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Speaker 1: Hello everyone, and welcome to Talk Nerdy. Today is Monday,

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May eleventh, twenty twenty six, and I'm the host of

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the show, Doctor Kara Santa Maria, And as always, before

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we dive into this week's episode, I want to thank

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those of you who make Talk Nerdy possible. I don't

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even know if I said it last week, but that

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was our six hundredth episode last week. We're now on

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six oh one, and it's because of all of the

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really just like giving and wonderful individuals just like you,

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that we're able to keep this train on the tracks.

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I'm just so grateful every single day for all of

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the support that this show has. We use a platform

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called Patreon. You can visit us at patreon dot com

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slash talk Nerdy. There you'll learn more about the different

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tiers and the different ways that you can support on

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an episod sodic basis. This week's top patrons include Chuck Blell,

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David J. E. Smith, Daniel Lang, Mary Neva Will Defrayin,

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David Compton, Brian Holden, Gabo, Jay Ulrica Hageman, Pasqually, Je Lati,

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Rica Maharaj, and Joe Wilkinson. Thank you all so so much,

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all right, So this week I had the opportunity to

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chat with doctor Grace Ferris. She's a physician in Austin,

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Texas and an author illustrator of mom Milestones and more

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than a million. She's also a contributor to Cup of

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Joe and NPR's Health Shots, and her comics have appeared

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in a bunch of really incredible publications, including The New

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York Times and Vogue, and in art exhibitions all across

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the US, Ireland and Austria. And she has a new

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book out. It's called See One, Do One, Teach One

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The Art of Becoming a doc or a graphic memoir. So,

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without any further ado, here she is doctor Grace Ferris. Well, Grace,

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thank you so much for joining me today.

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Speaker 2: Oh, thanks for having me. It's an honor to be

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here talking to you. Kara.

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Speaker 1: Yes, it's gonna be a fun chat. Number one, because

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you are a Texas physician and I am a born

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and raised Texan who is actually working now out here

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in LA So I got to ask, are you from

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Texas or did you just end up in Texas?

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Speaker 2: Oh? I am. I work at one of the hospitals

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I work at is where I was born, and the

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other one is where I volunteered in high school.

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Speaker 1: Oh that's amazing. I love that so much. Oh good,

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So okay, So Texas is home. You're down in Austin.

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I'm actually from the suburbs of Dallas. I'm from a

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town called Plano, But of course, as a Texan that

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means I have family in Austin and Houston and San

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Antonio area, so you know, the big great state. We're

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usually quite connected. Did you ever leave the state for

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any of your residencies or fellowships or did you manage

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to match and stay in Texas the whole time you

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were in training.

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Speaker 2: I did go away, so like you, when I graduated

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high school, I was like, I need to see the world,

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and that starts by going to college far away. And

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so I was in New England for college med school residency,

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and then towards the end of that period went to

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New York City, and so I was gone for twenty years.

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I moved back in twenty twenty and I had actually started,

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like initiated the move back when my sister had a

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baby at the end of twenty nineteen, and so I

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interviewed in person here in Austin February twenty twenty.

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Speaker 1: Of course, and then we all know what happened. So

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where were you in February? So you interviewed in person,

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But then where did you go after the interview?

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Speaker 2: So? Right, I was living in New York City. I

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was working in midtown Manhattan, kind of behind the Lincoln

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Center at Mount Sina West, and I was I was

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the head of the hospitalist group there and so yeah,

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from March twenty twenty until July twenty twenty, I was, yeah,

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taking care of patients of COVID in Manhattan.

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Speaker 1: Yeah, that is a big seems like it was a

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big formative experience for a lot of folks who were

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either in those kinds of positions of leadership or I've

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known a lot of people who you know, they happened

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to be residents or fellows at that time, which meant,

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you know, all hands on deck, long hours, just being

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thrown into the deep end and learning a lot about themselves,

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learning a lot about what they're capable of, and you know,

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how to do what we have to do when resources

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are limited and there are just a lot of unknowns

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and a lot of uncertainty.

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Speaker 2: Yeah, definitely, I mean I was you know, I think

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it's very different. And to be in training during that

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period where you're you're you're it's it's not like it's

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optional for you to be there. I think that you know,

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where I was. I had been a hospitalist for like

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ten years, and so it felt like, you know, this

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is my calling and this is something that I'm here

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to do. But yeah, I think being in training is

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very different.

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Speaker 1: Yeah, so as a hospitalist, let's talk about that a

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little bit. We'll introduce the book in a second. But

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a hospital list it's a term that I learned when

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I first started working in a hospital not long ago.

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The hospital list is kind of like the I guess

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the internal medicine or I guess you could also have

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a specialty, right, but it's it's sort of like the

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PCP of the inpatient during their stay. Is that a

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good way to think about it?

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Speaker 2: Yeah? I think that, And that's definitely the birth of

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the hospital medicine movement was because PCPs were getting busier

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and busier and they couldn't go to all the hospitals

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where their patients might be, and so they realized they

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need to have like a generalist who can see these

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patients in the hospital and then hopefully smooth the transition

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when they're going leaving the hospital.

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Speaker 1: Yeah. Yeah, that makes sense. And so tell me a

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little bit about your you know, training. You told me

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about where you trained, but did you study like biochemistry

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and college did you actually go like the pre med

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route or you know, study something different and then find

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medical school and then when you were in med school

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medical school, you know, how did you specialize in? What

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did that process look like?

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Speaker 2: Yeah? Well, so I feel like I was lucky because

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in high school, at the beginning of high school, my

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mom said, you need to pick a summer activity. You

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can either volunteer at the Humane Society or the hospital.

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Because I didn't want to go to summer camp, and

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so I thought, well, I do the hospital. And I

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actually thought it was so interesting. I still feel like

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I'm like a hospital nerd. I just thought that this

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microcosm of the world inside the hospital was fascinating, and

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I liked the community and the different types of things

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that were happening. And so in high school I thought, oh,

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maybe I'll be a doctor, and so I ended up

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applying to this eight year medical program at Brown University

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where you study something other than biology as an undergrad

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and then you know that you're going to go to

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medical school. And so when I got there, I was

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thinking about being a chemistry major, and the advisor said, well,

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you know, you have plenty of time to do science,

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maybe you should think about something in the humanities. And

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so I ended up studying Spanish, which was basically the

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best thing I could have ever done to prepare for

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being a physician, because it's been this gift that I

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gave myself a long time ago, learning Spanish, and it

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comes in handy every day.

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Speaker 1: Oh yeah, especially in South Texas, but definitely the United

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States for.

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Speaker 2: Sure, everywhere I've worked as a hospitalist. You know, I've

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spent like, you know, a third of my career in Boston,

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New York and now Austin, and everywhere I've worked, I've

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had like a handful of patients every day who speak

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Spanish and only Spanish. So that's been really it's been

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really wonderful to be able to speak Spanish.

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Speaker 1: And so what about the the art the illustrating Where

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did that come about? Because of course your your new books,

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the one do One Teach One The Art of becoming

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a Doctor? Hu art play on words is a graphic memoir, right,

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So it's like it tells your story, but you illustrated

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the whole thing. So when did you start drawing?

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Speaker 2: Well, that was something I didn't I drawn all my life,

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and I drew a comic strip in college that was autobiographical,

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and I really thought that that would be the end

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of that chapter, and I didn't expect to come back

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to comics. But then and over the past ten or

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fifteen years, there has been a group of healthcare workers

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who have started this movement called graphic medicine that is

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like a kind of a movement about using comics to

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explore healthcare stories. And it's a really interesting it's very interdisciplinary.

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We have conferences every year and it'll be like patients

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chap you know, hospital chaplains, social workers, nurses, like nurses

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who draw comics, you know, people who teach about comics

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and universities patients who draw comics, caregivers who draw comics.

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And so I got involved with that group and from

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there I got back into comics.

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Speaker 1: That's so cool. I love that And what a great

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way to tell a very personal story, you know, both

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kind of the I guess the ease of the reader

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to have the illustrations and to see what you're you know,

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the scene means that you're describing. And also it really

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does make for like a page turner. It makes so

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that it's there is an ease in grasping the whole

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story that you're telling. And so let's let's talk about

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that story. How did you choose what to include what

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not to include, like what your storyboard was going to

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look like, because this is not fiction, this is autobiographical.

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Speaker 2: Yeah, I was so when I when I was starting out,

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I thought, okay, there's never been a book about medical

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school and residency told in comics for them, but there

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are books like that that are essays and kind of

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memoir and I read a ton of them when I

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was in high school and college, and I was wondering about,

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you know, what a medical life would look like and

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what the training would be like. And I found reading

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them really interesting and useful. And so when I said

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out on this project, I thought, you know, I'm going

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to make something that's like those memoirs that I used

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to read, but I wanted to be in comics form,

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so it's kind of easy to digest, It's very accessible,

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and I want to pull back the curtain on what

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training is like. I don't want to lie and like

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make it too optimistic or too positive, but I do

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want it to be encouraging and to make it feel like,

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you know, there are these beautiful moments and like moments

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of discovery that can be really like yeah, really really

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wonderful in medicine. So that was where I started. And

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then when I started the project, I started with the

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anatomy chapter where we're in this gross anatomy lab and

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we're all, you know, every all of the students are

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assigned to a cadaver, because I think that that in

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my experience, that was like a very visceruble, visceral and

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memorable part of the training experience, and that's really how

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you begin. You know, sometimes people say that the cadaver

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in med school is your first patient, and so all

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of those memories people some people have asked me, like, oh,

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how did you like remember all of this? Is Like

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the part in the anatomy lab is so vivid in

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my imagination because it's you know, there are so many

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smells associated with it that visuals are very distinct from

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the rest of training. So I started with that, and

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then I tried to highlight a lot of the parts

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of the story. I think I tried to pull out

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parts of the training that made me feel bad or

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made me feel ambivalent, to try to explore those moments,

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because I think that those are our struggles that a

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lot of people have. And so I think, you know,

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pulling out parts about feeling terrible about educational debt or

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feeling like you're not you know, fitting with the right specialty,

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I think that's a way of kind of exploring how

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how do you get through these moments?

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Speaker 1: Yeah, and kind of I like how the journey is,

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you know, in some respects obviously it is linear, right,

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there is a chronology here to this story, and there's

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an exposure to all of these different disciplines within the

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hospital because as we know, like you work as a hospitalist,

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which is like probably the most centralized and interdisciplinary, but

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as we know, our healthcare system is quite siloed, and

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so there are patients who see certain types of specialists

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and certain types of doctors, and they do this thing

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and they don't do this other thing. And sometimes when

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we are not dealing with the need for that kind

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of a referral, we don't know what it's like like,

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you know, I work in a hospital, but I still

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don't really know what it's like in sort of ob

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I've never needed to be an OB I don't have kids,

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and I work in a cancer center, and it's just

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not something I've been exposed to very much. So I

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like that you do a good job of sort of

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floating around and telling stories from all of these different places,

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and of course that means that very personal things come up,

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whether it be the racism that you observe, the sexism

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that you experience, or you know, the really beautiful and

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the good stories, the stories that kind of I don't know,

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help us remember our humanity and the fear and the

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sadness and the hope and kind of everything in between.

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I mean, it's quite an emotional journey, isn't it.

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Speaker 2: Yeah. I mean I think even just going back to

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that the cadaver at the beginning, like if that's your

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first patient, like obviously it's like it's incredibly intense to

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see a dead body, but it's also your very first

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patient is giving you this like huge gift. It's such

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a generous thing to like, don't your body, and so

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to start medicine like with that gift it's just I think, like,

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you know, the patients that you see throughout your training,

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they are all in different ways, Like you know, they're

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teaching you, they're like showing you a lot of like patients,

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and yeah, so I think I wanted to show that

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and try to make it feel more accessible for somebody

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who's like a pre med or even someone who's in

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high school and thinking about or even or even not

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just medical, but like going into a healthcare field.

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Speaker 1: Yeah. Yeah, so is that really like when you thought

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about your audience for this book, you were thinking about

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your role as somebody with first hand experience, especially a

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woman with first hand experience, and how can you share

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you know, these are some of the things that you

269
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probably need to expect. These are some of the things

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that you're probably going to be dealing with if you

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are interested in a career even that's related to this,

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But what about patients themselves? Right, because even if there

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are some people who will never end up working in

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the healthcare system, but they will encounter the healthcare that

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is that is a known you know, that's a that's

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the reality of life. We will all have a relationship

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with the healthcare system.

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Speaker 2: Yeah, well, so when I give talks on graphic medicine

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to like to the med students or pre meds. One

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of the things I like to point out is that

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in comics, you know that one of the major parts

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of comics is to have the speech bubble and the

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thought bubble, and like the speech bubble has like a

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very connected line, and then the thought bubble looks more

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like it has a curve year line. And you're introduced

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to that, like you know, usually as a kid, when

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you're reading comics as a kid, And I think when

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you think about the speech versus thoughts and how you

289
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can juxtapose them in comics, like I think almost anybody

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who's been in a healthcare setting, either on the clinical

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side or on the patient side or the caregiver side,

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you can see how very quickly comics is a great

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medium for talking about that because usually whatever is being

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said is not exactly what people are thinking about. And

295
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so I think that in that way, like using comics

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to explore that juxtaposition can be can be really interesting

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kind of like a quick way to show that.

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Speaker 1: I guess, yeah, yeah, yeah, so I'm curious, you know,

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you you talk a little bit, and I sort of

300
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mentioned this before, but you talk a little bit about

301
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some of those rotations that you did, the exposure that

302
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you had to different fields of medicine. Of course you do.

303
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You go into depth about your your psychiatry rotation, which

304
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makes me very happy because I am, of course a

305
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clinical psychologist in a hospital, and so I wish more

306
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physicians either paid attention during their psych rotation or actually

307
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did a psych rotation, because that would be helpful. And

308
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so I'm curious a about maybe what some of the

309
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more difficult rotations were for you personally, what some of

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the ones that were more meaningful for you, how you

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ultimately ended up specializing where you did.

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Speaker 2: I think well, And so one of the reasons that

313
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I ended up embarking on this because I hadn't thought

314
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that I would ever draw a graphic novel about medicine.

315
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But I had an encounter in the hospital cafeteria a

316
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few years ago where the med student that I was

317
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working with asked he was thinking about going into urology,

318
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And he asked me, oh, oh, doctor Ferris, did you

319
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ever consider going into surgery? And I had this cascade

320
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of memories, all negatives come back to me, and I thought, well,

321
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I'm not going to open this Pandora's box like right

322
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now in the cafeteria, but I would love to like

323
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revisit this. And so, yeah, for me, the surgery rotation was,

324
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you know, that is the hours that you have for

325
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surgery and some of the kind of the physical the

326
00:19:04,799 --> 00:19:08,920
physicality of it is punishing enough. But then the people

327
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that I worked with during that rotation, you know, we're

328
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not the most welcoming. But you know, one of my

329
00:19:16,039 --> 00:19:19,240
roommates from med school ended up becoming a urologist, so

330
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she probably had a very different experience than I did.

331
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And I think that comes across in the book, that

332
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like the power of the mentors and the people that

333
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you meet along the way, how powerful that can be

334
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in terms of shaping what you end up going into.

335
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At least for me, like seeing people who were great

336
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role models in different fields definitely kind of influenced where

337
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I went.

338
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Speaker 1: Yeah, it's interesting. I think we probably assume that part

339
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of the way that people select a specialty in almost

340
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any highly specialized field is because there's something intrinsic to

341
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your personality or something that is you know, fundamental to

342
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you that you're like hardwired to like this and to

343
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not like that. But ultimately, so many of these responses

344
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are learned, and they're learned through good and bad experiences,

345
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like you said, good and bad mentorship or you know, representation.

346
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There are things there are like aspects of my education

347
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that I think about now and I'm like, if only

348
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I had gone into that with more of an open mind,

349
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or if only I had had a teacher that, you know,

350
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I felt more connected to, or vice versa, maybe I

351
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would be you know, consider myself a person who has

352
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that interest area or a skill in that area. So

353
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so surgery was the not so good one. What did

354
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you really find yourself gravitating towards?

355
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Speaker 2: Well, I did you know? I had a fantastic mentor

356
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on psychiatry and I that rotation, I almost became a psychiatrist.

357
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And I for even the first like ten years of

358
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when I was doing internal medicine, I think I thought

359
00:21:02,160 --> 00:21:05,160
about going back to psychiatry because I thought it was

360
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so interesting and uh and I saw like a lot

361
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of people feel better during that rotation, which was really

362
00:21:15,640 --> 00:21:18,799
interesting and and kind of the changes in E C.

363
00:21:19,000 --> 00:21:22,359
T and how that has changed a lot since like

364
00:21:22,400 --> 00:21:25,400
the Bell Jar days, and it's much more successible now.

365
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But then then right after that, I had another great

366
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role model during internal medicine, And I think when I

367
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saw an internal medicine that you could have a little

368
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bit of everything, I thought that that would be a

369
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good fit for me. And I did really enjoy some

370
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of the diagnosis and internal medicine where there's a lot

371
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of different you're you're taking a lot of labs and

372
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the imaging results and the EKGs and kind of putting

373
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them all together to get a diagnosis.

374
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Speaker 1: Yeah, it's really interesting and I mean it's it's warms

375
00:22:01,440 --> 00:22:03,559
my heart and it's hopeful to me that as a

376
00:22:03,599 --> 00:22:08,599
physician who really took a lot from your psychiatry rotation,

377
00:22:09,440 --> 00:22:15,759
that you probably do implement a lot of I mean

378
00:22:15,839 --> 00:22:18,240
sometimes yes, it's the skills and the knowledge, but even

379
00:22:18,279 --> 00:22:21,240
more than that, it's like the positioning. It's the dispositional

380
00:22:21,279 --> 00:22:23,960
stuff that we learn. Like when you're working around people

381
00:22:24,000 --> 00:22:27,279
with severe mental illness, all the same stuff applies when

382
00:22:27,319 --> 00:22:30,000
you're working around people who are having As I always

383
00:22:30,000 --> 00:22:32,960
say in the cancer center, a normal response to an

384
00:22:33,039 --> 00:22:37,519
abnormal situation. Being in the hospital is so scary and

385
00:22:37,559 --> 00:22:40,160
not knowing what's wrong with your health or feeling like

386
00:22:40,160 --> 00:22:42,359
you're a different person because you now have a new

387
00:22:42,400 --> 00:22:46,319
limitation or you know, the future is uncertain. I feel

388
00:22:46,319 --> 00:22:52,880
like having a therapeutic mentality when you engage with your

389
00:22:52,960 --> 00:22:55,160
patients can go such a long way.

390
00:22:56,319 --> 00:23:00,400
Speaker 2: Oh definitely. I think that there are so many teaching

391
00:23:00,440 --> 00:23:04,119
points and techniques that either I observed or they talked

392
00:23:04,160 --> 00:23:07,599
about explicitly on psychiatry that I still use, like that

393
00:23:07,680 --> 00:23:12,119
I probably used earlier today because we do, you know,

394
00:23:12,160 --> 00:23:14,599
as a hospitals, I see a lot of patients who have,

395
00:23:16,079 --> 00:23:21,640
you know, different psychiatric diagnoses, and sometimes they're that's an

396
00:23:21,720 --> 00:23:23,839
issue too, like while I'm taking care of them. So

397
00:23:23,920 --> 00:23:26,480
it's yeah, I feel like I learned so much and

398
00:23:26,680 --> 00:23:30,200
I'm so grateful for that rotation because it was yeah,

399
00:23:30,279 --> 00:23:35,319
just really uh like yeah, just eye opening in a

400
00:23:35,720 --> 00:23:37,319
great way. Yeah.

401
00:23:37,400 --> 00:23:40,039
Speaker 1: I think it can do a lot to like reduce

402
00:23:40,960 --> 00:23:44,559
the stigma and the preconceived notions and sort of the

403
00:23:45,079 --> 00:23:50,880
separateness of the concepts of like behavior or mental suffering.

404
00:23:51,240 --> 00:23:56,759
I think that historically and societally, we we have uh it,

405
00:23:57,039 --> 00:24:00,240
you know, for worse not for better, a a kind

406
00:24:00,240 --> 00:24:04,039
of dualistic viewpoint which doesn't make sense, it's not evidence

407
00:24:04,079 --> 00:24:06,240
based at all. But that there is brain, and there

408
00:24:06,279 --> 00:24:08,359
is mind, and this is a mind thing, and that

409
00:24:08,440 --> 00:24:11,359
over there is an organic thing. But that's not right,

410
00:24:11,559 --> 00:24:14,400
Like everything's in the brain. And so when we make

411
00:24:14,440 --> 00:24:18,359
that kind of false distinction, it can be incredibly invalidating

412
00:24:18,440 --> 00:24:22,240
for individuals who are suffering from from mental health problems,

413
00:24:22,400 --> 00:24:25,920
especially when there's like a dual you know, comorbidity with

414
00:24:26,359 --> 00:24:29,160
something kind of severe, something that did land them in

415
00:24:29,200 --> 00:24:29,799
the hospital.

416
00:24:31,119 --> 00:24:35,119
Speaker 2: Yeah, yeah, I agree, And I think, you know, I'm

417
00:24:35,119 --> 00:24:38,640
always like I love all the like medical expressions and

418
00:24:38,720 --> 00:24:41,079
like bomos and things like that that come up, and

419
00:24:41,279 --> 00:24:45,359
I tried to scatter them throughout the book. But more

420
00:24:45,440 --> 00:24:49,119
recently a friend of mine who's a nurse told me

421
00:24:49,240 --> 00:24:52,000
she felt like, when you're in the hospital, your hormones

422
00:24:52,000 --> 00:24:54,960
are surging. And I mean I probably, like, you know,

423
00:24:55,000 --> 00:24:56,720
I knew that, but I just love the way she

424
00:24:56,920 --> 00:24:59,200
phreezed it, where it's like you're having this like fight

425
00:24:59,279 --> 00:25:03,480
or flight response sometimes, and like even that that was

426
00:25:03,519 --> 00:25:05,880
only a few years ago, but that has like reframed

427
00:25:06,279 --> 00:25:08,519
a lot for me. Also is thinking about, you know,

428
00:25:08,839 --> 00:25:12,279
right now, this person is having this like intense you know,

429
00:25:12,319 --> 00:25:16,039
their porters all maybe up or you know, and trying

430
00:25:16,119 --> 00:25:19,599
to just be as gentle as possible for sure.

431
00:25:19,519 --> 00:25:21,880
Speaker 1: Like I remember, and you know, again, I work in

432
00:25:21,960 --> 00:25:25,119
a major hospital here in Los Angeles, and I remember

433
00:25:25,160 --> 00:25:30,440
when I had a deep vein thrombosis after a after

434
00:25:30,480 --> 00:25:33,079
an iron infusion. It was a total fluke. It's a

435
00:25:33,200 --> 00:25:37,279
it's a rare but very serious possible side effect, and

436
00:25:37,319 --> 00:25:39,000
it did happen to me, and I ended up in

437
00:25:39,480 --> 00:25:42,119
the er of my own hospital, and I had to

438
00:25:42,160 --> 00:25:44,359
wait a long time because even though I was triage

439
00:25:44,440 --> 00:25:47,559
level two, apparently there were a lot of twos that night.

440
00:25:48,599 --> 00:25:51,400
And I remember, you know, every hour them taking my vitals,

441
00:25:51,440 --> 00:25:54,440
and my blood pressure was high, like it's never been

442
00:25:54,480 --> 00:25:57,640
that high in my life, like I have normal blood

443
00:25:57,640 --> 00:25:59,480
pressure usually, And I was like, oh my god, is

444
00:25:59,519 --> 00:26:01,640
that danger? You know, I have this clot. I'm so scared.

445
00:26:02,359 --> 00:26:04,839
I just love the nurses. We're like, yeah, we've seen higher,

446
00:26:05,000 --> 00:26:08,599
like you're in the yard, Like, no, I'm not worried.

447
00:26:08,839 --> 00:26:12,799
And just the the ease and the way that they

448
00:26:12,839 --> 00:26:15,759
were able to calm my fears, because you just don't know,

449
00:26:16,599 --> 00:26:21,319
even a patient with medical knowledge and with comfort in

450
00:26:21,359 --> 00:26:25,519
the system, when it's happening to you, you just don't know,

451
00:26:26,160 --> 00:26:28,759
and it can be really scary being a patient.

452
00:26:30,119 --> 00:26:35,519
Speaker 2: Yeah, I think that's that's stuff. Like we we see

453
00:26:35,559 --> 00:26:38,079
patients who have some conditions, you know, where you're like,

454
00:26:38,119 --> 00:26:40,599
this is the best case scenario, like this is gonna

455
00:26:40,599 --> 00:26:43,880
be one hundred percent better and you're gonna feel better

456
00:26:44,200 --> 00:26:47,759
and like, you know, but but even that person is

457
00:26:47,880 --> 00:26:51,559
like totally freaking out and so yeah, trying to like

458
00:26:51,599 --> 00:26:54,680
bring as much grace as possible into that situation is

459
00:26:54,720 --> 00:26:55,880
always helpful. I think.

460
00:26:56,319 --> 00:26:59,680
Speaker 1: Yeah, I remember having a supervisor once tell me, and

461
00:26:59,720 --> 00:27:02,640
this is even more so for a hospitalist, especially because

462
00:27:02,680 --> 00:27:05,039
you have probably if you look at your caseload over

463
00:27:05,079 --> 00:27:07,680
the course of a year, it's like hundreds of patients.

464
00:27:07,720 --> 00:27:12,119
But when I remember our supervisor telling me, like, we

465
00:27:12,160 --> 00:27:15,680
always have to remember that you are their only psychologist,

466
00:27:16,079 --> 00:27:19,720
Like you may have thirty forty patients, but they only

467
00:27:19,759 --> 00:27:23,640
have one you. And when you remember that, I think

468
00:27:23,680 --> 00:27:26,799
it can really help change the way that you talk

469
00:27:26,880 --> 00:27:29,960
to your patients. It can help bring you back to

470
00:27:29,960 --> 00:27:32,200
that place of like, right now there's just us and

471
00:27:32,240 --> 00:27:35,559
you are the only person experiencing this, and you were

472
00:27:35,599 --> 00:27:38,440
the you know, this is everything to you, whereas it's like, eh,

473
00:27:38,480 --> 00:27:40,559
you're gonna be fine, like, you know, so often we

474
00:27:40,599 --> 00:27:42,680
have that like, ah, this person's doing great, Like, yeah,

475
00:27:42,720 --> 00:27:44,839
I'm not worried about you at all, but they're like

476
00:27:45,000 --> 00:27:47,519
freaking out. You know. It's like, well, I'm sick enough

477
00:27:47,519 --> 00:27:51,119
to be in the hospitalso something's going on here. Oh yeah,

478
00:27:51,519 --> 00:27:55,359
it's it's such an interesting experience. So tell me, you know,

479
00:27:55,400 --> 00:27:58,039
what are some of the things that you hope as

480
00:27:58,079 --> 00:28:01,759
you were putting together this book and choosing which stories

481
00:28:01,839 --> 00:28:05,079
to tell that, what are some of the lessons that

482
00:28:05,119 --> 00:28:09,200
you are hoping that young, young physicians or people who

483
00:28:09,200 --> 00:28:13,599
are interested in going into medicine would take from it.

484
00:28:13,920 --> 00:28:15,319
And I guess what I mean by that, to be

485
00:28:15,400 --> 00:28:18,799
more specific, is I think that the way that medicine

486
00:28:19,599 --> 00:28:25,240
is taught now is a massive improvement over historical models.

487
00:28:25,440 --> 00:28:28,160
But I still think we have a long way to go.

488
00:28:28,640 --> 00:28:32,599
And I think that that kind of patient centered, humanistic care,

489
00:28:33,720 --> 00:28:38,079
although I'm seeing more and more physicians who really prioritize

490
00:28:38,200 --> 00:28:41,920
that we've all had those experiences in the hospital with

491
00:28:41,960 --> 00:28:46,079
those very academic physicians who have no bedside manner and

492
00:28:46,519 --> 00:28:48,880
who in some ways they may be doing a lot

493
00:28:48,920 --> 00:28:54,160
of good in terms of curing or healing or treating,

494
00:28:54,480 --> 00:28:58,000
but they may be doing a lot of harm in

495
00:28:58,119 --> 00:29:04,160
terms of medical trauma or that person's interest or ability

496
00:29:04,279 --> 00:29:07,400
to seek help in the future. So I'd love to

497
00:29:07,480 --> 00:29:10,279
hear a little bit as you were, you know, working

498
00:29:10,319 --> 00:29:12,920
on this book, as you were writing this story about

499
00:29:13,000 --> 00:29:16,160
some of those those lessons that you integrated.

500
00:29:17,240 --> 00:29:20,720
Speaker 2: I mean, I think the main one is like, yeah,

501
00:29:20,759 --> 00:29:23,480
this was like there were times when this was like

502
00:29:23,519 --> 00:29:28,880
a grind and it was you know, difficult, and I

503
00:29:28,920 --> 00:29:31,559
didn't know if it was the right choice. One of

504
00:29:31,599 --> 00:29:35,000
the themes I kind of like explored was like is

505
00:29:35,039 --> 00:29:37,680
this the worst decision or the best decision? And like

506
00:29:38,119 --> 00:29:42,279
how am I going to figure that out? But I think, like, ultimately,

507
00:29:42,599 --> 00:29:45,400
and I still feel this way that it's you know,

508
00:29:45,440 --> 00:29:50,319
it's been the such like a moving career. If it's

509
00:29:50,319 --> 00:29:54,480
something you are interested in, it's definitely, like I think,

510
00:29:56,319 --> 00:30:01,960
and like a gratifying and just a really interesting career.

511
00:30:02,200 --> 00:30:06,480
And something I think about a lot now is that

512
00:30:07,440 --> 00:30:10,079
all the people I meet who are in med school

513
00:30:10,160 --> 00:30:13,759
or residency are people who felt called to inter medicine,

514
00:30:13,880 --> 00:30:18,400
like after the pandemic and like so they saw like

515
00:30:18,519 --> 00:30:22,240
the worst case scenario, you know, and still felt like

516
00:30:22,279 --> 00:30:24,200
this might be the career for them, and I find

517
00:30:24,200 --> 00:30:28,039
that very inspiring. So I did want it to feel

518
00:30:28,119 --> 00:30:33,880
kind of inspirational. But also I thought, you know, looking

519
00:30:33,920 --> 00:30:36,359
back on some of the memoirs that I enjoyed, I

520
00:30:36,359 --> 00:30:39,599
felt like there needed to be more about debt, because

521
00:30:39,640 --> 00:30:42,799
that is something that my things over many people's heads,

522
00:30:42,839 --> 00:30:46,279
and I think it's not talked about as much and

523
00:30:47,200 --> 00:30:50,519
is like kind of sometimes a secret shame. And so

524
00:30:50,559 --> 00:30:54,039
I wanted that to be present because I can't kind

525
00:30:54,039 --> 00:30:58,599
of like paper over that. And then in terms of

526
00:30:58,640 --> 00:31:04,440
the like less from my teachers, some of the some

527
00:31:04,519 --> 00:31:06,640
of the phrases that are sprinkled in, like I think

528
00:31:06,680 --> 00:31:11,240
the wish, worry, wonder technique, that's a pallty of care

529
00:31:11,359 --> 00:31:15,000
technique that's used to think about a hard decision or

530
00:31:15,039 --> 00:31:17,119
to think about something that's hard, where you say, like,

531
00:31:17,519 --> 00:31:21,519
you know, I wish that you know, the the cancer

532
00:31:21,559 --> 00:31:25,519
wasn't get getting worse, but I like wonder, but I

533
00:31:25,559 --> 00:31:28,119
worry that it, you know, might be getting worse, and

534
00:31:28,160 --> 00:31:31,200
I wonder what you would want next or and that

535
00:31:31,440 --> 00:31:33,720
I think that framework helps for like a lot of

536
00:31:33,839 --> 00:31:38,680
difficult conversations even in just life. And so I think

537
00:31:38,680 --> 00:31:43,920
that that's been really helpful to me. And then some

538
00:31:44,000 --> 00:31:48,240
of the techniques, like the response of listening from psychiatry,

539
00:31:48,279 --> 00:31:51,079
I think that that also is helpful kind of outside

540
00:31:51,079 --> 00:31:53,000
of medicine as well.

541
00:31:53,599 --> 00:31:59,160
Speaker 1: Yeah, definitely. So going back before we talk a little

542
00:31:59,200 --> 00:32:05,519
bit more about that sort of that wish worry wonder framework,

543
00:32:05,559 --> 00:32:08,759
you talked quite a bit about medical debt and the

544
00:32:08,799 --> 00:32:10,839
fact that it is a bit taboo that it is

545
00:32:10,920 --> 00:32:14,039
sort of not talked about as much. What were you

546
00:32:14,240 --> 00:32:18,279
hoping to accomplish and how did you choose to approach that.

547
00:32:18,359 --> 00:32:20,839
Was it really about like reducing the stigma or was

548
00:32:20,880 --> 00:32:23,599
it sort of like preparing people like this is going

549
00:32:23,640 --> 00:32:26,400
to be the reality of your life and like you

550
00:32:26,400 --> 00:32:29,039
you need to work on your sort of financial literacy

551
00:32:29,160 --> 00:32:31,119
because you're going to be dealing with this for a while.

552
00:32:31,839 --> 00:32:38,400
Speaker 2: Oh. I think I think probably more just like normalizing yea,

553
00:32:38,640 --> 00:32:40,519
this is this is something that's going to be there

554
00:32:40,759 --> 00:32:44,680
and it kind of fades over time, but was something

555
00:32:44,680 --> 00:32:47,680
that was very intense, especially early on in my training.

556
00:32:49,039 --> 00:32:51,240
But I think, yeah, I think the more it's like

557
00:32:51,440 --> 00:32:56,480
under discussion and the more it's like put into like storytelling,

558
00:32:57,440 --> 00:32:59,440
I feel like that it will lead to more progress

559
00:32:59,440 --> 00:33:02,119
in terms of how you know what options there are

560
00:33:02,160 --> 00:33:02,640
for people.

561
00:33:03,359 --> 00:33:08,960
Speaker 1: Yeah, yeah, and it's it's true. I mean, it's sad

562
00:33:09,039 --> 00:33:11,279
that this is the reality for so many I have

563
00:33:11,319 --> 00:33:13,759
so many friends who are physicians who are dealing with,

564
00:33:13,880 --> 00:33:17,079
you know, quite a lot of early debt. Although you're right,

565
00:33:17,200 --> 00:33:23,000
like eventually it becomes less crushing, and it's not just physicians, right,

566
00:33:23,039 --> 00:33:27,519
I think increasingly this is the reality for uh, for

567
00:33:28,039 --> 00:33:32,039
young people overall. Is if you if you go through

568
00:33:32,079 --> 00:33:35,400
the steps to get an education, and especially if you

569
00:33:35,440 --> 00:33:38,119
continue with a postgraduate degree and you have a highly

570
00:33:38,119 --> 00:33:42,039
specialized education, especially in an applied field, right because of

571
00:33:42,119 --> 00:33:44,960
course some research degrees are fully funded, a lot of

572
00:33:44,960 --> 00:33:47,839
them are, but applied fields like medicine, like psychology, like

573
00:33:47,880 --> 00:33:51,160
we have to pay for this out of pocket, at

574
00:33:51,240 --> 00:33:53,799
least here in the United States. That's our model. So

575
00:33:55,359 --> 00:33:57,880
not easy to do. Not easy to do when you're

576
00:33:57,920 --> 00:34:00,480
not when you're young, not easy to do when like me,

577
00:34:00,599 --> 00:34:04,279
I went back in my mid thirties to get my PhD.

578
00:34:05,359 --> 00:34:09,840
And not easy to do as an adult either. I'm

579
00:34:09,840 --> 00:34:14,440
curious about your experiences. So when you were let's say,

580
00:34:14,559 --> 00:34:19,079
when you were an intern, for example, was that fresh

581
00:34:19,119 --> 00:34:22,360
out were you like what twenty two years old when

582
00:34:22,360 --> 00:34:22,920
you started.

583
00:34:24,280 --> 00:34:27,480
Speaker 2: Oh yeah, I was twenty six, So that's generally as

584
00:34:27,480 --> 00:34:28,280
young as you can be.

585
00:34:28,840 --> 00:34:31,360
Speaker 1: Oh right, twenty two would be straight out of undergraduat Yeah,

586
00:34:31,400 --> 00:34:37,760
so after medical school, very very yeah. Yeah, and so

587
00:34:37,880 --> 00:34:40,960
and in your experience, were most of your colleagues in

588
00:34:41,039 --> 00:34:46,000
the same age cohort or did you see a mix? Okay, okay, yeah.

589
00:34:46,039 --> 00:34:48,199
And so of course going into a hospital where you

590
00:34:48,239 --> 00:34:52,159
have young physicians who are attending, but also like people

591
00:34:52,199 --> 00:34:56,519
in their sixties who are your attending physicians, maybe even older,

592
00:34:56,880 --> 00:35:02,000
and working with that kind of spread of wisdom and knowledge,

593
00:35:02,119 --> 00:35:04,639
and some people who are much better at keeping very

594
00:35:04,719 --> 00:35:06,960
up to date with the latest, most cutting edge research,

595
00:35:07,000 --> 00:35:09,840
and some people who have just so much institutional knowledge

596
00:35:10,159 --> 00:35:12,760
and so much of the sort of art of medicine.

597
00:35:12,800 --> 00:35:14,840
That must have been quite interesting to observe.

598
00:35:15,840 --> 00:35:17,800
Speaker 2: Oh yeah, I think I had. I had a lot

599
00:35:17,800 --> 00:35:22,119
of clinician too, you know, some have passed away now,

600
00:35:22,159 --> 00:35:26,360
but who had Yeah, who had been involved in, you know,

601
00:35:26,920 --> 00:35:33,599
discovering different antibiotics or different treatments for you know, cardiac disease,

602
00:35:34,480 --> 00:35:40,159
and so that that was really inspiring. And many of

603
00:35:40,199 --> 00:35:43,400
them had like trained pre you know, computers, that kind

604
00:35:43,440 --> 00:35:45,719
of thing, and so had a very different approach and

605
00:35:46,880 --> 00:35:51,800
had great physical examination skills. Yeah.

606
00:35:51,880 --> 00:35:55,199
Speaker 1: Yeah, Oh, there's just there's so much to learn, Like

607
00:35:55,320 --> 00:35:59,159
how how did you cope with the potential overwhelmed the

608
00:35:59,199 --> 00:36:02,639
potential anciet of course, the questioning, you know, the self

609
00:36:02,639 --> 00:36:07,920
efficacy as you were going through your training and you know,

610
00:36:08,199 --> 00:36:12,079
being challenged sometimes, Like I think there is an experience

611
00:36:12,079 --> 00:36:15,519
that I've had people described to me where let's say

612
00:36:15,519 --> 00:36:18,000
they were the valedictorian of their high school, or they

613
00:36:18,000 --> 00:36:20,480
were in the top ten percentage of their class, and

614
00:36:20,559 --> 00:36:24,559
then when they made that transition from you know, academic

615
00:36:24,639 --> 00:36:28,880
training to practical training, when real life kind of hit

616
00:36:28,920 --> 00:36:32,039
them in the face, they were like, Okay, I don't

617
00:36:32,119 --> 00:36:34,159
know nearly as much as I thought I knew, and

618
00:36:35,320 --> 00:36:39,559
I need to really take a deep breath and find

619
00:36:39,800 --> 00:36:44,000
my find that balance I guess between humility but also

620
00:36:44,159 --> 00:36:46,679
self efficacy and the strength to keep going when you

621
00:36:46,719 --> 00:36:48,320
really do start to question yourself.

622
00:36:49,679 --> 00:36:52,119
Speaker 2: Yeah. I think, I mean, I definitely think that there's

623
00:36:52,199 --> 00:36:55,239
some you know, the learning curve is so steep, especially

624
00:36:55,280 --> 00:36:58,440
during your intern year, but I remember also feeling like

625
00:36:58,519 --> 00:37:00,760
there was a lot of like kind of life learning

626
00:37:00,840 --> 00:37:03,960
curve happening at that time also where I needed to

627
00:37:04,039 --> 00:37:07,480
learn how to talk to someone who's like, you know,

628
00:37:08,840 --> 00:37:11,760
sun had just been diagnosed with cancer or you know,

629
00:37:11,920 --> 00:37:15,880
different types of scenarios that I really had no experience

630
00:37:15,880 --> 00:37:19,239
with because I was twenty six. And so I think

631
00:37:19,239 --> 00:37:21,800
that that part is interesting to think about, Like you're

632
00:37:21,800 --> 00:37:24,079
trying to learn like all the names of the antibiotics,

633
00:37:24,119 --> 00:37:26,440
but you're also trying to learn like how do I

634
00:37:26,559 --> 00:37:30,800
like communicate in like a supportive way and in a

635
00:37:32,360 --> 00:37:35,400
sensitive approach. Yeah.

636
00:37:35,559 --> 00:37:40,960
Speaker 1: Yeah, Oh, it's so interesting, Like just the breadth and

637
00:37:41,199 --> 00:37:44,159
the depth that is necessary. And do you find as

638
00:37:44,719 --> 00:37:47,639
a hospitalist, you know, as somebody who's who focuses on

639
00:37:47,679 --> 00:37:51,760
internal medicine, that there is just so much more breadth

640
00:37:51,840 --> 00:37:54,599
right like you will you have these specialists who know

641
00:37:54,679 --> 00:38:00,800
a whole lot about very specific pathologies, are very specific treatments,

642
00:38:01,039 --> 00:38:03,360
and you have to know, you know, as much as

643
00:38:03,400 --> 00:38:05,639
you can know about a lot of different stuff.

644
00:38:06,760 --> 00:38:08,960
Speaker 2: Yeah, and that's the part I think you really need

645
00:38:09,000 --> 00:38:12,440
to like hopefully have a good sense of the kind

646
00:38:12,440 --> 00:38:16,000
of what when you when you don't know where you

647
00:38:16,039 --> 00:38:17,840
don't know, you know, like trying to get to the

648
00:38:17,960 --> 00:38:23,159
edge of your understanding, and I I mean I have

649
00:38:23,320 --> 00:38:26,719
a great relationship with like our consultants, so you know,

650
00:38:27,280 --> 00:38:29,440
I feel like sometimes when things seem like out of

651
00:38:29,480 --> 00:38:32,519
my scope, having the consultants there has been really useful.

652
00:38:34,199 --> 00:38:39,639
But I definitely I mean, now, you know, now it's

653
00:38:39,679 --> 00:38:43,559
like becoming more and more common to kind of console AI,

654
00:38:44,119 --> 00:38:48,480
which is like a whole new realm. Whereas for the past,

655
00:38:48,519 --> 00:38:52,320
you know, for most of my practice, it you've you'll

656
00:38:52,360 --> 00:38:54,440
look in like you know, you'd look in pub med

657
00:38:54,679 --> 00:38:58,000
or you would look in up to date to see what,

658
00:38:58,079 --> 00:39:00,639
you know, what the expert guidelines are. But now more

659
00:39:00,679 --> 00:39:03,159
and more it will be open evidence, which is like

660
00:39:03,199 --> 00:39:05,400
an AI platform.

661
00:39:06,119 --> 00:39:08,519
Speaker 1: Yeah. I actually just like had some trainings yesterday on

662
00:39:08,960 --> 00:39:11,239
the AI that we have in our hospital and kind

663
00:39:11,280 --> 00:39:15,039
of the conversations around it. It being such a useful tool,

664
00:39:15,079 --> 00:39:19,800
but it not being a you know, clinical decision making tool.

665
00:39:19,960 --> 00:39:20,159
Speaker 2: Yeah.

666
00:39:20,159 --> 00:39:24,119
Speaker 1: And I think that's the important point here is that like, yes,

667
00:39:24,840 --> 00:39:28,000
we are seeing more and more increases in sort of

668
00:39:28,079 --> 00:39:34,760
technological advancements, but like, ultimately healthcare is delivered by people.

669
00:39:35,159 --> 00:39:37,559
You know, we can be informed by technology, and we

670
00:39:37,599 --> 00:39:41,400
can use robots and all sorts of cool technology to

671
00:39:41,559 --> 00:39:44,960
aid in UH in sort of sort of treatment approaches.

672
00:39:45,000 --> 00:39:49,199
But people not only do they want to be treated

673
00:39:49,199 --> 00:39:52,599
by people, they have to be treated by people. It's

674
00:39:52,599 --> 00:39:55,320
about human connection at the end of the day, isn't it.

675
00:39:55,760 --> 00:39:58,440
Speaker 2: Yeah, I think, I mean yeah, And I think that

676
00:39:58,440 --> 00:40:01,400
that's going to become more and more important as like

677
00:40:01,480 --> 00:40:04,960
AI becomes like more integrated into the different systems that

678
00:40:05,000 --> 00:40:09,719
we're using, like for writing your notes and you know,

679
00:40:09,800 --> 00:40:13,920
answering like answering chatbots, answering questions in the portal.

680
00:40:14,679 --> 00:40:18,559
Speaker 1: Yeah. Yeah, oh, and that's that's always you know, it's

681
00:40:19,079 --> 00:40:22,599
it's wonderful that there are so many resources available to

682
00:40:22,679 --> 00:40:27,679
so many patients now, and I I always get sad

683
00:40:27,679 --> 00:40:30,880
when I realized that a patient either wasn't aware of

684
00:40:30,920 --> 00:40:33,480
those resources or wasn't like, you know, able to really

685
00:40:33,639 --> 00:40:36,599
utilize them the way that they they could and did

686
00:40:36,639 --> 00:40:39,719
feel disconnected because there's so much kind of I don't know,

687
00:40:39,960 --> 00:40:45,280
there's so much technological UH work on how to help

688
00:40:45,320 --> 00:40:47,679
people be more connected to and to get the care

689
00:40:47,719 --> 00:40:50,119
that they need. You know, you're in a like a

690
00:40:50,199 --> 00:40:54,719
major metropolitan area in Texas. How do you think that

691
00:40:54,719 --> 00:40:58,280
that differs the hospital experience from I mean Texas is

692
00:40:58,280 --> 00:41:02,119
a great state as a I guess a metaphor for

693
00:41:02,159 --> 00:41:05,079
this from sort of rural health care, because there's still

694
00:41:05,159 --> 00:41:10,280
so many individuals who are served either by rural hospitals

695
00:41:10,400 --> 00:41:12,320
or more and more we're seeing that they're closing down

696
00:41:12,320 --> 00:41:15,199
and they just don't have access to like, for example,

697
00:41:15,280 --> 00:41:18,119
level one trauma center within hundreds of miles.

698
00:41:19,239 --> 00:41:21,559
Speaker 2: Yeah, I take care of a lot of patients who

699
00:41:22,119 --> 00:41:25,320
previously would have been taken care of at a hospital

700
00:41:25,360 --> 00:41:28,000
that was between Austin and Houston, but that it was

701
00:41:28,039 --> 00:41:31,760
a rural hospital that closed, and so now it's you know,

702
00:41:31,840 --> 00:41:34,519
they they end up in Austin and they live almost

703
00:41:34,519 --> 00:41:40,159
two hours away, and it's really tricky. I at our

704
00:41:40,199 --> 00:41:44,119
hospital as conferences, I met a rural hospitalist who works

705
00:41:44,159 --> 00:41:48,199
I think like in northern Minnesota, and yeah, his job

706
00:41:48,440 --> 00:41:50,960
is very different than mine. He does a lot more

707
00:41:51,480 --> 00:41:53,679
like I think. He said he sometimes will have to

708
00:41:53,760 --> 00:41:58,960
do like minor surgeries, which is very different than what

709
00:41:59,039 --> 00:42:03,159
I do. But here it's like a rural access hospital.

710
00:42:04,119 --> 00:42:07,800
So that was really interesting and yeah, I think, and

711
00:42:07,840 --> 00:42:10,280
then there's also I think in a lot of rural

712
00:42:10,320 --> 00:42:13,559
praises now they're doing a lot more like Teley hospitalists

713
00:42:13,639 --> 00:42:17,440
and Telly Ice you and that's incredibly controversial.

714
00:42:18,039 --> 00:42:21,480
Speaker 1: Hmm oh interesting, Telly ic you. Yeah. I was like,

715
00:42:21,679 --> 00:42:23,880
it's one thing if we're always call it dialo doc like,

716
00:42:23,920 --> 00:42:25,480
it's one thing if you're talking about, hey, I have

717
00:42:25,519 --> 00:42:27,519
a UTI, like I do not want to drive two

718
00:42:27,599 --> 00:42:31,519
hours to get a prescription. I'm going to do, you know,

719
00:42:31,599 --> 00:42:34,360
a zoom meeting with a healthcare provider and describe my

720
00:42:34,440 --> 00:42:36,960
symptoms and do all of that. It's a It's another

721
00:42:37,000 --> 00:42:41,880
thing to be like intubated without people in person. I mean,

722
00:42:41,880 --> 00:42:43,719
I'm sure there are some people in person, but without

723
00:42:43,960 --> 00:42:47,440
expert care managing that, you know, managing the remotely, that

724
00:42:47,480 --> 00:42:49,719
can be pretty scary. Yeah, and a lot.

725
00:42:49,679 --> 00:42:51,440
Speaker 2: Of pressure on the bedside staff.

726
00:42:51,679 --> 00:42:55,760
Speaker 1: Yeah yeah, yeah, who maybe doesn't have uh that expertise

727
00:42:55,840 --> 00:43:00,480
or that training. Yeah, that's that's right. I mean I

728
00:43:00,480 --> 00:43:04,719
can imagine that, you know, as the landscape changes, there

729
00:43:04,800 --> 00:43:07,880
are going to be some some pain points along the way,

730
00:43:08,000 --> 00:43:10,960
and hopefully we don't learn a lot of these lessons

731
00:43:11,639 --> 00:43:15,039
the hardest way possible, because of course, in healthcare the

732
00:43:15,039 --> 00:43:18,000
stakes are high, aren't they. Yeah.

733
00:43:18,079 --> 00:43:23,159
Speaker 2: Yeah, And I think I think that in in that

734
00:43:23,280 --> 00:43:25,519
was like a big part of intern year is like

735
00:43:25,920 --> 00:43:30,440
either making a mistake or thinking that maybe you had

736
00:43:30,480 --> 00:43:34,679
made a mistake and not really knowing, uh, and trying

737
00:43:34,719 --> 00:43:38,000
to like figure out how to like how to live

738
00:43:38,039 --> 00:43:41,320
with that and how to learn from it. I think

739
00:43:41,360 --> 00:43:45,440
that that facing that was like a big challenge.

740
00:43:45,679 --> 00:43:50,960
Speaker 1: Yeah, yeah, I can imagine. So you know, this is

741
00:43:51,000 --> 00:43:55,199
not your Is this your first full length publication? It's not,

742
00:43:55,440 --> 00:43:55,719
is it?

743
00:43:56,360 --> 00:43:59,440
Speaker 2: No? This is my third book. The first one was

744
00:43:59,480 --> 00:44:03,000
a collection of Motherhood comics, and then the second one's

745
00:44:03,039 --> 00:44:08,039
a picture book because when with the Motherhood Comics collection,

746
00:44:08,199 --> 00:44:13,199
I got a lot of messages and emails from people

747
00:44:13,280 --> 00:44:16,239
saying that their kids were reading the Motherhood comics, and

748
00:44:16,239 --> 00:44:18,239
I thought, oh, I'll make a picture book. But now

749
00:44:18,800 --> 00:44:22,039
I am getting a lot of pictures of children reading

750
00:44:22,280 --> 00:44:26,320
the medical one, which I guess is okay. I mean,

751
00:44:26,599 --> 00:44:29,079
you know, see one do intention has some heavy topics

752
00:44:29,119 --> 00:44:33,400
in it, but I guess it's okay if they're you know,

753
00:44:34,440 --> 00:44:36,760
I think that the sense and like the you know,

754
00:44:37,320 --> 00:44:40,199
the reading and library world, is that if someone's interested

755
00:44:40,199 --> 00:44:42,000
in something, then maybe they should read it.

756
00:44:42,119 --> 00:44:46,199
Speaker 1: So yeah, that they'll seek it out anyway, And and

757
00:44:46,360 --> 00:44:49,079
you know, there's something interesting too about a picture Book

758
00:44:49,119 --> 00:44:53,280
because uh or Disney movies. I think they operate the

759
00:44:53,280 --> 00:44:57,320
same way, Like there are levels of depth of understanding,

760
00:44:57,599 --> 00:45:01,239
and so even though there's heavy topics, one of the

761
00:45:01,360 --> 00:45:07,559
drawings in the book are are you know, potentially traumatizing drawings.

762
00:45:07,960 --> 00:45:10,920
And so maybe you see something and you have questions

763
00:45:10,960 --> 00:45:13,039
for your parents or you you want to learn a

764
00:45:13,039 --> 00:45:15,760
little bit more about it. I mean, I won't go

765
00:45:15,880 --> 00:45:18,119
off on this tangent because we don't have time. But

766
00:45:19,280 --> 00:45:21,679
one of the things that I remember learning, you know,

767
00:45:22,840 --> 00:45:28,320
when reading IRV Yallam and some of his writing about

768
00:45:28,360 --> 00:45:33,719
existential psychotherapy and especially about concepts of death, is that

769
00:45:34,159 --> 00:45:38,119
we don't give kids enough to credit for their how

770
00:45:38,159 --> 00:45:41,840
sophisticated their understandings of death actually are just from your

771
00:45:41,880 --> 00:45:45,760
exposure to the world, And so often we do them

772
00:45:45,800 --> 00:45:49,800
a disservice by shielding them in a way to try

773
00:45:49,800 --> 00:45:52,639
and like, yeah, of course, maintain their innocence. There's certain

774
00:45:52,639 --> 00:45:55,159
things kids aren't ready to understand. But when we just

775
00:45:55,199 --> 00:45:57,800
straight up ask them, what do you think, well, what

776
00:45:57,800 --> 00:45:59,880
do you think happens? What do you think that word means?

777
00:46:00,400 --> 00:46:03,039
I think a lot of people are really surprised by

778
00:46:03,719 --> 00:46:07,719
by how much the narrative that they have developed based

779
00:46:07,800 --> 00:46:11,519
on their sort of cognitive level, is is a really

780
00:46:11,559 --> 00:46:15,719
meaningful and realistic one for where they are. So I

781
00:46:15,760 --> 00:46:18,360
could imagine a kid reading your book would take from

782
00:46:18,360 --> 00:46:20,440
it what they can and maybe there's certain things that

783
00:46:20,440 --> 00:46:25,320
are more sophisticated or above their head, but but that's okay.

784
00:46:26,000 --> 00:46:30,000
Speaker 2: Yeah. Yeah, I've gotten a bunch, you know, from friends

785
00:46:30,400 --> 00:46:32,679
whose kids have read the book. They've sent me sweet

786
00:46:32,760 --> 00:46:36,119
quotes that were the kids, you know, the ones who

787
00:46:36,119 --> 00:46:38,440
are children of doctors, have said, oh, I didn't realize

788
00:46:38,480 --> 00:46:41,880
that you you know, you did this in the anatomy lab,

789
00:46:42,000 --> 00:46:46,159
and you know I have Another friend's daughter has read

790
00:46:46,199 --> 00:46:48,960
it twice and I said, I saw her and I said, oh,

791
00:46:49,000 --> 00:46:51,159
I didn't realize you were interested in medicine. And she's

792
00:46:51,239 --> 00:46:54,320
ten and she said, I'm not. I'm going to be

793
00:46:54,400 --> 00:46:59,599
a physicist. Okay, But yeah, so that's that's been on

794
00:46:59,679 --> 00:47:01,519
expect Oh.

795
00:47:01,559 --> 00:47:03,960
Speaker 1: I love that. And of course we all know the

796
00:47:04,159 --> 00:47:09,280
power of representation, right that, like little girls, for example,

797
00:47:09,440 --> 00:47:13,119
are never going to see themselves as doctors when they

798
00:47:13,159 --> 00:47:17,199
grow up. If they don't see women doctors, they just

799
00:47:17,719 --> 00:47:21,599
like you have to see the representation to kind of

800
00:47:21,719 --> 00:47:24,760
approximate it and to know that it's it's feasible for

801
00:47:24,840 --> 00:47:28,400
you as well. And so what a wonderful way to

802
00:47:28,519 --> 00:47:32,800
show that representation in the intentionality of your doctors where

803
00:47:32,840 --> 00:47:35,840
you have, or just of all the healthcare professionals where

804
00:47:35,840 --> 00:47:39,239
you have, you know, people of different ethnicities, people of

805
00:47:39,280 --> 00:47:42,840
different genders, people of different body shapes and sizes. Like

806
00:47:42,920 --> 00:47:45,079
it's just it's a very important thing to do.

807
00:47:46,480 --> 00:47:49,840
Speaker 2: Yeah, And I you know, when I was embarking on this,

808
00:47:50,039 --> 00:47:52,840
like as a pre med I had a lot of

809
00:47:52,920 --> 00:47:55,000
I always thought like, oh, I'll probably end up like

810
00:47:55,079 --> 00:47:58,840
having kids, and I was very curious like what the

811
00:47:59,480 --> 00:48:03,119
doctor life looked like in particular because I just had

812
00:48:03,159 --> 00:48:07,400
not known any doctor mothers, and I really wanted like

813
00:48:07,440 --> 00:48:09,719
a visual of like how how does that feel and

814
00:48:09,719 --> 00:48:11,760
how does it look? And so definitely wanted to have

815
00:48:11,880 --> 00:48:14,519
a little bit of that kind of at the end,

816
00:48:16,719 --> 00:48:19,239
you know, for people who are thinking that they, you know,

817
00:48:19,800 --> 00:48:21,159
want to have that kind of life.

818
00:48:21,840 --> 00:48:24,920
Speaker 1: The doctor mom. I love that, Yeah, the representation of

819
00:48:25,360 --> 00:48:27,440
not just a doctor mom at the end, but also

820
00:48:27,519 --> 00:48:30,880
the pregnant doctor, which I think is an important representation,

821
00:48:31,320 --> 00:48:33,960
like my my primary care just to I think she

822
00:48:34,000 --> 00:48:36,840
actually just finally returned for maternity leave, but definitely before

823
00:48:36,840 --> 00:48:39,239
she left for maternal leave, she was real pregnant the

824
00:48:39,320 --> 00:48:41,519
last time I saw her, and I was like, Oh,

825
00:48:41,519 --> 00:48:43,400
this is just so lovely to see and for it

826
00:48:43,440 --> 00:48:48,079
to be normalized, it's necessary, you know, like moms are

827
00:48:48,119 --> 00:48:51,119
people too. Moms are doctors to and doctors are moms to.

828
00:48:52,000 --> 00:48:55,559
Speaker 2: I am. I felt like my first pregnancy that was

829
00:48:55,599 --> 00:48:58,960
like one of my more beautiful times of being a

830
00:48:59,000 --> 00:49:02,639
doctor because I had patients like it was kind of

831
00:49:02,719 --> 00:49:05,239
like I had you know, it wasn't a medical problem,

832
00:49:05,239 --> 00:49:07,519
but it was like I had something for them to

833
00:49:07,599 --> 00:49:11,119
discuss with me, and you know, they would I would

834
00:49:11,159 --> 00:49:12,840
be trying to talk to them about, you know, their

835
00:49:12,840 --> 00:49:16,199
antibiotic regimen or something, and they would be like, well,

836
00:49:16,559 --> 00:49:17,639
you need to sit down.

837
00:49:18,000 --> 00:49:18,960
Speaker 1: How are you feeling.

838
00:49:20,280 --> 00:49:21,400
Speaker 2: Do you think it's a pool?

839
00:49:22,000 --> 00:49:22,480
Speaker 1: Yeah?

840
00:49:22,679 --> 00:49:25,960
Speaker 2: And I thought that was wonderful because it was like

841
00:49:26,000 --> 00:49:30,599
this brief period where the you know, the like there's

842
00:49:30,639 --> 00:49:33,000
such an imbalance in the relationship and it was this

843
00:49:33,159 --> 00:49:36,199
brief moment where it was like tilted a little bit

844
00:49:36,280 --> 00:49:40,760
and such a like a pleasant way, and I you know,

845
00:49:40,840 --> 00:49:42,920
some people would ask if they could touch my belly

846
00:49:42,960 --> 00:49:45,320
and it was like sure, like, you know, I don't

847
00:49:45,360 --> 00:49:48,719
have any issues with that, so I didn't have any

848
00:49:48,800 --> 00:49:52,079
kind of like disturbing experiences. It was like a very

849
00:49:52,119 --> 00:49:54,400
positive pregnancy.

850
00:49:54,840 --> 00:49:56,719
Speaker 1: That's good to hear, and you're right, like it's not

851
00:49:57,039 --> 00:49:59,960
a quote unquote medical condition. Although manage care. Maybe it's

852
00:50:00,079 --> 00:50:03,559
not even so much managed care. It's more like our labor,

853
00:50:03,599 --> 00:50:05,800
like our department of labor that treats it like one.

854
00:50:05,880 --> 00:50:07,559
Like a lot of people have taken medical leave for

855
00:50:07,639 --> 00:50:11,280
pregnant Like what that is insanity? Yeah, disability, Like are

856
00:50:11,320 --> 00:50:14,880
you kidding me? But along that same line, you know,

857
00:50:14,920 --> 00:50:19,639
there is a kind of empathic power there that I

858
00:50:19,679 --> 00:50:23,800
think patients also experience when they have a provider who

859
00:50:23,920 --> 00:50:26,119
has like an obvious I don't know, like a dex

860
00:50:26,159 --> 00:50:28,440
calm on their arm, or like a provider who's in

861
00:50:28,599 --> 00:50:33,079
a wheelchair, or a provider who clearly has you know,

862
00:50:33,239 --> 00:50:39,639
both the provider and the patient relationship with the healthcare system, definitely,

863
00:50:39,920 --> 00:50:42,519
there's a lot of empathy there when you know, when

864
00:50:42,559 --> 00:50:44,800
you've been to the er, when you have to see

865
00:50:44,840 --> 00:50:50,760
a specialist, when you yourself have experienced the system, you're

866
00:50:50,760 --> 00:50:55,159
going to be more conscientious of the fear and the

867
00:50:55,239 --> 00:51:01,079
frustrations that the patient has navigating that same system.

868
00:51:01,360 --> 00:51:03,719
Speaker 2: Yeah, I definitely, I mean yeah, because I was like

869
00:51:03,840 --> 00:51:05,880
twenty six and then like by the time I was,

870
00:51:06,239 --> 00:51:08,840
you know, graduating, I was still very young. I think

871
00:51:09,440 --> 00:51:11,960
having that experience, even though it was not like a

872
00:51:12,079 --> 00:51:16,639
bad diagnosis or it's still yeah, like having to navigate

873
00:51:16,679 --> 00:51:19,679
all of the the you know, the healthcare and then

874
00:51:19,719 --> 00:51:22,559
the birth. You know, the birth couldn't have been any

875
00:51:22,719 --> 00:51:25,079
smoother or you know, like it was a very easy berth,

876
00:51:25,119 --> 00:51:29,440
but it still felt, you know, so terrifying, and like

877
00:51:29,519 --> 00:51:33,199
the clinical aspects of it felt just like very destabilizing.

878
00:51:33,239 --> 00:51:35,360
And so I think I feel like that was definitely

879
00:51:35,400 --> 00:51:39,320
helpful for my like later practice of medicine.

880
00:51:39,719 --> 00:51:41,880
Speaker 1: Yeah, I guess that's that's you know, if there was

881
00:51:41,920 --> 00:51:44,320
something that comes up for me that I'd like to

882
00:51:44,480 --> 00:51:46,760
close with, but of course, if there's anything that comes

883
00:51:46,840 --> 00:51:48,760
up for you, I'd like to touch on them as well.

884
00:51:48,800 --> 00:51:53,320
But it's sort of you know, I worked for many,

885
00:51:53,360 --> 00:51:58,239
many years outside of this field. I worked as a

886
00:51:58,239 --> 00:52:02,159
science journalist and you know, television host for fifteen years

887
00:52:02,199 --> 00:52:05,920
before I went back to school. I started as a

888
00:52:05,920 --> 00:52:09,960
licensed psychologist in my early forties, and so I'm coming

889
00:52:10,000 --> 00:52:13,000
into it with a lot of life experience, with a

890
00:52:13,039 --> 00:52:16,800
lot of you know, and I'm working in a cancer setting.

891
00:52:16,840 --> 00:52:18,440
I'm doing a lot of palliative work, a lot of

892
00:52:18,519 --> 00:52:21,039
end of life work, and I feel like a lot

893
00:52:21,079 --> 00:52:24,079
of that stuff prepared me in a way, and of

894
00:52:24,119 --> 00:52:30,199
course my exposure to the experiences of my patients continues

895
00:52:30,239 --> 00:52:32,679
to help me grow. I don't know what it would

896
00:52:32,679 --> 00:52:35,360
have been like to have been doing this at twenty

897
00:52:35,440 --> 00:52:39,920
six and in my forties. And I'm curious from you,

898
00:52:39,920 --> 00:52:43,159
you know, as you continue down this path, as you

899
00:52:43,199 --> 00:52:46,599
continue to age in this role, what are some of

900
00:52:46,639 --> 00:52:49,760
the differences that you've noticed between being a young doctor

901
00:52:50,400 --> 00:52:54,400
and being, you know, a more seasoned attending physician.

902
00:52:55,960 --> 00:53:00,519
Speaker 2: Yeah, well, I think I definitely think that how more

903
00:53:00,960 --> 00:53:05,000
life experiences. I mean, we you know, I remember in

904
00:53:05,039 --> 00:53:07,360
med school because I was twenty two, but we had

905
00:53:07,360 --> 00:53:09,880
some people who were, you know, had taken a couple

906
00:53:10,000 --> 00:53:13,599
years off to teach or do something else. And I

907
00:53:13,639 --> 00:53:16,400
remember at the time, every thought, oh my god, they're

908
00:53:16,440 --> 00:53:20,079
twenty six and they're just starting medical school. How that

909
00:53:20,400 --> 00:53:24,880
is that's so irresponsible? Yeah, so old, how can they

910
00:53:24,960 --> 00:53:27,559
do that? And we even had one forty year old

911
00:53:27,639 --> 00:53:29,960
who was starting med school and we were like, how

912
00:53:30,000 --> 00:53:33,320
could that be allowed? And now when I think about

913
00:53:33,400 --> 00:53:35,920
it now that I'm in my forties, I think, you know,

914
00:53:36,559 --> 00:53:40,119
I mean, sometimes it's nice, like, you know, there's the

915
00:53:40,239 --> 00:53:43,400
med students. I just met a bunch of twenty two

916
00:53:43,440 --> 00:53:46,280
year old med students yesterday and they were so optimistic

917
00:53:46,320 --> 00:53:50,000
and energetic and that was lovely, and so sometimes that

918
00:53:50,039 --> 00:53:55,039
can be really wonderful to have that energy. Yeah, and

919
00:53:55,079 --> 00:53:58,679
so I think everybody's like bringing different skill sets to

920
00:53:58,719 --> 00:54:03,280
the table. And you know, we recently had one of

921
00:54:03,320 --> 00:54:05,760
our med students a few years ago was in her

922
00:54:05,800 --> 00:54:09,039
forties and now she's like a wonderful palliative care doctor

923
00:54:09,079 --> 00:54:12,039
in the community and it's great to have her. And

924
00:54:12,119 --> 00:54:16,239
so I think, you know, I feel like right now

925
00:54:16,239 --> 00:54:18,880
in healthcare there's like a place for everybody if you're

926
00:54:18,920 --> 00:54:24,079
interested in like you know, but definitely I think now

927
00:54:24,960 --> 00:54:29,719
in my forties, especially having kids now, you know, sometimes

928
00:54:29,760 --> 00:54:32,239
I'll see like an eight year old guy named Floyd,

929
00:54:32,400 --> 00:54:35,440
and I'll think, oh my gosh, like eighty one years ago,

930
00:54:35,880 --> 00:54:38,239
someone was like, I'm going to name this baby Floyd,

931
00:54:38,480 --> 00:54:41,039
you know, and it's just like this is I think

932
00:54:41,519 --> 00:54:44,960
that makes it feel a little bit different now, and

933
00:54:45,920 --> 00:54:48,039
especially when I see, you know, because I'm taking care

934
00:54:48,079 --> 00:54:51,280
of adults. So sometimes I'll take care of patients, adults

935
00:54:51,280 --> 00:54:55,800
with Down syndrome or other adults who have different types

936
00:54:55,840 --> 00:55:00,760
of cognitive limitations, and their parents will be there, and

937
00:55:00,800 --> 00:55:04,920
so it's I think it's just like the parenting journey

938
00:55:04,920 --> 00:55:06,760
has brought like a different lens also.

939
00:55:06,960 --> 00:55:10,159
Speaker 1: But yeah, so it's not even just age. It's also

940
00:55:10,239 --> 00:55:13,239
being a mom and having that kind of relationship in

941
00:55:13,280 --> 00:55:15,880
your life that you didn't have when you were twenty

942
00:55:15,920 --> 00:55:17,000
six or twenty four.

943
00:55:17,559 --> 00:55:21,360
Speaker 2: Yeah. Well yeah, Now if I have a patient who is,

944
00:55:21,480 --> 00:55:24,000
you know, in the hospital, a kidney infection or something,

945
00:55:24,280 --> 00:55:25,920
and she tells me that she has like a three

946
00:55:26,000 --> 00:55:28,119
year old at home, I'm like, oh my goodness, Like,

947
00:55:28,519 --> 00:55:32,280
you know, just relaxed. I know you're here for a

948
00:55:32,280 --> 00:55:34,920
medical thing, but like I know, you're also probably really tired,

949
00:55:35,000 --> 00:55:36,639
and like, I hope you just get to watch some

950
00:55:36,800 --> 00:55:42,039
TV and like take it easy.

951
00:55:42,679 --> 00:55:47,800
Speaker 1: Oh that's hilarious. Yeah, well, gosh, Grace, I'm curious if

952
00:55:47,800 --> 00:55:50,679
there's anything that we didn't touch on that you were

953
00:55:50,719 --> 00:55:53,719
hoping to share, you know, something you would be remiss

954
00:55:53,719 --> 00:55:56,880
and not sharing with with the listeners.

955
00:55:57,760 --> 00:56:02,960
Speaker 2: Anything that I missed, I think, well, one thing that

956
00:56:03,000 --> 00:56:05,199
this is hasn't come up in a while, but sometimes

957
00:56:05,280 --> 00:56:10,760
people feel like comics are infantilizing or and so I think,

958
00:56:11,679 --> 00:56:13,760
you know, there have been a lot of great graphic

959
00:56:13,840 --> 00:56:17,760
novels and graphic memoirs over the years, but and I

960
00:56:17,800 --> 00:56:21,079
think in other cultures comics for adults are kind of

961
00:56:21,119 --> 00:56:24,519
more normalized. But yeah, this is definitely meant to be

962
00:56:24,679 --> 00:56:27,639
a book for adults, and it deals with dark topics,

963
00:56:27,719 --> 00:56:31,000
and but it is meant to feel kind of easy

964
00:56:31,039 --> 00:56:33,840
to read, easy to get into. It's you know, you

965
00:56:33,840 --> 00:56:35,800
could read these types of books like in a couple

966
00:56:35,840 --> 00:56:40,599
of hours, so they're very fast, but hopefully like bring

967
00:56:40,719 --> 00:56:44,159
some humor and then also some interesting thoughts.

968
00:56:44,760 --> 00:56:47,880
Speaker 1: Oh yeah, I love that. Gosh, Well, everybody, the book

969
00:56:47,960 --> 00:56:50,840
is See One, Do One Teach One The Art of

970
00:56:50,920 --> 00:56:56,159
Becoming a Doctor, a graphic memoir by doctor Grace Ferris Grace,

971
00:56:56,199 --> 00:56:58,199
thank you so much for being here with us today.

972
00:56:58,360 --> 00:56:58,840
Thanks Cara.

973
00:56:59,039 --> 00:57:00,639
Speaker 2: This is a fun convert station.

974
00:57:00,920 --> 00:57:04,920
Speaker 1: Definitely, yeah, so fun, And everybody listening, thank you for

975
00:57:05,000 --> 00:57:07,639
coming back week after week. I'm really looking forward to

976
00:57:07,639 --> 00:57:11,519
the next time we all get together to talk, nerdy,