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50. The Iceman and The Wedge with Scott Carney

Investigative journalist and bestselling author Scott Carney is our guest as we discuss: what it means to be human, going deep in the Wim Hof method, benefits of cold exposure, climbing Kilimanjaro without a shirt, using The Wedge to change conversations with your limbic system, kettlebell throwing, and why you might want to embrace failure.


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Guest Bio: Scott Carney is an anthropologist, an investigative journalist, an author and a seeker of both the fringes of human experience and the core of what makes us human. Scott has written four books to date, including The Enlightenment Trap, The Red Market, and What Doesn't Kill Us. Most recently, he authored The Wedge, which dives deeply into understanding the space between stimulus and response. Scott's work has been featured in many different magazines -- Wired, Mother Jones, Playboy, Foreign Policy, Men's Journal, National Public Radio. He has won the Payne Award for Ethics in Journalism and is a multi-finalist for the Livingston Award for International Journalism.



This episode is in support of the Altruism in Medicine Institute, an organization founded by Barry Kerzin, a physician, teacher, author, and Tibetan Buddhist monk. The mission is to increase compassion and resilience among health care professionals and their patients. Compassion fatigue is a very real thing, especially in health care. Building your compassion muscle is one of the most potent tools not only for avoiding burnout, but for finding joy in what you do.



Essentials of Emergency Medicine, the conference I host each year, is happening May 25-27, 2021. For an additional $100 off registration, use the code 'orman' at checkout.


We discuss:


The common theme of Scott’s books -- what does it mean to be human? [05:00];

Who is “The Iceman” Wim Hof and and why might cold water immersion lead to general resilience [09:10];

  • Wim Hof is a Dutch athlete who developed a method of ice water immersion and breathwork protocols that give him what appears to be superhuman powers. Wim claims that his techniques can boost the immune system and cure autoimmune disease.

  • Scott was initially dubious of Wim’s assertions and was eager to meet him. He quickly learned that Wim’s program works.

  • Extreme cold exposure combined with breathwork creates a stressful internal state and triggers a fight-or-flight response. With Wim Hof training, you tell yourself, “I can do this, the stress isn’t so bad”, and the amount of cortisol, adrenaline, and other stress hormones that are secreted is reduced.

  • By being able to handle that stress, your physiology adapts and contributes to overall resilience.

  • Link to the science behind the Wim Hof method.


“We live in relatively static environments, having manipulated the environment to make us feel comfortable. Wim’s message is to get into places that make you feel uncomfortable from an environmental perspective and then learn to be OK with that. You start activating biological systems that have let us survive for all of the millennia before central heating and electric lighting.”

The three elements of the Wim Hof method and how they relate to the wedge [15:10];

  • Deliberate cold exposure.

  • A breath protocol where you do rounds of controlled hyperventilation followed by exhalation and a breath hold. (Note: the cold immersion and breathing protocols are not meant to be done concurrently.)

  • Your mindset during the stressful states of cold or hypoxia. This mindset led Scott to the concept of the wedge.

  • If you put a wedge between challenging stimuli and your brain’s response to it, it gives you an opportunity to realize that this is something you can do.

  • “You can find the benefits of the wedge in everything you do, because you’re constantly interacting with the environment. That environment is sending sensations to your body, and you have a choice on how you respond to that sensation.”


“That's really the point of being alive. Who I am is not the person you see when I’m sitting on the couch watching Netflix. I am the person engaged in something that is difficult. By expanding those limits to where you can exist in challenging places and yet do so comfortably is really the measure of who you are as a person.”

An advantage of the Wim Hof method vs. other mind-body connection practices (like Tuomo) -- it’s fast and you can learn it in about 3 days [20:00];

  • Ice water immersion is a rapid exposure to a stimulus and the body responds immediately. Tuomo is a Tibetan practice with a similar goal, but it takes approximately 10 years to master.


Scott’s weekly cold water immersion practice with benefits that last 4-5 days [22:20];

  • Every weekend Scott joins a group of friends at a private lake where he does long immersions, at times lasting 26 minutes.

  • He loves the anticipation, yet wonders why he keeps coming back for what many would consider to be torture. He enters the water calmly, and when his mind tells him that he should get out early, there’s another part of him that replies, “What if I just want to see how far I can go?”

  • “It's so valuable to see my body go through these changes in the ice. It's this conversation between the words in my head and then what my body is actually telling me. When I get out, I feel warm with the sun on me. This good feeling can last 4-5 days where I'm in a better mood, knowing I've done something hard. It's almost addictive, to be put under these stresses and then come out and want to do it again.”

Why ‘gritting it out’ is not an effective strategy for prolonged cold exposure [27:30];

  • If you approach an ice bath fighting the environment, trying to soldier through, you’re doing the method wrongly. Don’t tell yourself this is the hardest thing you’ll ever do, because those words are counterproductive.

  • You need to relax, let the environment in, know you can do it, and zone out.


Climbing up to Gilman’s Point on Kilimanjaro shirtless and without oxygen [30:15];

  • Scott pushed through the hypoxia by doing the Wim Hof method of overbreathing (without the apneic breath retention) for 28 hours.

  • He found he could counter the problems of altitude sickness by increasing his respiratory rate, adapting his conscious breathing to the environment that he was inhabiting.

Scott’s sauna routine and the value of giving his body contrasts to adapt to new environments [33:25];

  • Scott enjoys a hot tub or sauna session after cold immersion. “The bigger the shift, the more response that your body is going to have.”


His latest book, The Wedge, and how the wedge is activating something within yourself in order to thrive in a difficult moment [36:25];

  • When you anticipate a remote stimulus that you’ve previously experienced (such as an ice bath), many expect it to be horrible and enter panic mode.

  • The actual stimulus is your experience upon jumping in the water. In that moment, you get to decide how important those previous assumptions about the ice water are. You can make it worse or you can make it better, depending on whether you fire the limbic system.

  • Once you’re in the ice water, you can redefine whether the experience is good or bad and whether it’s making you better or not better.

  • The wedge is a tool that can be applied to any environmental experience: heat, psychedelics, relationships.


Using a library as a metaphor for the limbic system [39:20];

  • In the library of the limbic system there is a librarian, and when someone first enters the library they come with no history of prior experiences. All of the shelves which represent sensations are empty.

  • When someone experiences a strong sensation, the librarian contacts the bookbinder (the paralimbic system) a few structures away in order to categorize this for future experiences.

  • The bookbinder takes this signal and links it with your current emotional state at the moment. For the cold stimulus, the instinctual emotional state is panic, so this book (panic = cold) is sent down to the librarian to be stored on the shelf.

  • The next time you go into ice water, the librarian has a book on the shelf which immediately links the cold with the unmitigated pain of your prior experience. “Your brain wires everything this way -- we are always living in our emotional past.”

  • We can add new books to the library, however, because each stimulus can have more than one sensation linked to it. Cold can be terrible, but it can also make us feel really good.


“If we add more books to the library, we have more neural grammar in which to exist in the world. And we find that we can do that with all sorts of things.”

The philosophical question -- do we experience a shared reality? [44:20];

  • For the most part, everyone feels raw sensation (such as cold) the same way.

  • As stimuli get more complex, we start to diverge because our own backgrounds (our “limbic libraries”) are different.

  • “We need to realize two things. One, that we are all individuals. Two, that we're all connected. Everyone’s wedge is going to be different.”

We're given this one package of life. And the thing about life is you have to make choices about the things you want to do. We need to follow the things that bring joy, and we can find our wedge even within those things.”

Applying the wedge in the emergency department when your heart is racing and you’re profusely sweating because you’re having difficulty with a critical procedure[49:25];

  • Scott’s advice is to visualize failure. There are multiple things that can go wrong, and you should have some degree of professional detachment knowing that bad things can happen.

  • Once you know that there is the potential of failure, of course you try not to do whatever might lead to failure. You do your very best in the present moment.

  • We must accept that from time to time people are going to die. “Why are you even attempting to save someone if you can't accept the fact that you might fail?”

“We valorize success. We do not accept failure in general. Do your best, but realize that you could fail and then realize that that failure breaks down into not just one error, but multiple errors before you get there.”

The solution (or wedge) for the mental irritation that often comes with reading opinions on social media [58:30];

  • What makes social media so impactful is that we automatically respond to things like tweets in fight-or-flight mode.

  • “You can insert a wedge, but you're never going to overpower all biology on this. It’s just our limbic system playing out on the internet. Social media is toxic for a million reasons, and this is just one more reason to delete those accounts.”


Going from fear to joy to almost a spiritual place with kettlebell partner passing [01:04:30];

  • While the movement of kettlebell throwing is easy, the stakes are real. You must pay very close attention to the stimulus.

  • It turns into an exercise of empathy. “I don't want to hurt you, you don't want to hurt me. And we're doing this thing that's actually a little dangerous. It really puts you into this moment of bonding.”

  • You're throwing the kettle bell with love and you're catching the love from the other person. It's a spiritual practice. You realize that what the external world sees and what you are experiencing are totally different.

And more.


Shownotes by Melissa Orman, MD


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