Nov. 2, 2022

Dr. Judson Brandeis - How To Reclaim Your Sexual Health and Well-Being | Mental Health Podcast

In this episode, I speak with my friend, Dr. Judson Brandeis, a national leader in technology and innovations in sexual medicine. He gives you the best tools, community, and companionship to rejuvenate and reclaim your (or your man's) sexual health.
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In this episode, I speak with my friend, Dr. Judson Brandeis, a national leader in technology and innovations in sexual medicine. He gives you the best tools, community, and companionship to rejuvenate and reclaim your (or your man's) sexual health.

Dr. Judson Brandeis believes in the importance of sharing knowledge and experience with other physicians. He is the lead trainer for Male Sexual Wellness for REVIVE.

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Michael: Hey, what's up, Unbroken Nation! Hope that you're doing well wherever you are in the world today. Very excited to be back with you with another episode with my guest, Dr. Judson Brandeis, who is an award-winning urologist and sexual medicine expert. Judson, my friend, how are you today? What is happening in your world?

Dr. Judson: Oh, I'm doing great, Michael. Thank you so much for having me on. And you know, I'm in the San Francisco Bay area, so we are celebrating the Warrior's Victory.

Michael: Oh yeah, that did happen last night. So, I love martial arts, I don't pay attention to most other sports, but it's impossible not to see that everywhere. So, as someone who doesn't care, congratulations!

Dr. Judson: Well, you know, it was nice to see, you know, the warriors were stacked for a while and the last two years are really, really tough years for the Warriors, Clay Thompson got two really almost career ending injuries and Steph Curry got hurt a bunch of times. So, it was really, amazing to see the grit and how they reform themselves into a championship winning team. I mean, I think that was the most remarkable thing, is that they didn't really have the same team of all stars that they've had before and so, it showed a lot of character. And sometimes I get inspired by those kinds of efforts.

Michael: Yeah, same. And I don't wanna be dismissive of basketball, it's just that I'm six foot four and I cannot shoot a basket to save my life, that's all, it's inner thing, I'm working through it, just let me go through it. All right. But that said, I appreciate you coming on and I'm very excited to have this conversation. You sent me a copy of your book and as it arrived, I was like, well, I'm gonna dedicate the rest of my life to reading this thing and that came from two place one. I mean, it's a very dense book, but also as I started going through it, I was man, there are some really practical and incredible tools in this thing. And so, before we kind of like dive into that world and that arena, I would love if you tell us a little bit about your backstory and kind of what has driven you to get to where you are today, to not only practice medicine in the way that you do, but also just to write this almanac of life, which I think is a really solid way to phrase it?

Dr. Judson: Yeah, so you know, I was really blessed with an amazing education. So, I went to Brown University for undergraduate, I went to Vanderbilt for medical school. I did a research fellowship at Harvard Medical School. I did the surgical training at UCLA and the urology training at UCLA. I've done research with the folks that did the first living related kidney transplant, I've done research at American Red Cross with the folks who figured out how to freeze blood. And so, I'm just incredibly blessed with this incredible education, and I feel like if you've had that experience, you should give back, you know that that's part of your legacy, that's part of gratitude, which are important chapters in the book. And so, I started out by practicing general urology, I help pioneer surgical robotics. I help pioneer MRI guided prostate biopsies. I built the big kidney stone center and about two, three years ago, I became really interested in regenerative urology, so helping men who are unable to achieve penetrative intercourse because of erectile dysfunction, get that function back. And from that, that kind of led into interest in hormonal therapy and then physical rejuvenation. And that kind of led to writing this book, which is prevention and Early Intervention of Health problems for men over the age of 35.

Michael: That's quite the journey, man. I'm like, damn. You know, there's a curiosity that must be involved in order to go and create something like that. I think about it like even in this arena that I kind of stand in regard to childhood trauma and psychology and mental health like it is consummate. I'm like, who do I learn from? Where do I go? How do I become a better version of myself through this information? You know, and I think that as we grow and as we step into that, there's some power in honoring that, right? And just being like, yeah, I'm curious about this, I wanna see what it's like. But, you know, writing the book and creating that context and as a man over 35, one of the things I've been thinking about a lot is longevity, is health is also, in my case kind of healing from a lot of the own self torture, for lack of a better term, that I put myself through. At one point I was 350 pounds, smoking two packs a day, drinking myself to sleep, I was stoned from the moment I woke up to the moment I went to bed. I never slept. I was just engulfed with the chaos of what my twenties were. Now it's about, well, how do I become regenerative? How do I heal myself diving deep into work from people like, you know, David Sinclair and Rhonda Patrick, and now you. And what I'm wondering, and kind of where I want to start this conversation is there's a lot of people, male or female, who are listening and they're probably in this place where they're like, man, I've beat myself up, I drink all the time, I want to get healthy. I want to lose weight and I don't know where to start. I don't know how to take care of my body. I don't know what to do. And I would love to just dive in from a broad, high-level spectrum of like starting points and game points on just creating some change in health.

Dr. Judson: Yeah. I mean, that's the tough part ‘cuz we all know what to do. I mean, let's be honest. Don't drink, don't smoke, don't do drugs, don't eat too much, exercise every day, stretch, meditate a little bit and be nice to other people, like that's 99% of what you need to do. But why is it so hard? Right. It's hard because life isn't easy and there are a lot of stresses in life and there's a lot of pressure and we try to take shortcuts and we try to the coping mechanisms that we use and we get ourselves in trouble. And so, I think the best place to start really is to step back and say, you know, all this stuff isn't all that hard and we're all capable of doing it. But it's the determination and the motivation to get there, that's what really is difficult for a lot of folks. And so, I think this book really helps you get down into the details and it goes from the 99th percentile to the 100th percentile. But at the very beginning, we kind of all know what we need to do. And then the other part of it, and this is the first chapter in the book, and I know you talk about this a lot on your podcast which is really amazing, is the hero's journey. So, seeing yourself as the hero of your own journey, you know, Tiger Woods isn't the hero of your journey, Johnny Depp isn't the hero of your own journey, I mean, we just saw on TV like those people have problems just ‘cuz they're movie stars and they have a lot of money and they have attractive, you know, spouses or girlfriends that doesn't mean don't have problems. They got problems and sometimes even worse problems than you. So, just understand that you need to focus on your own problems and solving your own problems and let everyone else worry about their problems. And I think you know, that's the best place to start.

Michael: It's very true, and I mean, I think about, I go rewind, I look at my life and at 26 years old, here I am the heaviest I've ever been, drinking like a freaking fish and, and really kind of just hitting this rock bottom moment and going, this is my fault. Right. And not playing the victim and having the willingness to step into the healing journey. And that healing journey came in a lot of different ways. Prior to recording, we were having a little bit of off-air conversation and you did a little calculation for me and I thought to myself, this is really fascinating, what a great place to start the show and I would love if you would share that with us.

Dr. Judson: Sure. Well, you know, I talk to my patients about alcohol. And I don't tell people what to do, you can't tell a guy what to do. You tell a guy, listen dude, you gotta stop drinking. They'll look at you and say, screw you, you know, I don't care how many diplomas on you have on your wall I like drinking, you're gonna tell me that's gonna make me stop drinking so, I don't do that. What I do is I explain to my patients, what is alcohol? Okay. So, alcohol really is four things. First of all, it's very much ingrained in our society, right? So, when you're young, you go out with your guys and drink beer, and then when you're older and a little bit more sophisticated, you drink wine. And then when you get older than that and you go out with your old cronies, you drink whiskeys or bourbon or whatever, and you know, there are advertisements everywhere, you know, drink alcohol, but okay. What is alcohol? Alcohol is a classified as a depressant, that's the drug class that alcohol is in. Second of all, it disinhibits you. Okay? So, most of the stupid things that we do in our life are done under the influence of alcohol. Okay? And you know, every time I say that to someone, I just see them shaking their head like, yeah, okay. And third, alcohol is empty calories. And what that means is that alcohol is a fuel for the body, right? Creates energy, creates calories, but there's no nutritional value of alcohol. Okay. And so, by taking in those calories, you get fat, so what I typically do is I have my patient take out their iPhone and I say, go to the calculator's function. A glass of wine is 125 calories. If you drink two glasses of wine a night, or two beers or two drinks, that's 250 calories, you multiply that times 365 days then divide it by 3,500. So, there's 3,500 calories and one pound of human fat. And what you end up with is a number of 26, and what that represents is 26 pounds of new fat that you create every year by having two drinks a night or a day. So if you wanna lose 26 pounds and save a couple thousand dollars, stop drinking alcohol. And then people are like, well, okay, that, you know, now that you put it that way, maybe I'll stop.

Michael: Yeah. And I think that's such a great way to just look at it in general. I downloaded this app long time ago on old, like I probably was like the first iPhone and it was one of the very first quit smoking apps. And I mean, at this point I was off and on with it. Right. I'd quit the major like back and forth all day long chain-smoking habit, right? But there was still like, man, I'm out with the friends, or I'm here in this situation or this triggering experience, I would just grab a cigarette. So, I started downloaded that app and what I realized is that I was saving, like $2,000 a year just on not smoking.

Dr. Judson: Well, do you know how many years of life you'll lose by smoking?

Michael: Probably too many, right?

Dr. Judson: Well, so it's quantifiable. So, I had this patient, 57-year-old periodontist, right? So, a guy should know better, but he had a tough life, you know, he came over from another country, put himself through dental school, driving a cab at night, and his vice, his coping mechanism was smoking. And he had tried a bunch of different things to stop smoking, but you know, I kind of knew it was half. And so, I talk about it a little bit and then I said, you know, you have two daughters. Do you like your daughters? He said, oh, yeah, I love my daughters. My daughter's so great. Okay, do me a favor. Take out a piece of paper and write 13 years of life lost two times. And then I want you to put that up on your daughter's doors, their bedroom doors, just tape it up there so that every time you walk into their rooms, you're gonna realize that you're gonna lose 13 years of your life with them by continuing to smoke. I don't want you to do acupuncture or Wellbutrin or hypnosis or any other that crap. And month later he came back, he said, you know what? You're right, I'm gonna stop smoking. Right. I mean, I just gave him the fact that he's gonna lose 13 years of his life by continuing to smoke. He knew better, but I gave him a reason to stop smoking.

Michael: Yeah. I think you need that, like, for lack of a better phrase, like that coming to Jesus moment. And for me, and I look at that and that's one of the things that I'll teach my clients, you know, a great analogy that I will use is like, especially if they're married and they have children, go, do you want to see your child get married? Do you want to see them walk down the aisle? Do you wanna meet your grandchildren? Because if the answer is no, just keep doing what you're doing, you'll be fine. And that could be smoking, drinking, diet, whatever. And if the answer is, I want that, it's like a dude, it's like a baseball bat to the face. And I remember, I was on this hike with friends, we had flown out to Mount Rainier and in the Seattle area in the Pacific Northwest and we're climb, I guess a Portland area and we're climbing and halfway through I was like, I think I'm having a stroke, and it was like fucking 26 years old. And it was because of how poorly I was taking care of my body. But I think, you said coping mechanism and I wanna rewind to that because now as someone who has done this work, and for you, someone who understands this work. Why does that work that way? Like I've always wondered this, and I know it's a very vague question, but why do coping mechanisms work and how do they work?

Dr. Judson: Well, I mean, I think they work in the short term, right? So, you drink alcohol, you're disinhibited, you kind of forget your problems or you smoke, you get a surge of adrenaline through nicotine or you know, sometimes I've had a really rough day or some crap happens at home. You know, I got four teenagers and a wife so, there's always, not always, but you know, there's plenty of drama to go around. And at 10 o'clock I'll take out my Häagen ice cream and have a bowl of ice cream cuz sugar perks me up. Right? That's a coping mechanism. I mean, I like ice cream, but sugar helps. So, I mean, we all have our coping mechanisms, but to make those coping mechanisms healthier, I mean, one of my coping mechanisms is exercise, right? And that's a healthy coping mechanism.  You know, people do drugs to kind of escape, but you know, once you come down, wherever you go, there you are.

Michael: Yeah, that's so true. And I think that's one of the, the really hard truths of life are like sitting in that. When I think about the journey and just a one to zero in here a little bit, just into this idea, and really the baseline of the book is giving people tools, men specifically over the age of 35, tools for longevity and health. What are kind of like the most important markers that they should be looking at as for health and longevity and dude, there's just so much information. I feel like overwhelmed sometimes, I'm like, am I doing keto this week? Am I using a whoop? Should I do the aura ring? Like all these things, right? And it's like, what are the most important things? Just be like, am I healthy? Like, what are the markers?

Dr. Judson: Yeah. The book is about prevention and early intervention, but it's written by myself and 60 others, you know, world renowned Men's health experts and physicians, right? So, you're not getting me as a urologist telling you about eye health or foot health or hand health or spine health or brain health, you know, you have people who are experts in those fields. And so, there's the stuff to get you to the 99th percentile, and then there's the stuff to get you top one percentile. So, there's stuff about peptides and performance and M sculpt and PRP and so there's a wealth of that kind of stuff in the book, but really it comes down to simple stuff, you know, are you an ideal body weight? I had a patient that flew in from Florida to see me, right? And he's like, well, you know, I'm taking BP 157 and alpha thymus and alpha one and this peptide and that peptide. And I looked at him, I said, Dude, you gotta lose 50 pounds first, once you lose 50 pounds, don't worry about the peptides. So, you know, really no alcohol is good for you regardless of what studies the red wine companies sponsor, no smoking is good for you, no illegal drugs it's good for you. You should exercise five, six times a week at least, don't overeat, you know, eat high protein, low carb, high fiber, diet with healthy fats. I mean, if you do those basic things, most of your markers will be just fine. I mean, there's a ton of other stuff that I talk about in the book, I mean, at 50, make sure you get a colonoscopy at 50 make sure you get a PSA, you know, I order a lot of heart calcium scans for my patients who have risk factors for cardiovascular disease, which is an amazing study to look at early heart disease. I have a whole chapter on genetics in the book talk about genetic testing that we can do to predict certain disease states. So, I mean, there's a ton of stuff to do, there's the basic stuff and then there's the sort of next step up. But the other thing is work with your doctor and there's an amazing chapter in the book on how to make the most of your doctor's visit because the average doctor visit in the United States is 16 minutes. And I actually have a video on the 21st century man website that you can download on how to make the most of your visit to your doctor and if you got a minute, I can just break it down really quick.

Michael: Yeah. I was literally about to ask you to do that.

Dr. Judson: No problem. And this is coming from someone on the inside, right? You got 16 minutes with your doctor, that's it. Don't expect more. Right? They're paying doctors less and less money each year, and so we have to cram more patients in one hour. What you need to do is you need to come to the doctor prepared. Don't talk about your cat, don't talk about football, don't talk about, you know, the weather. Come to talk about your health. And when you get there, you hand the doctor a stack of papers. And in that stack of papers is your health history so your medical issues, what surgeries have you had? Do you drink? Do you smoke? What's your family history? Does everyone in your family have cancer? Does everyone in your family have heart disease? Does everyone in your family have some odd disease like, polycystic kidney disease that the doctor needs to know about. Okay, Ben, a complete list of medications and maybe some medications that you've tried that didn't work, and maybe some that you've tried that had side effects, a complete list of imaging studies. Right. So, if someone comes into my office and they had imaging studies, but they don't have the results, I'm gonna have to take my time to go look for those imaging studies. Right. That time is your time. And then make a description of why you're there in as much detail as you possibly can. You know, my back started three weeks ago when I fell off a ladder, it started on the right side, it was 10 out of 10. Now it's five out of 10. I took Advil and Motrin. Something like this happened five years ago. I had an MRI. I ended up with an epidural. I ended up with surgery, etcetera.

So, give the whole history and then make a list of questions. You know, these are the five or 10 questions that I want answered in this medical visit. And then take that, hand it to your doctor, you'll get a big smile from the doctor. I use voice dictation system, I go through patient's records, which takes me about three or four minutes to dictate everything, and then you got me for 13 to 14 minutes, right? Then I can examine you, I can formulate a plan, I can talk to you about the side effects of the medications I'm gonna put you on, right? But if I have to spend three, four minutes talking about the weather, and then five or six minutes taking a history, and then I have to go tell my nurse to go get your labs and your imaging studies, by the time a nurse comes back, I'm looking at my watch going the next patient's here.

Michael: It was very much my experience. So, I got pretty sick when I was 29, ended up turning out, it was sibo which then led to c.diff, which would be, yeah, it was a fucking nightmare, ended up doing a couple fecal matter transplants, you know, elemental diet for 21 days, like real, deep, it was pretty much life or death, right? And this was without having any exposure to what you just said, but had I not done literally exactly what you just said, I don't know that anybody would've been able to help me. And it was really interesting because I would go to these doctors and it took a lot of doctors, it took a lot of effort to get this problem solved. But once we figured it out, now it's just been literally rebuilding my gut health for years and years and years and years, where now I feel probably better than I ever have while paying close, close attention to everything I put in my body. I feel though that two things and I'd love to know your thoughts as an expert on the insight here, I think two things. One, I think people are really, really scared to tell the doctor the truth. I don't know why, but I feel like that holds true. And two, I think that when people hear this is what you need to do, they don't execute against it.

 Dr. Judson: Yeah. When I started my medical training, I did a year of research at Harvard Medical School and Harvard Medical School had the Harvard Medical School Library, which was the biggest medical school library in the world, had a million volumes and people would fly from all over the world to spend time at the Harvard Medical School Library. Right. Now you have a cell phone, you have the whole Harvard Medical School library in your cell phone, you can look anything. So that's kind of leveled the playing field a little bit in terms of access to information. So, doctors don't live at the top of this great mountain and tell patients, you know, do this, do that. And so, it's important to see your doctor as a partner, that's what I tell my patients. You know, I'm your partner in you care. I'm not gonna tell you what to do. I'm here to help educate you, and I'm here to be a resource for you to help figure out what's going on and help to create a plan. But it's up to you to tell me what's possible, what's not possible, and how you can execute on that plan. And when you turn that relationship from a paternalistic relationship into a partnership, I think it changes the dynamics of healthcare. And I think patients are much more likely to open up to you, I mean, the end of the day, they have to really trust you. And my office, you know, I have a very unique medical office, I don't take insurance anymore because I don't wanna spend 16 minutes with patients, the stuff that I do to really treat sexual medicine properly you need an hour on an initial intake with a patient. You just can't do that with conventional medicine, but, you know, I had a patient, 55-year-old guy, contractor, you know, it looks great doing really well, but having these really significant medical problems. And at one point I looked at him, I said, listen, you know, there's something that you're not telling me because given what you've told me already something's not adding up for me. And he just got really quiet and he said, you know, I didn't tell you this, but for 15 years I was a meth addict. I said, okay, now we can start, you know, now I can start helping to rebuild you and we did, you know, he did fabulously well. But it wasn't until he actually trusted me and trusted that I actually cared about him, you know, more than patient number 62, that he was able to open up to me in a way that I had enough information that I could actually take care of him.

Michael: I think that one of the things is just how quickly people are dismissed, I don't wanna use the word dismissed, but the feeling of, dude, you got 16 minutes, what's up? And I love what you said about creating preparedness to have that conversation in a way that's going to lead to a positive outcome. One of the things I'm curious about is how do you know if you actually have the right doctor? And the reason I'm asking that question is because often, and to your point about cell phones and the internet, really realistically, and I know that you'll agree with this quite often, the right doctors, whoever showing up first in the Google results, because they paid. And so, what I'm curious about is how do I know if I have the right doctor, the right practitioner? Especially because a lot of people, especially on this show have medical trauma, have been through some really dark stuff in their life, and trusting people is a terrifying experience for them. Are there some things they should be asking or looking out for to make sure that it's the right person?

Dr. Judson: Yeah, you know, you're not gonna like my answer, really because you know, I love what I do, I know a lot of physicians who are absolutely extraordinary, but the way that the system is built, it's really hard to be extraordinary. And part of medicine is knowing the medical stuff, but the other part of it is the art of connecting with people and your patience. And you know, I've really been blessed to have lived in lots of different places I've probably traveled to 40 or 50 countries. I've had all sorts of interesting experiences and so there's almost no patient that I've ever met that I couldn't connect with in some way. I was a history major, so I know a lot about world history, you know, so I have patients from Afghanistan, I talk about Afghanistan. If I have patients from Iran, I talk about Iran. If I have patients from Korea, I talk about, you know, the Korean War and you know where their families come from. And you have to have like a broad scope as a human being to really be able to connect with other people. But the problem is a lot of the people that are coming out of medical school these days, you know, worked really hard in high school to get to medical school, worked really hard in medical school to get into residency, worked really hard in residency they pop out like they popping out of a toaster and they haven't lived life and they spend, you know, most of the time doing all this crazy documentation that we have to. And so many of my patients complain that my doctor doesn't look me in the eye, he just spends his time looking at the computer, you know, they just wanna push drugs on me, etcetera, etcetera. And it's only gonna get worse. It's not gonna get better. And so, really, you have to be an empowered patient. And what I mean by an empowered patient is, have your medical history ready. Have your medications and your allergies and your imaging studies and your medical history and like when I go to my attorney, my attorney's 750 bucks an hour, right? So, it's $11 a minute, you know, 11 bucks is like a good lunch to me per minute. So, I use every minute of that attorney's time, you know, to talk about stuff that's really relevant to me I try to get the most out of it. You know, there's a lot of really good resources out there, and if you approach a physician in the right way, you'll get a lot out of it. But if you just go there saying, fix me, you know, like if you bring your card to the card dealership or the service place and say, you know, fix the car, you're not gonna get very much out of it

Michael: Yeah. That's a really great point. You know, a thing I have shared on the show, but not a lot, is I actually worked for one of the Fortune 10 insurance companies when I was in my twenties, and I can see I had surgery back in February and I looked at the cost of service on the EOB and it was exponentially higher than it was 15, 20 years. And the other thing is that costs are gonna continue to rise as well and I think that's part of the fear people have about even seeking medical care is like, Oh my God, this thing is so expensive.

Dr. Judson: But did you read the chapter in the book on health insurance?

Michael: Let's go into that. That's exactly where I was leaving.

Dr. Judson: Oh, it's so good. You know, the thing is writing the book, I didn't wanna write all the chapters, right. So, I would go and I would look for an expert, someone who'd written something that was really, really good and try to see if they could write, you know, contribute that chapter for the book. And I mean, we spent 20% of our gross domestic product, $2 trillion on healthcare and I couldn't find, and it wasn't for lack of looking, a single 20-page chapter that explained health insurance and the American medical System. How pathetic is that?

Michael: It's on purpose?

Dr. Judson: I mean, maybe it's on purpose, so we wrote it, I got myself and two masters of public health students at UC Berkeley, and Jim Corco, who's a medical director at Blue Cross Blue Shield of California. And we made the American medical system, you know, into 20 pages, something that's readable because you know you're each person out there you know, if your family's got health insurance, it's 25,000 bucks a year, that's a big investment. You better know what you're purchasing for that investment.

Michael: Talk us through it, because I really want people to at least at high level baseline have an understanding ‘cuz the only reason I do, I'll be honest with you, is ‘cuz I worked for the company for six years, had I not done that, I would know zero about it. And it's incredible how often I'm not legally licensed anymore so, I'm hypothetically advising friends. And so, I would love if you would break down some of those discoveries and find them.

Dr. Judson: Sure. I mean that's like a three-hour lecture, but I'll give you some main points. 20% of GDP, $2 trillion dollars. Right. And then people think that we have a private insurance company, right? I mean, United States is private insurance, but really between Medicare, Medical, county insurance, you know, indigent care and the VA, the government pays more than 50% of healthcare, okay? Medicare has become the standard, Medicare kicks in a trillion dollars a year, and Medicare has what we call a 99.4% medical loss ratio. So, what's a medical loss ratio? And MLR dictates how much of a healthcare dollar is spent on actual healthcare, right? As opposed to bonuses or advertising or things that don't directly affect somebody's healthcare, right? So, you would think, I've put a hundred dollars in towards my healthcare, I'm gonna get a hundred dollars back or close to a hundred dollars back and government system, you get 99.4% of that healthcare dollar that goes back towards your care. But it's legislated for say, Blue Cross Blue Shield are united, that the MLRs around 88, 89%, meaning you put a hundred dollars towards your health care and you only get $88 or $89 back, like, wow, that's bad. Who would do that? Who would put a hundred dollars on the bank and only get $89 back? But that's the way our healthcare system is set up. And the reason it stays afloat is that folks like you and I now that we don't need very much, healthcare, we put in our $25,000 for our family, and fortunately, you know, my family may only use four or $5,000. So that $20,000 goes towards someone else that's using more of those healthcare resources. Are you with me?

Michael: Yep. Following.

Dr. Judson: Okay. So, then there's different health setups. So, there's Kaiser. Kaiser is what's called a capitated system, meaning you go in and you pay a fixed cost and then you get a full service of care. There are systems called an HMO, which is kind of like Kaiser, which you pay a fixed amount, but you have what's called a narrow network, you can only see certain doctors that are contracted with that HMO. Then there's something called a PPO. And I have patients, you know, these guys work at as PhDs at Lawrence Livermore Labs, right? The nuclear lab for the United States, these guys are rocket scientists. And I ask them, do you have an HMO or a PPO? I don't know. Well, let me look at your healthcare card. I don't know where it is. Right? So, it's not like the people are unintelligent, it's just, it's not something that we're sort of educated about, unfortunately. So, a PPO allows you to see a wider panel of physicians and then, you know, there's something called Medicaid, or in California it's medical, right? And that's indigent care. So, if you have an income level below a certain amount, you get free medical care, but it may only be from certain physicians who, you know, instead of spending 16 minutes with you might spend five minutes with you. You know, there's just so much to it, but you know, the chapter talks about the differences between HMOs, PPOs, EPO’s, Kaiser talks about Medicare, talks about medical, talks about deductibles, why do you have deductibles? It talks about pharmaceutical formularies. It talks about vision plans and dental plans, just so that you understand, you know, when you get there with your health insurance card, what you're actually getting.

Michael: Yeah. And the reason I brought that up because I would argue, especially in this country, it might be the most important chapter of the book just from a healthcare service provider standpoint. And you know, when I worked for that company, I mean, I was licensed in 48 states with 48 different tests that I had to take under 48 different sets of laws. And I mean, when I say it's complicated, when you get down into that granular level, like I mean, you understand, I really mean that. But my hope is that for the folks listening right now who just they're not educated on it because it's not something we're educated on, when did you take insurance class in high school? Cause I sure as fuck did it. Right? And so, if we can give people…

Dr. Judson: You don't take it to medical school.

Michael: I know, well, that's a whole another conversation, but my hope is that this will spark curiosity for people to start to take more control over their health because ultimately, at the end of the day, I mean, it's like you said, you want to be there to support and to guide and to give information not to say, this is the game plan, go do this no matter what. And I think that's a really important thing, but that only really starts with having educated yourself first.

Dr. Judson: Yeah. And you know, the book is, it's not c spot run, you know, you're gonna have to work to understand some of the concepts in the book. But I think any man who wants to put his mind to it that's reasonably intelligent will be able to understand everything in the book because I either wrote every chapter or I edited every chapter, and I made sure that it was understandable. And the other thing is, a lot of times I'll read a 300-page book, and at the end of a 300-page book, I'll be like, you know what? That could have been four pages. There's like four pages of information in this 300-page book, and the rest of it just fluff and stories. But I can guarantee you this is a 900-page book that really should be 5,000 pages, but I distilled it down to 900 pages and the least number of pages this book could have been is 900 pages.

Michael: Yeah. And I agree as having gone through the book, not in its entirety, again, full transparency, but having gone through the book and consuming a vast quantity of it, like I can agree with you that makes sense to me. When I wrote Think Unbroken, it really needed to be about 2000 pages, truthfully it did. But ultimately, I came to the conclusion like, in reality it needs to be 300 of just nothing but actionable and practical tools. And that's how I felt when I was reading your book and to have the information in conjunction with 60 other experts I mean, I cannot think that's why I called it an almanac, I cannot think of a more comprehensive book that I've had come across my desk in the health realm over the years and so, it's a huge accomplishment to you. And my hope is like we're not just sitting here touting like, go read this guy's book like that's not, I hope the thing people are taking from this conversation is that there are tools that are accessible to you that will change your life forever if you're willing to put them in your hands.

Dr. Judson: Yeah, I mean, but no one's gonna sit there and take care of you. At the end of the day, you know, you may have had horrible trauma in their life and you may have had terrible things happen to you, but at the end of the day, the only person that can fix the problem and the only person that can get you healthy is yourself. You know? And I tell my patients that all the time, you know, okay, yeah, you work really hard, you got family at feed, you got in-laws, et cetera, et cetera. Okay, yeah. Everyone wants a piece of you. But at the end of the day, you're gonna go downhill physically, mentally, emotionally, unless you decide that you wanna take care of yourself and you want to carve out some time to improve yourself in whatever way you need improving.

Michael: Yeah. Brilliantly said, I totally agree. It's been an amazing conversation, my friend, before I ask you my last question, can you tell everyone where they can learn more?

Dr. Judson: Absolutely. So, is my medical practice website in Northern California. The book website is the, all written out in letters. And then I have a YouTube channel where I do a lot of physician teaching and lecturing and so I have pretty much all my content up on my YouTube channel, which is Brandeis MD. And what else? I have a supplement company. I make men's health supplements; we have a supplement for improving circulation and erectile function called AFFIRM. We have one for premature ejaculation called PreLong. We have one for prostate health called Spunk. And we have one for boosting testosterone levels and that's called SUPPORT and that's available at

Michael: Brilliant. And of course, we'll put the links and the show notes for the audience. My last question for you, my friend, is what does it mean to you to be unbroken?

Dr. Judson: Wow. Well, you know, I think we're all broken. You know, we're all broken in sort of different ways, but you wanna bend but not break. So, we all have little micro fractures, but hopefully the whole bone doesn't break.

Michael: Truth. Thank you so much for being here, my friend, Unbroken Nation. Thank you so much for listening.

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My friends, Be Unbroken.

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Michael UnbrokenProfile Photo

Michael Unbroken


Michael is an entrepreneur, best-selling author, speaker, coach, and advocate for adult survivors of childhood trauma.

Judson Brandeis, MDProfile Photo

Judson Brandeis, MD

Urologist, Researcher, Author, Educator

Dr. Judson Brandeis is an award winning urologist and sexual medicine expert, clinical researcher, physician educator, and a caring clinician and surgeon. A graduate of Brown University and Vanderbilt University School of Medicine, with Urologic Surgery residency at UCLA and a post-doc fellowship at Harvard, today he specializes in the emerging field of sexual health and medicine.

Over the course of his 25-year career as a board-certified urologist he has performed thousands of surgeries and pioneered surgical robotics. In February of 2019, he opened BrandeisMD, a national leader in technology and sexual medicine innovations for men. BrandeisMD engages in ongoing clinical research to improve wellbeing and provide tools for men to live their best lives. Dr. Brandeis is dedicated to helping his patients and men everywhere feel great, look good, and have better physical intimacy. He brings this wealth of expertise and care to his first book, The 21st Century Man: Advice from 50 Top Doctors and Men’s Health Experts to Help You Feel Great, Look Good and Have Better Sex. A native New Yorker, Dr. Judson Brandeis now resides in Northern California.