HealthyGamerGG - Psychiatrist and Dr. Mike Discuss Being Happy on Social Media

Episode Date: June 1, 2021

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Yeah, so thank you so much for joining us today, Dr. Mike. Yeah, of course. Thank you so much for having me. I'm really excited to have this conversation. Oh, really? What is this con? What are we talking about? Well, I think we're talking about how the mind and the body are actually mind-body,

not two separate words. So I'm hopeful that, you know, I can sort of bring up the subject of how interconnected these two subjects are and then get your take on your experiences, maybe personally, maybe professionally. If you agree or disagree with some of the statements that I make, I always like for these to be as personal and conversational as possible. But if you have a different way of doing it in mind, I'm all ears. Yeah.

So sometimes when people come on or actually usually when people come on, we'll have like something more of a personal conversation where, you know, I think a lot of people are interested to hear actually like your story and kind of sometimes people will come on and will have, you know, particular questions that or sometimes they're facing challenges and potentially want to work through some of those. But I recognize that, you know, as both being like medical professionals, like we could have a conversation about something instead of doing a more traditional, like, personal interview kind of thing. So I'm really game for both. It really depends on, you know,

what you want to do, bro. I'd love to have a conversation about the subject of the mind-body connection. Awesome. From there, if we have personal anecdotes to work those in. I'm open to sharing some stuff. Sure. So that's cool. So let's get started. So tell me about the mind-body connection.

Yeah. So for me, just to give a little background, I'm a board certified family medicine doctor, but I happen to be a DO, not an MD, which is an equally licensed medical licensed degree in the United States. And basically the premise of our education in comparison to that of an MD education, is we really try and put forth a holistic patient-forward approach to everything and anything that we do in the field of health care. This could mean something as simple as a patient coming in with acid reflux symptoms.

Instead of simply fixing the acid reflux through a medication, we would do that. But in addition to look at some of the risk factors that that patient might have in their everyday lives that are predisposing them to continually having this acid reflux condition. And as a result, we kind of take a bigger picture approach when it comes to treating patients. Using that background, I've started treating a lot of patients for pain. Because what would happen is anytime a colleague in my hospital, in a nearby hospital, in urgent care would run into a patient who's having chronic pain issues or perhaps in acute pain condition, they would end up sending them to me as a referral for osteopathic treatment. because in addition to this patient first philosophy that we have in DO schools, we also learn an extra

hands-on technique called OMT. And it's not really one technique. It's more of a therapy. It's more of a way of thinking. It's not magical. It may look somewhat like physical therapy, like chiropractic medicine, but in theory it's more medical in nature in that we use the body's own mechanisms that no one disagrees with in the medical community to try and help patients out with their pain.

perhaps with the dysfunction that's causing them concern. So an example of this could be a patient having recurrent tension headaches as a result of spasms in their neck. A proper and osteopathic exam could go into what their work ergonomic situation is like. Are they sitting in the right chair? Where is their monitor in relationship to their eye level? Then putting our hands on the neck, feeling where the dysfunction comes from, checking the joints above and below, meaning that if it's the neck, we're checking.

the thoracic region as well and not just forgetting that the cervical spine is connected to the thoracic spine and there's impacts of that. Checking for shoulder dysfunctions, seeing if a patient is using one shoulder over another because of another injury that exists. And then figuring out a way to treat that condition, whether it's through using the body's own reflexes to relax this spasm, because the body has a lot of these innate reflexes in it where it essentially turns on some muscles and turns on other muscles. I'll give you an example. If you ever try pushing against a stationary object like a wall or a pole and you know that object's not moving, what your mind tends to do is actually send signals to those muscles that are being activated during this isometric contraction

where the muscle is not lengthening, not shortening, is to relax because it doesn't like to waste energy on something where there's no eccentric or concentric motion happening. So we use that body's response to an isometric contraction in order to induce relaxation and increase range of motion in spascent areas. That's fascinating. I wonder if actually that, I never connected the isometric contraction. I wonder if actually that is partially responsible for the clinical superiority of exercises like especially yoga, which are essentially isometric contractions, right? Because you take a position and you hold it. And whether that, because I know that yoga is sort of superior to physical exercise in terms of recruiting like or shutting down the HPA axis. And I never thought, I never realized that

there was actually a mechanism that involves isometric contraction that induces relaxation. But that sort of, because I've been always curious why yoga sometimes outperforms exercise in clinical trials. And this is the first time that I've ever heard of a potential physiological mechanism through which it acts fascinating. Yeah. And there's another level why yoga is probably superior in a lot of instances because of breathing. The HPA access is directly affected upon our sympathetic or parasympathetic state and we can control that state based on how we control our breathing. And this is where I can throw in a personal anecdote. I'm horrible at controlling my breathing. I tend to hold my breath a lot. Maybe not when I'm doing weightlifting, but if I'm bending

over to tie my shoe, I catch myself holding my breath to focus on tying the shoe, even though it's such a simple task. But when we do that, we actually start decreasing our ability to heal, our ability to breathe properly, and yoga really institutes proper breathing mechanics where it's diaphragmatic breathing, belly coming out, lower rib cage spreading out to the sides. And you could practice this, not even just doing yoga through a mindfulness session. And that's where I think a lot of the benefits of yoga comes from probably those two instances. And while isometric contraction is really crucial in yoga, eccentric contraction, which a lot of times is missed out on when you're doing weight training,

I'll give an example. So if you're pushing a weight, like you're doing a bench press, the eccentric contraction is when you're bringing the weight down, where the muscle essentially slowly lengthening, but still contracting to control the lengthening process. Yeah, that is a very good way to rehabilitate your muscles, injured muscles. It's actually the best form of rehabilitation. So if you have like Achilles injury, a calf injury, these types of eccentric contractions is what you're, physical therapist is likely to focus on first. So yoga in a in contradiction to like when we push our weights down and then drop them real quickly and then push them back up really focuses on that eccentric isometric phase, the breathing phase. And that's where you get so much of the benefit, obviously in addition to

the mindfulness component of it. So I'm glad you brought up yoga. I don't know if eccentric contractions is also something in the back of your mind or something you've heard before. What are your thoughts on that? No, so I'm not familiar with this degree of, you know, physiology around muscle contraction. Like, it's certainly not, it's not something that I've, like, studied extensively. So it's fascinating to hear. I mean, if you asked me what an eccentric contraction was, I wouldn't even know. It's interesting because when I think about yoga, though, I think, you know, most of yoga is not actually about movement. It's about stillness. So if I had to put my money somewhere, I'd say that, you know, the isometric component of yoga,

generally speaking outweighs the eccentric component. But at the same time, you certainly have compared to regular exercise, a very significant amount of eccentric muscular movement, right? Because it's about slow movements that involve like gradually moving from one place to the other. You know, so you definitely have that. It's interesting. I never connected those dots. Like I didn't realize, you know, I have some theories about how yoga works and stuff like that.

but I just didn't have the resolution of understanding of muscular physiology to really connect those dots. That was fascinating. Yeah, I think that highlights why osteopathic medicine is so cool because we think so holistically in our approach that when a patient comes in with musculoskeletal pain of the neck, while we are thinking about this approach, we're simultaneously thinking about the anatomy of the region for, you know, real like medical interventions, whether it's medicinal, injection-based, surgical approaches, And it's not that I do all of these approaches, but I keep them in the back of my mind when I'm trying to figure out which patient is best suitable for these options. And in thinking this way and seeing so many patients who were in pain over and over and over again,

I began to see a relationship between the mental health state of my patients in addition to their pain that they were experiencing or physical symptoms that they were experiencing. And while it's very easy to conflate this correlation and say, oh, well, of course, someone that's in pain is going to be in an unhappier mental state, who's going to be happy when they're in pain? That is in fact true, but what I started seeing in doing thorough histories of my patients is that the mental health state preceded the physical pain. And once the mental health state was treated, because it was largely overlooked in their past treatments, that's when the physical pain went away. because I would have patients come in and they would start saying, you know, their elbow pain was bothering them for six months. They've had MRIs, CAT scans, x-rays, doctors would do special tests, and there was nothing to be found anatomically. But this is not to say that this patient is making this up. The reality is they were still subjectively feeling this pain.

It was debilitating to them because it prevented them from doing their work or enjoying their life. So it was real. It just, the source wasn't anatomical. And a lot of times our health care system falters here because if they can't point to something on an imaging scan, we right away start writing this patient off or we stop being able to help them because it's not reimbursable well by insurance companies because we can't say, look, this is what they have. This is why we're doing X for Z. And I did a lot of research into this field and I came across a great book called The Divided Mind by Dr. John Sarno, the late Dr. John Sarno actually. And his field of research is he's by training or he was by training a physical medicine and rehabilitation specialist, the PM&R physician. So he wasn't a mental health specialist by any means. And he actually worked and taught at NYU Medical School and NYU Medical Center just by me. And through his research, he actually found that helping patients deal with some of their most repressed childhood potential.

current negative life situations, mental health situations, treating those actually yielded better results for his pain patients, his chronic pain patients, his acute injury patients. And he started doing research on this where it wasn't just, okay, let's see this patient. Let's see if they improved. He actually started doing MRI studies. Can I jump in for a second? By the way, should I call you Mike or Dr. Mike? Mike is fine. Mike is fine. So let me ask you, what do you think is the main? So let me ask you, what do you think is the mechanism of that. How does that work? I don't know. I don't have a good answer for it yet. There are definitely proposed mechanisms. His research focused on, for example, if you had a true injury, let's say, in your low back

and you had a pulled muscle in the past, what he saw in MRI studies and MRI research, that individuals, when they were in a stressful state, the body actually limited the amount of blood flow to those areas in order to decrease their stress. And it was a high level of stress of thinking about those repressed thoughts, those acute stress thoughts, and instead focused on a physical problem, that low back pain. And it functioned as a distraction to not overwhelm the body, the mind. And this is a theory, and this is a very out there theory. And some physicians disagree with this theory.

The route he chose to explore. It's actually not that out there. In fact, there's good evidence to support that because if you look at self-injurious behavior, so self-injurious behavior that's not suicidal, like cutting and burning and things like that. These are actually not injuries that if you really look at self-injurious behavior, it's fascinating because from an evolutionary standpoint, what people do is the thing that causes the least damage to their body and also hurts the most. So if you look at cutting, it's very superficial cuts. And so if you think about what's that person actually doing, and if you talk to people who engage in self-injurious behavior, what you actually find is that their goal in the self-injurious behavior is almost meditative in nature.

That eliciting a cut slowly, like time and time and time again, actually distracts them from emotional feelings. And the intensity of the pain is so great that they literally cannot think about anything. else. So what we tend to find is that, you know, when I work with people who have self-injurious behavior and an addiction, that if you control the addiction, like let's say they're in a rehab, the self-injurious behavior will get worse because they need a coping mechanism because they can't use like alcohol or marijuana or like other things to cope. So it's really fascinating because I've never, you know, I'm not familiar with Dr. Sarno's work, but like there's actually a decent understanding that people will actually induce that principle of utilizing pain

is a distraction from the mind. Absolutely. It doesn't actually sound that out there to me. It's like, that's actually well. I probably misspoke when I'm saying that it's somewhat out there in that we definitely know that that sort of distraction method exists, as you said. The mechanism with the mind altering blood flow is the mechanism. that is somewhat questionable.

Interesting. So that it's, it's less of the patient doing it and more like it's like an automatic physiological, you know, neurophysiological like we're not going to fix this injury to protect our mind. Yeah, that certainly does seem, you know,

less understood. That's cool. Yeah. So, but that's one of the mechanisms. I mean, for me, the way that I think about it as an osteopathic physician is that not only do

we have electro connections in our body from neurodial. But we also have neurochemical connections with neurotransmitters, with hormones that are impacted upon our stress levels, the way that we feel. And if we're constantly in that hyper-pasympathetic state, I know that my patient isn't going to have good circulation of their neck. Because what happens? We're in a hyper-sympathetic state. We're locked in.

So everything is tightened. There's less circulation happening just because of this state. But then you're less likely to look at your surroundings, look up and down. and therefore you have less range of motion. And when you have less range of motion, you basically develop like a frozen shoulder situation just of your neck. And therefore you propagate the injury moving forward. So a lot of the work that I do with my patients,

even though they're coming in for a physical symptom, is exploring some of this mental health side of what they're doing. And I'm by no means a mental health specialist. I'm not a psychiatrist. I'm not a psychologist. Well, you're an FM doc, right? I'm an FM doc. But I broached the suburb.

But I broached the subject with them and I gauge their interest level in continuing this line of communication. And once I see that they have a layer of interest and they want to pursue and they've seen some good initial outcomes, we then connect them to a mental health specialist who can actually continue this work with them. But unless I'm going to be the one screening for it, catching this early, they're never going to see the mental health specialist in order to get there. So that's why I find the beauty of family medicine and osteopathic medicine combining in a place. where I actually have patient contact at a time where they're experiencing this pain, and probably when they're most motivated to seek help,

even though they may have come in for a sore arm, and yet we're now talking about their childhood and how things are going in life. It's a conversation they didn't expect. Yeah, absolutely. Mike, do you mind if I ask you like a couple of questions just a little bit about your training and stuff? Yeah, yeah, of course. So I've noticed that you've highlighted the fact that you're an osteopathic physician like several times and your sort of sharing principles of osteopathy.

Can you just help me a little bit, understand a little bit about, you know, what's the reason that you kind of highlight things that way, that you kind of draw that distinction? Yeah. So when I was in high school, I had options of where I wanted to go for college and then thinking about medical school in the future because I knew it was something I was passionate about. And when my father actually immigrated from Russia to the,

United States at age 40, I was six years old at the time, he actually went to medical school and residency all over again in the United States. And he happened to go to an osteopathic school, the same school that I attended. And I got to witness him learning OMT, the principles of being a DO, and it became part of my innate knowledge of how I treat patients. It's become something that I'm very proud of. Because historically in the United States, there has been some stigma around osteopathic physicians as being perhaps too alternative or not thinking about medications enough. And a lot of this stems from what osteopathic physicians, not physicians, osteopathy practitioners are across the globe. For example, in some countries in Europe and in Asia,

they are not fully licensed medical doctors and they do only perhaps perform OMT. And that is such an important distinction to be made because here in the United States, we are fully licensed. We can practice across any specialty. We can get more. board certified any specialty. When we do our residency training, our now programs are combined, all of them. This just happened not too long ago. My program where I did my family medicine training, I was trained alongside MDs and DOs. And after a while, we forgot who is an MD and who is a DO because our principals aligned so much that we took away what they learned in school. They took away what we learned in school and it really became merged. So much so that if I'm being honest,

The differences in MD and DO education is shrinking year to year because the MD curriculum is learning how well this holistic approach works that they've incorporated into their own. Honestly, Mike, that's why I was a little bit surprised by you highlighting because in my mind, like, whether someone is an MD or DO, you know, I don't like I fully understand that, you know, osteopathy has a different perspective that y'all learn OMT and we don't. And my experience, honestly, of DO versus MD school is that you all learn everything that we learn and you guys learn extra stuff. Yeah, you know, I think it also came from the idea that the entrance exams and grades initially to get into osteopathic schools were somewhat lower in that they were taking non-traditional applicants, perhaps those who are going into their second career immigrant applicants. And as a result, people just looked at the scores and said, oh, well, if I want to be. competitive and go to the highest specialty possible, you know, plastic surgery, ophthalmology, I'll have a better shot by becoming an MD. And that sort of changed the patient, the student selection for who went to each school. But now I think it's changing because now we see DO medical

students and DO doctors across all these specialties and, you know, at some of the highest positions in the United States. The former president, personal physician, the current president, personal physician, both were DOs. One is obviously still a DO. And the head of medicine for NASA is a DO. We really are now starting to expand into being everywhere. But I still bring up the concept of osteopathy because it's really my foundation as to why I think holistically. It happened because of my education. And in seeing how my MD colleagues were trained, it's not that they got a lower form of education. They're brilliant physicians. It was just with a slightly different focus. But I honestly they think that focus is changing and it's shifting for the better.

What would you say is the difference in the focus that your MD colleagues got? They had an intense understanding of the physiology and the pathophysiology behind conditions, but less of the psychosocial components, less of the communication component. And I can give a very concrete example here. When I went in as a third year student into my clinicals, into my internal medicine rotation in inner city Brooklyn, I was very comfortable performing physical exams because from year one as a DO you're working on your other classmates doing osteopathic manipulative therapy. So you're getting used to what it's like to feel normal structures on a body.

You're getting used to interacting with different people, different shapes, different sizes, etc. So when I came in, I was very ready to talk to a patient, to feel what was going on, to feel perhaps a tumor earlier than other colleagues of mine. So I think that that helped me in a way to be a better physician. And again, every school is different. Every residency program is different. I only highlight this because that stigma that existed probably 10, 20 years ago, more so than it does today against EOs,

to really highlight the fact that not only are we so similar, each year we're becoming more and more similar. Absolutely, man. So Mike, I'm noticing that a lot of your, it sounds like you've thought a lot about what you're sharing today. Like it sounds, you know, very well organized.

I can sort of see that the teacher inside you coming out. And so I'm a little bit honestly curious about it because it sounds like you sort of, you know, it sounds like you kind of figured things out, bro. I appreciate you saying that. I probably should prepare more for when I give presentations. But I like for it to come from an organic place because as I present information like this, I'm actually at the same time while I'm presenting it,

trying to re-understand it and process it myself so that if I say something that doesn't make sense, it's because I'm actively trying to listen to myself speak, kind of a way that I fact-check myself, especially when making YouTube videos and social media content. So I tend not to like to prepare for things like this because I wanted to be like, you're a patient or you're a friend of mine who's asking me these questions and we're just having a conversation about it. Yeah, absolutely. So I'm not, I'm not getting the sense that you're over prepared at all, but I just, I'm hearing a certain organization to your, you know, the way you're kind of talking. And like it really sounds like I'm talking to a teacher. It reminds me of being in class, like in

medical school where, you know, I totally get that you don't know everything. But at the same time, what I'm hearing is a very, you know, strong and consistent representation of when you work with a patient when you kind of think holistically, you've noticed that there are very real mental components that will contribute to someone's physical pain. And I mean, I don't, I kind of, I'm with you. Yeah. I mean, I love that we're on the same page on that because for me, I've always been a curious individual. I think my, uh, either my college or medical school application title was, essay title was, why am I always hungry? And it was hungry for knowledge.

And whenever I see a patient, I always treat every interaction as like one interaction. And then I think about it later, what could I do to improve that interaction or what I could do better to be a better doctor? And I think about the unanswered questions I have. And I think about that, not just for osteopathic principles, but also for, like, if a patient comes in for strep throat, why am I giving antibiotics for strep throat? The scary reality is if we ask most doctors why we treat strep throat, I think most doctors won't know the answer to that question.

Like they're going to say, oh, to get better faster, or they'll say, oh, because you can spread. Prevent cardiac complications, rheumatic fever. And the reality is if you don't take antibiotics, the symptoms will only on average be 16 hours longer. So it's not like patients think, oh, I need to get my antibiotics so I can get better quicker. not really going to happen. And we're really preventing complications, like you said, cardiac, rheumatic fever, and potentially kidney complications. But most doctors don't know that. They think they're just treating the bacteria where the bacteria here is not so much a threat as if it spreads,

it becomes problematic. And even then, it's a thin line as we study more and more, how often should we be doing this? What's the risk versus benefit in doing this? And we're starting to continually explore our knowledge here. That's why I fell in love with medicine because we're continually learning. We're continually fact-checking ourselves. Because even in an era like this where misinformation is so prominent, people are like, the science is wrong. No, no, no. Science is never wrong.

Scientists are wrong. Doctors are wrong. The science is never wrong. The science is the process that helps us figure out that we were wrong or that our hypotheses were wrong. So I love reading about that, studying that, and applying it to my everyday sort of patients and such. Mike, I find that the things that I'm the most curious about are actually like more you as opposed to your patient interactions because it's fascinating to hear, you know, maybe it's

because I'm a psychiatrist, but speaking holistically, like here we are having a conversation about mind-body connection. And what I'm sort of seeing is the person underneath. Like, so you're asking the question, but what I'm really find myself kind of curious about is like, who is the person asking the question? I mean, just so far, you know, because I think you, like I said, I think you've explained everything really well. I mean, you clearly know what you're talking about. And so what I'm kind of curious about because you sort of don't leave questions unanswered in the way that you speak. I think you do a really good job of, of, you know, kind of laying things out, offering examples, things like that, sharing personal anecdotes. And it really gets woven together, like, quite

beautifully. But what I find myself being curious about is, you know, who is the person who wrote that essay? What was it like to have a dad who was an osteopathic physician? And you kind of said that, like, you grew up with this stuff, right? And so I'm kind of thinking a little bit about, like, if we want to change medicine to be a little bit more holistic, like, honestly, the stuff that I want to ask you, like, I'm sure I could ask you questions about, you know, how you approach acid reflux. But to be honest, what I'm the most curious about is actually like you. Yeah, no, I mean, absolutely. If you want to venture into that, I'm happy to talk about anything. I consider myself one of those people on social media that treats life like an open book.

So whatever questions or whichever direction you want to take this, you're the host, you lead the way. Yeah. So if I ask anything that you think is kind of out of line or you don't feel comfortable answering, you know, just feel free. But like I was just curious. So it sounds like you, you, I mean, you moved to the United States at the age of six. Can you tell me a little bit about what you remember about Russia and? Yeah, I don't remember much. I just remember leaving very abruptly. My one story that I remember that I tell quite often is a really funny story. I remember, I guess my entrepreneurial sense was even very healthy back then. where my dad went to the food market and bought some pears home and corn on the cob home.

And I was eating some corn on the cob in the playground. And some of the older kids were like, oh, we want some corn. And I'm like, well, I have some corn upstairs. They're like, oh, we'll buy it from you at a markup. So I ran upstairs, and then I realized we had no more corn left because my whole family ate it. So instead, I brought outside pears. And I said, okay, I'll sell you these pairs. And I started selling pears at like 5x the cost, which is still not that much money, obviously,

to everyone on the playground, grandparents, kids, older kids, etc. And I brought home and I showed my dad the money. I'm like, look. And like, very surprising to me, my dad yells at me and says, how dare you rip people off? You have to go back and give everyone back their money. And I gave everyone back their money. Some people wouldn't take it back. They were like, no, you sold me the pair.

I knew what I was getting and you keep it. And he came with me and we went to those people's houses and he made me give it back. And they laughed and they took their money. money back. But I don't know why that story stuck in my head. I guess it might have a traumatic experience of sorts. But that is what sticks with me most from my Russian experience. I mean, I'm not hearing traumatic what I'm hearing. The word I'd use is formative. Perhaps, yep. Right? So like sometimes, I understand why you kind of go towards traumatic, because a lot of times we think of dramatic experiences as formative. You know, they shape the way that

we look at things. But I mean, what do you think it was that your dad was trying to like teach you there like what'd you come away with i think um he was probably going for fairness um equality making sure that i'm never unethical or moral in my dealings and i think it definitely stuck i mean in the work that we do on my social media channel i think i don't know if it's directly because of that situation obviously but the way that i was raised definitely affects the way that I run social media as a business entity. Like, I don't know, like a lot of, you know, YouTubers sell merch. And while I think it's great to make money from your audience, I feel like I'm already so blessed with the success that I've had, we like to do it all for charity. Or we have

a Patreon. And again, we're taking money from the audience. Instead, we decide every month where, collectively as a group, where we're going to donate that money. And I like to do good as much as I can in addition to, you know, succeeding on my own. Like I would want it to be a universal success as much as possible. I'm not in favor when I say that the communist model by any means. We left Russia for a reason. But if people are working for it, I want them to succeed as much as possible. And witnessing my immigrant family go through it, I think that definitely instilled some strong morals in me. And that was a formative experience for sure. What do you mean by watching your immigrant family go through it?

Well, coming to the United States, you know, we're very poor. We lived on welfare for the first few years here in the U.S., especially when my father was in school. My mom was a PhD math professor at an esteemed university in Russia. When coming here, she didn't speak English. So she was sweeping floors to make ends meet. She was saving money on bus fare, like the dollar or bus fare at what it was at the time, and would walk two, three miles to work every day. Like, there was this Russian saying that I frequently.

revisit in my videos called Chis Nymagu, and it means going through I can't. That's the very literal translation of it, but it's almost like Nike's just do it. I guess my dad was a fan of Nike back in the early 90s. Can you help me? That sounds like a cool saying. Can you explain what the meaning of it is, going through I can't? Yeah, so when things get going, it's basically pushing through the struggles. You know, there's plenty of great quotes out there. Michael Jordan, and one sticks out of my head of if there's an obstacle in front of you, think about going through it, think about going over it, think about, you know, digging underneath. I'm probably butchering that quote, but I'm paraphrasing. I see. So like that's sort of working through,

I can't. Like, yeah, like you want to say I can't. This is hard. Don't let that emotion stop you from whatever it is you're seeking to accomplish. Wow. So it sounds like your, you know, your parents worked really hard and really had to, I mean, It's got to be tough to go through. My parents, both my parents were medical doctors. Thankfully, they didn't have to repeat medical school, but they, you know, they did residency over here. And I mean, it must have been tough for your dad to repeat medical school and go through residency again. I try and pull myself in his shoes and say, okay, like, I'm a doctor now.

What's going to take in 10 years for me to be so unhappy living in the United States that I'm going to move to another country, let's say China. and learn Chinese. And while I'm learning Chinese, go to a Chinese medical school and then a residency. Like, I don't know how bad it needs to get and how motivated I have to be, 10 years from now to want to do that.

But it shows the level of dedication that he had for the success of myself and my sister for us to have a good childhood and grow up with opportunities because that's essentially why he came here and why we brought her family here and faced all these risks. And you said you kind of grew up

with that holistic perspective at home? Like, you know, do you have a sense of whether your dad, like, because I assume he went to like an MD school in Russia? And so do you have a sense of like, you know, how his perspective changed or what it means to grow up with a holistic perspective at school, I mean, at home? Yeah, I don't know if he ever went into depth. I think it happened through an osmosis type of knowledge transfer where he would be practicing OMT for his boards or for his exams.

and he would be practicing on me. And at the time, I was an athlete, I was doing taekwondo for about eight, nine years. I was going to tournaments, regularly getting injured, and him working on me and also helping me focus on school and giving me these mental health sort of boosts by telling me I need to go through, I can't. I think that sort of presented that holistic picture. And whether it came from the medical school that he was attending or that's who he was as a person before, it's hard for me to say.

Can you tell me about Taekwondo? Yeah, so that was a really long part of my childhood. When I was six right away, they enrolled me in this program. It was like three, four days a week, a lot of training. I was getting pretty good at it too, where I was deciding or at least considering trying out for the U.S. Olympic team. Wow. And, yeah, I won some like national tournaments and stuff for sparring.

And I was really excited about it. but then with school and I moved to a different city, I kind of lost track with it and started playing other sports. I became like the captain of my high school soccer team, played that for a while. And then when I went into my seven-year combined undergrad med school program, when you were in undergrad, they didn't allow you to play sports because you were taking so many credits. It would break the NCAA rules. So I didn't play any collegiate sports except some intermural stuff here and there. Wow. Mike, I'm fascinated. I mean, how do you understand why, I mean, how does someone become, you know, a national taekwondo champion captain of the

soccer team? Like, like, how do you do that? I mean, I don't know. It was just, it wasn't some pre-thought-out plan that I had. I think I'm athletic genetically. I'm tall, I'm lean, so I was training from an early age. I think any time that, you know, you have some good genetic, and you put the dedication in, you're going to have good outcomes. I didn't achieve, you know, Olympic success or do any of this stuff. So I don't want to take the credit for any of this, but it was fun. I genuinely enjoy sports. And I think I sort of have taken some of the principles from sports and applied it to my medical

training and even the way that I treat patients, whether they're one-year-old or a hundred one-year-old, I try and treat them like athletes. You know, like even Parkinson's patients, we now treat like athletes. We create a rehab program as if they're rehabbing from an ACL injury in order for them to be moving better, swallowing better, working with a speech language pathologist for their swallowing, working with a physical therapist to improve their gait. And I really believe in the sports philosophy. I think there's a lot of great takeaways from it as well as some negatives, you know, like sports psychology is a really interesting field of research that I'm constantly looking at, connections to the mind, body from sports. is always something I'm really interested in. And that sort of interest and constantly moving, I think, translates well to the medical field.

Interesting. And can you tell me a little bit, it sounds like you went to a combined seven-year undergrad med school program. How did you decide to do that? Yeah. So I knew I wanted to become a physician when I was in high school. I witnessed, you know, as kind of popular as it sounds. my father going through the whole journey and seeing that I really enjoyed it, that it was a respectful field.

I was good at science. I liked learning about the human body. Like I said, I was somewhat athletic. So that was part of the journey. And I said, what's the quickest way I can do it? Because I was always in a rush. Like, I never had any patience for anything. And because my father went to that program, he was aware that there was this seven-year program

that existed. Sorry, he went to that medical school. And I applied and I luckily got in. And instead of going the undergrad route, I was accepted into this very competitive program where there were about, let's say, 88 acceptance people's, 88 individuals accepted to the program. And then upon completion of medical school for the seven years, like 13, 14 individuals finished. So you had to maintain a very strict GPA in undergrad. You have to get an MCAT score to continue into the medical school portion.

And also, life gets in the way. I mean, in seven years, things change for people. You know, when you're 16, 17, 18 years old, you're making a decision what you want to do for the rest of your life. People change and grow. Yeah. So it's interesting because you say that you knew you wanted to be a physician in high school. Can you help me? Are these two personal, by the way?

Or is this, are we cool? No, no, absolutely not. Yeah, of course, please. How did you know you wanted to be a physician? Yeah. I mean, like, I knew as much as a 16 or 17-year-old would know anything. I didn't know. But I thought it was a good choice in that.

it was something I enjoyed. I thought it was a good choice because it lined up with my skill set, communicating with patients, having an interest in the human body, being able to focus to actually study on these topics. Because my mom being a math professor, I hated math. You know,

luckily she tutored me so much so that I crushed the SAT because of her. I almost got a perfect score on the math portion. But if you told me I had to study math on my own, it would never happen. So science was just like a really happy, line that matched up with my skill line that worked really well for a career and seeing what the intricacies were like. A lot of students say they want to go into medicine, but they have no idea what

medicine is. I knew. I went with my dad to his residency when he, when there was a bring your child to work day. I saw what his on call rooms were like. I saw what it looked like when he was studying with his PowerPoints or his textbooks. So like I kind of got an inside look at the journey and I got the good with the bad. He never forced me to become a doctor. In fact, he said, you sure you want to do this? Probably not ideal. Our health care system is broken. I'm doing this because I'm old and there's nothing else to do. You can do anything. But he always spoke very highly about his connection with his patients and how it's never a dull day. And the career sold itself for me. Wow. So, med school. And then how did you decide on family medicine? Or what? Yeah. Yeah. So I initially wanted to

pursue the field of surgery going into medical school. And I, during my first two years, that's still held true. During my third year surgical rotation, it was about 12 weeks. And I spent that time in Lutheran Medical Center, a very high trauma area. It was a level one trauma center. And I scrubbed into like 60 surgeries at the time, maybe 70 surgeries. And I was like, I want to make a good impression, because this is a program that accepts some of our medical school applicants, so maybe I want to go here. And the more and more I did it, I realized it's not where my skill set was. It wasn't where I found myself to be most happy.

While I enjoyed the technical prowess of becoming a surgeon, I disliked the fact that I didn't get continuity with the patients, and I didn't get to communicate much with them because the realities they're asleep for the majority of the time. So I spent a lot of time doing family medicine as well because that's part of your required rotations. and then I found myself just addicted to the field that I constantly wanted to do it more and more. My fourth year, I had like five different family medicine rotations as my electives.

I was also really passionate about sports medicine. I considered making that as part of my fellowship training after residency. And I started even during my residency, my first year covering sporting events, high school, college football games. And I was really passionate about that as well, especially being an osteopathic physician. position. And, you know, I just kept exploring more and more. Family medicine was the field for me. Fascinating. Yeah, I think the most important lesson I took away from my surgery rotation was that if you round super early in the morning, no one wants to talk to you. And it's something that I actually sometimes would use when I'd be like moonlighting. So I'd cover like, you know, weekends at hospitals

and stuff. And, you know, shift starts at 630. So a lot of times we're like, oh, you know, like you can start rounding around eight or nine. You know, the patients will be awake then. And I was like, uh-uh, I'm going to round it like seven. Well, speaking of mind and body, isn't that like messed up that we do that to patients who are healing in the hospital? We don't let them sleep and then we round on them at 5 a.m. And then like not getting better because they're not resting. We're pretty evil in hospitals. And then we give them the worst food ever. I think, I think hospital care is important. And I think that's part of the reason why, you know, people get so much better after they leave is because, you know.

And speaking of, you know, giving people healthy food, this is a, if I can share a story. One of my favorite stories from residency is on the inpatient psychiatry unit. At Mass General Hospital, they were doing like, you know, they're trying to be healthy, right? So like their food has gotten a lot healthier over time. And it's actually like the cafeteria is like pretty good. Okay. So relatively healthy, like relatively tasty. And so we had this one person that was hospitalized who had a lot of,

behavioral problems. We had to keep on calling security, you know, inpatient psychiatry. I'm sure you remember a little bit about how it can be sometimes. And so one of my colleagues was just absolutely brilliant. And she was just incredibly compassionate. This patient is just really combative. And so she sort of asked him, like, you know, like, what, like, is there anything we can do? Like, what do you hate about being here? You hate being here. We can't let you leave. I'm so sorry about that. Is there anything that I can do? And so somehow I think she like figured out that he wanted like chicken fingers. So what she did is get him a pediatric menu, right? Because like the adult menus have like salads and like, you know, like, you know, wheat bread with like lean protein kind of sandwiches. So she got him a pediatric

menu. And like the behavioral disturbances just tanked. He was just like as long as he got his chicken fingers and pizza and stuff like that. And then the funny thing is like the rest of the unit like started to revolt because they're like, why does he get chicken figures and I just get salad? And so then we had this like unit wide. They're like, I want my chicken fingers. Like, where's my attendees at? You know? And so it was a real problem. Our unit, like, you know, the person who ran the unit was like really frustrated with the situation because he's actually someone who's very into like diet and, you know, all about like mind-body kind of stuff. And like we have to, you know, we have to, you know, offer patients like healthy foods.

And so some people, you know, we just sort of, I think some people ended up, you know, it was like 10 days on the unit for a week and then people started to get discharged and then sort of evened itself out. But yeah. Yeah. Well, that's like a form of risk reduction, right? So like, you know, eating chicken fingers isn't great. But if it's going to prevent patients from harming themselves or harming others, maybe chicken

fingers aren't so bad. Absolutely. Right. I think that's, that was ultimately the approach is that it's way better than injecting them with medication that they don't want. like just give them some, you know, give them some tendies. I love that you call them tendies. That's awesome. Yeah, that, you know, tendies.

I don't know if you're how familiar you are with 4chan. Familiar with 4chan? I've heard of it. That's like a Reddit-esque forum, right? I don't know if people are going to be insulted or flattered by that comparison. I don't know. So, Fort Chan. Yeah, yeah. So 4chan is, it's a message board. that's entirely anonymous. So there are no accounts.

And maybe I don't know if there are accounts or not, but like since it's all anonymous, it tends to get a lot of flack for actually there's a lot of like weird and relatively toxic stuff there because. And so a lot of like memes and things like that come out of 4chan. And one of the big things that came out of 4chan is actually 10D. And I don't know if you were following any of this GameStop kind of stuff. Yep. we're actually doing a we're actually in the process of doing a research paper on

prevalence of different mental health conditions on 4chan and I wonder have you ever heard of something called RFID I know it's like a relatively new diagnosis it's like a wait our fit you said arfid yeah it's like a restrictive it's a restrictive feeding disorder it's like a new kind of eating disorder so kind of on the frontier is a relatively new diagnosis but the interesting thing is that people who have ARFID who basically can't eat certain foods because they can't tolerate like the texture. So sometimes kids will be like, you know, picky eaters and some people grow out of it. But especially some people on the autism spectrum seem to have like a lot of Arphid like qualities. The one thing is every single patient I've had with Arfid loves tendies.

It's like the one thing that they can eat. So like it does like, you know, it's not, it seems to be like that tendies are what people eat. Also, every patient that I've had with autism, actually, I don't know about every patient, actually, yeah, that I can fairly say. Likes tendies too. Wow. And so we're really curious about whether there's actually like a correlation

between the prevalence of ARFID and whether you hang out on 4chan. So we're studying. And those are the kinds of studies that unfortunately the NIH isn't funding, you know? Wow. I'm clear whether, you know, it serves human. to know whether the prevalence of RFID is greater on 4chan or not. I don't really know, but it's a research question that we're fascinated in,

so we're going to try to study it. I love it. Okay. And that should be a fun study to get results from. I'm sure you're going to get a meme out of it. Yeah, so I think it's going to be all memes. Like, memes is one of the major outcomes of the study. There's going to be like prevalence of arfid and production of memes are going to be the two outcomes that we look at. But anyway, yeah, I don't know where I was going with that.

Well, I learned something. I didn't know about ARFID, and now I know that attendees are the go-to for patients that are potentially struggling with texture. And yeah, so, you know, as an FM doc, like, I don't know, you know, how pediatric your population is, but for picky eaters, like some of them may have actually ARFID. So just kind of going back to, so it sounds like you did a seven-year combined program and then went into family medicine. And can you tell me a little bit about like social media and how that started for you? Because as I understand, you're huge. It happened in a weird way. During medical school, I had an Instagram profile. And I never had social media prior to Instagram.

But then when I was studying for my boards, actually, I was studying alongside my friend who was a nursing school, studying for his NCLEX. And he was taking pictures outside of the small library window of clouds. And I'm like, what are you doing? like stop distracting me like you're taking pictures i hear the flash i hear the clicking sound and he's like no dude there's this new app it's called instagram where if you take a picture of the sunset and you do hashtag sunset uh you'll get a bunch of likes and all these people come visit your profile and i was like that sounds silly like you're just bored so later that day i come home i'm like oh it's kind of a cool app let me try and i posted a picture of my siberian husky at the time and it got all these likes and

one of the likes stood out to me was from a professional like i think alpine ski or that I watched in the Olympics, the prior Olympics. And I said, wow, look how cool this is. This app can bring people together. Let me, like, use this as sort of my blog, if you will, day-to-day activities, put pictures on it. There was no stories at the time. So just kind of like posting on there and without any real goals, but with the potential

that it could somewhat help my medical career in the future, whether it was for marketing, connections, et cetera, et cetera. And I did that through our mental mindset. Exactly. That I just thought like connecting. with people by the thousands is going to be beneficial in one way or another. And it also didn't hurt growing up. I didn't get a lot of compliments or like female attention. And now on social media, I was probably in the best shape that I was at the time I was posting on social media and I was

really into bodybuilding that was getting a lot of compliments there for that. I'm sure that played a role in continuing to do that. And I was doing that for a while. Sorry, what role do you think that played? Positive dopamine hits continue to come back. There was definitely a point in time where it affected me in a way where I became arrogant with the fact that I had, you know, 5,000 followers or something. And my friends, they are quick to humble me and they pointed out that I was becoming that person. And I had to do some introspection. I actually deleted the app for a while, not like my profile off the app, but the app off my phone.

and really questioned why I was doing it. Was there something unhealthy behind it? And I definitely saw that I was talking way too much about it all the time. And it became something that I didn't like about myself that I was becoming. So I said, okay, I need to like tone down the amount of time I'm talking about social media, realize that my value is not tied to the self-worth of how many followers I have, that if people like me, it's because they like me, not because of the followers. And I learned that lesson fairly early on.

Yeah. you're fast forwarding past all the good parts. So like here's what I'm hearing. Like if like like, just think about this for a second, okay? Because like people getting wrapped up in social media, people becoming arrogant. As you said, people becoming that person. There are a lot of those people out there. And if there's one thing that I think actually could be very educational for people, it's like not everyone is able to do that, right? Like in fact, it's, I'd love to ask you a few more questions. But if, you know, if you. Yeah. No, no, that's fair game. I think my sort of scale like I'm always kind of making fun of the fact that I'm not the smartest person in the world and that I wasn't the top student in my class.

But I think where my skill lies in being introspective and constantly reevaluating my actions and my thoughts. So if you'd like to ask about that, I'm all. Yeah. So who did you become when you say you became that person? What started to happen? What does that person look like? Yeah. It would basically be every conversation that I had.

was about the social media. And my value ranking system of the people in my life became about who had followers. I don't know if you're familiar with Black Mirror or the TV show on Netflix. There was an episode where, yeah, there was one episode where they kind of like rated each other, a ranking system.

Yeah. And like no joke, it was eerily similar to what was becoming sort of in my mind to a degree where like if someone would talk to me, I would feel perhaps above them because I had a certain following. And keep in mind, I'm 19 years old at the time. So, like, I'm still a student. Like, I have no money.

I'm broke. And this is the only thing where I had some value that I was like, oh, my God, I'm cool because of this. And I realized I was tying all my self-worth to it and everyone else's self-worth to it because it was simple in that the dopamine hits came when likes came, that you could easily quantify, like, people based on their numbers. but that's not reality because people aren't just numbers. So it was a false system, but it was an easy system.

And yeah, I just talked way too much about it. And I showed off way too much about how many likes my post God or how many followers I had. And I didn't like who I was becoming. I didn't like that I was doing that so often. And I learned that lesson early on. But that's not to say that I didn't relearn that lesson over and over and over again. Like even over the last year, not so much that I was becoming arrogant, but over the last year, I found myself, again, tying my happiness levels or my fulfillment levels to numbers on social media.

And that's something I talk about not doing all the time. And yet I did it so often even this last year. So it's a constant process of learning and tying things back to things that you learned before. That sounds like really, really helpful to understand. Like, because what I'm hearing is that, you know, you kind of fell into that trap once and you kind of worked your way through it, you know, and then, but at the same time, you can still fall into the trap again. Yeah, for sure. And it might be a slightly different trap. Like, it might be the numbers again, but not so much with arrogance the next time, but with happiness or success or fulfillment, what have you.

So the trap is always there. Can you help me understand that? And you mentioned like over the last year. Yeah. So I have a cool, probably one, an example that you'll really relate to well being in the field of psychiatry. The treadmill of hedonism where we constantly are on this treadmill chasing extrinsic levels of happiness. So whether it's money, fame, what have you is something I try and stay away from as much as possible. I try and get fulfillment from my deep personal relationships from the volunteer work that I

do my patience, et cetera. However, YouTube, specifically YouTube, is savagely pushing the treadmill onto you and doesn't let you leave the treadmill. Because YouTube is this unique algorithm that essentially is this evil personal trainer that doesn't let you get off the treadmill. Because when you create a piece of content that does well, it doesn't allow you to celebrate that success because the next video has to either equate or even supersede the success of the next one. Otherwise, the algorithm will just stop recommending it and the feedback mechanism of what makes you happy falls off very quickly. So while in other platforms, like if you did well, you continue doing well, YouTube, you're either growing or you're shrinking. There's no like

in between. And because of that, you find yourself on this treadmill all the time. chasing success and you never really get to take a proper break unless you have a great understanding of how all of this works psychologically and knowing yourself. So I like to make the comparison between traditional television and YouTube in this way. And I'm borrowing part of this concept from a good friend of mine who runs this channel called Infographics Show. He talks about deserved views versus earned views. And when we talk about like, Game of Thrones. If season one is a hit, everyone will tune in to season two because it deserved those views. YouTube is savage in that you can have a great 10 videos, but if your 11th

video gets a lower watch time or has a lower click-through rate, YouTube doesn't care that you crushed it on the last 10 videos, your views will just get destroyed in the algorithm, which is great for the viewer because the viewer is only getting the top tier content, but as a creator, you're constantly under the gun because all of your views have to be earned. None of them are deserved. So good in the concept that the viewer gets the best content, good in that it's created a level playing field, that it doesn't matter if you have one subscriber or a million subscribers, any piece of content can get recommended and get viral success.

Bad for the creator in terms of burnout. Bad for the creator that you never really get a chance to disconnect or celebrate your successes unless you are a really, really organized and psychologically well-understood individual. That blew my mind, first of all. Thank you so much for sharing that. And I'm so curious, like what, so what does that do to you, right? So you talked about YouTube. You talked about how you basically like can't ever stop growing. Otherwise, you'll fall off. And what is that, do to you? How does that affect fulfillment, success, things like that? Well, I've been doing YouTube for probably just over four years now. And never missing a posting

date, you want to continue that. Your growth was really good. You want to continue that. Inadvertently, you end up tying your self-worth to your subscriber count or your view count or your growth count. And as a result, if that for whatever reason, pauses, fades, decreases, it ultimately starts affecting your mental health. And unless you are in a very healthy, healthy psychological mindset, like I'm talking about where you can be in that Buddhist state where you're like, everything is transient, even if something bad happens, it won't be long. And if anything good happens, it won't be for that long. So I'll be happy here, sad here. and I'm so balanced, you're going to suffer as a result.

And for me, despite how balanced I come off or happy I come off in my posts and all of that, this last year was absolutely a struggle. You know, pandemic has affected everybody to a degree. But watching sometimes content drop off or going through some difficult times in life, watching the YouTube channel suffer affected me way more than it should have. And as a result, I had to function in much the same way. way I did when I was 18, 19 years old when I was becoming arrogant and tying myself worth to it back then.

And how did that, you kind of say, you talk about it like it's inevitable. What, like, what was your experience of, so I'm, I'm just inferring here that over the last year, your YouTube channel growth slowed down? Yeah, well, not only did it slow down, but also, you know, burnout is real. Like, like I said, you don't get deserved. views, you get earned views. And when, you know, you do that without taking any breaks. And that's essentially what I've been doing for four years saying like, I will outlast. I will persevere. Going through, I can't, you know, my dad's advice. I have been pushing really hard in

addition to residency because all of this started towards the middle of my residency. And I made sure to make that a priority. So never took a day off residency to do anything socially. media related. So while finishing that, also doing this at the same time, it just, it was such a long process that it caught up with me in that I was like really getting burnt out, like the classical symptoms of burnout where you derive less joy from the things that once brought you joy, sleep was messed up, anxiety was high, where I actually had to seek therapy throughout the pandemic. And I learned a lot, you know, I learned a lot going through there because it's something I advocate for my patients, and now it was the time that I realized I do need help and I need to

figure out what was going on. And I think this was a cool takeaway that I learned from therapy, which is you're very familiar with CBT, cognitive behavioral therapy, you know, attacking your irrational thoughts, putting in a more rational thought to at least decrease the grasp or the depth of how sad you feel or how depressed you feel. And I would do that quite well for the last 10 years or so, I would say, or at least well enough to help me manage. But over the last year, what I found was that I was doing the CBT on myself so often that I was reliving the negative experiences over and over again. Where, like, you know, if you watch a movie, a scary movie, or an action movie,

your brain on a functional MRI lights up the same areas of your brain as if you were experiencing that pain or that fear. So I was essentially doing that to my brain over and over again by trying. to force CBT on myself and only when speaking to a mental health professional realize that I need to actually disconnect from that and I need to disconnect from social media and I need to not constantly be refreshing my feeds and that while they're going through I can't could be a great coping mechanism and hiding or disconnecting like disconnecting viewed as hiding could be perceived as a negative coping mechanism if I'm not facing reality but that wasn't what was happening I was

facing reality, but I was doing it so much so that it was actually having a negative effect. So the coping mechanism of hiding or disconnecting was actually a strong positive that I was missing out on. And that was something I learned that I wouldn't have learned had I not sought out help. Yeah, that's, thank you so much for sharing that, Mike. Can I just kind of recap what I heard there? Please, yeah. So it's interesting because, you know, when I, when I, when I, you know, what you give off is like unrivaled success. Right?

Like it's like, you know, it's the immigrant story like growing up like, you know, this, I mean, you're driven, you're focused, you're caring. And, you know, like national, oh, yeah, like, like even the, even the humility is so amazing. Because you're like, yeah, like, it's not like I was an Olympic athlete. I was just a national champion, you know, like, NBD. And so it's like, because you seem to, you know, really succeed a lot, man. Like, you know, like succeeding from a young age, like seven-year medical programs are not easy to get into. They're fucking way more competitive than MD schools for sure.

I'm pretty sure about that. I mean, I actually don't know the statistics. But my understanding of the accelerated, you know, programs are that they're hard to get into. And like you said, because they have like a high drop off. right, right? Because it ain't easy. A lot of people drop out, so they're very selective with who they take. And then FM residency and then social media. And it's kind of like whether you like, whether it starts with offering to sell corn and making a profit on pairs, right? You find a way. Right? You follow through or you, you, what did you say? You work through. I can't.

Yeah. And and so it's really interesting to see kind of what that mentality, how it's, helped you a lot. And also, like, it sounds like you've sort of paid a price for never letting yourself say, I can't. Can't take a break. Got to keep growing. I can do this. You know, like, and even the way you, when you were talking about CBT, you said, attack your rational thoughts. And I was like, yeah, that's, that's going to be a problem. I mean, I think if we're talking about, you know, balance in the mind and the Buddha state that you're talking about, attacking your mind is not how you get there. You can absolutely succeed. It's how you can get success. And this is what I've seen time and time again. It's that, you know, when people, you know,

really like don't let themselves fail, it's a very brutal way of living. It's a very successful way of living. But it's brutal on the self. You know, it's hard because I don't think you're quite listening to other parts of your body, listening to other parts of your mind, because you're not going to be a quitter. You know, that's not, that's not who you are. And so it was really fascinating to hear. I think I feel like I learned a lot. And thank you so much for sharing that. Yeah, I think any coping mechanism, if it's successful in the beginning, if you overuse it, it's ultimately going to have drawbacks. So, you know, this isn't a problem unique to me or unique to people who've had success. I think every human goes through something like this, just in different

ways in different situations. Just for me, I've always been like this energized kind of person. People called me Energizer Bunny growing up. My friend here in New York, he's like, you're like a cockroach. They can't kill you. You just keep going. Like you never get tired. I would work a 36-hour shift and I would go play basketball with my agent here in New York. So like, yeah, like I've always viewed that as a badge of honor or something that I identified myself as. But at the same time, I need to be aware of the pitfalls of always being on or of always being super friendly and accessible, even like right now. So if I go outside in New York and let's say I want to take my headphones and listen to an audio book and chill out on the grass on the west side highway with my dog,

without a doubt now it's come to the point that someone will come up and maybe ask for a picture, which isn't a big problem, but we'll want to get into a conversation and I want to talk to people. I want to meet people. But sometimes you just kind of want to be by yourself and vibe out on a book. And now I'm learning the reality of it. It's not a show off thing. People want to come up and get to know you and talk to you and they get excited. And I would have gotten excited if I was 18. I was meeting someone I was following. So I understand it. But now understanding that I can't always be available and I can't always be super friendly or just say yes to everybody. That is a completely for an experience to me because I hate saying no. I don't like saying no. But for my own mental health,

I have to sometimes now set some boundaries, which I've never set in my life before. Wow. Yeah. Sounds like it's a lesson you had to learn the hard way. It's not a hard way because there's way harder lessons learned in life from my patients, from my friends that I've seen, you know, struggle with serious, serious problems. And it's not to downplay the seriousness of my problem. It's just that's exactly what you're doing. It's just there's things that are cause real suffering and there's problems like each problem has a scale and I would say this is a true problem and it's truly affecting me. Um, but on levels of severity and how bad things could get, I know, maybe this is my own coping mechanism at play. And that's exactly what it is. Well done with

the introspection there. Right. Because it's interesting how you invalidate your suffering. I think that's what got you to four years of burnout. Because I think that's actually, Mike, like, I'm sorry if this is going off the rails in terms of what you're okay with. But like, that's how you get burnt out, right? Because there's a signal in your mind. And you've learned how to say, like, actually, I am okay having boundaries. But why did it take you four years? It's because when you say, like, even now when you say to me like, oh, my God, I sound like such an asshole.

Right. Like, that's how it feels to be like, because you want to be a nice person. you don't want to be that arrogant prick who's big on social media and doesn't have the time of day. Like, you recognize because you're a physician that every human is a human. It doesn't matter how many followers you've got on social media. Like you've got one heart. You can get an MI. I can get an MI.

We can both get strokes. We can all get cancer. You know, I think medicine is great in terms of teaching you that all humans are equal. And bizarrely, I think that's what's actually trapping you. Right? Because not all humans. I mean, when I just took a walk before we stream today and I walked around for 15 minutes, I've been recognized a total of four times on the street, you know?

And so it's still fun at that frequency. It's like four times over two years is great. Makes you feel good. But I still get to take walks. You know, it's like it's something that most human beings get to do. And I'd be really careful with yourself because, you know, sure, the suffering that other people go through is greater. But like, be careful there. because I think that makes you a good physician,

but it's also going to burn you the fuck out when it comes to social media. No, you're absolutely fundamentally in every way, right? The reason why it's confusing is it's unnatural. Yep, you're right. This type of notoriety is not a natural human thing, and it's not something even, like, I guess you could look to celebrities in traditional formats, actors, singers, etc. But like really from medical professionals or regular people, there's not a lot of people I can go to for advice, especially in the beginning when I was starting all the social media thing.

So I'm kind of trailblazing in a weird way. So that's why I'm always, you know, there's people who are growing in the medical space. I keep my DMs open to them. Again, sometimes at my own peril, where at midnight, where I shouldn't be sleeping, I'm having an hour conversation helping a fellow medical influencer navigate how to not get taken advantage by a brand. So like I want to do that as much as possible. So I'm trying to figure out how to manage all that. But it's a journey and I'm going to make mistakes. And you know, as long as I learn, I feel like that's okay.

And by the way, the comparison thing isn't also just looking at what other people are going through. It's also things that I've gone through in life. And, you know, well, I don't want to get too much into childhood stuff. But like during medical school, I did lose my mom to medical, to cancer. And that was a very tough thing to not, again, it was tough for me for sure. But the toughest part for me was watching how it affected my father, who did this whole process, who, you know, sacrificed so much of his life and was finally getting on his feet as a doctor. Him and my mom had all these plans, watching that break down, that hurt.

And, you know, leaving Long Island where I was living on campus at the time and moving back in with my dad, that presented all sorts of challenges. And I saw how difficult that was. So when I look through what I'm dealing with now, dealing with now, there definitely is a layer of like, An understanding of this is less serious than that. So it's not that I'm just saying, oh, people have it harder. So my broken bones shouldn't count. I've experienced 10 broken bones.

And this one broken bone is probably not as bad. Yeah. So what I'm hearing there is that there's a healthy amount of perspective as opposed to invalidation. Yeah. Right? Like in the grade. I don't want to say healthy. Why wouldn't you say healthy?

Well, no, it is a healthy mechanism. But I wouldn't say that this is perfect all the time. Again, I don't want to give myself so much credit that I'm like, oh, all the time I'm able to make this healthy comparison between my past struggles and my current struggles. I absolutely look at other people and see that they're struggling more than me and that I invalidate my own experiences. I do that. That's for sure. I was just really confused. Bro, like, why can't you give yourself credit for growing? No, no, I take the credit.

I just don't want it to come off like I know everything because it's not true. Why? Okay. I'll explain why it's important. I think it's important because I want people to see that while I'm doing this job that you labeled healthy, and I appreciate that, it's not always healthy. A lot of times am invalidating my feelings. So while I do have this sense of healthy perspective and all that, I also make a lot of these mistakes of comparing myself and invalidating my feelings. So people can understand that if they do that too, they're not failure.

This is what everyone does, including myself. Can I just think for a second? Sure. You're probably like, this guy is crazy. No, on the contrary. I think, you know, so here's what I'm seeing, Mike. You're not crazy. You're at the top of the bell curve.

And the problem here is that which I think which, and apologies, because I kind of think of you as a colleague, but what I'm going to say now may come across as like I know better than you. But, you know, I think we each have our respective. areas of specialty. So I think you got to be careful because like, how do I want to say this? There's just something about how hard you try to consider other people. Right. So like you think so much about how what you're saying is being perceived, which may be like related to social media, but I don't think, I think that would be a little bit unfair. I think it's just like you want people to

understand that it's okay to fail. You want people to understand that like you struggle too. And that's not you could you could say that there's a piece of that that's like, oh, like image conscious, right? Like in and you don't want to come across as arrogant. There may be a piece of that, but I'm getting a lot of genuine like you care about sending the right messages to people and not propagating actually like a lot of the messages that social media seems to project, which is that there are the chads, right? The taekwondo champions soccer captain's seven-year medical school program, people on YouTubers,

like you're all of those things. And then they're like the normal people over here. And so I think it's very clear to me that you're trying to share that you're not actually any different, right? That it's the introspection, it's the work, it's the effort. And that's what you really want people to come away with. Get that. But there's a subtle thing there,

which is like you're caring so much about other people like what about you? Yeah, that's the way that I would, first of all, 100% accurate. So very well done reading me and clearly you're a specialist and a professional in this space. No surprise there. For me, I sum it up in this. I become very good at being comfortable with being uncomfortable.

I'm shit at being comfortable with being comfortable. So part of that comes from all of that. is essentially how you explained it. So, yes, there's a layer of I don't want to come off arrogant and there's like a brand image conscious thing that I'm doing. But also it's because my ultimate mission and why I'm doing social media and where I derive my intrinsic value

is by putting out the accurate message. And especially to help people who are truly suffering with things that are confused and want good information. So. Hmm. Are you happy, Mike? Yeah. I'm fulfilled. Oh man, there's such a, did you see that show? I'm such a TV geek and movie geek. I relate everything back to shows. I don't know if I've watched too much TV in my life, but there's a show called Magic City. Tell me about it.

The worst show that I'm using as an example for such a high level of conversation about mental health, but it's a show about gangsters starting up gambling from Cuba in Florida and they're trying to get it. and all that, but they ask one of the mobsters, like, are you happy? And he says, howdy duties happy? I'm content. And I don't know why that line stuck with me, but instead of content, I think I'm fulfilled. What is that? So help me understand what fulfillment is. Fulfilment is, I like to think of it in a situation. So if today's my last day on earth, do I feel like I have accomplished everything I could have until this point? And am I satisfied? And the answer is yes. And I feel like if I could be in that mental state as much as I can in my life, I'm happy.

Like that's how I sort of grade it. So fulfillment is about accomplishment before you die? Satisfaction with what you have accomplished. And when I say accomplished, I really mean it in a holistic way, in an osteopathic way, if you will. Good relationships with my family, good relationships with my family, good relationships with my friends, being an ethical and moral person, helping the world while having success on my own right. That's how I think of accomplishments as opposed to, you know, seven million followers or whatever it is. Can I think for a second? How are we doing it on time, by the way? I don't know.

So we usually run for about two hours of the stretch. I think that's like the bandwidth that I have, but, and then we're coming up on an hour and a half. I'm good. I'm used to long interactions with my patients. So. So fulfillment is happiness? Yeah, I mean, like, are we looking for an Oxford definition of happiness? And the funny thing is, I love the field of positive psychology. So Martin Seligman, I'm going to butcher his name, Mihaili, the author of the book, Flo. I think, is how you pronounce it.

Not even going to try because it's so bad at my part. If I ever end up cross paths, I'm going to apologize. So I've read a lot of these authors and I've tried to figure out what happiness means. And I don't know. Like, you know, Martin Selleck's whole thing is flourish instead of happiness. He changed the term in his books. For me, I think happiness is fulfillment. I think happiness is also probably more accurate as a state of mind in a single moment as opposed to like, is your life happiness?

I don't think you can say that. I think happiness is like how you feel in this given moment, one to ten, boom. And right now, I can be happy because we're having a very fulfilling conversation. But if I stub my toe in 10 minutes and you ask me that, I'm not going to be so happy. So I think happiness is like a point of time reference where fulfillment is sort of a more grand scheme adjective. Or now. Yeah, so I'm not so sure I agree with you there. I love it.

Please share with me why I'm wrong. So here's what I'm hearing, okay? What I'm hearing is that you're not sure what happiness is. So your mind has figured out in an almost like a rational way. Like you've asked like, I don't want to make it sound intellectual. I think it's a little bit more philosophical or spiritual in nature. You're like, what is the nature of happiness? And when you kind of looked at like, here's what I'm imagining.

Okay. Like you kind of looked at your life and you were like, you know, because I think even the way that you define fulfillment comes with the construction of if I died today, would I have regrets? Could I be proud of what I've accomplished? Could I be proud of the life that I've built? Like, I'm on this earth. I've been given certain challenges. I've been given certain privileges. Did I do a good job? And if the answer to that question is yes, then you feel fulfilled. Is that fair? Yes, with just the small stipulation that yes is not a binary. answer, it's kind of like a percentage, if you will, of how much yes. Yeah, absolutely, right? So, like, there are these certain things that you can say, like,

you know, did Mike, like, do a good job? Did he leave the world a better place? And, like, you know, then he left it. And I totally get that. But I think it's, it's a little bit of a philosophical answer. And then it's interesting because then on the flip side, you also talk about an experiential answer, right? Which is that in a particular moment, I can have a particular state of mind. My sympathetic and parasympathetic nervous system or like in a right kind of balance. You know, I'm in a state of you stress,

like in kind of a flow state where it's not boring, but it's also not overly stressful. And I can feel like a temporary moment of happiness, but that that happiness is transient by nature. So when you talk about the Buddha, when you did this thing over here, right? So like when you talk about that, it sounds to me like that's really the one thing

that you sort of don't, quite haven't grasped fully yet. Like you're aware that it's possible. You know that people kind of do it. I'm not saying that you haven't grown and you haven't learned how to carve out balance in your life. But it feels like like Mike, everything you do is so damn effortful. You work so hard at it. It's funny.

You're saying the exact opposite of what like the attendings who have trained me say. They say, Mike always takes the path of least resistance. You work smarter, not harder. It's like the exact opposite of the feedback I've been giving my whole life. So it's interesting that you say that. Yeah. So that means on the one hand, maybe I'm completely wrong. Right?

Because if it's completely contrary. There's truth to both sides, as always. And no, well, maybe I'm just wrong, right? I just could be talking about it. Because you're not wrong. You're not wrong in the sense of like, I sometimes feel that on an unfair characterization of my work. when, like, I remember my ex-girlfriend's father said something like, oh, Mike's really smart. Like, he figured out a way to not work so many hours in the hospital.

Great. I'm like, are you insane? Like, do you know how many hours I work on social media and how stressful this is and all this? Yeah. So, like, sometimes I do feel like it's an unfair characterization. But at other times, I agree with it. I mean, so here's like, even when it comes to happiness, like you talk about being introspective, you've worked at happiness. Mm-hmm.

Well, it's not like, it's not like work sounds tedious. I enjoyed what I was doing, learning about happiness. Effortful. Effortful. You exerted effort, right? That's like, like, I'm noticing that you thought about it. You know, I'm not saying it's bad. I'm not saying it's not enjoyable.

But like there was energy expended. Let's put it that way. Agreed. And so I think that there's actually something in between those two states. So on the one hand, there's like the construction of Canada. I be proud of my life? And then on the other hand, there's the variant emotion of like transients. Maybe it's not quite emotion. I think it's a little bit more than that. But I think that if you, if you really pay attention to Buddhism and what that sort of being content is, like when you talk

about being psychologically like, let's say grounded to the point or yeah, like, you know, tethered enough to where the fluctuations of social media, which from a dopamine perspective, the neuroscience perspective, they're going to knock you off track, right? It's the equivalent. of sailing in stormy seas for your ego and your sense of, like, happiness. Like, that's just what it is. That's what social media does. That's why it's so successful because they figured out how to, like, flip all these switches in our brain that, you know, make us creating content and never quitting and giving a wonderful

experience to the user at the sacrifice to ourselves. And so I think finding that place of Buddha is actually there's something in between, which is actually a space of detachment. where it's sort of like, I know it sounds kind of weird, but like, you know, acknowledging... Like nihilism? Nope. Not nihilism. Detachment.

And so this is where, you know, and I think it kind of comes back to like when, and I think you would probably understand this actually. So when you make some YouTube content, I think there are a lot of different drivers in your mind. One is like the entrepreneurial, like, how do I make successful content? And then there are times, though, that I think that you probably put out of people. of con or you've got conflicting things. Okay. So there's a tension between what would be successful and like what feels spiritually or holistically like the right kind of content. There's some balance

between that. And so I think if you think about the spiritually, when you lean towards the holistic content, what you actually have to do is like detach from the consequences of what's going to happen with the content. When you make a piece of content, you're like, this may not do very well, but I'm just going to let that go. If it doesn't do so well, it's actually not that big of a deal. Like, I acknowledge it's going to do well. I'm not going to get bent out of shape that it's not going to do well, but I'm going to do this because it's like aligned with my values and it's like what I want to do. Does that make sense? Absolutely. And if I could just like from here, not to ruin your train of thought really quickly throw in here. I think about that a lot.

think about from a practical perspective what it would mean if I would switch and just go to making the content that pleases the soul, if you will. And I also think about how, on a practical sense, what it means to survive, what it means to, you know, be financially well off to be able to help others and do all these things. And I think about the value that comes from perhaps making like a memes video that may be on Memes 28, I'm not so excited to do Memes, 29, but I know that it'll bring in a ton of viewers that will watch the meaningful content content that will then enrich their lives. I think of all these things are kind of... I think content creators struggle with this a lot. But here's the interesting thing. If you made

content for the soul, I think you'd be unhappy. Interesting. Okay. So, because here's the important thing. It's not choosing content for the soul or choosing content for success. It is the detachment from the decision that is the source of happiness. I don't know if that makes sense. But like when you make content for the soul, it's not making content for the soul that is actually the source of happiness. It's the internal process

that you go through to let go of the successful content that is the source of happiness. Is that true? Does that like, is it possible? I agree that that could be the case. Could it also be the case that there is a source of happiness

that you enjoy doing that for the soul, not just deciding not to do the other thing? I know this is going to sound weird, right? It's going to sound really weird what I'm about to say. No. So this is where, and then this is where we have to be really careful, right? Because I'm talking about happiness as if it's true.

So what I'm going to say, like, so let me qualify that statement, okay? So I think this is the problem is because people like do what they love, right? Like, and they think that that's the source of happiness. That's not how it works. I think bizarrely, happiness is actually a relatively simple thing that I think would the, like, there's a reason. we kind of quote him, right? Because I think he figured it out. And the reason that a religion cropped up around him is because he actually like actually figured it out in sort of a scientific

way. That what is the nature of happiness? And the nature of happiness is actually detachment. And, you know, if you kind of think a little bit about why was it so hard for your dad when your mom passed away, it's because he was so attached to all of the things that they were going to do. Right. And so it's kind of interesting, but if you think about, you know, I know it sounds kind of weird, but like the more you get tangled up with something. And I think you probably understand this too because it sounds like you've gone through the process of disentangling yourself from your social media identity like over and over again. And so if we really think about it, each of those times, if you look for a common thread, I think what you're going to see is that you got caught up in it, right? Like who Mike was, Mike wasn't over here. Mike got taken over by Dr. Mike. And the more that you get entangled with Dr. Mike, you can be successful actually in both situations, but one of them is going to come with suffering

and one of them is going to come without suffering. Does that make sense? Yes. My pushback or question would be, first of all, I would venture to say that there's probably not one right way to live life. Like who is the ultimate judge of what happiness is? If someone finds happiness in not following a Buddhist mentality, they could be doing the right thing for them. Right. So like I try not to judge other people's definition of happiness.

When it comes to attaching yourself to something and then feeling tremendous sense of loss, like you mentioned with my father, this is not based on any evidence, but perhaps there is a layer of beauty in that. That is happiness. That is not defined by neurotransmitters or numbers on a happiness rating scale. Yeah, absolutely. This is why detachment is separate from the axis of emotion. Right? So like appreciating, like you're 100% right.

And I think it's sort of like is not actually, I don't take that as pushback. I think that point is actually exactly what I'm trying to say. It's the distance from the thing. The loss, you can feel sadness. and you can still find contentment and happiness in sadness, which is weird. So this is the axis that Buddha was talking about, which is sort of like if we think about watching sad movies, right? So you're movie buff.

So if we think about the experience of movies, like, have you seen Parasite? Yes. Okay. So like, no spoilers, but like Parasite is an emotional roller coaster. And the emotions that you feel are largely negative. Like they're not in the positive valence. You know, it's not, you know, a story of, you know, puppy. and Siberian huskies and things like that.

It's like it's emotionally brutal. And yet, why do we enjoy it? Because the axis of positive and negative emotion is separated once we have that detachment to a certain degree, right? Right. You wanted to say something about why. No, it's going to answer your question of, like, to me, why we feel sadness watching Parasite is the same reason we feel happy. Sorry, the reason we feel happiness after watching Parasite, despite it being a sad movie, is the same reason we feel happiness after eating an incredibly spicy pepper.

It's like you had this potential threat. So the capsaicum attaches to your receptors, you feel this pain, the pain goes away, you realize there was no damage, endorphin rush combined with surviving this painful experience, brings you happiness. That's interesting. So Parasite, your brain, functional MRI, is going off and experiencing all these negative things. The movie ends. You realize you didn't go through this horrible situation and you feel better.

I would also relate this to addiction with gambling. You lose all of your money. You've mortgaged your house. You've lost all this stuff. After you lose, you realize you're still alive and life goes on. You get an endorphin rush. And that is why frequently people are addicted to gambling. and actually addicted to losing because there's such a rush in losing and yet still surviving.

Correct me if I'm going to have to think about that. Let me see if you've tumbled down the entire foundation of how I understand this stuff. Give me a second. I don't think so. So here's what I'll say. Okay. So I think what you've done a beautiful job of doing is illustrating the mechanism of like rebound relief. You know, so there's an interesting experiment. I can't think of the reference right off the top of my head, but I know I've got it. sitting on my Google Drive. So they took, they took like, you know, 100 people and they had them put their hand in cold water. And like the water was of different temperatures. So like it was like painfully cold and then like even more painfully cold. But the experiment that they looked at was that, you know, if you have the most painful experience, like painfully cold water, and they start to warm it up at the end. And even though they never get to the warm, like they never read,

like the less cold water, people will rate that second experience as more favorable than absolutely being in warmer water. So I think there's absolutely a principle that you're tapping into, which is like a neuroscience mechanism through which the relief of a negative experience can be like reinforcing in some way with you. I think that's very good point from a neuroscience perspective. I still think, though, that that is a mechanistic, neuroscientific thing that doesn't quite translate. If anything, maybe I gave the wrong example. But I think what I'm kind of talking about is actually like a state of consciousness or a state of mind.

It's a perspective that I think we can all experience that essentially when we look at like the, the karmic religions, they talk about something called enlightenment, which is a state of persistent happiness. it's, actually they don't use the word happiness. They use the word bliss. And so if you think about this experience that has been described by people like over and over and over again, there has been something of a scientific study. And this is where you kind of say, I try not to judge. And that's where I kind of say, well, like, I don't know if I really agree with that. Because as a scientist, I do believe, as a scientist, a psychiatrist and studying some neuroscience, I do believe that happiness is, while there is an individual determination and every person's life is different.

I do think as a scientist that if you study 100 happy people, 100 sad people, that you will find common elements that lead to this experience that human beings have. And I think that like Buddhism is essentially, I mean, it's a religion, sure, but it's essentially like a group of people who sat down and like studied the science of happiness in a personal and individual way. And it's been my experience that when I work with people that teaching them this. Like, I don't think that I have had a single person who has not arrived at the same

conclusion if they have done the work. Do you think that's that selection bias at play, like that they did the work? So we've pre-selected the people that are going to do the work. So these are the people that are going to get the benefit. Absolutely. Do I think it's selection bias at play? No. Is it possible at selection bias? Absolutely. Right. So, So like, this is where I would like, so let's, let's, you know, let's think about it. You know, if I give someone antibiotics for, let's not use strep throat, let's say pneumonia, right? Is it selection bias at play that the, like, could selection bias be at play? It's studying the efficacy of our antibiotics for pneumonia.

Of much lower likelihood because it's randomized and double-minded. Absolutely. Right. So like, like, it's much lower likelihood, but, you know, I would also argue that. that, you know, it's unclear because we haven't done. Well, actually, we sort of, hold on, let me think about how to respond to this. So as an individual practitioner, by definition, I'm going to have a lot more selection bias than any RCT. At the same time, I think that you could argue that a religious tradition has selection bias to it.

But I think it's really tricky because when you have a sustainable answer that generations of people have found have been like successful, it's hard for me to tease apart what part of that is selection bias and what part of that is like an actually correct treatment. I know what you're saying. I was going to say like if you let's say you have a cure for pneumonia, like 100% cure, but the compliance rate is only 5% with this treatment. Is that a successful treatment? Yeah. How would you define it? Yeah.

So I would call that a successful treatment, right? The problem is in the compliance. I would it as a family medicine. I'm with you. And I think that's fair because I think you have to bake in compliance. But this is where so also is like, you know, as a psychiatrist, I mean, I'm with you. I completely understand. I still remember in my first pharmacology lecture, they were like any monkey can prescribe blood pressure medication. It takes a doctor to get a patient to take it when they have to wake up twice in the middle of the night to go pee. That's the job. The real doctor is the job of a doctor is compliance. And this is also where like if you think about as a I get that as an FM doc. But like, if you think about what do I treat, what I treat is the compliance issue. I don't treat them, you know, like 90% of, I'm an addiction psychiatrist. You know, my treatment is focused on compliance. So if we think about, you know, meditation is an effective treatment, like is meditation an effective treatment to reduce negative symptoms of

schizophrenia? Yes. Is it hard to get people to meditate? Is it an effective holistic intervention? possibly not. But if we look at the actual treatment, does it work? Yes. And I'm with you that an intervention, and this is where maybe I'd qualify a little bit, that the intervention globally may not be effective

if it only has a 5% compliance rate. But is the treat? So I'd separate out those two things. And I'd say that that's where like 90% of the work that I do is getting people to be compliant. Yeah, like for me, we have such great evidence behind, you know, behavioral therapy, it working sometimes as well as antidepressant medications,

usually best in tandem, obviously, when you look at the evidence. But let's think about it from my perspective as a family medicine doctor. I have a patient who comes in and is experiencing depressive symptoms, and I diagnose them with major depressive disorder. A lot of my patients suffer with low motivation levels. They struggle to shower, to get out of bed, to go to work, work, to take care of their family, to enjoy things that once brought them pleasure, all what you see on a commercial format. And these patients are suffering. I then give them a referral

to see you or a psychologist, and now they have to be motivated enough to call the number on the back of their insurance. Get five providers, one who's no longer taking new patients, one who's no longer a network, one who has a six-month waiting period. And we then say these individuals, who end up finding this care do well. How do we study the people that have never even got in? And I don't know, maybe they would have had the same impact

as the people who got in. But to me, when I look at the individuals that I help, a lot of times I'm only helping the people who actually end up getting the motivation to go for these treatments. So how do we sort of merge those two groups? Yeah, so this is where,

I think this conversation is changing a little bit, which I love. So this is where, where like I'm a big fan or like meeting people where they're at. So I think the biggest problem in medicine, the problem you're describing, and if we talk about if a treatment works 100% of the time, but only 5% of people do it, I think that's the problem that needs to be fixed. Right. So the question is like, and this is the problem with the RCT because like this is why, like I know that in Western medicine, the RCT is the gold standard of treatment. I think it's

a terrible standard of treatment. I think it's the fact that the RCT is the gold standard of what we use in medicine creates these problems. Because the whole point behind an RCT, which is a randomized controlled trial, is that it removes all of the real world from the equation. Well, so when you take... Athletics versus effectiveness, right? So this is where, like, in psychiatry, there's actually a couple of really great studies that are naturalistic studies.

So what they did is they followed patients over time and, like, put them on certain medications. And they actually factored in, like, if this medication has this science, effect, what's the likelihood that the person will stop taking it? And so I personally, I've found the naturalistic studies to actually be superior to RCTs in this way, because it mirrors a real world thing where we're following patients. We're giving them something like clausapine, right? And then, like, sure, it's the most effective drug for, like, schizophrenia, but it also causes people to, like, drool constantly and gain 200 pounds. And so how effective is it? And so how effective is, is it in the real world? Like, I think that's a better way to study it. And this is where I think

if we want to solve that problem, like, that's sort of why we, you know, a lot of people, like, will criticize this. And I think that criticism is fair. That we offer like mental health support services at Healthy Gamer, like we help parents and we help people. But we do it as coaching instead of therapy. And what's part of the reason for that? It's because there are so many barriers. And like, we actually try to meet people where they're at, which is, I think, how you fix it. Right. So you're right that the 95% compliance issue is. is the big problem. So how do you fix that?

I think it's like stepping away from the RCT. The reason I brought it up, even, to bring us back to the previous conversation, the tie-in that I saw, was we're talking about this very difficult-to-grasp concept for most, myself included, of being detached but not detached emotionally, as you described in the Buddhist model.

How do we get there in a way that is compatible and practical with our current everyday life when we are not living on a mountain top without distractions, without this thing constantly going off. Great question. And so this is where the answer is going to be weird and you're 100% right.

It's actually not compatible. You can't actually do both. Okay. So this is the story of Buddha, right? So like Buddha was a prince and he was wealthy and powerful and all this other crap and he was unhappy.

and then like in his journey he first like he just pieced out like he left his wife left his infant son and just went on this journey of self-fulfillment and then like decades later he's he's going back through his capital city former capital city because he gave up his kingdom he's walking down the street and he sees his wife and his kid and his wife lets him have it she's like you piece of shit you abandoned us you left you have a responsibility to your child you gave it all up you suck at life and she's right, right? And then so he says, you know, you're right. I do have a responsibility. It's my job to pass on what I understand to my child. So he shows his wife begging bowl and he's like, let me make up for it. You've had him for 20 years. I'll take him

for the next 20 years. We'll wander around India. I'll have my begging bowl and I'll teach him everything that I'll do my father's duty. And she's like, uh-uh, no, no, you crazy? He's a prince. There's no way I would let him fall around your broke ass. The first thing, though, it's interesting, Mike, because you're right, it's not actually compatible. If we really talk about true enlightenment, it's not, in a sense, compatible with regular life. If you are, if you are measuring by the level of accomplishment of regular life. So, for example, if you were enlightened, would you be as successful of a YouTuber as you are, jury's still out? theoretically, I think you can make a strong case and I won't argue against you that the answer is going to be no.

In my experience, though, and this is where things get really down the rabbit hole, is that the more personally detached I've become, the more I realized, so I was planning on becoming a monk, like I studied to become a monk for a few years, and then decided to not do that. And then ultimately realize that like being a monk is not about living on a mount top. It's like all internal. And so whether I'm married or not married or, you know, whether I enjoy, you know, like soda, I like it's, the work is entirely internal. And there I've found really promising results that you can learn to be detached. Because, Mike, I think you've done it, dude. You've disentank, like you've been wrapped up in it, right? And as you disentangle yourself, the really bizarre thing is that I think you will actually

become more successful. Because these things, as you become aware and detached, like this is where I got to say, this to you, like, I think it's amazing that you're, you identify as a person who's got to work through Kant. And it's responsible for so much of your success. And it's become maladaptive. The higher you go, that which is adaptive starts to become maladaptive, which is a beautiful lesson that you've learned. And so like, if we really kind of think about it, like, as you start to detach, I think you'll actually become more successful because I think some of those ways that you view yourself, you say to yourself, I am not going to be some, I'm not going to let my dad down.

Like he taught me these are really important lessons. He taught me all these things and that's who I am. And the higher you go, the more that's going to cause you problems. And bizarrely, like those helped you. They helped you become a national taekwondo champion. They helped you become one of the most successful medical influencers in the history of medical influencers. And at the same time, the next step up is actually like pulling away from some of those things.

And as you become detached, I think I know it sounds weird. And then you asked the question, you asked me a question, which is, how do you do that? And there are ways. So we can go into that. But I want to give you a chance. The mysterious ways. No, no, they're not that mysterious. It's just I wanted to pause for a second and give you a chance to respond, you know, disagree.

No, agree. And I think we're coming to this similar conclusion that I did when I was doing my therapy, which is, you know, you call it detached. She called it disconnect. It's all aiming towards the same. in principle, you know, we get caught up in nomenclature and science probably too often. So I completely agree. And I think I've already seen the benefits of doing therapy and disconnecting some and

watching a video underperform and not have it affect me negatively. Be like, oh, yeah, that sucks. But let's figure out the next one or what's my takeaway from this so that we can learn from it. So, yeah, I absolutely think that that is the case. To me, thinking it in a bigger picture sense, like the concept of my, mindfulness or like meditation. I've tried with a, like me being a person who's tried a lot and accomplished a lot,

the failure I have with mindfulness and like sitting and breathing and doing this is like insane, like how much failure I've had with it. So it's not to say that no one can do it. It's just to say as someone who's consider myself a dedicated person, I cannot for the life of me do this. I start wondering, is this a practical solution for most people? The answer is absolutely yes. So let me ask you a question, right? So you are you working like, do you work in an academic setting or like community setting?

Like you guys are residents and stuff? My, yes. So like I have, I'm in a community health center, but I work with residents. Okay. I actually have a resident shadowing me right now for this YouTube channel. So if we think about it, like if you have a dedicated student who's smart, driven, focus, and they're not learning medicine, where's the problem? Maybe they don't want to learn medicine?

No, they do want to learn medicine. They're trying really hard. Maybe medicine's not for them? No, medicine could be for... That's what they would think, right? That's exactly what the person would think. And that's exactly what you think about mindfulness. It's not for me.

That's what I'm hearing from you. So I'm with you there. But the fault is with the teacher. So if you've got all the right stuff, right? You're driven, you're focused, you're dedicated. Like, whose fault is it? It's the attending's fault if they're not learning medicine. And so this is where, like, I'd turn to you and I'd say, I completely get what you're coming from because this is what I hear time and time and time again.

I suck at meditation. Meditation's not for me. And that's where I'd say, like, how qualified are your teachers? How did you try to learn? Yeah, I've self-trived. Well, there you go. Right? So like meditation is something that traditionally has been taught by very qualified teachers.

And so I don't think you're bad at meditation. I got to say this, Mike, and this could also be a selection bias. Like 95% of people who I teach meditation to, first of all, half of, I'm successful in teaching meditation to 95% of people that I work with. Half of them feel like meditation is not for them the first time they come into my office. and the reason is because they don't have good teachers. And the reason is because we have a propagation of meditation resources without meditation teachers. The reason is because meditation teachers are taught in one tradition, right? So like how do you become a certified meditation teacher?

You go to a particular person, you learn their particular branch of meditation, and then any student comes to them, they say, this is the way to meditate. And if a teacher says this is the way to meditate and it's not suited to your cognitive fingerprint, then the student walks away thinking, I suck at meditation. And meditation is not for me. Because look at this like, you know, Tibetan monk who's like an expert on meditation. If they're such a good teacher, like people don't acknowledge that there are different traditions of meditation. It's sort of like, if we force you to become a surgeon, you would think that you were bad at medicine.

But the whole point is that like you're an FM doc through and through, right? And so like becoming this successful doctor has to do with the tradition that you're trained in and the tradition that you practice within as opposed to like, you know, you're not a bad doctor. It's just if we force you to become a surgeon. Like, does that make sense? Does. The question that I have is if we like, for example, maybe not me. Let's say I have a friend. He's five foot one and he wants to play basketball.

And by your methods, any teacher, a good teacher would be able to teach him how to play basketball very well. But genetically, he's slow. He's clumsy. He can't play on a even moderately competitive level. No matter how great the teacher is. That's physical limitation. Yep. For me, I feel like when I practice meditation,

I can't pick up on it. I've gotten some benefit from it. Absolutely, I see it. But maybe I'm not the one that's going to be the collegiate meditator. Does that make sense or no? Absolutely. But listen, the five foot one guy can learn how to play basketball. 100% can learn how to play basketball.

He may never be in the NBA. He can decide what to do with it, right? So I feel like I've learned what meditation is, how to sort of do it. But then like it didn't give me enough value to continue doing it. Is that possible? Absolutely. Right? So it may not be for you. Like, you can teach a five foot one person how to play basketball.

You can 100% do that. I'm not saying they're going to enjoy it. I'm not saying they're going to play in the NBA. But isn't the purpose of Buddhism, like, to have meditation and mindfulness part of it? Is that intertwined with it? Sort of. Sort of. Sort of.

But let's think about a couple of distinctions in the analogy. The goal of teaching you meditation is not to get you to play in the NBA. Enlightenment is not for every. not everyone is temperamentally appropriate to it. So when I work with someone who's got down syndrome and I teach them meditation, my goals are different from if I work for you with you. Right. So like, like the kind of meditation that I'm not going to teach, it's not one standard for all people, which is the problem with the NBA analogy, and I think may actually be your problem with meditation. Because what you're doing is if you really pay attention, you're setting an objective standard. And you say,

suck at meditation because I am not able to live up to the objective standard. That's the problem. Because you're meditating against an objective standard instead of meditating to like, like meet you where you're at. It's right back to like, you know, recommending therapy to a patient because there's an objective standard that's RCT supported. Evidence based works. Here's the referral. And it doesn't go anywhere. The same problem with you because you're saying, oh, I should get this out of meditation. This is the way that I should meditate. Isn't it supposed to do? do this, forget all that crap. If you want to learn how to meditate, we start, you got a few more minutes? Yeah, I do. Okay. Can I give it a shot? Okay. So the first question is, why do you

want to meditate? To reach a state of detachment with an emotional component still present. Okay. So, okay, so, all right. I feel like I'm the Riddler right now. No, on the contrary, you just dug yourself into the biggest pit you ever could. Okay, so this is what I want you to do. You want to feel an emotion and be detached from it? You want practice at that? You want me to teach you how to do that? Yeah.

I want you to be a shitty meditator. I want you to meditate every day. I want you to feel like a failure. I want you to feel like this doesn't work. This doesn't help. I'm doing it wrong. And I want you to separate. So we can pick any meditation technique.

And it's perfect. Because all you're going to do is you're going to practice feeling like a bad meditator. So any time... Is this the go up to 100, you know, women ask them for their phone numbers, get rejected by all of them, and then you get okay with rejection and you have no fear to talk to anybody else? I think there's some overlap.

But if we're really talking about what meditation is, if you want to practice something, if you want to practice being detached from something, I'm going to, this is what we're literally going to do. I'm going to teach you one meditation technique that you're bad at. You ask God for patience and God gives you the most frustrating situations over and over. That's what you're giving me. So you're going to do any kind of meditation that you've learned that you suck at. Then what we're going to do is notice the feeling of sucking at it. Then I'm going to give you a quick breathing practice and you're just going to sit with it all. And like, I know it sounds kind of weird, but the worse you feel like,

like you're doing at it, just notice, oh, see how bad I am. See how much it isn't working. And I know it sounds kind of weird, but the more you're able to see, because what happens is if you get tangled up and being bad at it, you're not going to be detached. You're going to be attached. Does that make sense? Yeah. How do you find the motivation to continue doing something you're bad at? That's my question. Very good. So this is the perfect technique for you. right? So like, like this is where, and the short answer is that you become detached because if you're detached, whether you're good or you're bad, it doesn't matter. Like the five foot one guy who plays basketball. How does someone who's five foot one play basketball? They let go of being in

the NBA. Who cares if I'm a failure? I just love shooting hoops, man. That's how you do it. You detach. That's what I'm saying. It's like the actual answer to your question. It's the actual answer to happiness. How do you find the motivation? You let go of the success and you do it for the sake of the thing. Because you enjoy doing it. The 5-1 gentleman is enjoying learning how to play basketball as opposed to making a goal to play in the NBA. And so it's a chicken or egg thing because as he lets go of the goal to play in the NBA, he will enjoy the basketball more. See, that's the thing. I need proven to me.

Yep. Because you're saying, by saying I will get nothing from meditation or I will fail at meditation, starting with like a really low set point, like almost a negative set point of expectation, I will then start enjoying it. Only one way to find out. Okay. Yeah. No, this is tricky.

You have to be really tricky here, okay? Because if you say to yourself, it won't work, Mike. If you say to yourself, oh, I'm going to start enjoying this by. suffering through it, it's not going to work. Because you're good at that, right? You're good at making temporary sacrifices for success in the end. No, no, no. You're going to fail if you do that.

So what do I do? You have to do it knowing it'll never work. You can't trick yourself because it's going to be the same fucking thing. Because then what's going to happen is you're going to start to meditate and you're saying it's not going to work, but I'm going to start enjoying it at some point. I'm going to walk up to 100 girls and then I'll get good at it. Because in the back of your mind, you're going to know I'm going to know I'm I'm going to get good at it.

And then what's going to feel like a failure? You're going to do it 100 times and you're not going to be good at it. And then you're going to feel like a failure. Oh, it's not working. It was supposed to work. But it's not working. It's not working. So you see what I'm saying there?

You've got to be careful. Sneaky, sneaky. I understand the complexity of it. It just, to me, I'm going to try. I'm honestly going to give it a try. To me, it sounds like there's like knobs. Like, okay, turn down expectation. Turn down expectation of not having an expectation.

And it's like, I don't, like, who, I don't know. Like, I don't think I have that good control over my mental state, but I'll try. Yes, you understand it perfectly, Mike. And when you can turn down knobs all the way to infinity, that is enlightenment. Yeah. I mean, I'm more than willing to try it. Okay. So now you're going to teach us some meditation, okay?

You get it. You get it, bro. You're on this. You're good. You figured it out. Seriously, I'm very optimistic for you. It's going to suck. I'm sorry. And it's not going to amount to anything. See, but I know you're lying. You know it's going to amount to something.

No, I don't. I don't. I do. I heard you, I heard you give the intellectual statement earlier. No, no, no, no, because as long as you believe that I think it's going to be successful, you think it's going to be successful. And then it's going to fail. I know. So it's not going to work. Do I lie to myself? Nope. You just do the practice. And then you practice, you notice, like, you, it's, it. The more knobs you see, the better you're going to get at it. Okay. Okay. And then I'm actually tricking you into a completely different direction, but we'll worry about that later. Okay.

So this is what I want you to do. I want you to just share with us. Yeah. A meditation practice that you've tried. You're doing great, bro. Love it. Like, just anything. Four, four second inhale, eight second exhale.

Diaphomatic breathing. Beautiful. Okay. So what we're going to do is, let me just think for a second. Okay. So this is what we're going to do. All right. So we're going to do four seconds of inhalation followed by eight seconds of exhalation.

We're going to do like, let's say, five rounds of that. And what I want you to do as you're breathing is notice that there may be thoughts in your mind of this isn't working or this doesn't feel like working or whatever. And then as you notice those thoughts. it's just like notice them, like prepare for it, right? It's like this person's got an SD elevation on the EKG. When I look at the echo, this is what I'm going to be looking for, right? So we're going to look for it. And then as it arises, you're just going to see it.

And then after the five rounds of breathing, I want you to see how long the feeling of this is a waste of my time. I'm not doing it right. This will work in the end. Just see how long those feelings. kind of last. And then what I want you to do is try to find the moment where inhalation becomes exhalation. After the five rounds. After the five rounds. I'm not sure I grasp what that means that's good. That's good. So like, you know, we have an inhalation and then we have an exhalation, right? You can observe that there's a period of time where you're inhaling and you can observe

the time that you're exhaling. And in between, that as long as you don't hold your breath, there's going to be like a moment where one becomes the next. And I want you to try to catch that moment. Okay. Okay. Okay. You want me to do it now? Yeah, let's do it now. We're going to do it together. So can you count for us? Like for the first round, like show us. I like to do it mentally, but I guess I can do it. Okay, okay, okay. Then do it mentally. Can I count the first round? Please. Yeah. Okay. A guided session. I like you. Okay. So I'm going to, I'll count the first, let's, I'll count the first round and then you'll continue I'll. I'm fine with it. If you, if you prefer it that way. Let me just think about how I want to do this.

No, we're going to do just the first one. Okay. Okay. This is what I do to my patients when I want to check their reflexes on their knee and they won't let me do it. So I make them pull their hands up and look up at the ceiling and then their reflexes come back. That's what you're doing to me. It's seen right through me. Okay. All right. So I've met my match. Okay, so we're going to just take, start with just take a moment to feel the weight of your body in the chair. Okay. So now we're going to take a deep breath in, expanding your diaphragm, pushing out your stomach. One, two, three, four, and then exhale for eight seconds. One, two, three, four, five, six, six, seven, eight. And now again, breathe in. One, two, three, four, and breathe out. One, two, three, four, five, six, seven, eight. And now continue at your own pace. We'll practice for about 60 seconds. just continue breathing. I'll prompt you when to stop.

Go ahead and finish the breath that you're on. And now just observe yourself. See if there are sensations of feeling like you didn't do a good job, like you should have done better. And we'll let you just pay attention to thoughts and feelings as they arise for another 45 seconds or so. And now I want you to take a deep breath in. and exhale and again exhale and then a third time in and out as the final breath as you finish your

expiration go ahead and or exhalation go ahead and open your eyes tell me what happened when you stopped counting and i started to have to count for myself i cannot count i lose track of the numbers So that happens. I started worrying about my 545 meeting. I thought about some emails that I should have received today that I did it. Okay. That's the majority of the thoughts. Okay.

So you have a goal for meditation. Now I'm going to be a teacher and I'm going to teach you one more technique. Okay. This is what you, I think you need. So I'm going to teach you a technique called Nari Shodana or alternate nostril breathing. Have you ever learned this? before? Okay. Can you do this with your right hand? So bring your index. Yep, very good. Now, just let the thumb out. Perfect. Yeah, it could be like that. That's fine. Okay. I think it's pretty good.

Yeah. So what we're going to do is I'm going to take my right thumb and I'm going to block my right nostril and I'm going to breathe in through my left. Allergies are making this a little hard. Okay. And then once you have a full breath of air, once you inhale, then we're, we're going to We're going to switch and exhale out the other side. And now we're going to inhale again through this side. Switch and exhale. Good. Inhale.

Don't switch yet. Inhale. It's going to be tough because you've got allergies. Switch and exhale. Inhale. Switch. Exhale. You got the rhythm of it.

So let's pause for a second. Maybe tough with allergies. I understand that. But what I want you to do is inhale through one nostril, switch and complete the breath out the other side. Then you start with the same side again and switch on a full total lung capacity filled of the brim, okay? Okay. I hate that I know what you're doing. What am I doing?

I'm not doing anything now. Seriously. Sorry. Go ahead. Sorry. Go ahead. What am I doing? Tell me.

You're not doing anything. No, you're distracting my mind. You're giving me an activity to. do. Good. Okay, so close your eyes, 60 seconds. Altered nostril. God, why is this so hard for me to do it?

It's okay. You can... No, I can do it with my pinky. Okay. Pinky is great. Yeah. Okay. Okay.

So start with the right nostril blood. Good. In. Switch. Out. In. Switch. Out.

In. Switch. Out. Good. Now the train. training wheels are coming off. You do it at your own pace. We're going to do it for 45 seconds. I'll keep track of the count. You just focus on not screwing up the breath. Go ahead and finish the breath that you're on. How is that?

Good. What does good mean? I feel like my breathing is slowed down. I also feel like my brain is wandering if I have a deviated septum or true allergies and why my left nostril is so congested. But I also hate that I appreciate what you're doing, like in the sense of, like, my brain is like, oh, this is a distraction method. So this is what you're doing. And it's, it's rationalizing it. I wish it wouldn't, but it's hard to control it.

So, yep, so don't control it. Just continue the practice. Okay? So like your problem, Mike, is that the meditation you're trying is too easy. So you need something called a powerful alumbana. And this is where I have to, I have to beg your, if this doesn't work for you, I have to beg the opportunity to have another shot at it. Okay. Okay.

I'm going to try it. What's the prescription? How often when all that good stuff? I want you to practice for five minutes whenever you, like, I would say three times a week, five times a week. But just, yeah, five minutes, five times a week. Okay. On week this. Okay. And this is where, so what you need is a powerful alambana. An alambana is the Sanskrit word for support. You need something that there's so much going on in your mind. You're actually so good at multitasking. You can juggle so many things at the same time that you actually need a very intensive technique that will demand all of your attention. So I'm going to leave you with one other technique. Don't try this one yet, but just as an example. You need to stand with one foot. You need to balance on one foot with your eye.

closed. That's going to be your form of meditation. You can't try any of this new observation stuff because your mind is going to fill that vacuum. You need a very powerful focusing technique. And why this makes a lot of sense to me specifically at a practical level is, for example, if I was to and my headphones listen to an audible book right now sitting here, there's no way I could listen to it. But while I'm driving to the hospital and I'm busy with the stimuli of driving and doing all these things. I can grasp the most complex subjects, whereas, like, if I'm just sitting, I have no idea what the speaker is saying. This is a deficiency of your prior teachers, because your mind needs to be occupied. So the way that you keep your mind from wandering is by keeping it

focused on one thing alluringly enough. Imagine you're doing pediatric physical exam on a kid. What do you do? Right? You're like, oh, hey, why don't you play with my stethoscope while I look in your ears. You're right. You recognize what I'm doing. You get the principle and it still works. It's not about manipulation. It's about providing a technique for your mind that it can sit in one place and giving it what it needs to. It's like training a dog where you give it a treat first and then it learns how to fetch. Then it no longer needs the treat. So we need to train your mind to be able to do this. We'll give it the alumbana the support it needs at the beginning. And then as you get better at it, you're not going to need the alumbana and then you'll know how to meditate.

I'm hoping that is the case. My balance also sucks. So if I fall, is there malpractice coverage here? There is not because it is not a medical conversation. It is not medical advice. I am not your doctor. How I hate our legal system. Yeah.

There is not malpractice coverage for standing on one foot on the West Side Highway of all places. I was literally just discussing with my producer about doing a video. about giving medical advice and how complicated it is, like when my friends call and say, like, hey, I'm dizzy. What should I do? And I just had that at the back of my mind because we just had this conversation. But it was just crazy, how complicated it is. So I applaud you for doing this on social media and on Twitch and YouTube. Yeah. Of course. Thank you very much. So Dr. Mike, it's been a pleasure. I know you've got something in what sounds like 20 minutes. So I want to give you enough time. Thank you so much for coming on. I really enjoyed this. Do you want to just

tell people very quickly where they can find you. I mean, I assume everyone already knows, but. Yeah, well, the only apparently Dr. Mike, or at least the one that comes up most when you search. So if you just search Dr. Mike on YouTube, Instagram, Twitter, Facebook, all that good stuff. So just search Dr. Mike. And if you ever have a topic you're curious about, like cholesterol or what happens when you swallow gum, just search Dr. Mike gum, Dr. Mike, cholesterol. All those videos will pop up for you. That's awesome. Thank you for the opportunity. This has been an enlightening session. I didn't reach enlightenment, which is not for everybody, as you say, but it was a very enlightening session. And I love having these types of conversations. So thank you for that opportunity.

Yeah. Good luck to you, man. Yeah. And give me a chance if it doesn't work, okay? Oh, I'm your Discord friend now. That's it. So now I'm going to hit you up. Okay, cool. Take care, man. Bye. All right. Thanks. All right. He's a fantastic guy. You know, I think, I mean, I saw some stuff earlier. I think, you know, some people don't like him. and, you know, no one's perfect, as he's said before.

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