Conversations on Healing

Welcome to the Conversations on Healing podcast, where host Shay Beider speaks with renowned healthcare leaders, practitioners, and thought leaders to explore the world of wellness, the incredible powers of self-care, and what it truly means to heal today. Join us on this journey to become more whole, healed, and connected.

Shay Beider Hello, I’m Shay Beider, and welcome to the Conversations on Healing Podcast. Today, I have the heartfelt privilege of speaking with Dr. Jonathan Fisher, a compassionate, Harvard-trained cardiologist and organizational well-being leader with more than three decades of experience in healthcare. As the bestselling author of, “Just One Heart: A Cardiologist’s Guide to Healing, Health, and Happiness”, Dr. Fisher beautifully integrates mind-body science, mindfulness, and compassion to help individuals lead healthier, more connected lives. Through his inspiring keynotes, workshops, and retreats, he has empowered thousands– including healthcare professionals and leaders from Fortune 100 companies– to reduce stress, prevent burnout, and embrace a more wholehearted approach to health and well-being. In today’s episode, we explore key insights from Dr. Fisher’s book, “Just One Heart”, beginning with his belief that we must view heart health in a new light. He shares how his personal experiences, including the loss of his sister, shaped his focus on the connection between heart health and emotional well-being.

We discuss the four dimensions of the heart– physical, emotional, social, and spiritual– and their interrelationship. Dr. Fisher introduces “heart wakers,” emotions like gratitude and kindness that support heart health, highlighting their significance through a particular study that actually led to coining the term, “The Rabbit Effect.” We also touch on emotional contagion, the impact of social isolation, and the seven timeless traits of the heart that help us to navigate life’s challenges, while emphasizing the value of being warmhearted. This is a powerful and transformative conversation with Dr. Fisher, filled with insights that could literally change how you view heart health and well-being. So you won’t want to miss it. Let’s get the conversation started.

All right. Well, Jonathan, it is a delight to welcome you to the Conversations on Healing podcast. So thanks so much for joining me on the show.

Dr. Jonathan Fisher Shay, it’s my pleasure. I love the work that you do and I’m really happy to be in conversation with you.

Shay Good. We’re going to have a fun conversation, because the essence of everything we’re going to talk about today relates to the heart– and all the various dimensions of the heart– and how important our understanding, like a depth of understanding, of the heart is in relationship to the quality of our lives. So I want to start– you have a book called, “Just One Heart”, and the very first line that you write in the prologue is: “I have something to prove. We must start seeing our heart’s health in a new way. Our lives depend on it.” So I want to ask you: What is it that you think we need to see differently about heart health, that you really wanted to prove in this book? What was that motivation?

Jonathan I wrote that line in response to one of my colleagues in healthcare– a doctor who read the whole book– and he said, “It seems with all of the science that you put in here, you could have left it out. You could have just said what you wanted to say from your heart. It seemed like you have something to prove.” And initially, I was defensive about that, and I thought, well, maybe I should take it out. And then I realized, Shay, that I’ve been in medicine now for three decades. I’ve read all the textbooks, I’ve read the science, and I see that there’s a lot in medicine that we do well, and there’s a lot that we could do better. And often, we’re missing the holistic approach that is the only path to healing. Specifically, in my field of cardiology– I spent years learning how to be a cardiologist– and at no time did my teachers, did my colleagues, talk about how our spiritual life, our connection with something bigger, has an impact on our physiology, on our beating heart. At no time was there a single lecture dedicated to how our emotional health and well-being deeply impacts our physical heart’s behavior and health. At no time during my medical education did anyone talk about how our social connections predict our heart’s survival. And so, when I say I have something to prove, I mean it.

Shay Yeah, you really do. And what’s beautiful in your book– you share a little bit of your personal backstory and kind of what led you to get onto the path that you’re on today. So, as you mentioned, you know, you’re actually a Harvard-trained cardiologist. As you were going through your education and your early training, you found yourself struggling at times with both anxiety and depression. And then you had a very significant loss of your sister, Andrea, that had a huge impact on not only your life, but then subsequently how you’ve chosen to focus your work– and helped you, I think, to understand more deeply that connection between the heart, and health, and happiness, and how they all intersect. And so I’m interested, from your own story, like how those seeds were planted that have now helped you to kind of blossom into the type of physician that you are today.

Jonathan My initial approach to becoming a doctor was to follow what the dominant culture and message was, which was: we will teach you how to become a doctor, we will give you knowledge, and then you will be the one who helps others heal– or really, you are the healer yourself. The whole paradigm was off, and I realized that only after my own experiences. As I was going through medical school and residency training, I had a whole other life that no one knew about. And frankly, it seemed like other people didn’t care about– not my professors, not my colleagues. And in retrospect, I’m sure they all had their own lives as well, that maybe they weren’t comfortable sharing, because the culture around us said: we don’t talk about emotions. We simply come and do our job. We follow our calling to help others. There was no talk about what’s happening in our own hearts as we’re going through these motions and jumping through the hoops.

For me, as you mentioned, it was a beginning with anxiety. I was on the spectrum of personality traits– the Big Five, they’re called– “Neuroticism” is the fifth one, and I ranked very highly on the neuroticism scale. I was constantly worrying about: What if I do this? And what if this person does that? And what do they think of me? And what could go wrong? It was on repeat in my mind, over and over and over. And this neuroticism led to a state of generalized anxiety about everything– my personal life, my professional life. There was very little thought space in my mind for what could go right, and what would might go right, and what my strengths were. It was all about what was bad or wrong– or, at that time, I would’ve used the word “broken.” I wouldn’t use that word anymore. And anxiety, as it often does, was linked with depression, which for me was not so much worrying about the future in my life…

It was thoughts about my past, and using those thoughts about my own personal failures– as I saw them– to predict a future where I would be incredibly successful according to all external metrics. If I could only get into Harvard– and I did. If I could only get an advanced degree in cardiology– and I did. If I could only be the best-rated heart doctor in my region– and I did. And somehow I was still really deeply unhappy and unable to feel comfortable with other people, but also with myself. And I had to learn how to look at those parts that felt broken– took me 10 years, and I’m still doing the work today. And it was in doing that work that I recognized that my physical heart was aching– many, many times. I could feel the squeezing, I could feel the pounding, I could feel starting to feel nauseated and sweaty, almost as if I was having a heart attack myself. And yet, none of that was in my textbook. So, it was from my own deeply personal experience– working through anxiety, depression, burnout (which is a whole other important subject)– and ultimately, it was grief and the loss of my best friend, my sister. In many ways, my spiritual guide, at a young age, that forced me to my knees. Forced me to reconcile and reckon with what I had been taught and how it wasn’t serving me well.

Shay It’s so fascinating. There’s so many healing journeys of, you know, people who’ve gone into healing arts in a variety of different ways, and the thing that often brings you to your knees is the very thing that elevates you into becoming better at your profession.

Certainly, your story illustrates that for me. And so, you went on through your work to describe these four different dimensions of the heart, and I kind of want to lay those out cause I think it’s foundational in our discussion today. So, you’ve defined these four dimensions of the heart as the physical, the emotional, the social, and the spiritual. And as you’ve already described, the Western medical lens has focused, obviously, primarily on the physical. And you see these dimensions not as separate, but as relational and interconnected. Can you talk more about those four dimensions, and how kinda they came to be in your own mind?

Jonathan I started to allude to the emotional dimension of the heart, where– as I was experiencing anxiety– and at times it wasn’t even in my home life, it was in my work life. So the irony was that I am being called to the emergency room for someone whose heart is about to stop, and they’re about to die, and I am desperate to help them with a team that’s there. At the same time, I would feel a clutching physicality in my own heart that previously doctors would say, “Oh, it’s in your mind.” And many women– unfortunately, more than men– are often told, “It’s just anxiety,” so that women wait a full 37 minutes longer than men to seek emergency care when they’re having heart attacks. We have to change that understanding. And so the emotional dimension of the heart was the first to become clear to me. And later on, it was the social dimension, where in my own loneliness, I would go home after work, and I wouldn’t go out to the parties with other people.

I had so many thoughts and so much social concern about not fitting in and not even belonging, that that was leading to my poor health myself. The spiritual piece came in through other means. Some of it was through my own practice. I’m Jewish, and we even have a prayer book that’s called in Hebrew, Lev Shalem. Now, in Hebrew, lev means heart, and shalem means full or whole. So why is it that a whole tradition has prayers that are rooted in the desire to find wholeness in our heart? Well, it’s not because Jews are cardiologists. It’s about something timeless in that desire to live with a whole heart. In my other explorations in Christianity– in the Gospel of Matthew– it says, “You shall love the Lord your God with all your heart,” not with all of your lungs or all of your liver. Why is that?

Again, that led to more curiosity for me. And then, finally, in part of my own healing process, someone introduced me to the practice of meditation. I wanted to find out where it originated, and one of the traditions is in mindfulness and the teachings of the Buddha 2,500 years ago. And lo and behold, there’s something that’s called the Heart Sutra in Buddhism, which is this thread of the heart. And then, from there as a scientist, I wanted to understand why, not just these three traditions, but all religious traditions dating back thousands of years– any of what we might call today, wisdom traditions– place the heart at the center of the human experience. And I realize that if we are to treat the heart, if we are to seek and find wholeness, we have to approach it from the spiritual dimension as well.

Shay And you share some of these interesting stories in your book. One of the pieces that I was also I thought was really important is you talked a little bit about how, in Eastern traditions, the idea of the heart and the mind are actually unified in certain cases. And so it’s also– there’s a slightly different understanding even of what “heart” is– that there’s this “heart intelligence,” and that there’s this heart-mind unification, that often we’ve kind of separated those two out. And you also discussed the kind of Cartesian split and Descartes’ influence on how we think about things. And you go through some of the history also to describe how we’ve gotten to our current understanding, but that actually we’re in a moment now of reintegration, in a way, of certain things that we separated for a period of time.

One of the other things that you share in your book and in your work is that there’s these things that you call “heart wakers,” and these are emotions and traits that protect and awaken all the dimensions of the human heart. And some examples of these are things like gratitude and optimism and compassion and kindness and joy and laughter. And you also make a point– which I think is a very important one– that these are things that can be cultivated, that they’re skills that you can learn and there’s practices that you can do. So I’m interested, from your perspective now, how you’ve come to see our capacity to strengthen those heart wakers to help us to have a higher quality of life.

Jonathan First, Shay, I want to say that the preparation you’ve done for this conversation is simply awesome. And I know you do this for every one of your conversations. I’ve been on over 90 podcasts, and various interviews here and there, and your passion for this really shines through, and it’s something that I really appreciate.

Shay Thank you. That’s incredibly kind. Thank you.

Jonathan And to answer your question, I do speak about this term that I developed– because I had no other word for it– which is this idea of these mindsets, these beliefs, these ways of being in the world, these emotional experiences that waken up the heart. Not just in a spiritual or emotional sense, but prime us to be more connected socially with others– that social dimension. And the point here, for my medical colleagues and trying to change healthcare, is laying out the evidence– with 350 citations in the back of the book– that these don’t just waken the heart in some mystical sense. There is strong evidence that when we cultivate these nine emotional states that you mentioned many of, our blood pressure goes down, our heart relaxes, we live longer, we have fewer heart attacks, our cholesterol may even be lower because we’re better able to make wise choices about our diet. We tend to sleep better as well.

So all of these three other dimensions– when we practice these heart wakers instead of what I call the heartbreakers, which come before the heart wakers (which we can talk about as well)– when we develop these skills, when we spend our time not doing the normal thing, which is: I’m trying to avoid things that make me feel bad. I’m going to instead actively seek out those emotional states that open me up to the most meaningful, beautiful experiences in life. And the reason that I emphasize they can be developed is that, for a long time, I thought that I was stuck. I mentioned the neuroticism of one of the five personality traits. I believed that that’s just the way that I am– I was born that way. And my message, which you stated so clearly, is a message of hope and empowerment for anyone who might read this book or start on their own journey to awaken their hearts– that wherever you are, even if you feel stuck, there are ways to open the heart, take down the walls from around the heart. A very nice way to begin is with this field of positive psychology, which is a scientific field of the art of happiness. And I’m simply trying to create a bridge so that people interested in the science of happiness understand how those particular emotional states benefit our physical hearts.

Shay Yeah, and obviously that work has had such a profound impact, I think, on how we were– I think there was sort of awakening to, oh my goodness, in the fields of psychology and psychiatry, we were looking at everything that was wrong. Right? We were just like so focused on everything that was wrong. And then all of a sudden, people like Martin Seligman and others came along and said, wait a minute. We also be looking at the things that are right, the things that are working well, the things that support our health, that help us to feel better, that shift us into places– instead of negative affect– of positive affect. And like, wait a minute, shouldn’t we be thinking about all of those things too? And it was such an important shift, because for the reasons that we’re discussing, there is the capacity to develop skill. And even in your own story, you know, you mentioned in the book– and actually I think you shared this with me previously– how there was that moment of like sort of desperation at an early point where you were like, how do I feel better? Right?

And then just the Googling of like: how can I be happy, and like how do you do this? And what’s amazing is, you know, what you discovered is a lot of the work in the field of positive psychology– that there actually are tools, tangible things that we can do actively that help us to feel better. And so it’s not like an accident. There actually is an infrastructure to it. And a lot of what that field is helping us to see is: what is that infrastructure, and how do you develop a different mindset? And things like a growth mindset versus a fixed mindset– Carol Dweck’s work and others are really important– and in relationship to this social piece. Because we’ve talked about how your first identification– you know, okay, physiological heart– emotional heart was kind of the next piece that, you know, became very apparent. But then there was this understanding of, okay, wait, there’s this social, there’s this spiritual dimension.

And a lot of the work now that I’ve been quite interested in as well is, you know, around these ideas of emotional contagion and kind of social and emotional contagion. And the single longest study– right now, actually out of Harvard, the Study of Adult Development– and the key researcher actually makes this basic statement: that the biggest predictor of your health at age 80 is your relationships at age 50, right? And that quality of having good, positive social interaction, connection, and happy and healthy relationships is very protective for our health. And so I want to talk a little bit about those ideas and how that’s influenced your understanding as well.

Jonathan I’m so glad that you’re shining a light on this particular aspect, because that’s really at the core of the message. It’s a core of the meaning of the word, “Just One Heart.” We have this false message in our Western culture over the last few hundred years– since the Industrial Revolution, maybe before that– we must be individualists, we must go at it alone, we should celebrate those people who have gotten the gold medal. And we forget about the coaches and the mothers and the fathers and the friends and the spouses and the teams that allow people to reach the heights that they reach. Even those that reach those heights often forget they didn’t do it alone. And for 2.3 million years– our Homo erectus– we did not make it this far by surviving alone. We only survived in groups, initially in small tribes. Now, for a variety of cultural reasons over those last 150 years, the structures that supported these small tribes that allow us to thrive– whether it’s in civic groups, religious groups, affinity groups, whatever it is– we are separate from each other.

And we have this belief that we can go at it alone. Our physiology for 2.3 million years says otherwise– and we’re sick now because we have forgotten that we cannot function alone, and it’s a myth that we can. This was also made worse by a misinterpretation of Charles Darwin, who people say put forth the idea of “survival of the fittest.” Well, it’s not exactly what Darwin was getting at. Darwin was really getting at the survival of the “kindest.” The survival of those people who are able to form bonds and networks with others, to create this collaboration, this mutual support, so that my weakness may be your strength, and vice versa. You pointed to a couple of studies. You pointed to the Harvard Study of Human Happiness, beginning in the 1930s, where they took Harvard students and compared these young men to Boston kids. And they found out that, as you said, the greatest predictor of survival over the next a hundred years was the strength of personal relationships.

This is also true in Dan Buttner’s work with the Blue Zones– looking at these five Blue Zones around the world and these nine aspects that he has found. Really above all, it’s this human connection. This is also true in the work of Dean Ornish, who was the father of lifestyle and preventative medicine way back in the 1970s and ’80s, before it was cool. And he noticed that to reverse coronary artery heart blockages– yes, diet is important, yes, stress management is important– but above all, he created the idea of social support groups for people wanting to heal and protect their hearts. And that’s part of his recipe even until this day. The message is so important: loneliness is an epidemic. It is the number one public health crisis of our time. Our last Surgeon General said that. And we have a lot of work that we can do– and we must do– to heal many of the root causes of disease. And it begins with establishing stronger connection with ourselves and with those around us.

Shay And you share some specific data in your book, “Just One Heart,” that social isolation raises mortality rates by 29%, and that living alone raises mortality risk by 32%. And Vivek Murthy, who you were referencing– our former Surgeon General– had written a whole book on this, about loneliness and, you know, the impact of that, and how it is a defining element of our times. Because, largely through technological advances and our ability to now move into distinct places far away from our families of origin, we’re living more lonely lives. And then also, shifts with cell phone use and computer development, et cetera– there are ways in which we can be more isolated, but still connect with others, but be separated. And so there’s these very interesting changes that are happening. And then recently, when I interviewed Dr. Bruce Perry– whose work focuses a lot on trauma in children, a psychiatrist and neuroscientist– I was asking him about: what are you seeing in terms of differences with adolescents and young people today?

And he said, developmentally, they’re often six to eight years behind. They’re immature. And one of the reasons he said he thinks that’s occurring is because, in those social groups– in our relational networks that used to be very tightly bound and interdependent upon one another in very direct, in-person, relational ways– young people were learning and reading facial cues, and having to parse that information. And their brains were developing, and their neurology– their whole system– was wiring around human expression, human interaction, human conversation, et cetera. And that we went from that being the whole basis of our evolutionary like, you know, footprint, to then suddenly this shift where we broke from that and have far less like interpersonal exchange– human to human. And that actually, developmentally, people are delayed, essentially, because they’re not getting that face-to-face interaction. And I’m curious too about how that like the shift from those tight-knit networks to these very diversified, sometimes technological networks– that we’re now creating “social networks,” we often call them– like how is that affecting our heart too? I’m interested in your take on all of that.

Jonathan You alluded to it a little bit when you used the term, “emotional contagion.” So, there was some great work by Boyatzis and others from Harvard looking at how this plays out in the workplace, for example, which is why this is an important conversation for organizations, Fortune 100 companies that are struggling to figure out why they can’t retain employees, why they’re not meeting their metrics. And sometimes it’s as simple as understanding evolutionary biology. The point is that our health is directly impacted– even without words, even without conversations– by those that we work with. When we see other people eating certain things, see other people either sitting at their desk sedentary or going for that walk at lunch… when we see other people behaving in toxic, unkind, hostile ways towards others– often it’s the boss– as opposed to when we see those leaders tapping into compassion, empathy, and kindness for those that work around them… even without saying a word, our body changes. Our hearts physically change.

There’s also been some great research out of Europe showing that stress in the workplace– as a result of these new tribes (that’s our new tribe, it’s in the workplace for many of us– children as a separate conversation)– it results in an increased risk of heart attack and death. There is a strong link between job stress and culture and heart disease, which costs many millions of dollars each year in unnecessary, wasted expenses. So what you’re pointing at there, Shay, is the direct impact that our social environment has on our physical health. Some of the beautiful work was done by Dr. Steven Porges, who developed something called the “polyvagal theory”, which you know about. The vagus nerve is perhaps the most important nerve in the body to understand if you want to know how social connections affect our physiology– affect our hearts. And there is one branch of the vagus nerve, what’s called the ventral vagal branch– and that’s the one that links our social environment with our physical heart: slowing our heart down when we feel safe, increasing our heart rate when we feel threatened, and priming us to be open to social connection, creativity, and collaboration when we really feel safe with others.

So part of the message of the book– and the reason that the very last chapter is on warmth and developing these qualities of being a warmhearted leader and a friend and a colleague– is because that’s the ultimate way to create health in the holistic sense: is simply by being generous, kind, giving, altruistic, loving, and compassionate. And it’s because, our physiology, we are wired to lean into people who are generous and kind and want to know us better. We are wired to avoid and feel threatened by people who are threatening.

Shay It’s quite interesting– you mentioned both Dr. Steven Porges and Dr. Boyatzis, and actually I recently had the opportunity to interview Dr. Boyatzis. And what’s so interesting, right– in Dr. Porges’ work, the polyvagal theory and the idea of basically intentionally eliciting that ventral vagal state, right, and through social engagement we’re in that place of being– what I thought was so interesting is, in Dr. Boyatzis’s work too– his most recent book is called “The Science of Change,” and it’s about what is the science of how we actually change– not like how we think we change– but if we really look at it, you know, over all the research that’s been done, how do we actually change? And one of the key things that he talks about is actually eliciting a parasympathetic state– that you actually have to get your whole nervous system into a particular state– which you also talk about in your book, right: eliciting that parasympathetic state, which Dr. Porges talks about in his work. And you start to see that there’s ways that we can elicit certain states within the body, that then better position us for a whole range of things. Right? And so from your lens as a cardiologist, I want to talk about– because a lot of what you’re describing is helping us to shift from one state that’s fear-based, that’s anxious, that’s contracted, that’s frightened– into another state that has feelings of compassion and warmth and kindness. Right? So we’re literally moving our system from one state of being into another– you could say, somatic sensory experience– that’s qualitatively quite different. And from your lens, what are you seeing and valuing, and in a sense, recognizing is protective in that state? And I guess I could give a quick side example of that– where you talk about the Rabbit Effect in that study– and how there’s actually these protective factors, right, by shifting into those places of kindness– and then through relationship expressing that. So, I’d love to hear your understanding of all of that.

Jonathan This is such an awesome conversation, Shay. I feel like I’m talking with a friend that I’ve known for a long time that I’ve just met.

Shay I feel the same, so I appreciate it very much.

Jonathan Yeah. Well, when I’m asked the question, from your lens, it gets into a question of, well, my identity. So I’ve got two eyes, and they’re looking through two different lenses, and if I apply that to my professional life, at least, I have at least two different lenses. So I have the lens that I take into my clinic and into the emergency room and intensive care unit as a cardiologist– watching people’s hearts in distress and watching people’s hearts heal. And then I have a second lens as an executive, looking after the wellbeing of nearly 40,000 employees in a healthcare system– including doctors and nurses who have a 50% burnout rate. So there are two lenses, and yet they really are the same– and that’s part of the message. What you alluded to, I think, is one of the most beautiful studies to explain how they’re connected, and that was The Rabbit Effect.

Now, an amazing book by Dr. Kelly Harding– which I describe in the book– and it was in late 1970s, Ohio State, Dr. Nerem was trying to figure out: how did heart disease develop in the first place? A lot of us take for granted, “Oh, of course we know that– it’s too much cholesterol blocking your arteries.” Though of course, there are social media influencers who think that that’s all just a big controversy and it’s conspiracy and it’s not true. I can tell you– for 30 years now– that cholesterol is important for creating blockages in the heart. But the way we know that is because of early research done on rabbits. These poor little rabbits were given high-fat, saturated fat diets in the laboratory, and a research assistant would go and feed them essentially cheeseburgers and fries. And these poor little rabbits eventually underwent autopsy to look at their arteries.

What wasn’t surprising is that these rabbits developed blocked arteries in their hearts that they otherwise wouldn’t in the wild. What was very surprising was that there was a small group of these rabbits that had 60% fewer blockages in their arteries– and they live longer. And Dr. Nerem couldn’t figure it out, until he looked at the journals and found that there was one research assistant who wouldn’t simply feed the rabbits the burgers and fries. In doing that, she would also take them out of their cages, hold them, caress them, love them, talk to them– giving them compassion, empathy, kindness– and then feed them and put them back. So even with eating the same food, which is a high risk for heart disease, the compassion that these rabbits experienced shifted– as you were discussing– their nervous system from a state of threat or neutrality to a state of relaxation and healing.

And this also is partly why Dr. Herbert Benson, a cardiologist, went on to found the Benson Institute at Harvard many decades ago, and he did the pioneering research in what’s called relaxation response activation, which essentially is helping individuals shift from our chronic state of unremitting stress and sympathetic overactivation, for a variety of reasons, actively shifting– downshifting– the sympathetic state and proactively activating the parasympathetic state of relaxation, which has physiologic effects. People are left with the question, okay, doc, why does that prevent heart attacks? Well, that’s a whole another section. I have a whole chapter on the science of how this happens. It’s fascinating. But put very simply, when we are not in that threatened state, when we’re in the relaxed state, there are shifts in our neurochemistry. There are shifts in our physiology. Our heart rate and blood pressure relax. Our blood is less thick, less prone to clotting. And perhaps most importantly, our behaviors change. We, as humans at least, make wiser health-related decisions around exercise, sleep, nutrition, and social connection. So there’s a fascinating mechanism getting from point A to point B. How is it that a feeling, an emotional feeling relating to social bonding, creates a shift in our body’s physiology? That’s the beauty of the mind-heart connection.

Shay Yeah, the mind-heart connection. It’s interesting because we hear a lot the language of the mind-body connection, right, but the mind-heart connection. And for quite some time– and this is very anecdotal– but for quite some time I’ve felt in my own body that my heart is the master regulator of my immune system. And Western medicine does not perceive it that way to some extent. Certain facets of traditional Chinese medicine do see it that way. But it’s interesting cause I can actually feel if my heart is overly like too stressed; I can feel the impact on my health or illness. And for me, that’s always been the central element that I pay attention to, because I can literally notice like, oh, I have to pay attention to my heart first, because that’s what then allows my body to stay well, essentially.

Jonathan I’m happy that you pointed that out, and it’s something that we often take for granted. And there are very good reasons. The heart actually is the ultimate weather vane that can cue us into how things are inside. Of course, every organ in our body– from our skin to our liver to our heart– is represented in our mind. There’s something called a homonculus. There’s part of the brain that you’re familiar with, the insular cortex, which has now been linked with what’s called visceralception– awareness of the organ sensations, including the heart that you’re describing– and also more generally, interoception. We think about touching and feeling things in the outside world, but many of us, until we come to the work of somatic work and mindful awareness of our body, are not aware that interoception is a very powerful cue– perhaps the most powerful because it’s the source of our intuition.

When I write about wisdom, I speak literally about the wisdom of the heart, which is what you’re describing. Sometimes it just is a matter of checking in with: does my heart feel contracted? Is it quick? Is it slow? Is it open? And this isn’t something that is only in traditional Chinese medicine or in Buddhist philosophy– talking about the heart. There’s some great research that came out of Finland a few years ago studying how people around the world experience the spectrum of emotions, and they created maps of the human body based on when you feel anger, where does it show up in your body? And there was no copying. People weren’t looking at others’ responses. And yet, when the researcher, Nummenmaa, came and looked at all of the data, what they found was that there was a remarkable correlation. Whether you were in Thailand or in Boston, that when you felt joy and love, your heart would relax. It would feel more open and more slow. When you felt more self-concern, anger, and hostility towards others, your heart would feel more cold and quick. And so the heart is the weather vane for our emotions. It is the source of our deepest intuition.

Shay I want to give you an opportunity, Jonathan, to talk about the seven timeless traits of the heart. Cause you share that in your book, and so I’ll just state what they are. So you identify these as: steadiness, wisdom, openness, wholeness, courage, lightness and warmth– and that these serve as inner resources for facing life’s difficulties. And so, I want to give you a chance to talk about these seven timeless traits of the heart, and why those matter so much to you.

Jonathan Well, I like the number seven, first of all.

Shay That’s a good answer.

Jonathan I’m the youngest of seven children, and seven has always had a special number for me. The first question is: why do I need to have this list? Why do I find it helpful when I’m working with other people? And it’s because I often forget. I catch myself getting frustrated on the highway. I catch myself eating all the foods I know I shouldn’t. I catch myself being cold and unkind to other people at work– sometimes even to my patients. Hopefully they don’t know about it. It may be so subtle that only I’m aware that they’re not getting the full loving version of this doctor. And so essentially, they began as my own reminder to myself. The second piece to know about these seven timeless traits are: they’re in a particular order. And it’s because I was told too many times by people who are well-meaning, but who oversimplified the path towards social connection and happiness in life. People would just say, “Just be kind.” “Just be kind to others. Be kind to yourself.” Well, as a burnt-out, stressed-out doctor who was physically exhausted, who was anxious, I can tell you that I wasn’t ready to step into the kindness in many of those moments of my life.

And I needed to explore: well, what needs to happen for us to reach that full potential that we all have, which is our innate compassion? What are the steps that I’ve had to go through? And so, before I could write these down, I actually did research for I thought was going to be three to six months. It ended up being a year of research before I wrote the book, where I called up people that I trusted, including a neurosurgeon, Dr. James Doty, who wrote an incredible book that changed many of our lives, “Into the Magic Shop,” and now wrote a book about the magic of the mind for manifestation.

And I spoke with Dr. Porges and Dr. Ornish and just on and on– anyone I could get my hands on– and ask them the question, “When you think about living from your heart, what does it mean?” And I took notes, and I came up with about 20 different qualities that everyone mentioned. And then, when I did my analysis of 60 hours of interviews and I matched them up with the science of positive psychology, where this has already been studied– what are the heart qualities?– these seven were the ones that emerged. They were the only ones that stood the test. That’s where the list came from. And they serve for me as kind of a stepping stone guide that can really go in any order, but they often have to begin with steadiness. This also is based on my experience in the emergency room, when I’m called, because someone’s heart is beating two or three times its natural speed…that’s not the time for me to overlay on the compassionate inquiry, asking about their childhood. In that moment, what the person needs is an immediate steadying of their heart. And then sometimes can be a medication, sometimes it has to be an electric shock. But before we can study the heart itself, I can’t help that person return to the state of healing. And so, steadiness for me has to do with the practice of checking in with my body, recognizing how much our culture pushes us to rush and to go all the time– looking at the definitions of success, how it’s always about leaning forward rather than grounding ourselves in this moment, as you and I did before we began this conversation. That’s what steadiness is. The next step for me is really an honor of my parents, who were very wise, and my mom was always reading about wisdom traditions.

And it also comes from the Buddhist tradition, which says that what they call the Eightfold Path– requires wisdom. It’s not a matter of simply starting out on the path– we have to have the right view, the right intention. We have to kinda have an understanding of the way that the world works and the way that we work. And that’s what wisdom is about. It’s knowing that real happiness is not about getting more and seeking things in the outside world. It’s about steadying ourselves and being satisfied and content and knowing that we are enough. So that’s part of what wisdom is. And then moving on to openness– Adam Grant wrote a whole book called “Think Again.” Dr. Daniel Kahneman, Nobel Prize-winning behavioral economist, wrote a whole book called “Thinking, Fast and Slow.” And both of them, what they’re trying to hit on is the importance of opening our minds to new ideas, even rethinking our old beliefs.
And so much of the conflict and division we see in the world right now is because of a lack of open hearts. People are standing where they’ve always stood and fighting for what they think is right for them, not realizing that their view isn’t the only way. And this leads us towards Brene Brown’s work and living wholeheartedly. So, for me, I’m fascinated not from a social work or a psychological standpoint only, but from a holistic view. As a cardiologist, what does it really mean to have a whole heart? I’ve held hearts in my hands. I know– I’ve seen them. And so I discuss how we can live with a whole heart, which has to do with integrating our past, including all the wounds. And I discuss ways to do that. And also, living with a whole heart means being passionate. When you and I are in this conversation right now, if one of us is looking at some other screen or a device, we are not in this with our whole hearts.

We cannot extract the juice and the goodness out of this. And can we show up that way in each and every interaction in our lives? And then, moving to the last three traits of the heart– none of this is possible without courage, because what we’re leaning into here is something that goes against the grain. In order to live this way, to live wholeheartedly, we have to reject a lot of what we’re being told, which is: make it about me, make it about mine, get more, more is better. It takes a lot of courage to stand up and say, “This isn’t right, and I think there’s a different way.” And the word courage itself comes from the Latin “-cor,” which means heart. And the Mayans and the Incans and the Aztecs all believed and knew. I would say that the heart is essential. The courage we feel often comes from the heart.

It doesn’t come from the brain. Neurons in the brain don’t feel anything– they convey information. It’s the heart that feels, literally. And then the last two qualities: none of this is much fun if we can’t laugh at the joy in life, but also laughed at the insanity and the absurdities that we see in life. So I speak about– that’s where the “heart wakers,” the nine “heart wakers” come in. They are sources of lightness of our heart. I can tell you as a cardiologist that when a heart becomes heavy– and it literally does, it becomes thicker. It starts to demand more oxygen than it can receive. And heavier hearts don’t live as long. Lighter hearts live longer. And then the final, and the ultimate point of all of these seven, is: if we had to pick just one, it’s– we know warm-hearted people, warm-hearted leaders. We know the power that they have. And yet, there’s a science to it as well. There’s a science to developing empathy. Empathy is so often misunderstood. There’s a science to turning empathy into compassion. And there’s also a science and a practice to love. Love is not simply a feeling. Those are the seven traits in a nutshell.

Shay Yeah, it’s great. I’m so glad you took the time to go through each one and share kinda the meaning and value and importance behind it. Cause I think that it is such a useful framework, and like you said, even the sequencing and knowing sometimes like first step is just 101 steadiness, right– that sometimes that’s exactly where we begin. Cause I do agree with you very much. You know, you work, like you said, with a lot of people in healthcare that are dealing with burnout and, you know, trying to find ways to be resilient in highly stressful environments. And when you’re in those highly stressful environments– I’ve spent a lot of my time over the years working in hospitals, specifically primarily with children who are dying or suffering and very ill– and in those environments, what are the protective factors? Right? And so some of what you’ve just described are protective factors. They’re things that we can do internally.

They give us an inner resilience, even in highly stressful environments. I mean, the very nature of being a cardiologist has, inherent to that profession, states of high stress, right? Because you’re dealing with humans that can be in an incredibly vulnerable moment in their life that can be life threatening. And so again, like, there’s an interesting question there as a healthcare provider, and it became a very interesting question on national scale, particularly during COVID, right? Like in the midst of something that stressful, that demanding, that overwhelming in many ways, like, what are the essential factors that you can hang on to that give some kind of sense of inner capacity and protection, even in the face of really hard things? And I think because so much of my career has been focused on working with people who are suffering from significant trauma and illness, and also a lot of families that are losing a child to those kinds of things, I’ve always had to look underneath that surface of not wellness in the context of, you know, “everything is smooth and easy in my life,” and that’s where I get to practice wellness, but actually, under the context of: if I have just had a heart attack, or if my child has just gotten a cancer diagnosis, or if I did just have a horrible traumatic accident, and, and, and, all those kinds of tragedies– how still can I find a place of steadiness and solace and warmth and comfort and kindness? How still can I hold this essential core nature that is contained within each one of us and allow that to still guide me, even in my worst moments? And that’s an art as much as a science, right, of how you support a being in the brokenness that I’ve heard you talk about that sometimes people feel, right? It doesn’t mean they are broken, but you can feel broken. And from those places of feeling broken, how do you reconnect with that experience of wholeness? It’s like such an interesting question I feel.

Jonathan Well, this may be round two of our conversation, Shay, because that’s what I’m passionate about as well– very much so. As someone who was going through burnout for a decade before the research out of California came out, even talking about burnout on a public basis before the first article in the New England Journal of Medicine, not even 10 years ago, discussing burnout as a public health crisis– I was at a loss. I didn’t know what to do. I didn’t know who to turn to. You described a whole spectrum of what I’m going to call trauma. You described examples of physical trauma in children, psychological trauma, trauma and working with pain, and the pain that comes from grief, and the grief that comes from loss. This is a huge conversation that we all have to become more expert at if we want to become healers of not only our own hearts, but of the systems that are often causing the trauma itself.

Now, an accident is one thing, but often when we look, there are systems at play that result in what we previously thought of as accidents. In the airline industry, if there’s one airline crash, they may think about it as an outside isolated event. But once you start to see a pattern of crashes– and we’ve seen a pattern of crashes in healthcare– 400 physicians are taking their lives by suicide every year. That is not an accident. Then we have to start– and I really believe strongly in this, and I want to point this out– that though we’re talking about self-care, that’s not what my message is. That we should simply dissolve into looking into our own hearts and we will find all of the answers– that would be impractical and unwise. The message is that there’s a parallel path that we have to take to heal our trauma.

We have both individual trauma, but we also have collective trauma. And we’re experiencing it during COVID. We’re experiencing it now with the political divide that are keeping people up at night. And so those of us who want to be in this conversation have to be willing to speak on both of these parallel tracks– which are, as you know, it’s just one heart. What happens inside of me affects you, and what the both of us bring into the world can affect another group as well. My mind also goes to the work of Eckhart Tolle, who I read more than a dozen years ago. You mentioned a couple of examples of people in pain, and how that’s part of your calling– is to help people find comfort in pain. And what, as I recall– I haven’t read him in a while– but what struck me was his approach to working with pain. And the core message is that is we must remember that we are not our pain.

Our pain doesn’t define us. We are much bigger than the pain. And when I’m helping someone who’s having a heart attack or who has had a heart attack, what I try to do is to create a more open space with compassion– that this person can simply be who they are, that can hold their anxiety about the future: that they won’t be able to care for their families and their loved ones, that they’ll be living with permanent disability. Because so often that anxiety is about the future. It’s not even about the pain in this moment. And then, when we can also bring mindfulness to pain and grief, we start to see that we often make things worse by the machinations and ruminations and predictions of our mind than they actually really are in the moment. And then lastly, it brings me to the Buddhist wisdom. It’s the First Noble Truth, which is: if you think you’re going to get through life without pain, try a different approach, because it’s not going to happen. That in life, there is pain.

And I think one of the beauties of the wisdom of Buddhism is that it teaches us that to experience pain is not the same as to experience psychological suffering. And that the phrase there comes to mind: that pain is not optional, but suffering is. And what’s meant by that is: if we can become skillful at seeing things as they actually are in this moment– without letting our mind proliferate and offer us 1,001 things that could go wrong– staying in this moment, we might even find comfort in the pain, and be able to draw attention to that one tiny part of ourself that is not experiencing pain, that may even be experiencing comfort or joy that has gotten clouded out.

Shay I love to ask– given that this show is called Conversations on Healing– I’d love to ask every guest the same question, because no answer is ever even remotely similar because it’s always from the lens of our own individual life experience. But yet, I do see parallels across. But the question is: How would you, through your lens, through your life, through your work, define or describe what healing is?

Jonathan I first learned the meaning of the word healing from reading John Kabat-Zinn in his book, “Full Catastrophe Living.” And as I recall– I think it was through him that I learned it– that the word health comes from the old English, which means whole. And so, for me, healing means return to wholeness. And the second part of the answer is that wholeness doesn’t necessarily mean that a broken bone is magically healed in a moment. We can have something that’s physically broken– we can have a tear in the skin, we can have a scar in our heart tissue as a result of a former heart attack– and at the same time, we can be whole. And that may sound like a paradox: How can I be healed at the same moment that I’m broken? And this is where it’s important to think about, you know, the role of the mind. If we believe that we’re broken, we will always be broken. And if we believe that we are whole as we are, in this moment- even with our wounds– then we are already whole, we are already healed in some small sense. Not to deny that if we have cancer, it still is there– it is not gone.

It’s to draw attention to the importance of the mind and our beliefs and our attitudes in the process of healing, which really is… it is a process. Those are my initial thoughts about healing. And then, I guess the last thing that I’ll offer is– it’s in the book, and I describe it– and I think I first heard it from my friend James Doty, who knows a lot about healing… and it’s this Japanese practice of Kintsugi.

Which is when a ceramic pot falls off the side of your desk, as opposed to in the West where we may say, “Well, let’s sweep it up and throw it out.” The Eastern approach to wholeness and healing is different, where it’s a matter of looking at the broken pieces– where the pain is– and instead piecing them together, and using a gold lacquer glue to piece together the pieces, and not hiding the broken parts, but instead placing it on full display, so that we can see where we came from, and not being ashamed of our wounds, and what we’ve gone through, and what we’re carrying in the backpack of life. But instead, can we celebrate the beautiful aspects of how we have made it through to this moment right here today? So, it’s the opposite of avoiding, and hiding in shame. In fact, it’s sharing that with others, which can ultimately be incredibly inspiring for those around us, and help others heal as we share our own healing journey.

Shay I had the good fortune of having Dr. Doty on the Conversations on Healing podcast, and he actually talked about Kintsugi, because it is, that idea is so valuable. And I actually, in my own life, I take it one step further, because it’s just been the reality for me. I’ve had a story that’s had a tremendous amount of brokenness. I think it’s why I’ve had some capacity to support others in their journeys. And the piece that actually, for me, has been the strongest– and I’m always curious to learn from others like what’s helped them– but has been the ability, almost like you said with Eckart Tolley would be an example of this like: the part of yourself that never is broken, right? So the part of yourself, using the Eckart Tolley analogy that’s beyond the pain right– the part that inherently is always whole, is always healed, is always kind of perfect and complete– and each one of us has that, right?

There’s an essential part to our nature that, no matter what happens to us, it has this inherent quality. And you can actually, you know, through states of meditation, in certain practices– but you can actually cultivate an experience of feeling that viscerally like in your system. And that, through these practices, things like mindfulness-based stress reduction, which you mentioned in your book– it’s like these are ways, and there’s a lot of others– but that you can get into this experience, of visceral experience, of connecting to something larger than oneself. And then, in a sense, in your terminology, recognizing that there is just one heart, right, like that we are all actually, in a visceral way, connected, unified, through this one heart, and that it can actually be felt and experienced, which is pretty amazing.

Jonathan Beautiful. I love how you put that, and I also appreciate your emphasis, Shay, on practice. This can get very heady, and I know we’ve talked about, you know, historical examples and statistics and science and other books and other authors, and I don’t want to give you or anyone who might be listening the wrong impression that this journey is simply about getting enough knowledge, and then everything kind of falls into place. That’s actually the opposite of what I’m hoping to communicate in this conversation and in my work, which is: there are different ways of knowing than we think about in the West in our narrow view, and it really is about knowing things in our hearts, knowing things in our body, and it takes practice– which means to practice shifting the way we think and what we believe, and even practicing tapping into the body itself each and every day for moments at a time. I want to highlight and celebrate that, because I’ve heard you mention that a couple of times.

Shay Well, thank you. Well, just in closing, I want to give you an opportunity Dr. Fisher, if there’s anything else that you wanted to bring into the conversation for our listeners.

Jonathan When I think about the last 30 years since I began medical school, and I think about the thousands of hearts that I’ve had the privilege to literally see and listen to, and then also more metaphorically, just human beings working with humans, I look to: what would be the essential practice? What would be the essential practice that would benefit the most people? And what I come back to again and again is the one that helped me, which is the practice of starting by loving ourselves.

And the changes that I’ve seen happen in my heart patients have been dramatic. When, instead of simply focusing on their cholesterol numbers or medications for blood pressure, focusing on the core belief– whether this person in front of me loves themself as they love so many others, or whether they have this inner conflict that’s never fully resolved. If we can get to that place of self-trust, everything else falls into place. Because I do believe that at our core, we are compassionate, and we need each other, and we know that. And we act against that– something doesn’t feel right. And if something doesn’t feel right, we end up at the doctor’s office even before we feel a problem. Cause I can see it when people are acting out of that alignment. So my message would be, Shay, if we can just be a little kinder to ourselves and notice the impact that might have and how kind we are to other people.

Shay That’s wonderful. Well, I want to personally thank you for your body of work, because to have the combination of a mind that has the capacity to go to Harvard Medical School, to become a cardiologist, to get your M.D., and then a depth of understanding and really a wisdom to recognize all of these other dimensions and traits of the heart that matter so much, and how you can weave that all together– and that heart-mind interconnectivity– that’s such a powerful thing to be offering in the world through your work. So, I want to thank you very much for who you are and what you’re doing.

Jonathan Thank you so much, Shay. That’s so kind of you, and it means a lot coming from you.

Shay Thank you so much for joining me on the show.

Jonathan Thanks.

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