Cleared Hot - Powered By BRCC - Full Auto Friday - Round 29

Episode Date: November 27, 2020

Last week's episode stirred up a bit of a hornet's nest with my answer/suggestions to a doctor expressing signs of burnout.  A few from the medical field reached out, and I appreciate their time and thoughts.  Let's dig back into this...My response and continued thoughts on COVID, burnout, limited resources, and personnel.  No time cap, one topic.  Enjoy

Ladies and gentlemen, welcome to Full Auto Friday. I was just about to say, I hope everyone has a happy Thanksgiving, but I realized I'm recording this on Wednesday the day before Thanksgiving, so if I said that, it would be slightly out of place. But regardless, I hope everybody did have a good Thanksgiving. Before we dig in, a quick thanks and reminder that this episode of the podcast is brought to you by on it. Probably the longest standing sponsor that I have had with the podcast. And right now, if you were unfamiliar, it's a great time to check them out because they're having their black friday sale.

Onit.com forward slash hot. Traditionally, that would take you to the podcast landing page. You would know that it was the right place because it has the podcast artwork on it. Now, if you land there, though, you're going to see some pretty goddamn psychedelic, trippy artwork, which is actually pretty cool. Looks like a gorilla with a third eye holding a mace that happens to be a skull, which is the O. have on it. Pretty damn sweet. Regardless, it is your landing place for human optimization. You can go there for supplements, nutrition, fitness, apparel. They have content. Obviously, I mentioned that they're having a sale right now. Go there, check it out. And if you like what you see, you can take advantage

of their sale and at the same time support the podcast. What I will say is this, and I try to say this every time I mention supplementation. It should be the last thing you consider, not the first thing, What you really need to focus on is your diet, your rest, your recovery, your workout, those macro pieces, they're going to make a huge difference in your life. Then, once you're ready, what you want to do is dive in to the micro, which would be supplementation. Another way to say what I just said is, I don't want you to have expensive piss, right? If you eat like a garbage can and you don't work out, no supplement in the world is going

to get you where you want to be. Onit.com forward slash hot, your landing page for human. optimization. And that's it, ladies and gentlemen, let's do this. Full Auto Friday, round 29. Last Full Auto Friday, I answered, I believe, four questions, or emails, emails that contained questions. I think that's the way I could say it and at least be partially correct. The first question that I answered was from a physician from the Midwest who was experiencing what I would describe as burnout. And to some people, it seemed as if maybe I was pissed or came off the top rope, neither of which were intentional by me, and if it came off that way. Sometimes I think people

have a hard time picking up on the fact that sarcasm is by far my primary and favorite weapon system. But I digress. I get my thoughts, and I received a few emails from people in the medical field, specifically one that I want to cover today for a few reasons. And most importantly, the reason that I'm going to re-address this topic is I want people to understand that my ideas and how I feel, they're not necessarily fixed in place. I certainly feel the way that I do, but I am open at any time to being challenged on my beliefs. I am open at any time to have a conversation. I also believe there is a difference between listening to somebody when they talk and hearing what they are saying. And oftentimes, if there is confusion, I would say the burden falls on me because I am imperfect in my words sometimes.

I'm incomplete in getting my thought process across. So I'm going to redive in on this issue when it comes to the physician. And I'll explain the email that I got. And I want to talk about a few things in that email. And then I'm going to explain the response that I sent to this individual. First and foremost, I am very easy to get a hold of. I have multiple contact me buttons on the website, whether it's for the podcast or the public speaking that I do, or over social media platforms. And the reason for that is, again, I am open to dialogue and I want to make myself available to be challenged because I am sitting here speaking into a microphone and people do not have the ability to have a two-way exchange if you're only on the received.

only mode. Now, I can't say that I'm going to get back to everybody, but I do appreciate the time that people take to reach out to me, and I will do the best that I can. So if you do execute one of those options to try to get a hold of me, I will do the best I can to get back to you. Now, let's dig into this email. Dear Mr. Stumpf, in regard to your full auto Friday dated November 20th, 2020, I had a couple of issues I wanted to bring up. I'm a practicing emergency medicine physician, and I'm concerned about your take on the first letter you discussed. I don't want to speak for the Midwestern radiologist, but I don't think his message was quite conveyed the way you thought it was. He may be burned out. He definitely sounds frustrated,

but he also took the Hippocratic Oath, the same as I did. In essence, it means that we will take care of anyone, anytime, anywhere, no matter how big of an asshole you are. That's the job. And you're absolutely right. That is the job we signed up for. But that doesn't mean that we can't care for an individual while simultaneously think they are also a complete and total fuckwit. Now I'm going to pause here and just let this individual know how much I appreciate the usage of that term because it's one of my favorite. Moving on. Many of the patients we take care of are complete and total fuckwits, gold star for second usage.

People smoke. They eat too much. They ride a motorcycle without a helmet and get acquainted with the front end of a Mack truck, et cetera, et cetera. That's why I have a job. So when you say that eating too much or smoking will eventually kill you, you are absolutely right. As you have said in the past, play stupid games, win stupid prizes. I don't begrudge these folks.

We're all human. They made their choice, and because it's my job, I'll do the best I can to care for them. But I can't catch diabetes from my patients. I can't infect my family with lung cancer after caring for a smoker, and my brain isn't going to turn into a turnip a week after intubating a traumatic brain injury patient who wasn't wearing their hair. helmet. COVID is different. That shit actually could kill me. Even worse, I could end up bringing it home to my family, but I take every single patient who comes through my doors regardless. So when a patient who refuses to wear a mask against COVID wants me to save them and there's a good chance they could have prevented their sickness through social distancing and wearing a goddamn mask,

then yeah, I have a visceral reaction. When some fucktards think it's a left-wing power grab conspiracy to wear a mask or that it violates their constitutional rights when a political leader or when political leaders are trying to keep their fellow Americans safe, then yeah, I have a visceral reaction. And when you tell a Midwestern radiologist to take a knee because you think he's getting burned out and you, sir, aren't on the front lines of this, then yeah, I have a visceral reaction. One of the things I've admired about your podcast is your capacity for self-reflection to be able to take a critical look at your behavior and decide that perhaps you need to change or address something. It takes an immense amount of courage to talk about one's mental health and

advocate for the mental well-being of others. I think that self-reflection about your previous statements may be one of those opportunities. Eating too much and becoming obese is a choice. Starting to smoke is a choice. Riding a motorcycle, Sons' helmet is a choice. And I fully support people making those choices. Even if they refuse to accept the inevitable consequences of their actions because apparently in this country everyone has rights, but no one wants the responsibility that goes with those choices. I can live with that. What I can't abide is when those personal choices affect me or my loved ones. You ask any emergency medicine doc the two types of patients they have zero sympathy for. It's drunk drivers and parents who refuse to vaccinate their kids.

Because those circles, I'm sorry, because those choices directly harm other people. Those who refuse to take measures to prevent the spread of this fucking virus are quickly becoming the third group of individuals we despise. They are harming other people because of willful stupidity. So when you think that physicians are becoming burned out, yeah, you're right. When I have someone who isn't a constitutional law scholar carrying on about their rights between coughing jags because of something they read on social media, yes, I get burned out. When I have someone who can barely read, tell me that they know more about medicine than the vast majority of the physicians in this country, yes, I get burned out. To put it in context, how would you have felt in your old job if a large

vocal segment of the population back home was constantly dismissing your hard work and was actively putting you at risk? What if you were overwhelmed by the number of hostages you had to save on a daily basis because more and more Americans just kept flying into Kabul to vacation in the Hindu Kush all the while complaining that it was a State Department conspiracy to keep them from seeing the natural beauty of sunny Afghanistan. There are only so many doctors, so many ventilators, so many ICU beds, and we are getting overwhelmed. Also, if you keep infecting and killing off the medical professionals who are trying to help you

because of your pride and not wearing a mask because someone, you're not wearing a mask because someone from a different political party told you that you should, who's going to take care of you when you need it? What does that say about our society when some uneducated twat states that they know better than a respected epidemiologist with decades of experience because of something they read on Facebook? Physicians across the board, by some estimates half, are burned out, burned out by the commercialization of medicine, burned out by a president who tells us to inject bleach, burned out by our patients who trust social media but not our expert medical opinion. So if we all follow your advice to take a knee, where does that leave us?

A while back, you had Mr. Bishop on the podcast, and he related his story where he was at a firearms convention. He counted having a random armchair weekend warrior randomly roll up to him and just start espousing the virtues of a particular brand of firearm. From Mr. Bishop's telling, this guy had no idea what he was talking about. even though he thought he knew more about combat and weapon systems than a former operator. So if the shoe is on the other foot, how do you think physicians feel when someone, such as Mr. Bishop, in parentheses, who does not have a degree in medicine, this is accurate, starts spouting off about how they read that masks are ineffective and they don't believe the science behind masks and social distancing? Medicine is far from perfect. I'll be the first to admit that, but it's the best that we've got. And there is a ton of nuance and caveats, which is why we go to medical school.

But espousing ignorant opinions of which you have very little background in is dangerous. Pathogens do not give a fuck what you believe. They will try to kill you regardless if you believe in them or not. If I were trying to tell you how to conduct a direct action operation, I think at best you would give me a gentle, condescending smile thinking, this fuckstick really wishes he knew what he was talking about, doesn't he? Isn't that nice? I love your podcast and I love your honesty. That's why I keep listening.

But you are wrong on this one. As an aside, you frequently talk about pushing yourself, about staying uncomfortable about betterment. Then how about this? Go to medical school and become a physician. I'm not joking and I'm not busting your balls. I've been impressed with your discussion about mental health on your podcast. You would be an asset to others, particularly to those in your community who struggle

with mental health issues. I truly believe that you would be an excellent, compassionate psychiatrist and that you could help an inordinate number of veterans, active duty personnel, and first responders. You'd be surprised at the amount of good you could do, Mr. Stumpf. Look at it this way. If you're going to hit 50 eventually, would you rather be 50 in doing what you're still doing, or would you rather be 50 and be a physician? I know you always say that you're average, but you're not. Average doesn't do what you've done, and if I can manage to get my dumbass into and through medical school, I'm pretty sure you can too. That is my challenge to you. Do something that scares, that will scare the living shit

out of you. Sincerely, the letter E. Water break. Ah, delicious. Just got done to him like two hours of jih Tijuana. I'm a sweaty hot mess. I'm thirsty. Sorry that my voice is a little dry. Okay. That's the email that I got. I can't tell the people listening or watching, however you consume this. How much I appreciate the time, energy, and effort it takes for somebody to write down their thoughts. And I would have said that if this person was calling me a fuck-wit or telling me that they agreed with everything that I said. I can see that this took a lot of time. They put a lot of effort into it and I appreciate that. So before I talk about my response, there's one thing I noticed about this email and about certain emails that I receive on occasion. I hit reply and I noticed

that this particular email came from a proton server. So I had to look up exactly what that meant because I heard about it before, but I wasn't necessarily sure exactly what it meant. And essentially, what I can determine, and please, if you're a technologically savvy individual who knows more about this, feel for you to correct me. It is an email platform that allows for more security, but it also allows for anonymity. Now, if you're going to take the time and effort to write to me an email like this, but you are going to do that after taking effort to obscure who you are, I'm not going to fault you for that. but it gives me cause to question why you would want to obscure who you are. If you listen to this podcast or you know anything about me, you will know without a fact that I am not here to try to expose anybody, to try to track anybody down, to try to docks anybody. That's not my jam.

The only time that I actually ever use names on emails is when they explicitly give me permission to do so. And I'm almost at 30 full auto Fridays. When asked to not use somebody's name, I always comply with that. I am not here to try to expose anybody. So I'm not saying that I take this response any lighter, but it does make me wonder why somebody would take so much time to obscure their identity. It also seems like it makes it difficult for me to respond to this individual. But that's neither here nor there. Just food for thought. My response. I didn't write as long of a response, but it encapsulates my thoughts back to this individual, and I will read portions of it, and then I'm going to expound a little bit more. My response to this person, the letter E, reads, first and foremost, thank you for taking a time to send me your detailed thoughts. I'm always open to having my thoughts and ideas challenged. I believe it is how we evolve as humans.

I have a few thoughts and response to your email and points. First, the Hippocratic Oath. Although it is noble, as I would say the oath of enlistment is for military members, compliance varies greatly among those who take any type of oath. The words themselves and the oaths themselves are meaningless unless you live them. In my 17 years in the military, I have seen firsthand men and women who lived up to every inch of their oath. And I've also seen those that used the military as a vehicle.

to pursue their own agenda up to, and including murder and torture of other human beings. They all took the same oath. And at this point, I'm going to get a little bit broader. Where I live right now, there is an issue with a surgeon who is currently no longer allowed to go to the hospital for reasons that I will leave out. But let's just say it would fall into malpractice. That individual also took the Hippocratic oath. And the bottom line is this. The man who reached out to me certainly took that oath, but it in no way guarantees that he cares for his patients in a manner that the rest of your community would expect of him. I would hope and operate under the impression that he does, but I am a realist when it comes

to the behavior of human beings. And I can't express this point enough. The Hippocratic oath, I think, is very noble. I think the oath of enlistment is very noble. I think that the oath that clergy members take is noble, police officers. Any organization that has an oath, I think that they're great, their frameworks, they're anchors, they are skeletons for behavior. And they are also completely and utterly fucking meaningless unless an individual complies with that oath and actually uses it to govern their behavior. You cannot say because you took an oath that an individual is going to behave in accordance with what society or civilization is looking for.

That's just not the way that it works. I try to be a realist when it comes to the behavior of human beings, and I have enough laps around the sun to know and have seen firsthand that every single one of those occupations that I mentioned that takes an oath also has a cohort of individuals who fell well short of it. There's a reason why people get sued for malpractice. There is a reason why clergy members get sued and removed for child abuse. there is a reason why there is the Geneva Convention, the UCMJ, and people in jail for war crimes. All of them took an oath, and none of those oaths matter unless it changes who you are as a human being. So it cannot be used as a defense. That is my point, I guess, of that entire paragraph.

I continue on. You are, of course, correct. You cannot be infected with diabetes, heart disease, and lung cancer from smoking, like the examples I gave in the podcast. My point in using those as an example was not in their transmission, but in the individual choices that led up to a patient presenting to you or a medical provider for care. I think it is a stretch for you or any other medical professional to claim you have a crystal ball that gives you total insight into how someone ends up in your care. I do not blame you at all for having a visceral reaction, but claiming to know the causality of everyone who presents for medical care, to you is a stretch for me. You're right. I am not on the front lines with you, and I am certainly not a medical expert, but I do know quite a bit about stress. You are, of course, free to have whatever

type of visceral reaction you want to, with me telling the doc to take a break, but it is exactly what he needs to do. In fact, I would hope that the medical profession around him, or professionals around him, are expressing that same sentiment because it is what he needs to do. Later in your email, you made the statement, if we all follow your advice to take a knee, where does that leave us? That's not the advice I was giving to the medical community. That's the advice that I was giving to one individual. I can completely understand your analogy of limited resources and manpower.

I operated in a world very similar to that and some of the highest consequence environments for nearly two decades. The key to surviving in that environment was leadership. Our leadership consistently tracked and managed our research. resources and they made operational decisions based on our readiness. They manage stress through structured rotation of downtime, sometimes with entire units, oftentimes by rotating personnel. I am not surprised that half the medical professionals feel burned out. This has been a crazy year and I can only imagine how difficult it is to deal with social media medical experts.

I would hope that the medical profession is taking care of itself and presented and when presented with a coworker who is at his or her wit's end, action can be taken to ensure not only quality of care given, but longevity and sanity for that medical professional. This is one of the things I received a few emails like the one that I read. And one of the most resounding, I don't know how to describe it, topics, I guess it would be or talking points would be that from the medical professional, they're tired and exhausted of dealing with people who are are COVID deniers now seeking treatment. And I think it's really, really dangerous to say or state that you know with certainty every single person that is presenting to you in that environment,

why they are there, and what precautions they have taken. I know people here where I have lived, where I have lived, Jesus Christ, obviously I need a little bit more water. Hold on. Dehydrated from the jiujitsu. I know people here, where I live, who have taken every single precaution humanly possible and still have COVID. Did they go to the hospital? Some of them did. Some of them did not. But when they go to the hospital, and again, I'm not sure on the intake form what it says or what questions every doctor is asking. But I suspect that you're not looking at patients or talking with patients and going, hey, are you a COVID-denier? Do you wear your mask at all times? Tell me about the preventative measures that you've taken. I don't expect that to be the case.

So let's just be very cautious assuming or generalizing that the majority of people or most people who are showing up for care are doing so because they didn't take the proper precautions. I just don't think that that is a reasonable statement to make. When it comes to the rest, like I said, I'm not telling the medical field that they need to take a break or they need to take a rest. my statements were directed at that one individual and one individual only. And what I ended this paragraph with was hoping that the medical practice, the medical profession is caring for itself. If you're working with doctors as a doctor that are expressing burnout, I hope that your leadership is figuring out a way to rotate people through so they can get the rest that they

need. Because if not, you're going to implode your own system. I know that there's limited resources. I'm completely and utterly aware of what that's like. to not have enough of what you need. But you still have to be able to do your job. And the best organization to police your organization is you, right? You are in the best position to listen to your coworkers, to understand the stress and to make sure things are in place to allow people to get the rest.

The person who should be telling that doctor to take a break is not actually me. It's other doctors and people that he is working with. Two more paragraphs. I do not need to imagine what it would feel like to have a large and vocal segment of society dismiss the years I spent overseas. It happens every day and it's increasing in its frequency and volume. Oftentimes, there were more hostages that needed to be rescued than we could manage or operations in general that needed to be executed than we could manage. In your scenario that you used in Afghanistan, I'm sorry, in your scenario you used Afghanistan. In reality, in my personal experience, it seemed like people,

were more interested in traveling to Iraq, but I digress. How did we handle it? I suspect the same way that your profession does. Triage. We analyzed risk, access, intelligence, and then executed on our highest probability or highest level of confirmed intelligence. Not once, not a single time did we take into account why the individual was there when I was talking about hostage rescue, of course. Why? It had and has no bearing on the job. We accepted the risk. Every single time we had actionable intelligence without hesitation because that is our job. Did we bitch about it? Fuck, yes, we did. Did it ever impact our performance on the job? Never. Anyone seen not holding the standard is benched for their own safety. Anyone seen repeating that behavior is removed. Why? That is what our nation demands of us, period.

And this ties into what I said in the previous paragraph. The best people to police your organization are those from the inside. You're going to have to triage when you have limited resources, limited information, and limited manpower. I get it. Bitch to me all that you want to. I understand that and I'll take it. But don't allow that to impact your on-the-job care. And that's going to be a combination of managing yourself and managing your peers.

Two more paragraphs. I just said that last time. but I continued. I actually get quite a bit of shit for having Bishop on, which will not stop me from having him on in the future for one key reason, an economy and ecosystem of ideas. He gets crushed sometimes when he makes statements like the one you referenced. I do not believe in silencing those thoughts. I believe in exploring them and allowing the good ideas, the opportunity to overcome the bad ideas. His stance has actually shifted due to the feedback he has received, which I consider to be a positive outcome from him expressing his thoughts.

One thing I will say is that I don't think he was attempting to give any type of medical advice. He was expressing his opinion. I don't see the analogy of you giving direct action guidance during the mission planning phase and him expressing his opinion as valid. Again, that's me. Perhaps people will disagree. That was my own personal thoughts. And to close with, on the medical school front, I don't see that as being the cards for me.

For one, I don't have a single second of college education. So I need to knock that out first and all of the required schooling before even attempting medical school. I'm not against it at all, but it would take me well past my 50th year to accomplish that. And I hope that I can make a bigger impact elsewhere. Thanks again for your email. I appreciate the time you took to write it, Andy. And on the medical school front, I don't know if I have what it takes to be a doctor, honestly. I think I might just be better off watching them on TV.

I think I can make a bigger difference by hopeful. growing this platform and giving people who have already gone through that schooling, who are specialists, whether it be in suicide prevention or psychiatry or psychology or epidemiology, whatever it may be, allowing them to come and talk about their experience as opposed to taking that chunk of time and trying to develop that experience myself. I suppose I could do both. I guess I could look into that, probably not going to if I'm being totally honest with you. but what I would love to do is provide this platform for people who are exports to provide their opinion and guidance and insight.

That's the biggest impact that I think I can make. There's a lot, a lot in those emails. And I hope people, after hearing the email that was sent to me and hearing my response, realize that I'm open to being challenged. I'm open to have my ideas being pushed back on. But a portion of this back and forth, again, I'll say there's a difference between listening and hearing what it is that I'm trying to say. At no time did I ever tell the entire medical profession to take a knee. That would be utterly unrealistic.

What I'm saying is nobody has a crystal ball. You can't tell me that every person that you see is somebody who didn't take every step possible to not get this medical condition, this disease. which I 100% totally and absolutely believe in. COVID is 100% real. I don't want anybody to die. I know that it's killing people. And I also know that we're going to get through it. And the way to get through it is to rely on our medical personnel and our medical community,

which right now they're feeling a massive burden. And I hope that they are doing the best they can to not only take care of their patients, but take care of themselves. And I'll close with this. you know, when I bring up all the communities that take an oath, I believe I used medicine, the military, police, clergy, and just apply that to any organization that you know that takes an oath. And when I talk about people who fall short of it, hopefully, hopefully people intuitively think in their head, yes, that does happen, but that's the anomaly and it's not the

norm. Or to use a commonly used phrase that I hear, those are the bad apples. And you could not be more correct. I don't think we should judge communities by individuals. And all that I want to close with is this thought. If when I'm talking about medicine and I talk about either malpractice or people who took the Hippocratic Oath and they fall short, if your initial reaction is, you know what, those are bad apples. They don't define the community. Please keep that in mind when you see information on social media and mainstream media talking about the police, because if you are going to rapidly apply that to the medical profession or the religious profession or the military profession, understand that those professions are defined by their

similarities, not their differences. It's exactly the same when it comes to our law enforcement. They're under an incredible amount of scrutiny, an incredible amount of pressure. And right now, in my opinion, and this only counts for me, they do not deserve the social optic and pressure that they are receiving. There are people, individuals, that are not living up to the standard, but they don't define the community. So if you're quick to defend the clergy, you're quick to defend the medical profession, you're quick to defend the military, keep that in the back of your mind.

The next time you see something breaking on Fox News or CNN or fill in the fucking blank, however you consume your information, right? Perhaps the occupation deserves the benefit of the doubt. Have a great weekend. See you guys Monday.