns out I had a peanut stuck in my right main stem bronchus, so on the right side of my lung, right? So, I had pneumonia in one lung and atelectasis or collapse in the other. So, they take me into the operating room, and I remember the ether. They put ether across, it's a distinctive smell. They put ether across my nose and I went out and then they removed the peanut. Then I was in the hospital for about a week in an oxygen tank recovering. That was my first introduction to a hospital. I have to tell you from then on, it was like I don't really like hospitals. I don't really ever want to be in a hospital.

Steve Reiter: Yet you got into medicine.

Dr. Jeffrey Gladden: Yet I got into medicine, but from a young age, it's like I don't really like hospitals. If I went to visit somebody, it's like I don't like the smell of these places. I don't like being in here. This is not a friendly environment.

Steve Reiter: So, what did you want to be growing up then?

Dr. Jeffrey Gladden: A race car driver. I wanted to be a race car driver. At age five, I could name every single car, make, model, year on the street. I had a thing for cars. My grandfather knew how to work on cars and things like that. I really idolized race car drivers, and Jackie Stewart was a childhood hero, but Jim Clark prior to that was a real hero of mine, was a Formula One driver who was ultimately killed. 

Steve Reiter: So, what point then did you decide to actually get into medicine? What was that journey like?

Dr. Jeffrey Gladden: Yeah. So, I graduated from high school. I went to Wheaton College, and my mom wanted me to be a doctor. This dovetails into my sister. My sister was three and a half years older. She had an anoxic birth when she was born. In other words, in 1950, my mom went into labor and they delayed her labor until the doctor got there. So, it turns out that Linda was in the birth canal and not getting oxygen to her brain adequately for probably about four or five minutes. So, she was a perfectly normal kid, but she ended up with brain damage from that. From that, she also had a seizure disorder, not a large grand mal type seizure disorder, but she would just blank out.

What's really interesting is that my parents never even picked up on the fact that there was a problem until she started kindergarten. It was at that point that they said: "Linda's not catching on the way that she should." So, my parents took her off to the Mayo Clinic. I remember that. She was, what, six years old maybe, and I would've been two and a half or something, but I remember my grandmother coming to stay with me and my parents leaving with Linda. When they got back, it was a different world. There was a new world order around Linda and what are we going to do, how do we take care of her and all that sort of thing. 

So, my parents were told by physicians: "Well, why don't you put her in a home or why don't you put her in a state institution and just forget about her?" They said: "No way. We're never going to do that." So, they spent really their lives really devoted to taking care of her. 

Steve Reiter: That's so admirable because of the reaction most of society had at that time for those kinds of situations, just put the down syndrome kids into a facility and go visit them occasionally.

Dr. Jeffrey Gladden: Yeah, exactly. Yeah. You have to understand too, Linda, I mean, she was articulate. She could speak just fine, I mean, carry on conversations. She was musical. She was athletic. She was actually inherently more athletic than I was, swinging, jumping on our trampoline doing flips, I mean, swimming, all kinds of stuff. She was actually a more natural athlete than I was. She was also a wonderful person. I mean, just a beautiful spirit. Everybody loved Linda, so to speak. She was just gregarious and sweet and just very loving, just that pure love that somebody without a lot of filter going on has. So, yeah, interesting. 

Steve Reiter: So, your mom wanted you to be a doctor. You go off to Wheaton. Is that what you pursued?

Dr. Jeffrey Gladden: Yeah. I majored in chemistry. The reason I majored in chemistry was because I thought: "If I'm going to get weeded out, I'd rather get weeded out right away, and so I'll take a hard major instead of biology." So, I majored in chemistry, and it was a bit of a struggle for me. I did well at organic chemistry, biochemistry, all those kinds of things. That all made a lot of sense to me, but things like physical chemistry and things related to quantum mechanics and some of that stuff was a little bit, although I loved those topics, the math was somewhat beyond me, quite honestly. 

I did well in physics itself, but some of the more abstract things mathematically were a little bit beyond me. So, also, I was a first person in my family to ever go to four years of college. So, that was interesting too. I didn't really have any real guidance from home or anything, quite honestly. So, I just went off to college and took what I took and whatever. Then I never studied for the MCAT. I just walked in and took it because nobody really told me that I should study for it. I looked over a few things the night before. 

So, anyway, I didn't get into medical school the first time I applied. So, that was a bit of a setback, of course. My mom was very supportive, actually, at that point in time, which was very sweet. I also had always had an interest in theology and philosophy. My college roommate was a philosophy major and really enjoyed all of that. So, I went off and went to seminary, actually.

Steve Reiter: Really?

Dr. Jeffrey Gladden: Yeah. I did two quarters of seminary.

Steve Reiter: Where'd you go to seminary at?

Dr. Jeffrey Gladden: Fuller Theological Seminary in Pasadena.

Steve Reiter: I'm very familiar with it. Yeah. I've got some friends that used to be professors there.

Dr. Jeffrey Gladden: Yeah, exactly. So, I did two quarters there and my roommate, Charlie, introduced me to skiing and also I'd grown up in Pennsylvania around Philadelphia. We moved there when I was seven, and I started body surfing in Atlantic City or Ocean City in the summer times with a neighbor of mine that would go down there for a month and I'd go down and visit him on the weekends or something. 

So, anyway, when I moved to California, I lived with Charlie's parents and I got a job as a janitor to make some money. Then I basically would wake up every morning and get the newspaper and look and see what the wave report was. If the surf was up, I'd go body surfing. If it wasn't, then I'd finish school. What was interesting was that I had a 4.0 in seminary and Charlie, I took a course from Charlie's dad. I took all senior level classes. So, I got an A from his dad too, who was notoriously difficult to get an A from.

The biggest compliment I ever got was he said: "Most people in my class read about 1800 pages. I've never given an A to anybody that's read as little as you have, which was about 950 pages, but," he said: "your papers were so good I had to give you an A."

It's like: "Oh, okay. Well, great." 

So, that was pretty fun too. So, yeah, I have fond memories of living in California. That was fun times. The body surfing was great. We bought wetsuits. We went down and started surfing at the wedge. I don't know if you're familiar with that. It's in Newport beach, ultra famous body surfing spot. Had some epic days there. So, that really got me hooked on the ocean. I really fell in love with the ocean living in Southern California like that.

Steve Reiter: You're currently in Puerto Rico splitting your time between Dallas and Puerto Rico.

Dr. Jeffrey Gladden: Yeah. I body surfed yesterday. So, all good. 

Steve Reiter: The ocean is good for the soul. So, why seminary?

Dr. Jeffrey Gladden: Well, I'd grown up in this Christian family and I'd gone to Christian schools. I went to a little Christian school in Newtown Square. I only had 31 kids in my graduating class. I basically just wondered if this was a direction I should go or not. If I didn't get into medical school, maybe I should go into seminary or something like that.

Steve Reiter: Was your goal to be a pastor or was your goal to be a theologian?

Dr. Jeffrey Gladden: Well, no, my goal was to just feel it out. I didn't have a goal except to actually understand it better. That was the only goal. What I figured out after I went through that was that I can think about theology or philosophy anytime. That can be a hobby, but to be a doctor, you can't do that as a hobby. So, I think I'm going to go to medical school, and I'd actually rather do something that's a little more tactile, a little more manual where I can actually have a sense of helping somebody quicker, potentially.

So, after doing that, I reapplied to medical school and Temple University in Philadelphia was interested in me. I went in and talked with the dean there. Prince Bringham was his name and he said: "We really liked you. We didn't take you the first time you applied, but we really liked you a lot, but tell me about this seminary thing," and I told him, and he said: "Well, okay. Here's what I'll do. You take a few more undergraduate biology classes. If you do well in those and do some research, and if you do well with that, apply early decision then we'll take you next year." 

So, I said: "Deal." So, I took some undergraduate biology stuff. Of course, got A's and all that, and then worked in a research lab for a year. Did well there doing some rat studies and things, and then sure enough, there I was.

Steve Reiter: Yeah. So, how was medical school for you? You're back in Philly, close to your parents…

Dr. Jeffrey Gladden: Yeah. Medical school was interesting. I will say one other thing about my educational path, which was that in junior high school, I had a teacher who actually had a PhD in geology from Swarthmore University at this little Christian school he taught. He pulled out about four kids from seventh grade and four kids from eighth grade and started this group called Science Seminar. We would meet one night out of the week and we would meet maybe twice a month. He had us reading Copernicus and Galileo and all these different things. 

I have to tell you, it was so intellectually stimulating to me. All of a sudden, we're questioning: "How did the church look at the progress of science? What's the interface here? Where's truth? How do you understand it?" and all these different, really, really fascinating questions. He literally changed my life. I mean, from then on, it was like: "There's a much bigger world out here than the doctrine that's being indoctrinated into me," so to speak. So, that was a real part of my intellectual development right there. 

Steve Reiter: That's amazing, that foundational of an age that someone really tapped that part of you.

Dr. Jeffrey Gladden: Right. Yeah. I was in seventh grade and I never looked back ever. It was just like somebody opened up a brand new universe to me and it was so beautiful. So, when I got to medical school, quite honestly, it's like drinking from a fire hose, but I found the work to be actually relatively easy. Did very well in medical school. I graduated with honors and was elected to the Alpha Omega Alpha honor society and all that sort of stuff. So, I did very, very well, but the interesting thing is not having gotten in for two years I had this ongoing question of: "Am I really an imposter?" I had the imposter syndrome, right? It's like: "Am I really supposed to be here? All these other people are here, but am I really supposed to be here?" 

Then I had a breakthrough there, which was I realized that instead of always comparing myself to other people and saying: "Well, this person's smarter than you are. This person can remember more things than you can," or whatever it is, I just had this realization that, "You know what? I'm smart enough to do anything I want and that's good enough." From that moment on, I never looked back either. It's like: "that's good. I'm good. I'm good. I'm good enough." I made great grades and I went on and did all the stuff I wanted to do. 

Steve Reiter: So, your residency, where'd you end up at?

Dr. Jeffrey Gladden: Yeah. So, I went to Case Western, which is university hospitals in Cleveland, Ohio, place where the sun never shines except for probably about 30 days out of the year. I married a medical school classmate, and we went there together in the matching process and she went into the pediatrics program and I went into the internal medicine program. That was a beating. I mean, I was on call every other night in the ICUs. I was on call every third night on the floors. So, you're just chronically fatigued, I mean, chronically fatigued, and you're taking care of a lot of sick people. I found it to be stimulating and interesting, and I was good at it in the sense that I could recognize when people were sick. I knew what to do, things like that, but I found it to be very draining at the same time.

Steve Reiter: That idea of being chronically fatigued as a doctor, I've heard where that comes from, but talk a little bit about that for people. Has that changed at all? Because you watch these TV shows in the '80s and '90s of doctors and they're pulling these all-nighters and now looking at the importance of sleep, it's like: "What the hell are you doing? Why?" 

Dr. Jeffrey Gladden: Oh, exactly. Well, it all started with a guy named William Osler at Johns Hopkins University, actually. He had a working theory that in order to understand disease, that the young doctor needed to be at the patient's bedside 24 hours as much as possible to actually see the evolution of the disease, be able to understand the subtleties of how things change either for the worse or for the better. So, they instituted this educational program around that premise that doctors should be at the bedside as much as possible. So, that led to being on call every third night, every other night. The surgeons in my program are on every other night for five years. Think about that.

Anyway, it's changed. People have realized that it's really counterproductive. People don't learn or remember nearly as well when they're chronically fatigued. They make poor decisions. I had a couple of experiences there that were dramatic in the sense that I remember working at the VA and people would come in over and over again for the same problems. I got into medicine really from a very compassionate place. I really want to help people. I really want to see them do better. Yet it got to the point where you were so tired that the patient actually became the enemy.

I could feel that happening. I could feel that happening. It's like: "I don't really want to get up to go see this person." So, all I really want to do is sleep. So, when I felt that coming on I thought: "I've pushed this way too far, and I don't really want to end up there." So, when my residency finished, when I was able to start to do my fellowship, the call schedule was quite a bit better and I was able to get away from that desperation of chronic fatigue, so to speak. 

It's interesting how you can take well-intended individuals and put them in a training scenario. I think this happens to surgeons also, where they're just working so much that they really start to lose sight of the humanity of the person that they're working for and to take care of: "They're just numbers, they're just things, they're just cases, they're just whatever they are." I think it's a tragedy in the traditional healthcare system that the patients suffer at that. They don't really have empathetic physicians the way that they could have because it's not that the people didn't start out empathetic, it was just beaten out of them, quite honestly.

Steve Reiter: Yeah. Well, how'd you move from internal medicine over to cardiology? Because you made that move to being an interventional cardiologist.

Dr. Jeffrey Gladden: Yeah. Well, that's the interesting thing. I finished internal medicine and I realized I didn't want to be an internist. I didn't want to be-

Steve Reiter: Why not? 

Dr. Jeffrey Gladden: I don't know. I just didn't want to be taking care of people with high blood pressure and diabetes and those kinds of problems. So, I wanted to do something that was more procedurally based. So, I looked at the different specialties. It's like: "Well, there's neurology. They don't really do anything. There's pulmonary. I don't really want to deal with people that are coughing stuff up all day long. There's GI. I don't really want to deal with poop all my life. There's kidneys, people on dialysis. I don't know. I don't really want to just take care of dialysis patients all the time." So, I went through all the different specialties, and it was like: "Cardiology. Hmm. Yeah. I think cardiology." 

The reason was the heart was like an engine and it's like: "Well, I want to be a race car driver. So, there it is. So, we've got pipes, we've got exhaust, we've got valves, we've got ..." I thought: "Well, I'll do cardiology." So, it was really my process of elimination, quite honestly. Then I got accepted into the University of Colorado Health Science Center cardiology program. My then wife went out there and did pediatric psychiatry. 

So, at that point it was like: "Okay." The more I went into it, the more and more I liked it. So, the deeper I got into it, the more I liked it. Yeah. It's like: "This is really interesting, the mechanics of it, the hemodynamics of it, the procedural aspects of it." All of a sudden it was like: "Oh, this is really great. This is actually a great specialty." So, very cool.

Steve Reiter: So, you moved out here to Colorado where I am.

Dr. Jeffrey Gladden: Yes.

Steve Reiter: So, you were in Denver then?

Dr. Jeffrey Gladden: Yup. I was there from '85 to '88.

Steve Reiter: Where'd you go after that?

Dr. Jeffrey Gladden: My wife and I had my son in Cleveland, actually, and Chris was born and that was a transformative moment for me in my life, quite honestly, anybody that's a parent, right? I mean, I had never felt unconditional love for another human being until I held him in my arms the night he was born. It was a game-changing experience to feel that unconditional love. It's like: "Oh, man. Where has this been? I've never known anything like this." I just bonded with him from the get go. His mom went to a protracted labor for 24 hours, first child, et cetera, a stalled labor. Eventually, had a C-section, but he was wide awake and I was wide awake. She was sleeping. We were just sitting there bonding. Then the sun came up and I held him up to the window and showed him his first sunrise and it was like: "Welcome to planet earth. Welcome to planet earth, little Chris." It was just super, super sweet. We've been tight ever since, I mean, ever since.

Steve Reiter: You had two with your first wife, or three?

Dr. Jeffrey Gladden: I had one. I just had Chris. 

Steve Reiter: One, okay, so just Chris. 

Dr. Jeffrey Gladden: Yeah, just had Chris, yup. Then in Colorado, the marriage fell apart and we went through a divorce there in Colorado, which was depressing because, obviously, I love my son so much. So, it was difficult, very difficult time for me. I got fairly depressed for a period of time, as you can imagine, but was able to come around with some therapy and some other help. Then I had to work really hard to get joint custody because in the divorce system, everything is slanted towards the mom, particularly with a young child. I mean, the mom has every leverage, but ended up with joint custody.

Then I got to a point where I wasn't going to basically live my life based on just Colorado per se. So, I started to look at other areas for going into practice. I came down to California or Texas. California was interesting. I had already had some history with California, and Texas was interesting also because there was a lot of chicken fried steak eating, tobacco-chewing people down there and I thought: "Well, this is a target-rich environment for a younger interventional cardiologist."

So, I also wanted places that were a fairly short direct flight for Chris to come down. So, I would fly him down every third weekend and I ended up going to Texas, which I'm glad I did because California turned into a fiasco with regards to medicine and everything else. So, anyway, that worked out well. Then I flew him down every third weekend and we continued to do all kinds of really fun stuff together.

Steve Reiter: What was it like starting a practice and getting that thing going? Did you come underneath someone that already had an established practice or did you start one yourself?

Dr. Jeffrey Gladden: I did. No, I joined a couple guys. I joined three guys, actually. I will tell you this. The first time I moved to Texas, I was asking myself: "What have I done?" I was missing Chris and I actually was in tears missing my son, but it's like: "No, I think I could make this work and I think this will work out." So, I joined these guys and I started to do really well. I had done a locum tenens earlier that summer, where I covered a guy's practice for a month while he went back to India in Ohio. I was really well-liked by the nurses, by the cath lab staff, all this kind of thing. I would come in and do cases and they would be so complimentary of my skill and my demeanor and the way I treated patients and everything. It was very reassuring.

So, when I started practice, I felt quite confident that I could do this. So, I started doing really well. I made friends. The nurses liked me. The cath labs liked me, again. Patients got along well with me. There was another doctor there who had started just two years ahead of me, who's the son-in-law of the senior partner who became very jealous of my early success, very, very jealous of my early success. So, he went to the senior partner, who I got along with incredibly well and still do to this day, and he had me fired. 

So, I started in October. I started in October and then on my birthday, February 28th, my first job as a doctor I get fired and I'm like: "Oh, my gosh. What is going on? What is going on? What is going on?" It was a major crisis, but some other physicians had been trying to recruit me because they'd seen the work that I was doing. So, I called them up and I said: "Hey, I guess I'm available." So, I was working with them by the end of the week, which then turned out I worked with them for about seven years. Then they started doing some funny things with regards to the finances and some other stuff and I thought: "You know what? I think I can do this better on my own," and that's the point at which I left and started my own group, my own practice, really.

Steve Reiter: How long did you do that?

Dr. Jeffrey Gladden: In total, for 25 years. So, I was with them for seven. So, really, I had my own group for about 17 or 18 years and started just with myself and then grew it up to 12 doctors and 10 offices. We flew around in a little A36 Bonanza to Southeast Oklahoma and parts of Texas. I had a real passion for bringing high quality cardiology care to outline areas, people that didn't have access. 

Steve Reiter: Really? Really? 

Dr. Jeffrey Gladden: Yeah. It was a little bit of this leftover missionary mindset from all of my upbringing. It's like: "No, I want to go out to people that don't have good access and bring them things that they didn't have." So, I started cardiac rehab programs and diagnostic testing programs and STEMI programs, which are basically heart attack programs, where you get somebody from their house to the cath lab and get their artery open within 90 minutes, things like that. I started cath labs. We started owning cath labs. 

Then I came together with one of my former partners and co-founded at a heart hospital in Plano as well. So, I got involved with lots of things and then got involved with medical device companies and a pharma startup. I'm still on the board of a couple medical device companies and things like that. So, I loved it. I loved all of it. I really enjoyed all that activity. 

Steve Reiter: Yet you got yourself to a point where your health really started to decline and you were burned out, really.

Dr. Jeffrey Gladden: That's right. Yeah. I flirted with burnout on various occasions, I suppose, but what happened in my 40s was ... When I went to college, I played soccer. I didn't mention that, but I played soccer. So, my freshman year, I played on the freshman team, and then I played on the JV after that, in part because I couldn't make the practices. All my chemistry labs ran too late, so I couldn't make practice, but I had fun playing soccer and I could run all day. So, here I am in my 40s and I'm got remarried now. I've got two young girls. Chris is still coming down every third weekend. I decide that: "I'm not really feeling that great. I think I should start to get in shape again." So, I go for a run and I run two blocks and I have to stop.

Steve Reiter: How old are you at the time?

Dr. Jeffrey Gladden: I'm at my early 40s, yeah, early 40, so probably maybe 43, something like that, 44. Anyway, I run two blocks and I have to stop, and I'm like: "Oh, my goodness. What has happened here? I mean, I could run literally all day. Now it's two blocks." This is when I had the realization that we really leverage our health for the sake of developing our practices, building our families, building our businesses, whatever it is. We really, really, really leverage our youth and our health at that point in time. That was a major insight. 

So, then it was like: “Well, I'm super busy. How am I going to get back in shape?" So, the idea came to me: "Well, I'll start riding a bike to work. I'll start riding my bike on the weekends. I'll start jogging. I'll start all these different ways I could fit into my life." After a few months, I could run three miles again and stuff like that. So, anyway, yeah. 

Steve Reiter: So, you're 43 at the time, 43-ish. What year is that? It's late '90s? 

Dr. Jeffrey Gladden: Would've been in the '90s. Would've been around maybe '90. When would that have been? Probably around '97, '98, somewhere in there.

Steve Reiter: This is before steps and the idea of parking further away from the grocery store that you get those extra steps and take the stairs, not the elevator.

Dr. Jeffrey Gladden: That's right. That's right. Yup. I started doing that just on my own. Nobody was talking about it, but it was like: "You know what? I'll take the stairs. I think I'll walk. I think I'll run when I come home and run or run in the morning or I'll get on my bike." I like to do things that I enjoy. So, I would get on my bike and I would ride through the neighborhood, ride through some streets on a Sunday morning, get to a bike path. All in all, this was about a 25-mile loop and go out and ride around a lake that had bike paths all the way around at White Rock Lake and then ride back to Preston Hollow. It was super fun. It was very enjoyable. It was just like I'm outside. The path, there's trees, all this stuff. So, for me even running, it was like: "This is enjoyable. I'm outside. I feel the air." So, for me, exercise has always had this element of enjoyment attached to it.

Steve Reiter: So, you're 43. You decide to start to get yourself into shape. At what point then did you start to transition into functional medicine? Did you leave interventional cardiology and get into functional medicine because-

Dr. Jeffrey Gladden: No. Well, I had-

Steve Reiter: Was that a gradual thing or was that a life crisis?

Dr. Jeffrey Gladden: That's a great question. So, what happened was I got back into shape. My son who was born in '84 is now 15 and he's like: "Dad, you need to learn how to snowboard." Because I learned how to ski in college, I had tried it previously, and I don't know if you've ever snowboarded, if you haven't, try it. 

Steve Reiter: I'm awful. 

Dr. Jeffrey Gladden: Yeah, right? It's like I felt like a quarterback with no front line. I mean, you just get so beat up because there's no catching yourself. You fall face first, you fall backwards. It's really tough. So, he's like: "No, dad, you're really going to love this." We were doing some skateboarding together and stuff like that. So, it's like: "Okay." Well, I started riding dirt bikes with some friends. I always had a thing for motorcycles, always had a thing for speed. At this point in my life, I had I think a Ducati in the garage. I had I think at least one Ferrari, maybe a Porsche. I'd gotten into shifter karts. I was racing those. I was going to be this race car driver, right? So, I always had this thing for speed. 

I will say this about riding motorcycles that I got into riding high performance motorcycles like Ducatis and Yamaha R1s and things like this, and I realized fairly quickly that if you're going to do this and not kill yourself, you really need to learn how to do this. So, I started doing all kinds of track days and wearing all kinds of protective gear, back protectors, elbow, shoulders, the best helmets, hip protectors, knee protectors, the best boots, you name it. I've had some motorcycle crashes and walked away from all of them, quite honestly, because of the safety gear, but I became fascinated with how do you control this very powerful, very dynamic motorcycle at speed.

It wasn't a thrill for me. It wasn't like I was trying to scare myself. For me, it was all about precision. It was all about how do I actually set this bike up to take this corner perfectly and get the drive off the corner where it just feels so invigorating. So, what I learned from that was that I became a better interventional cardiologist because of the motorcycle riding. The reason was-

Steve Reiter: Really?

Dr. Jeffrey Gladden: Yes. The reason was is because I started to be able to manage risk so much better. It's like: "Okay. I see the risk here. Let me start to manage this differently because if we crash here, this is going to be somebody's life." So, I actually became a better ... My thought process got cleared up and even better doing stuff like that. I love the cross pollination of different disciplines, if you will, like you're running better, that has an impact on this, maybe some impact on your sex life or you're learning how to do a new skill, and that has an impact on your vocation. I mean, all these different cross places to be are really fascinating. I think it's one of the reasons I like variety so much.

So, anyway, I had all this safety gear that I'd accumulated from riding dirt bikes, riding motorcycles. So, when I was going to snowboard, I put on every bit of it because I knew it was going to be a beating and I started snowboarding again. Sure enough, I fell down and I had wrist protectors on. I never got hurt, but over time, I learned how to snowboard. Then my then wife and I thought: "Well, why don't we learn how to heli snowboard? We didn't know how to do that." 

So, we went to south America because we heard about a place that would teach you how to go what's called off piece. So, we went down there. Did that for a few days at Valle Nevado in Chile, and then jumped on a helicopter in the Andes for two or three days, and you're getting dropped off at 14, 15 thousand feet and doing these massive runs. We're falling, we're doing stuff, but we're learning how to do it. Then long story short, became really, really good snowboarders. So, I mean, now it's like throw me down something steep and deep with lots of trees and it's just like: "Oh, yeah, this is a party. This is fun." But it all started with me not knowing how to do it at all. I think I love that empiric learning that goes on.

Steve Reiter: So, at what point then did you move into functional medicine?

Dr. Jeffrey Gladden: Yeah. Good question. So, I'm in my 40s. I'm doing all these things. I also meet a friend and he introduces me to mountain biking and I thought: "Well, I can ride a mountain bike." I crashed in about the first quarter mile. It's like: "Oh, okay. This is a new thing to learn." Anyway, I got into mountain biking and everything's going great. Then in my early 50s, all of a sudden the wheels came off. I started putting on weight. I'm really tired. When I come under pressure, I'm getting stressed and anxious and depressed again. It's like: "Holy cow! What's happening?" 

This was the realization that whatever we do in different decades doesn't necessarily translate into the future. You have to be willing to adapt. So, that's when I went out and did the testing. I had my routine lab work looked at and all that sort of thing, and that's when I got the answer: "Hey, you know what? Everything checks out. You know what? You're just getting older," and that's where that happened. I was already in the process of being healthy, so to speak, and when I got that, that was such an existential moment for me. It's like: "Are you kidding me? It's all going to be downhill from here? The mountain biking, the snowboarding, the running, the body surf, all this stuff is just going to be downhill from here? I'm not going to be able to keep up with my kids anymore? I'm not going to be able to do all these things that I've loved? Plus, vocationally, all these things I'm involved with, it's going to be downhill from here because I was developing brain fog too?" 

My dad died with dementia at 89. I mean, it was literally the most existential moment in my life. So, that's when I threw myself into functional medicine, integrative age management medicine. It took me two and a half years, but I cracked the code for myself in terms of what was going on.

Steve Reiter: Talk about that journey of cracking your own code.

Dr. Jeffrey Gladden: Yeah. So, it started out with going to conferences. It's like: "I'm not going to accept the answers of my traditional medical colleagues here. I'm going to do something different." So, that's when I started going to conferences and I started hearing about things that I knew nothing about, but I started to see data that people were presenting that: "You know what? These things actually work. We're actually reversing diabetes. We're actually optimizing hormones. We're actually finding out that people have something called subclinical hypothyroidism. We're actually reversing heart disease. We're doing all these amazing things," and I'm like: "Holy cow! How come nobody knows about this?" 

It's because medicine is really tied to pharma and tied to insurance payers. So, if pharma's not providing it and the insurance payers aren't paying for it, well-intended doctors just are completely oblivious to it. So, anyway, once I saw this new universe open up, it was a little bit like seventh grade all over again. It's like: "Wow. This is parallel universe in terms of healthcare, and this is actually healthcare." I was in the process of going through all this training and conferences that I realized: "Hey, I'm hormonally depleted. Testing showed that," and then: "Hey, I have subclinical hypothyroidism. Testing showed that too. My reflexes were delayed. Then all my genetics, by the way, I don't make certain neurotransmitters efficiently." So, I figured that out too. So, I got myself on the right combination of things.

I basically lost 20 pounds of fat, put back on 10 pounds of muscle. I looked better. I felt better. I feel sharp. It's like: "Hey, what a new lease on life. I was told that I'd hit my zenith and it was all downhill and now I feel great. In fact, I feel as good or better than I did in my 40s." I'm like: "Holy cow! I'll bet there's some other people out there that would like to benefit from this." So, that's the point at which I decided: "I've had enough of sick care. I'm going to leave the cardiology group."