Why Sacrificing Your Health Doesn't Make You More Successful: Bryan Johnson, Kate Tolo and Dr. Mike Mallin on "Martyrdom Culture"

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Overview

In this episode of the Bryan Johnson Podcast, Bryan Johnson, Blueprint co-founder Kate Tolo and physician Dr. Mike Mallin take on what they call one of the biggest myths of modern professional life: that you have to martyr your health to achieve epic success. Johnson's position is that ambition, wealth, status and power are legitimate goals, but that compromising your health is a bad strategy for reaching them. The hosts argue that prioritizing health produces better outcomes in success, happiness and status. They lay out the research they gathered, trade personal stories about sleep deprivation and burnout, argue over which mental models help people change, and end by admitting how hard some of this still is in their own lives, especially international travel.

25 min read

Martyrdom Masquerading as Hero Culture

Johnson frames the problem as a culture that looks heroic from the outside but is really martyrdom. Late in the conversation the hosts settle on the phrase "martyrdom culture masquerading as hero culture." They choose it on purpose. Johnson doesn't want to call it "hustle culture" because he sees hustling as a good thing. Mallin suggests "just work culture," and Johnson objects that "work" is a positive word too. They want a term that signals an illusion.

Johnson describes the system in which people are expected to sacrifice health. It says to "sleep like this, eat like this, look like this, be like this," not because the data shows it works best, but because a system "designed by we don't even know who" says so. In entrepreneurship, he says, no amount of travel is too much and no amount of sleep is too little. Exercise gets sacrificed and junk food is fine as long as revenue, headcount and fundraising keep climbing. He calls this "a spectacular failure of our societal systems," harmful to individuals, their companies, and everyone around them.

Johnson's Own Case: Braintree and Venmo

Tolo brings up a common reaction to Johnson's story. He built Braintree (which included Venmo), sold it to PayPal/eBay for $800 million, and people assume he can only focus on health now because he has money. She notes that she recently heard him say, for the first time, that he would have made more money if he'd been sleeping better. Johnson confirms it without hedging: "Unquestionably, I would have made more money and been more successful had I made health my top priority."

Tolo also says that, as she understands it, he sold the company at a certain valuation mainly because he couldn't keep going. Johnson doesn't elaborate on the details. He generalizes instead: nobody reaches peak success when their health is in a bad place, and he says two people on the call went through that experience.

The Medical Version: Mallin's Burnout

Mallin agrees that he went through a similar path in emergency medicine and accepts the "B-word," burnout. In medicine, he says, physicians are expected to "just crush themselves," and it starts in medical school. He studied chemical engineering as an undergraduate and thought that was hard. Then medical school shocked him with the study load, residency added more, and professional life added more again. He describes it as "a step-wise function of increasing expectations" with no attention to personal health. Nobody teaches you how to be healthy and a doctor at the same time.

He stresses that the trade was never stated. No medical school interviewer asked whether he was ready to sacrifice his health and longevity for the profession. The motivation was "I want to help people," and it quietly became "I want to sacrifice my own health to help people." Johnson says he has seen a statistic that emergency physicians have the lowest life expectancy among medical professionals, something like 59, and asks Mallin to correct him if it's wrong. Mallin doesn't give a number but says it is "crazy low" and that if he'd known, he never would have gone into emergency medicine: nobody can sell you a career by saying you'll probably die about 15 years younger than average.

Mallin doesn't think this is unique to medicine or startups. He sees it as a society-wide expectation across professional careers that you crush yourself for some theoretical benefit, and he calls that misguided. Johnson goes further. In his view, the global system treats humans as disposable pawns for its own progress. Trophies like power, wealth and status are "a giant cope" for being martyrs to something bigger than ourselves. He connects this to his "Don't Die" idea: when existence itself becomes the priority, people are no longer pawns to be arbitraged for the system's gain.

Why Ambitious People Won't Let Go

Tolo, who is 29, describes the pressures she has faced. In New York's startup community there is social pressure to announce that you've been working hard and staying up all night on a project. From her time in fashion, she recalls a different pressure: going out, drinking, networking, more smoking, and a "cool person, debaucherous" image. Looked at soberly, she says, neither is a good situation.

Johnson describes his conversations with founders. He starts with an analogy they accept easily: you don't want to write inefficient code or run sloppy hardware, and you yourself are software and hardware, so not prioritizing health means running sloppy systems on yourself. Founders agree in principle. But when they see competitors willing to martyr themselves, they fear falling behind. That means fewer international trips, not sleeping three to four hours a night, and fewer hours worked even if those hours aren't productive. He finds it "incredibly hard" to make people feel safe prioritizing health. He compares it to hanging from monkey bars: if you let go, there's no safety net.

Tolo proposes a structure for the episode. Assume the listener is part of this culture and may not realize it or see how it affects their health. First lay out what happens to the body under sleep deprivation and burnout. Then address the harder question, which she thinks stirs up the real angst: "Do I have to choose between myself and my company?"

The Evidence: Overwork Will Kill You

Mallin organizes the evidence into four claims: overwork will kill you; working too much destroys your relationships; all-nighters and sleep disruption cause heart disease and diabetes; and sleep disruption and overwork make you a bad leader.

On the first claim, he cites a 2022 meta-analysis concluding that burnout increases heart attack risk by 78%. He emphasizes that this is larger than the effect of most things health discussions focus on, such as specific supplements or exercise, which he says generally shift risk only modestly. He also cites research attributing about 800,000 deaths from stroke and heart disease in 2016 to working more than 55 hours a week. People who worked over 55 hours had a 35% higher risk of stroke and a 17% higher risk of death from heart attack. From this, Mallin concludes that both burnout and raw hours worked directly affect how long you live.

The Devil's Advocate Argument: "I'll Trade My Last Ten Years"

Johnson plays devil's advocate. Someone might say they don't care about living to 80, they're happy to give up their last ten years to be epic in their 20s and make a lot of money, and they'll reverse the damage in their 30s and 40s.

Mallin's rebuttal is that the cost doesn't just show up at the end of life. It lowers performance and quality of life during the years you're trying to optimize. The harder you push, the less you tend to sleep, the less time you spend with family and friends, the worse you eat, and the less you exercise. All of that reduces your ability to perform at your highest level. He says the research supports Johnson's claim that he could have been more successful with better self-care.

On relationships, Mallin describes a trial in Belgium where employees moved to a 30-hour work week and reported higher general well-being. He says the improvement came mostly from less conflict between work and family. He adds that studies repeatedly find people who work more have more trouble in family life and relationships and get less overall happiness from life.

Johnson steps out of the devil's-advocate role and reflects that his first reaction was "totally inaccurate." The real trade isn't losing some years at the end. It's a "much more sophisticated cascade" of second-, third- and fourth-order consequences that start right away in relationships, leadership and everything that follows. Mallin agrees.

Sleep, Decisions and Leadership

More statistics come up. Sleep-restricted CEOs make 29% more risky errors in lab simulations, which the hosts take to mean you become a worse leader immediately, not just decades later. Physically fit workers log two extra productive hours per week, so health decisions raise the productivity of both individuals and teams in the near term.

Mallin highlights a study of Israeli judges deciding parole cases that he finds especially striking. In the morning, when the judges were most rested, about 65% of people received parole. Right before lunch, the rate was 0%. He says similar effects have been found in leaders: sleep-deprived leaders not only decide worse but are more pessimistic and are perceived by others as less charismatic, and they lead their teams less well. He finds this intuitive. People pick up, even subconsciously, that you're less energetic, understanding and kind when you're tired.

"Night-Shifted": Personal Stories About Tired Selves

The discussion turns personal. Tolo says she now avoids hard conversations in close relationships after 5 p.m., because the chance of them going badly is much higher. If everyone's goal is to work things out together, it makes no sense to attempt difficult conversations then.

Mallin says he and his wife Britney had a term for this during his ER shifts: "night-shifted." They deliberately avoided difficult conversations after a night shift, because she noticed he was quick to cut her down, be pessimistic, or be "aggro" when he hadn't slept. They named it and changed their behavior around it.

He then tells what he calls an overshare from residency. After a 36-hour ICU shift, he was running his dog when another dog joined them and kept darting into the street, including in front of a car. The elderly driver stopped and said something he didn't really hear. He assumed it was rude and started cursing at her. She looked at him like "the worst human in the world" and drove off. Only afterward did it occur to him that she might have been trying to say something kind. He says the reaction was "so not me," and that it shows the pessimism and lack of empathy that come with sleep deprivation, which many people don't recognize in themselves.

Johnson describes a similar pattern from a previous relationship. The "6 or 7 p.m. Bryan" could manage little beyond bathing, feeding and putting the kids to bed, so he tried to set a rule against difficult conversations in the evening. His partner at the time felt she needed emotional reconciliation in the moment, which he describes as a real need of hers. She would break the rule, he would plead that it would go off the rails, and the result was "a train wreck." Tolo says she has been on the other side of that, insisting a conversation had to happen now. She reflects that consciousness makes you feel that who you are in the moment is simply you, and until you can step back from that, you don't see it. She now considers herself unreliable for emotional stability after 5 p.m. and schedules hard conversations with team members carefully. She suggests one takeaway is empathy: when you see someone lose their temper, ask whether they've slept.

Fitness and Diet

Mallin extends the argument beyond sleep. He describes a close relationship between fitness percentile and missed workdays. The top 25% in physical fitness miss about two days a year on average, and the bottom 25% miss about six. Being fit is an investment in simply being present at work.

On diet, he says this culture tends to choose food for convenience, meaning ultra-processed junk and fast food, and that cognitive performance tracks closely with diet. He cites the figure that each daily serving of ultra-processed food increases dementia risk by about 13%. He argues the effects appear both in long-term risk and in day-to-day performance and decisions.

"Do You Think We've Convinced Them?" — Health as Religion

After the evidence, Johnson asks whether they've convinced anyone. Mallin says probably not. Some things people have to live before they believe, and this may be one of them because it's so ingrained and everyone around you is doing it.

Johnson offers a religious analogy. People used to do almost anything to comply with religious obligations and earn an afterlife reward. He believes people are equally or more zealous about martyrdom culture, where the prize of status, power and wealth is so clearly defined that they are willing to kill themselves "even in a slow-mo fashion" to win it. People seem "transfixed in a zombie-like fashion." To them, statistics about heart attack risk are background noise, while they hear "this triumphant anthem" of the man in the arena. He connects this to his own experience. After 11 days of international travel, he felt his self-control drop dramatically and felt almost powerless to make his own decisions, stuck in what he calls "primitive brain land." He suspects people living this way are in a similar state of deficient wisdom where they can't make good decisions for themselves. Either they don't want to face it, or they see it and decide the trade-off is worth it.

Mallin adds nuance. He thinks future focus and delayed gratification are part of human nature, and we teach them to children for good reason. The problem is pushing them so far that they take you out of the present entirely. He doesn't mean this in a "woo" sense. He's asking whether you can be your best self now and still succeed later.

Tolo summarizes the argument. Religion has been replaced by status, wealth and money as the organizing framework, and the hosts propose putting health in that place. Their claim is that you can still earn status, money and wealth while making health your top priority, but the transition is painful and uncomfortable. She tells listeners who feel anxious hearing this that there is a way and it doesn't need to feel so scary.

Johnson points to what he sees as an easy bridge: athletes. Almost nobody argues that an Olympic or professional athlete should be sleep-deprived, eat poorly or over-travel, because their bodies are obviously their main asset. Professionals who compete with their minds, emotions and judgment somehow don't see themselves as subject to the same physical requirements, which he calls "a disconnect of cognition." Still, he believes "we are winning the war." He sees the culture shifting, and he says many of his friends, especially investors, now evaluate founders' health before investing and second-guess founders who aren't health-forward.

Three Mental Models for Making the Switch

Tolo asks for an easy on-ramp for someone with an intense schedule who can't spend five hours a day on health. The three hosts then describe very different mental models.

Kate: treat sleep like work. Tolo admits it may sound odd but says it works for people like her who absorbed the old mindset. She used to see sleep as a luxury, basically slacking off. Around midnight she becomes creative and wants to stay up. Now she tells herself that going to sleep is part of her job. It sits on her list alongside "I need to have this meeting" and "I need to have this call," and she goes to bed even when she doesn't want to because "that's my job." She describes this as tricking herself.

Mike: self-compassion by depersonalizing. Mallin says the frame doesn't work for him. He can get anxious about sleep, and that anxiety feeds insomnia, so calling sleep "work" adds another layer of obligation. His career has built up a lot of self-judgment, so what he needs is compassion. He gets there by imagining he's deciding for his child or someone he cares about. As an ER doctor, he would ask whether his patients tomorrow would want their doctor to go to bed now. Depersonalizing the choice lets him find empathy he can't otherwise find for himself.

Bryan: social permission. Johnson thinks the largest group of people already feels the pain of this culture and wants out but feels trapped by others' expectations. At a conference the week before, he met two founders from Australia who were making roughly one international trip every 30 days, to Asia, the U.S. and the Middle East. When he described the health toll of international travel from his recent Europe trip, one founder said he would tell his board that Bryan Johnson said he could only make one international trip a month. Johnson encouraged that. He said investors shouldn't want founders traveling more than once a month because it lowers performance, increases anxiety and depression, hurts relationships and disrupts biological systems. If needed, the founder could stretch it to something like two trips over 90 days, but there should be a budget. Johnson sensed the founder felt emboldened, and he concludes that most people want social permission to do what they already know they want to do.

Agency and Entrapment

From there Johnson widens the frame. He says he was thinking that morning that the peak form of existence right now is agency: freedom from entrapment. He sees the world as very good at trapping people in dopamine-driven addiction cycles through algorithms, foods, social feeds and porn. Losing sleep drains willpower, and then that entrapment tightens "to like this strangulation." People sense this and get angry when told to simply stop, because they have no willpower left and the addictions are too strong. That's why he thinks putting the burden only on the individual's willpower is "a really hard equation." It works better to tell people that those doing this to them need to stop, and to give them support from others.

Practical Guardrails and Non-Negotiables

Tolo then gets concrete, noting that the answer always comes back to sleep, diet and exercise. First, block out a morning routine and don't schedule anything before a set time. She says Johnson's calendar starts after 10 a.m. and hers does too. Second, protect the evening the same way. Treat sleep time as already taken, so any social event has to be planned around it instead of sleep getting whatever the calendar leaves. Third, take travel seriously. She began preparing for their Europe trip about two months ahead. She used to fly red-eyes between New York and Los Angeles thinking she was saving time, and now finds that "wild." She books flights that fit her sleep and morning routine as much as possible.

Mallin praises Johnson's non-negotiables and jokes about a "40-step morning routine that takes three and a half hours." Johnson corrects him: "five and a half." Mallin makes the serious point that we're very good at talking ourselves out of things. Give yourself any acceptable alternative and you'll take it every time. He thinks this is especially true of type-A, successful people, who are skilled at persuasion and therefore at persuading themselves.

Johnson acknowledges the objection many listeners will raise: they don't have the luxury of a morning routine. They take late-night calls with Asia or the Middle East, have kids who wake early, or care for parents. There's no one-size-fits-all. That's why he likes resting heart rate before bed as a target: whoever you are, you can build life systems around it. His principle is to avoid in-the-moment decisions and let "morning Bryan," high in willpower, design the systems instead of the worn-down 7 p.m. version who wants to soothe himself.

He gives an example. The day before, while he was giving a tour of the clinic, a visitor said he had optimized everything, including red light and a last meal four hours before bed, but still couldn't sleep. Johnson probed and found the problem was rumination. The man is intensely ambitious and spends every night before bed thinking about how to change the world. Johnson told him that rumination would cost him five to 25 beats per minute, that bedtime isn't the time to solve the world's problems, and walked him through what rumination is and how to minimize it. The man is supposed to report back. Johnson suggests bringing guests like this onto the show, because hearing real people who think they're doing everything right, while one or two things undercut the rest, may persuade more than statistics.

A side exchange about the ER drama series The Pit (on Max), which Mallin watches, becomes another example. Mallin says his last episode "crushed" him and he's taking an extended break. He suggests a guardrail like not watching it after 6 p.m. His general advice is to pick the three to five things that matter most to you and make them non-negotiable. That might be no junk food, in bed by 10 p.m., or getting up an hour before the kids to meditate and journal. It will differ for everyone, but it's an easy place to start.

Johnson's Summary: Don't Give Up Your Power

Johnson closes the main discussion with three points. First, don't give up your power. People want power, status and wealth, and the best way to be powerful is to claim your agency. Anything that erodes it is bad for you, including a culture that demands martyrdom and traps you in a system you didn't choose. He lists what that martyrdom costs: willpower, cardiovascular health, charisma as a leader, insulin sensitivity, and weight gain.

Second, embody these habits. When others see you living this way, they respond, and that builds social permission. If everyone went to bed on time nobody would notice. He argues that a few loud outliers who claim three hours of sleep is the path to success create a cultural illusion that this is what it takes, and the more the zeitgeist shifts, the more cover people will have.

Third, once you cross the threshold you'll experience it yourself. You'll become a better leader, entrepreneur, professional, parent, child, friend and co-worker, without sacrificing success. Then you can speak about it with confidence.

Where the Hosts Are Right Now

The episode ends with personal updates. Tolo was sick the previous week. She's still a little congested and says illness is always a reminder of how much health matters. She's about to fly to Croatia for her cousin's wedding, which is important because she rarely gets to celebrate with her Bosnian family. She says she's dreading the travel. Mallin points her to the travel episode he and Johnson recorded the week before. Mallin says he's doing great: he isn't traveling much and isn't watching The Pit, both good for his sleep, though he expects the steady routine won't last long.

Johnson describes two experiments. The previous Friday he had a 1927-nanometer non-ablative Lutronic laser treatment on his face, aimed at rebuilding collagen and elastin and reducing wrinkles. He estimates it removed about 30% of his facial skin surface and says it was "pretty spicy" even with numbing cream. He has also started red light therapy before bed. By his team's estimate, the lights deliver 4 joules per square centimeter per minute, and at eight minutes that comes to 32 J/cm² of red and near-infrared exposure. On the first night, he reports, his sleep duration rose by an hour. He calls that a huge boost but says they'll see what happens over time.

He also says he's still recovering from the Europe trip: his sleep architecture isn't back on point and his body systems aren't fully back online. He knows some people call him a "snowflake." His explanation is that when you already feel bad you don't notice the damage as much, but when you feel exceptional and then go bad, "it stings." He describes himself as being in a "recoil phase" over how devastating international travel is for health. That leaves an open problem: Blueprint has clinics opening in China, the China team wants them there in the fall, and a Middle East trip was also planned. Johnson says he doesn't yet know how to do it and is still figuring out what to do about international travel.