Ep. 195 - Brains Under Pressure: Trauma, Tau, and the Future of Brain Health

The Smartest Doctor in the Room

In this powerful episode, we explore one of the most important—and least understood—medical challenges of our time: how brain injury and aging impact mental health, behavior, and society. Our host is joined by renowned neuropathologist Dr. John Crary, a leading expert on brain diseases at Mount Sinai, to unpack the science and lived reality behind concussions, CTE (chronic traumatic encephalopathy), dementia, and more.

Dr. Crary shares his early fascination with neuroanatomy, how pathology reveals the hidden stories inside every brain, and why repetitive mild head trauma—not just big hits—may be the true danger in contact sports and military service. He explains how CTE is diagnosed, why tau tangles are the “smoking gun,” and how the exact location of damage reveals the cause. The conversation digs into why certain brain regions drive memory loss, depression, and even aggression—and why some athletes and veterans develop devastating symptoms at a young age.

We also discuss:

• Sports like football, boxing, and soccer—how risky are they really?
• The biomechanical “Nestlé Crunch bar” model of brain injury
• Why CTE can only be definitively diagnosed after death (for now)
• Emerging tools: PET scans, blood tests, MRI biomarkers
• How studying athletes may help unlock treatments for Alzheimer’s
• New hope in RNA-based therapies and amyloid/tau-targeting drugs
• Whether recovery is possible after multiple concussions—and when it’s too late

This episode blends science, medicine, personal stories, and societal urgency. Whether you’re an athlete, parent, physician, or just curious about the brain, this is a must-listen conversation that could change how you think about brain health forever.