228 – Dr. Judson Brandeis of San Francisco, A Board Certified Urologist & Author Of The 21st Century Man

Transcript:

Tom Couch: Special thanks to Horizon Therapeutics for sponsoring the Special Fathers Network Dad to Dad Podcast, working tirelessly to research, develop, and bring forward medicines for people living with rare and rheumatic diseases. Discover more about Horizon Therapeutics’ mission at HorizonTherapeutics.com.

Judson Brandeis: That’s one of the great things about my medical practice is that my patients are just fantastic. They really are. They’re really hardworking, good guys. I think guys have taken a real beating over the past five or 10 years because of people like Weinstein and Epstein, and 99% of the guys out there are really good people and they work hard and they take care of their families and they take care of their jobs, and they take care of their communities and they don’t expect other people to take care of them. But at the same time, it’s really important to know and to understand that you do have to take care of yourself, and if you don’t take care of yourself, you can’t take care of other people.

Tom Couch: That’s our guest this week, Dr. Judson Brandeis, a board certified urologist whose mission is to help men maintain their overall health. Dr. Brandeis also wrote and compiled the book, The 21st Century Man: Advice from 50 Top Doctors and Men’s Health Experts. He’s an amazing guy and he’s our guest on this week’s Special Fathers Network Dad to Dad Podcast. Say hello now to host David Hirsch.

David Hirsch: Hi, and thanks for listening to The Dad to Dad Podcast, fathers mentoring fathers of children with special needs, presented by the Special Fathers Network.

Tom Couch: The Special Fathers Network is a dad to dad mentoring program for fathers raising children with special needs. Through our personalized matching process, new fathers with special needs children connect with mentor fathers in a similar situation. It’s a great way for dads to support dads. To find out more, go to 21stCenturyDads.org.

David Hirsch: And if you’re a dad looking for help or would like to offer help, we’d be honored to have you join our closed Facebook group. Please go to Facebook.com, groups, and search “dad to dad.”

Tom Couch: Now let’s listen to this conversation between David Hirsch and Dr. Justin Brandeis.

David Hirsch: I am thrilled to be talking today with Dr. Judson Brandeis of San Francisco, California, father of four, a board certified urologist, founder of Brandeis MD and AFFIRM Science as well as the lead author in The 21st Century Man: Advice from 50 Top Doctors and Men’s Health Experts. Judson, thank you for taking the time to do a podcast interview for the Special Fathers Network.

Judson Brandeis: Oh, it’s my pleasure to be here. I appreciate you having me.

David Hirsch: You and your wife Angelie have been married for 21 years and are the proud parents of four typical children, ranging in age from 15 to 19, including 15 year old twins. Let’s start with some background. Where did you grow up? Tell me something about your family.

Judson Brandeis: Oh, I grew up in suburban Long Island.

David Hirsch: And did you have siblings when you were growing up?

Judson Brandeis: I had one younger brother.

David Hirsch: Okay. And outta curiosity, what did your dad do for a living?

Judson Brandeis: We had a family art supplies business in New York City.

David Hirsch: And what type of business was that?

Judson Brandeis: They sold art supplies, so to artists, but also to illustrators. Back in those days you didn’t have computers and computer graphics. Animation was all done by hand. Architects was all done by hand. Advertising was all done by hand, and so they used a lot of art supplies.

David Hirsch: Gotcha. It sounds like back in the day, if I can say it that way, that was probably a very lucrative business and if you didn’t make the switch to digital, maybe not so much.

Judson Brandeis: Yeah, my father saw the movie Tron, which was the first CGI movie, I think in 1984. And he came home, I still remember, and he said, you know what? They’re not gonna use the stuff that we sell anymore. So he actually looked towards selling the business and eventually did sell the business a couple years after that.

David Hirsch: Yeah. Interesting. You saw the handwriting on the wall. Out of curiosity, how would you describe your relationship with your dad?

Judson Brandeis: My father and I were very close when we were growing up. We’d become a little bit more distant with time, but we shared passion for running and for academics and for sports.

David Hirsch: Okay. Are there any important takeaways, something that you’ve learned from your dad, either as a role model or things perhaps that you didn’t wanna incorporate into your own fathering?

Judson Brandeis: Yeah, my father was a problem solver. So he was a salesperson and he would never accept no for an answer. He would always find a way to make a sale or a creative way to connect with someone or solve a problem. And he really instilled in me the importance of understanding things from another person’s point of view. Always put yourself in another person’s shoes. Learn how to connect with someone wherever they are.

And I think that’s really helped me connect with patients where patients are, rather than seeing things from a doctor’s perspective. I can really understand things from a patient’s perspective and really show patients that I understand where they’re coming from.

David Hirsch: Yeah. Very important insight. Thank you for sharing. Cuz I know as professionals, highly educated in many cases, it’s difficult at times to see beyond all your experience and your education and remind yourself that, hey, there’s a human being who’s got some challenges. Maybe they don’t have the same level of understanding or perspective and trying to put yourself in their shoes to help them better understand, interpret, what the facts and the circumstances are. And I think about it a lot with the type of work that I do as a financial advisor. And to a great extent people think that I manage their money, but in reality what I’m doing is I’m managing their expectations. And you have to understand where they’re at and help reconcile the difference between their expectations and what you understand to be the facts. And that’s what I heard you saying.

Judson Brandeis: Yeah, absolutely. I stopped taking insurance about three years ago because I couldn’t connect with my patients in a way that I wanted to. I just couldn’t… I had 10, 15 minutes to see a complicated patient, and you just can’t do that. Especially when you’re treating someone for erectile dysfunction, which is an intensely personal part of themselves. Sometimes it takes 30 minutes for me to really even get the story out of a patient. And so I agree. It’s all about setting expectations. It’s about understanding patients and you have to take the time to do that.

David Hirsch: Absolutely. So I wanna go back just a little bit. I was thinking about father influencers. I was wondering what, if any, influence did your grandfathers have first on your dad’s side and then on your mom’s side?

Judson Brandeis: Oh boy. So my mother’s father was the one that started the business and he started the business in 1929 in the height of the Great Depression and had to drop out of high school at the age of 16 to work to support the family. He wasn’t married at that time. My grandfather was from Switzerland. My grandmother was from Munich, and so they actually escaped ahead of the Holocaust. And that example of the Holocaust… My father’s father was actually in Dachau for a short period of time until he was able to show everyone his Swiss passport and that he wasn’t German. That sort of was somewhat formative also in terms of my understanding of the world.

David Hirsch: Yeah. Thanks for sharing. There are a number… you can only look back and see who’s influenced your life. And that situation, back in the late thirties impacted millions, tens of millions of families as it did yours and mine.

My dad was actually born in Germany and immigrated with his parents as an only child back in September of 1938.

Judson Brandeis: Wow.

David Hirsch: So that was certainly part of our family lore. And my grandfather was very bitter about having to leave a five-generation business behind. A multi-city, five-generation business. And he never really wanted to talk about it. But one of the outcomes of all that was that he really emphasized the value of education. As a result of having virtually everything else taken away from him, he said that’s one thing that people can’t take away from you is your education. You can take that with you and hopefully you can do something with it.

And he wasn’t able to replicate the success that the family had experienced over five generations. He carved out a niche for himself and it does shape your character. It’s a multi-generational experience when you hear these stories that are passed down from generation to generation. And hopefully we can help our kids or our grandkids, future generations, put those experiences into perspective and maybe not take things for granted.

Judson Brandeis: Yeah. One of the quotes I have in the book is from an American Indian Tribe. I forget exactly which one. But basically what it says is what you do now lasts for about six generations.

David Hirsch: Yeah.

Judson Brandeis: And it’s really true.

David Hirsch: Yeah. Thanks for sharing. So my recollection was you took a BA in American History from Brown. You got your MD from Vanderbilt University Medical School, and then you did your residency in urology at UCLA.

Judson Brandeis: Yeah, I did some research stops along the way. So I worked at American Red Cross for a guy named Harold T. Merryman, who was the one that figured out how to freeze blood. And then I did a Howard Hughes Medical Institute sponsored year of research at Harvard Medical School in the lab where they did the first living related kidney transplant.

So research has always been an important part of my education. It’s one thing to read in the books what other people have done, but it’s a whole other thing to write the chapters yourself. I’ve always found that really to be an exciting thing.

David Hirsch: Yeah. Thanks for sharing. So you’re a board certified urologist. You’ve got 20 years plus of work experience providing urological services for adults in the Bay Area, and you’ve served as the president of Pacific Urology where you worked for 18 years. You were chief urologist at Hills Physicians and then John Muir Medical Center for a decade.

And then it wasn’t so long ago, back in 2019, that you created something called Brandeis MD to focus on men’s sexual health and regeneration. I’m wondering when you reflect back on your career, what was it that excited you at the beginning part of your career and then has reignited your interest in the work that you’re doing?

Judson Brandeis: Man, you make me sound so old. [laughing] No one’s asked me to reflect back on the beginning of my career. Is this like a retirement party or something?

David Hirsch: Not quite. This is like a midlife. This is midlife for you. You’ve had 20 years. Now you’ve got another hopefully good 20 years ahead you.

Judson Brandeis: That’s why I do what I do because I want to be young forever.

David Hirsch: I’m in denial about my age, too.

Judson Brandeis: About three years ago, I became really interested in regenerative treatments for erectile dysfunction. Low intensity shock wave therapy and PRP and stem cells and things that we could do to regenerate erectile function in men who could no longer achieve penetrative intercourse.

David Hirsch: Thank you for mentioning that. And would it be objective to say that your practice as a urologist was for both men and women, and then your focus of your practice has become more of a male-focused practice?

Judson Brandeis: Yeah. It used to be about 50/50, and women and men both get kidney stones and women get more incontinence and men do get vasectomies and circumcisions obviously. But I saw a fair amount of women, but now I just see men. So the women are not allowed into the man cave unless they’re accompanied by their spouses [laughing] and they get really pissed off and it’s fun.

So many medical offices are oriented around women. You go to a plastic surgery, cosmetic dermatology, et cetera, et cetera, and it’s not a comfortable place for men. And my office is a super comfortable place for men. I got a Eric Clapton guitar on the wall and a Peyton and Eli Manning signed football. And these are all cool things that my patients give me. One of my patients gave me a Muhammad Ali signed boxing glove. And I program all the music in my office cuz I used to be a radio disc jockey. So if you go to Brandeis MD Lounge on Spotify, I have 2,600 songs on my playlist of all different genres. And it’s a very comfortable place for men. And I’ve introduced a lot of technologies for men. We do some Dysport, we do some hair removal, on top of sexual rejuvenation or hormonal rejuvenation, physical rejuvenation. Because my patients say, oh, it’d be so great if you guys had hair removal. I got all this hair I want to get rid of. Not on the head, [laughing] other parts of the body. And so we’re like, ah, sure. We’ll do that too.

So that’s one of the great things about my medical practice is that my patients are just fantastic. They really are. They’re really hardworking, good guys. I think guys have taken a real beating over the past five or 10 years because of people like Weinstein and Epstein and Prince Andrew and whatever. And 99% of the guys out there are really good people and they work hard and they take care of their families and they take care of their jobs and they take care of their communities and they don’t expect other people to take care of them. But at the same time, it’s really important to know and to understand that you do have to take care of yourself and if you don’t take care of yourself, you can’t take care of other people.

And people show up in my office because they don’t take care of themselves. And then something breaks, their hormones plummet or they can’t get an erection, or they’re fat, or they lose muscle, or they feel bad about themselves. And I’ve become… Because I wrote The 21st Century Man, which is the most comprehensive and medically accurate book ever written about men’s health, I know so much about men’s health now I’m able to put together a plan to resurrect them. But it would be so much better if you didn’t need to come into my office when you were 53, you needed to come into my office when you’re 63 or 73 or 83.

And The 21st Century Man is just a wealth of information from top doctors in all specialties. Because I’m one of those people that knows that I don’t know everything about everything. So I have really some of the top specialists in the United States writing about their specialty. And most of them are guys that are our age that get it. That won’t waste your time.

This is a 900-page book. I can’t stand if I read a 300-page book and at the end of the book I’m like, that could have been four pages. [laughing] Don’t you have that experience?

David Hirsch: Oh yeah.

Judson Brandeis: I’m like the rest of this crap… You make one good point and the rest of this crap is fluff. But my book is 900 pages plus, and the least number of pages I could have written it in is 900 pages. I wrote 30 or 40 of the chapters and the rest I edited with also my editing staff. And I write in the active tense. I don’t put fluff in my sentences. Every word in the book counts. Every word in the book is impactful. Every word in the book has meaning. And you don’t have to read every word in the book. You can skip around. I would recommend reading the introduction, then the first chapter and the table of contents, and then skip around and figure out what is important to you.

But when you actually read those chapters, you know they’re gonna be impactful. They’re gonna be actionable. They’re gonna be filled with information. They’re gonna be funny. I have a relevant quote at the beginning of every chapter from people like Robin Williams or Woody Allen. People in our generation. Like the Woody Allen quote in my orgasm chapter is, “I wanna live my life backwards. I wanna start off dead and end up as an orgasm.” [laughing] Just funny stuff like that. Or a Robin Williams quote was on the cocaine chapter. “Cocaine is God’s way of telling you you have too much money.” [laughing] I have a warped sense of humor and so that warped sense of humor permeates its way into the book.

David Hirsch: Yeah. It’s brilliant. And what an amazing resource that it is. And I think one of the things you said a moment ago really struck me, and it’s something that I’ve tried to reflect on, which is one of the dads in the network, I did an interview three years ago, and this fellow is in Ohio. Not a lot of resources. Three kids with autism in pretty severe situations beyond just the autism.

Judson Brandeis: Wow.

David Hirsch: So very overwhelming situation. And his wife had a nervous breakdown. He becomes a single dad to these three boys with autism. But one of the things that Rob said was, it’s important to be selfish before you can be selfless, which is what I heard you saying. That you need to take care of yourself before you can be the guy that’s taking care of other people, family members, things at work, things in your community. And that’s not what most guys are usually thinking is that I need to take care of myself first.

In fact, we have the additional challenge that we’re the generation that doesn’t pull over and ask for directions when we’re lost. Combine that with the challenges that we have from a physical standpoint, emotional standpoint, it only makes it more challenging.

Judson Brandeis: That’s a good entree actually to what I was gonna say, cuz I think you’re right on with what you say. Most of us know what we need to. Don’t drink, don’t smoke, don’t do drugs, don’t eat too much. Exercise every day. Do some stretching, do some meditation. Be nice to other people. But we have stresses of life and so we don’t all do those things. And the thing is all those things are free. It’s all free. You don’t have to spend a penny. So I teach people those things. I also teach people and pioneer research of devices and things like that, that are really expensive that will shortcut or biohack those things. But the question is, why don’t we do the things that we know we need to do?

Okay. And so there’s two answers to that. One is that, let’s take alcohol for example. Alcohol is so entwined with our life and there’s so much marketing around alcohol to convince us to do something that we know that we shouldn’t do. And when you’re young, you drink beer and you go to the game, and then when you’re older, you hang out with your wife and drink wine and then when you’re older than that, you go out with the boys and drink bourbon or whiskey.

But what I tell people is alcohol is three things. Okay? First of all, it’s a depressant, so if you want to get sad, drink alcohol. Second of all, it disinhibits you. So most of the stupid decisions that most of us make in our life are related to drinking alcohol. [laughing] And every time I say that to someone, I can see them nodding their head. I said that the other day to a patient and he started tearing up and he pointed to a scar on the side of his face. I didn’t see it cuz he was African American, but he had this three and a half inch scar on the side of his face, like someone smacked him with a beer bottle. The other thing is that alcohol is empty calories and 40% of men are obese in this country. By the end of the decade, 50% of men will be obese in this country. And it’s calories with no benefit other than to make you fat. So I look guys straight in the eye and say, listen, if you wanna be sad, stupid, and fat, keep drinking.

But we’re told, you should drink. If you wanna be socially acceptable, if you wanna be part of the gang, you’re gonna drink. But think about it. Think about the data. That’s the thing is you can’t tell a guy what to. That’s the beauty of The 21st Century Man is it doesn’t tell you what to do. It gives you the information that you need to make intelligent decisions about yourself. I don’t tell people don’t drink. I say, listen, it’s something that’s gonna make you sad, stupid, and fat, and I have lots of data to back that up. If you wanna be sad, stupid, and fat, go right ahead.

I had a patient the other day. He needed to lose 28 pounds, right? He was 28 pounds overweight, and he was drinking two glasses of wine a day. I said, okay, take out your calculator because all our phones have little calculators on it. I said, okay. And I pulled up on my computer. I said, let’s see. Let’s ask Google, how much is a glass of wine? How many calories? 140 calories in a glass of red wine. I said, okay, multiply that times two. Okay, 280. Multiply that times 365, and then divide that by 3,500, which is the number of calories per pound of human fat. So what’d you get? Oh, 28. Okay. How many pounds do you have to lose? 28. Okay. So if you stop drinking two glasses of wine every night for the rest of the year, not only will you save thousands of dollars, you’ll be in a better mood, but you’ll lose 28 pounds.

And he just looked up at me like a deer in the headlights, and he stopped drinking. But if I had told him, listen you idiot stop drinking, he would’ve been like, screw you. Who the hell are you? But when you actually provide information… That’s what The 21st Century Man does.

I’ll give you another example. I had a patient, he’s a dentist, 57 years old. Really smart guy, had a hard life, put himself through dental school driving a taxi cab, right? And he smokes. And he knows he shouldn’t smoke, and he has tried a couple times to stop smoking. I said, all right, do you have kids? Yeah. I have two daughters. They’re, aw man, they’re so great. Eight and 10 years old. I said, great. Do me a favor. I said, write on a piece of paper “13 years of life lost.” He said, what do you mean? I said if you keep smoking, you’re gonna die 13 years early and then that’s 13 years you won’t have with your daughters.

I said, and just take that and put it on the door of each of their rooms so that every single time you walk into their room, you’ll be reminded that you’re gonna die 13 years before you should, and you won’t have 13 years that you would ordinarily have with your daughters. And he said oh, okay. I’ll do that.

And a month later he came back. He said, you know what? I stopped smoking. I said, how come? He said, you’re right, I wanna live longer so I can see my daughters grow up and their kids. And so I didn’t have to say anything, right? I didn’t tell him take Wellbutrin or go to acupuncture or any of that. I just told him this is the consequence of your stupid behavior, and if you wanna live with that consequence, listen, you’re a big boy. You can do that, but just understand that the decisions that you’re making are impactful.

And so the first chapter of the book is called “The Hero’s Journey,” and any father that takes care of a special needs child, gosh is a hero. But still, heroes have good days and bad days, and it’s important to understand what the hero’s journey is. What the pitfalls in the heroes journey are. And it’s a concept created by a mythologist named Joseph Campbell. And so many of our literature is based on this concept, all the Star Wars, George Lucas was a huge fan of Joseph Campbell. But it’s important to see your life as a hero’s journey.

Tiger Woods, he’s a hero, but he’s got his own journey and he’s got… I tell my patients all the time, listen, I can lay out a world class plan for you that will turn your life around. Patients ask me, what do I owe you for the, how much is your consultation? I said, my consultation is priceless, but I’ll charge you $200.

Are you making decisions in your life that are heroic, that a hero would make, that the person that you look up to? Are those the decisions that person would make? Because your kids look up to you. Your spouse looks up to you. The people at work look up to you. The people in the community look up to you.

They look at you as a hero. And if you’re making those heroic decisions, you’re gonna be even more of a hero. Don’t smoke, don’t drink, don’t do drugs. Don’t eat bad foods so that you are obese or you become diabetic, or you develop cardiovascular disease because then you’re gonna be a burden on those other people that look to you as a hero. And that’s how you take care of yourself.

And you know what? That’s all free. Exercise, it’s free. You don’t have to join a fancy gym. Get some TRX bands and work out at home, or go for a walk or go for a run, or hop on a bicycle. I stretch for 15 minutes every morning. Gosh, that makes me feel so much better physically. And if you don’t know how to stretch, I have a YouTube video, not that I’m an expert in stretching, but this is what I do every morning. And you can meditate. Meditation is free. Just sit there in a quiet room and think about stuff. You don’t have to go to the top of the Himalayan Mountains to meditate. All these things. And there’s just… The book is just packed with Incredible information on how to take care of yourself, prevention and early intervention.

I get so sad when I see people come into my offense and they tell me, oh, I developed colon cancer. Did you have a colonoscopy when you were 50? No. I didn’t wanna go through that prep and it was so gross. And what’s gross is having a colostomy bag! That’s gross. Having a colonoscopy, it’s not so bad. You sit on the toilet for a couple of days cuz of the prep.

Or someone who doesn’t get a PSA and end up getting metastatic cancer to the bone and then has to go on medical castration. How horrible is that? You could have gotten a PSA, you could have gotten some surgery or radiation. There’s some side effects from that, but it’s not nearly as bad as dying in severe pain from metastatic prostate cancer to the bone or being on medical castration.

I think that’s really the most impactful thing. And you really work with a incredibly special group of fathers. I have a good friend who, his son has cerebral palsy, and I see what he does. Michael Tebb, I see what he does with his son who is confined to a wheelchair, basically quadriplegic. He takes him up on airplane rides. And he sent me a picture recently. He took his son to Tahoe and they put his chair on skis and he was skiing him down the bunny hills. It’s such a joy to watch the love and special attention that he gives his son. Yeah, the people that listen to this podcast are true heroes. True heroes can always do better for themselves.

Tom Couch: We’ll be back with more of the conversation on the Special Fathers Network Dad to Dad Podcast in just a few moments. But first, this quick message. Please help 21st Century Dads gather research on families raising children with special needs by having them complete the Special Fathers Network Early Intervention Parents Survey. A link to the survey can be found in the show notes. As a token of our appreciation, each person, mom or dad, who completes the survey, will receive a Great Dad Coin. Thank you. Now back to the conversation.

David Hirsch: I’ve got 101 things that come to mind as you were going on about prevention and early detection. That’s what I heard you say. And it’s something that is real basic and it’s not usually costly: to do the right thing, and make the hero’s choice. And I love the book. I didn’t get through all 900 pages. [laughing] I was thinking, how come there’s no audible copy of this book? That would really make it a little bit easier.

Judson Brandeis: There is, it’ll be out in a couple days.

David Hirsch: Okay. Thank God for that. But all joking aside there’s a couple things that I picked up on in the book and I don’t appreciate or fully understand them. I’m wondering, maybe you can make it simple for our listeners. Other contributors talked about the importance of testosterone levels, and I’m wondering why is that important as we get older to be able to maintain your testosterone levels?

Judson Brandeis: Oh man, testosterone is the key hormone. There’s no hormone in men that’s as important as testosterone. So my son, he is almost 16, right? 13, three years ago, he was this little scrawny kid. His testosterone was probably 200 or 300. Now every week, he and I… he only has sisters, right? So I’m his father, but I’m also his brother in strange way. And we’re always wrestling and sneak attacking each other. And I can just feel him getting stronger every week. And the stuff that I used to be able to do with him I can’t do. And pretty soon, he’s gonna be able to turn the tables on me. And that’s three years. And his testosterone went from 200, 300 to a thousand. And when he hits 20, it’ll drop one or 2% every year for the next 60 or 80 years, however many years he lives.

And so that’s the effect of testosterone, right? It builds muscle, it takes off fat. It gives us more libido. It gives us motivation. It helps us sleep. It gives us drive. If you’re 50 or 60 or 70 and your testosterone is low… A lot of us go to our primary care doctors and our testosterone is 350 or 400. But we feel weak. We’re losing muscle. We’re low, we’re sad, depressed, low libido. There’s a combination of clinically low testosterone and lab low testosterone. So I have guys whose testosterone is 200, but they’re doing great. Life couldn’t be better for them and I wouldn’t put them on testosterone in a million years. But I’m looking for guys with symptoms of low testosterone that have low lab testosterone, and then you have to rule out other stuff that could be symptoms of low testosterone, right?

So if you have sleep apnea and you can’t sleep. You don’t get into REM sleep. So then you’re sluggish, you’re tired all the time. You put fat on, you lose muscle. You’re unmotivated. You can’t sleep. Same stuff. So fix the sleep apnea first before you replace testosterone. Or if you have low thyroid. You got low metabolism, so you put on fat, you lose muscle, you’re sluggish, so on and so forth.

So you gotta check someone’s testosterone. You gotta check the B12. You gotta check the vitamin D. You gotta check their hematocrit. It’s not someone with no medical training can just start up a business and say, let’s put you on testosterone. You’re gonna do great. You actually have to rule out all the medical conditions that could be low testosterone or symptoms of low testosterone. And when you rule out all that stuff and someone’s got low testosterone, then they’ll do amazingly well if you put them on testosterone. And I get my guys up to a thousand or 1100 or 1200.

And you just have to understand that maybe there’s some effect on the prostate. If you’re on it for too long, your body will stop producing it unless you go on certain medications. In my vast experience with testosterone, it is extremely safe and enormously beneficial for men. But it’s not a drug. Drugs work 60% of the time, 70% of the time, 80% of the time, whatever. If you’re a guy with a penis and two balls and some facial hair, testosterone will work for you a hundred percent guaranteed.

David Hirsch: Okay, thank you for the testosterone 101 lesson.

Judson Brandeis: Yeah, there you go. I’m actually coming out with an ebook. I’ll probably put it up on 21st Century Man. So I crank out content like it’s nobody’s business because I’m constantly honing my message with my own patients. Instead of explaining the same thing like a thousand times, I’ll just make an ebook or write a 900-page book [laughing] and just say, just read it or watch the video or view the ebook.

David Hirsch: I love it. So another thing that I picked up in the book and it was like new information for me and I was like, this can’t be? But it seemed like it was a well-written chapter and it had to do with hand health. And that hand health is a general barometer for overall health. And I’m wondering if you can just give us the 101 on that.

Judson Brandeis: Yeah, so Greg Horner’s a good friend of mine from UCLA. He’s a brilliant guy. Went to Johns Hopkins Medical School, trained at UCLA with me in orthopedics, and he wrote an exceptional chapter on hand health. To be honest, that’s why I bring guys like him in, because I don’t… I’m not expert at hand health.

The really interesting thing is if you’re a good physician, you can assess someone’s health through the lens that you’re looking at. Uhhad Mahuchi is a good friend of mine. He wrote an amazing chapter… He’s a top ophthalmologist in Florida. And he wrote an amazing chapter on eye health. And you can pick up diabetes in the eye, you can pick up circulatory issues in the eye. There’s so much that you can see in the pathology of an eye. Same thing with a hand. You can pick up autoimmune diseases, rheumatoid arthritis and so on and so forth. You can look at circulation in the hand. You can look at skin conditions in the hand. You could probably pick up what someone’s testosterone is. The grip strength is a great barometer of overall male physical strength. If you’re a really perceptive intuitive physician, you should be able to assess someone’s general health through the lens.

That’s what the genesis of The 21st Century Man was. Sitting across from my patients, talking about erectile dysfunction. So I see erections or sexual function in men as like the Maslow’s Pyramid. You know what the Maslow’s Pyramid is?

David Hirsch: Hierarchy of needs. Sure. You got a big base and self-actualization.

Judson Brandeis: Exactly right. So there’s a hierarchy of middle-aged men, okay? And the bottom of the pyramid is physical function, and then above that is like emotional function, mental health, relationship health. And then at the top of it is sexual health. And so if you’ve mastered physical health and emotional health and mental health and relationship health, then at the age of 50 or 60 or 70, you’re gonna be having a lot of sex with your spouse.

And if your relationship sucks or your physical health is bad, or you’re depressed or you’re anxious or you don’t have good work-life balance, guess what? You don’t make it to the top of the pyramid.

David Hirsch: Yeah.

Judson Brandeis: And The 21st Secretary Man is the only men’s health book I’ve ever seen, and I’ve looked at all of them, that not only address physical health, most men’s health books are like, sex, food, and exercise. Like we’re cavemen, right? We chase mastodons, we eat them and then we have sex. But the Harvard School of Public Health did the Harvard Longevity Study. And the Harvard Longevity Study was the longest study ever of men’s health. And they studied men like Harvard students and then they followed them and their kids and their kids’ kids, and they looked at health and they did labs and they looked at relationships. And what they found is the number one thing that determined someone’s health and happiness in life. It wasn’t your PSA, it wasn’t taking aspirin, it wasn’t your heart calcium score. It was the quality of your relationships. Numero uno. As a physician, if you really wanna help your patients, talk to them about relationships too. You gotta talk about the whole picture.

David Hirsch: Yeah. I love it. One more aspect about the book before we move on. Prostate cancer is something that affects one out of eight men throughout their lives, and I’m wondering if there’s something that you can share overall from a prevention standpoint or once the diagnosis has taken place, what do guys need to focus on?

Judson Brandeis: Yeah, so prostate cancer, there’s a tremendous amount of research going on in prostate and prostate cancer. And back in the day, early on everyone got a PSA. Everyone got prostate surgery or prostate radiation, and a lot of people got messed up that didn’t need to get messed up. Because low grade prostate cancer isn’t going to kill you.

The most common cause of death in men with prostate cancer is actually heart disease, right? So even if you have prostate cancer, focus on your heart because that’s more likely gonna get you. Then we really pulled back and the US preventative care organization gave PSA a D rating and they said we’re overtreating prostate cancer, which is true, and we should really pull back on it.

And then what we found is all of a sudden a lot of people started dying of prostate cancer and people were being diagnosed more and more with metastatic prostate cancer. And so the thing that we have now are MRIs. So before anyone gets a prostate biopsy, they should have an MRI and they should have an MRI-guided ultrasound fusion prostate biopsy.

And if you don’t have a urologist that does that, go find another one. And your urologist shouldn’t be offended. If they don’t do that, then they’re not keeping up with the times. And those are the kind of things that you’ll find in the chapter. I’m not afraid to say those kind of things.

But the other thing that we have now are genetic tests, so that we’ll give you a better indication of how biologically aggressive your prostate cancer will be. So we have a lot more tools to determine how aggressive prostate cancer is. For example, I had a patient who became my real estate agent, helped me sell a house about 10 years ago, and he emailed me. He’s living down in Monterey right now, and he said, Dr. Brandeis, can I get your second opinion on this? I was just diagnosed with prostate cancer. I said, John, send me all your stuff. He sent me all his stuff. I said, there’s something that doesn’t make. Did you have an MRI-guided prostate biopsy? He said, no. I said, okay you need to go to Stanford and get an MRI-guided prostate biopsy. And so he went to Stanford. This is a true story. Went to Stanford, got an MRI-guided prostate biopsy.

Turns out the guy that had done his biopsy didn’t do an MRI-guided prostate biopsy. Totally missed most of the cancer. And he had a much higher volume, much more aggressive prostate cancer than initially was identified. And the first guy wasn’t gonna treat him, but I said, listen John, you gotta go and you gotta get some radiation because this is a much more aggressive prostate cancer. You’re dealing with a totally different beast.

And so we have tools now, genetic testing, MRIs, MRI-guided ultrasound fusion prostate biopsy that will help you make a much more informed and intelligent decision about the diagnosis and treatment of prostate cancer. And so we’re much better able to determine who should get treated and who should not get treated.

David Hirsch: So I’m wondering beyond the advice that you’ve just shared, if there’s anything else before we wrap up that you’d like to share?

Judson Brandeis: The 21st Century Man really is everything that I’ve learned. I’ve been incredibly blessed to have an amazing education. I went to Brown University, I did research at American Red Cross. I went to Vanderbilt. I did research at Harvard. I trained at UCLA. I’ve had incredible colleagues. I’ve been really just incredibly blessed to have worked and learned from the best. And all that learning over 25 years or more I crammed into a 900-page book in addition to all of the colleagues that I’ve interacted with. And I pushed them to tell me what they knew about their fields.

And I put this into the book with some personality and in a way that men can digest it. And it’s not ‘See Spot run’ kind of book. Most medical books, medical content is written for fourth grade reading level. My guys are smart. I’m in the Bay Area. I got patients from Google, Apple, Facebook, Lawrence Livermore Labs, and I have respect for men’s intelligence. You know, you don’t have to read a ‘See Spot run’ medical book. You can really just sit down for an hour and try to digest all the information that I’m giving you. I’m really good at explaining difficult concepts to men in a way that they can understand them and not insult their intelligence.

My advice would be get the book. And I want to give you guys a discount code for the book cuz the fathers that you represent are really special human beings. Just seeing the people that I know with special needs kids and autistic kids, God bless you. And really focus on doing your own hero’s journey and making decisions for yourself that will be heroic for yourself and for the people around you. And really the other theme that goes through the book is feeling good, looking good and having better intimacy or relationships or sex.

And then read my little vignette about fatherhood. I’ll give you a little hint. I’m a lousy golfer. It’s been 10, 15 years since I’ve played golf. With four kids, you don’t have the time to do that. When I did play golf, if I broke a hundred, that was a small miracle. But every once in a while I would just hit a shot that was just perfect, and it would land on the fairway or land on the green and that’s what kept me coming back to play golf. Fatherhood, especially fatherhood with a special needs kid, you’re in the trenches all the time. But every once in a while you’ll just hit a perfect shot and your kid will just smile at you or do something just incredibly remarkable. And that’s what keeps you going. Those special moments really just keep you coming back.

David Hirsch: Yeah. Thanks for sharing. I love it. So let’s give a special shout out to our mutual friend, Shana James at “Man Alive” for helping connect us.

Judson Brandeis: Oh yeah. Absolutely.

David Hirsch: So if somebody wants to learn more about Brandeis MD, AFFIRM Science, your book The 21st Century Man, or contact you, what’s the best way to do that?

Judson Brandeis: Yeah, so my website for my medical practice is BrandeisMD.com. And we do Skype consultations for people. I have people that fly in from around the country, or I do Skype consultations. And then the book is thetwentyfirstcenturyman.com, all written out in letters. And then our supplement store is AFFIRMScience.com. So we make AFFIRM, which is a nitric oxide boosting supplement. We make SupporT which is for men with kind of borderline low testosterone that don’t wanna go on testosterone replacement. We make SPUNK, which is a prostate health supplement, and we make PreLONG, which is for premature ejaculation.

David Hirsch: Awesome. We’ll make sure to include all that in the show notes so it’ll make as easy as possible for somebody to follow up. Judson, thank you for taking the time and many insights. As a reminder, Judson is just one of the dads who’s part of the Special Fathers Network, a mentoring program for fathers raising a child with special needs. If you’d like to be a mentor father, or are seeking advice from a mentor father with a similar situation to your own, please go to 21stCenturyDads.org.

Thank you for listening to the latest episode of the Special Fathers Network Dad to Dad Podcast. I hope you enjoyed the conversation as much as I did. As you probably know, the 21st Century Dads Foundation is a 501c3 not-for-profit organization, which means we need your help to keep our content free to all concerned. Would you please consider making a tax-deductible contribution? I would really appreciate your support. Judson, thanks again.

Judson Brandeis: Hey, thank you David.

Tom Couch: And thank you for listening to the Special Fathers Network Dad to Dad Podcast. The Special Fathers Network is a dad to dad mentoring program for fathers raising children with special needs. Through our personalized matching process, new fathers with special needs children match up with mentor fathers in a similar situation. It’s a great way for dads to support other dads. To find out more, go to 21stCenturyDads.org.

David Hirsch: And if you’re a dad looking for help or would like to offer help, we would be honored to have you join our closed Facebook group. Please go to Facebook.com, groups, and search “dad to dad.” Lastly, we’re always looking to share interesting stories. If you’d like to share your story or know of a compelling story, please send an email to David@21stCenturyDads.org.

Tom Couch: The Special Fathers Network Dad to Dad Podcast was produced by me, Tom Couch.

Thanks again to Horizon Therapeutics who believe that science and compassion must work together to transform lives. That’s why they work tirelessly to research, develop, and bring forward medicines for people living with rare and rheumatic diseases. Discover more about Horizon Therapeutics at HorizonTherapeutics.com.