In this raw "trifecta" episode, Ashley, Brian, and Collin sit down for a candid update on Brian’s battle with Stage 4 tongue cancer. Recorded just weeks before a life-altering surgery, the team discusses the physical toll of chemo, the overwhelming weight of "decision fatigue," and how the dental community has rallied to support them. This is an unfiltered look at resilience and the reality of navigating a healthcare system in crisis.

1. Life in the "Messy Middle"

• Family Strength: Brian shares the emotional (and humorous) reality of home life, from their sons shaving their heads in solidarity to a breakthrough moment of faith and empathy with their middle son, Brady.
• The "Messy Years": Brian reflects on a quote by Chris Dixon: "The messy years make the obvious years possible." He views this grueling season as the "mess" that will eventually become a message of hope.

2. Clinical & Dietary Pivots

• Metabolic Support: Brian details his 72-hour fast leading into his third round of chemo to improve treatment tolerance and "starve" the metabolic pathways of the tumor.
• The 180-Degree Shift: After seeing rapid growth on high protein, the couple pivoted to a 95% plant-based, whole-food diet inspired by Dr. Valter Longo. Ashley discusses the shift to juicing and "clean" plant proteins like lentils and tofu.
• Favorable Momentum: Recent imaging shows that while the journey is far from over, the tumor growth has slowed, and the lymph node architecture is improving.

3. The Mental Burden: Decision Fatigue

• The Surgical Plan: Brian explains the upcoming Hemi-Glossectomy (removing half the tongue) and reconstruction using a thigh graft.
• The Weight of Choice: After researching alternative trials (like Chef Shirley’s non-surgical path in Chicago), Brian speaks candidly about "decision fatigue." When every choice feels like life or death, he has reached a point of mental exhaustion. He finds a strange peace in surgery because it shifts his role from "decision-maker" to "rehab worker."

4. Advocacy & A Broken System

• Access Challenges: Despite being a physician, Brian reveals the "mind-boggling" difficulty of scheduling scans, with major institutions booked out for months.
• The Power of the Tribe: Ashley discusses her "bulldog" approach to advocacy—leveraging her network to get a patient liaison at MD Anderson in Houston within 30 minutes of a single text.

This episode is made possible by:
Studio 8E8 — Dentistry’s story-driven growth agency for startups. Learn more at https://s8e8.com/vsl
Net 32 — The online marketplace to compare brands and prices so you never overpay. Check them out at net32.com/themakingof

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