Dr. Peter Attia
speaker
5,258 appearances
36 recordings
6 series
first heard Jan 2024
last heard Jun 2025
Dr. Peter Attia’s voice in public audio — every appearance, attributed to the second.
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I mean, I felt awful. You felt worse between 5 a.m. and 8 a.m., and then you get this second wind, usually about the time you're operating, and then you usually feel pretty good. But overall, I mean, it's a haze.
Yeah, for sure.
Well, look, there's so much going on. I'm happy to tell my story because it's a great introduction to the work you've done. So for folks that haven't heard it, I've shared this before and we were talking before the podcast. I don't remember how much of this is in the book because at one point I wrote all of this out. I'm pretty sure much of it got cut out.
But when I was in my third year of medical student, I was having just a great old day, rode my bike to the gym, was just about to go in the gym and I get off the bike and I feel a pain in my back like I've never felt before. And it was enough that I decided not to work out, which says something because I would have worked out through any amount of discomfort.
I limped home, laid down and said, you know what, I'm just going to sleep this off and tomorrow will be fine. Tomorrow it wasn't fine. I was in so much pain I couldn't get out of bed, had to actually call my roommates. we had separate phones in the same house, to come and get me up and out of bed. And the next two weeks proceeded to be a really unbearable episode where I was doing an ICU rotation.
This is back in the Wild West, where I think the nurses and the residents were just shooting me up with Toradol every day, nonstop, getting me through the day. But the nights were brutal. And what I now realized happened was I'd had a really significant herniation. A piece of that L5-S1 disc broke off.
I would later find out it was a five centimeter piece and it had extruded, broken off, was sitting on the S1 nerve root. Every night now I was going to bed feeling as though the skin on the bottom of my foot was being ripped off. The only way I could sleep was to put my foot into a bag of ice. and take some amount of Benadryl that was enough to knock me out.
This went on for about another week until the dean of students saw me limping along and said, hey, Peter, what's going on? I told him. This was a Sunday afternoon I was studying. He took me directly to the ER, got an MRI, showed all of this mess. The next day I had surgery. As I've talked about in the past, everything went wrong in a series of surgeries. And fast forward three months,
three trips to the operating room, multiple discectomies, laminotomies, multiple levels. In theory, my back should be fine. I'm anything but fine. I now have a new pain, but this is unlike anything that was related to my back. This is where you come in. I now have a pain that is so significant and it sounds grotesque to explain it, but this is all it was.
It felt like someone was reaching in my body from my kidneys into my groin and tearing my testicles out from the inside of my body. So needless to say, I was out of commission. I did not move. I laid on a floor 24-7. And to your point, how did I feel? Well, it wasn't just that I was in so much pain that I couldn't do anything. It was I watched my life disappear.
So it went from, you're not going to graduate from medical school on time, to I'm You're not going to get to do a sub-internship in surgery to you're not going to be a surgeon to you're never going to walk again. So by that point, the overlap was how were the opioids that I was being prescribed to control the pain tripping into these are a tool to numb me to this entire experience.
So at this point, I've talked about this in the past. At this point, I was taking, I think I was up to maybe 320 milligrams of Oxycontin a day. Which is kind of amazing, because if you and I took that today, if you and I split that right now, we would die. that I'm mainlining 320 milligrams of Oxycontin a day just to blunt the emotional pain of this, I think says what we need to know.
We can come back to the story of how I met you and how my life turned around from that point. And it's still a miracle for me to believe I actually graduated from medical school on time, despite that all happening now into my fourth year, because this was my third year bleeding into my fourth year of medical school when all this was going on. It's kind of amazing. A difficult time.
Third year is tough. So we'll come back to the what happened, but that's a long answer to a question, which is at some point, it wasn't even about the pain. The pain was unbearable, but it wasn't the most unbearable part. It was the expectation of what that pain meant for the rest of my life that became much more unbearable.
I call it the best worst experience of my life. Yeah. more best today. The gratitude I have for that is, I mean, again, I wouldn't want to do it again, but it has been such a positive impact on my life.
Before we go into the ins and outs of what pain doctors can do, let's just talk about some of the bread and butter stuff on pharmacology. How can we navigate our way through what NSAIDs do, what opioids do, what COX-2 inhibitors do? What should people be aware of in using these things? Obviously, opioids are a remarkably controversial topic.
But there's probably a nuance to it that's missing from the broader discussion. But why don't we start with a softball like NSAIDs? How do they work? Everybody's heard of Advil, Aleve, Naproxen, all of these things.
Now, are you talking about this through the lens of acute pain or only through the lens of chronic pain at this point?
I did too. And I still remember the day in, oh God, it must've been December, 2001 when the FDA came down and said, no more Vioxx. And I looked at my last bottle and I was like, oh God, no.
I mean, in the world's most susceptible individuals at a relatively small, absolute rate. I've already had this discussion with Eric Topol, which was like mistake, net negative. Oh, is that right? Absolutely, net negative. Yeah, because I've always wondered- Merck's is faulted. They should have been much more transparent about this.
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