The Checkup with Doctor Mike - ER Doctor Sounds Alarm On Grill Brushes, Trampolines, & Unvaxxed Kids | Dr. Beachgem

Episode Date: February 18, 2026

Today’s episode is brought to you by Microsoft Dragon Copilot. Dragon Copilot is an AI clinical assistant that streamlines documentation, surfaces critical information, and automates routine tasks ��� empowering healthcare teams to focus more on patients and less on administrative work. Learn more at http://www.aka.ms/clinicdayI'll teach you how to become the media's go-to expert in your field. Enroll in The Professional's Media Academy now: https://www.professionalsmediaacademy.com/00:00 Intro01:30 Is Pediatric Medicine Harder?07:23 Training Residents10:35 Treating The Amish / Blizzards15:24 Hurricanes / Disaster Medicine22:00 The BBQ Grill Brush Accident29:38 Medical Dramas / The Pitt35:48 Anti-vaxxers43:55 Becoming Famous Online49:25 Medical Institutions on Social Media57:30 Feedback From Parents1:02:28 Her Health Troubles1:11:35 Mental Toll Of ER1:17:43 Haters & Burnout1:24:50 Raising 4 Kids1:31:32 E-Bikes, Scooters, Pets1:36:25 Hollywood1:41:15 Sick Kids / DaycareHelp us continue the fight against medical misinformation and change the world through charity by becoming a Doctor Mike Resident on Patreon where every month I donate 100% of the proceeds to the charity, organization, or cause of your choice! Residents get access to bonus content, and many other perks for just $10 a month. Become a Resident today: https://www.patreon.com/doctormikeLet’s connect:IG: https://go.doctormikemedia.com/instagram/DMinstagramTwitter: https://go.doctormikemedia.com/twitter/DMTwitterFB: https://go.doctormikemedia.com/facebook/DMFacebookTikTok: https://go.doctormikemedia.com/tiktok/DMTikTokReddit: https://go.doctormikemedia.com/reddit/DMRedditContact Email: [e-mail] Producer: Doctor MikeProduction Director and Editor: Dan OwensManaging Editor and Producer: Sam BowersEditor and Designer: Caroline WeigumEditor: Juan Carlos Zuniga* Select photos/videos provided by Getty Images *** The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional **

I fell in love with pediatrics because kids get better. Mm. You just don't always see that with adults. He's on the front lines nonstop in the hospital. What drove you to specifically the emergency portion of it? I have ADHD. Okay. Yeah.

So you need quick moving? Quick moving. I never even dreamed of making content. This entire thing was just a complete accident. What makes you good at this? I don't know. One of the most interesting cases that I have had to date. What's the scariest thing that can happen in a barbecue?

Do not use grill brushes with metal wires. I have another related story. This is rough. I don't know if we can handle this. This is a medical podcast. So this is safe. There's a kid that's eating a sandwich from a local joint. He suddenly starts to like cry and complain up.

His throat hurts. Like something is sticking in his throat. So they took him to the OR and they did a scope. Are you ready for this? Okay. Is it a toothpick? No. Welcome back to the checkup podcast.

We're on this episode. I'm interviewing Dr. Beach Gem, the pediatric ER physician who has blown up online for her authentic self and informative videos about health and her. That's right, Dr. Beachgem has not only had to treat patients in the ER during natural disasters in Florida, but done so after paddleboarding out of her own flooded house. She's truly one of the most genuine voices in healthcare online, and I was thrilled to dive in deep with her on the reality of treating unvaxed kids,

which toys actually send kids to the ER, and the horrifying things her patients have found in their sandwiches. Let's get to it. And huge thanks to Microsoft Dragon Copilot for sponsoring this video. practicing pediatric medicine is really hard. True or false? True. But I think medicine in general is hard.

I personally prefer pediatrics to adult medicine, honestly. Interesting. Why? The kids are just better. Sorry, no offense. You don't ever feel that when you have a pediatric patient, you also have multiple patients with the parents? Oh, yeah, you do.

You definitely have like multiple, multiple. But I think the thing that's different is that everyone's goal is the same. Everyone's goal is to get the kid feeling better. Right. And so, like, I don't really, to me, it doesn't feel like multiple patients because, like, the goal for everyone there is to do the same thing. It's like, let's get you better. You never have the struggle because something that I've experienced is I'm treating the child,

maybe not in the ER, maybe as an outpatient. And the parents have different expectations of what they believe should be done based on something they've read online, sometimes based on misinformation. How do you handle it? that? I think it is really important, especially in the emergency department, to set expectations early in the visit. And sometimes you can tell when there's, they have, they come into certain expectations, whether they're verbal about it or whether you can kind of tell by the way that they're asking questions or talking. In the emergency center, like, we don't order a lot of like,

you know, send out genetic tests and we don't do certain, we don't do routine MRIs, for example. And I've had patients come in that say, you know, I need an MRI of my knee. I think I have a, you know, meniscus tear or something like that. And that's just not something that we do in the ER. We don't have access to an MRI table. It's being used for all of those outpatient studies that are maybe sedated. And so I think it's really important to walk in the room, you know, have the conversation, listen to what the patient's saying. And sometimes we have to set expectations. I'm not going to be able to do an MRI for you today. Let's talk about I can get you outpatient ortho set up. I can get you some pain control, some crutches. What else can I do for you? But, you know, an MRI is not

something that we're going to be able to manage. So setting expectations, early in the visit is so important before we get down the road or you know whatever. I'm just talking about what I'm able to do and what I'm not able to do. Yeah, that requires a very high level communication skill set. Is that what having that drove you to falling in love with pediatrics? I fell in love with pediatrics because kids get better. And that's something that I noticed. Usually quickly too.

Quickly, right? So resilient. Like, you know, we see kids in really bad accidents and they have full recovery. you just don't always see that with adults. I think a lot of the conditions are more chronic, and when they are injured, a lot of times they carry those limitations with them for the rest of their lives.

So kids get better. It's so fun to watch them get better too. And they're fun. I color, I blow bubbles on shift. Like, we have a blast. And so I think, like, I can play. We have a facility dog.

Wow. And kids are going to get better. Most of the time, kids get better. And so I think that there's that aspect of it that we don't see in adult medicine all the time. And what drove you to specifically the emergency portion of it? I have ADHD. Okay.

Yeah. So you need quick moving? Quick moving. Okay. So I had a couple qualifications for a job. I wanted to wear scrubs. I was like, I will not be dressing up the rest of my life. I didn't want a round.

I was so bored on rounds in residency. I struggled. And then I just needed something procedure based in quick moving and ER hit all those buckets. In moving quickly, do you feel like you're able to process your emotions, your attention, hyperactivity, symptoms a bit easier. Is that part of the treatment that you have found that works well for you? Yeah, I think so. You know, the emotions, most, there's not many times that I have emotions that I need to process.

A lot of times it's the, you know, the bigger cases, the stronger ones, a bad diagnosis. But so much of pediatrics is not that, you know, pediatric ER. We do a lot of like the bread and butter type of pediatric stuff, mostly GenPeed stuff. So, but the quick moving, it just fits with the ADHD and I don't even, I don't even have to medicate most of the time just because there's so much adrenaline in the ER. And what is your shift schedule look like? Are you working every day, three shifts a week? What's the general? Flip a coin, I might be working that day.

There is no consistency to my schedule. It's completely inconsistent. I work on average 12 or 13 shifts a month. And then I work anywhere from early shifts to late shifts to over. overnights to the urgent care section. And I could work 13 days in a row or I could work every other day. It's completely random. Yeah. Do you work for a hospital system or are you subcontracted by an employee group?

I work, I basically work for the hospital. Okay. It's like a separate hospital employee, no, hospital-owned separate physician group. Group, got it. But it's the hospital. How do you feel the world that exists in our health care system that staffs ER physicians? Do you think overall it's moving in the right direction, wrong direction, or are you pretty neutral about it? You know, I, since I do pediatric emergency medicine and I'm in my cute little bubble, I feel comfortable,

but I know that a lot of the emergency care in the U.S. that's owned by these groups, I'm concerned about the level of care that they're able to provide, the people providing the care, and that it's really for profit. like instead of you know focusing on doing the best care for the patient we're focusing on making the most profit and we're focusing on some of the checkboxes as well but again I think like we really just need to get back to focusing on the care which is luckily what I'm able to do in my hospital which is academic base I'm able to take the time I need for my patients I'm not worried about productivity I'm able to do what I need to do but from a lot of my ER colleagues you know they're struggling with some of the ownership of these groups sure do you have

residents? We do. We have residents and fellows and students. Yeah, what's that like? How do you feel in the ER with residents about? Yeah, I really enjoy working night shifts with the residents because I feel like the night shifts actually give me more time to like teach, sit down, like go over some stuff, go in with them and, you know, examine the patient together. On like a day shift, I feel like sometimes we're so busy and we have like all these learners around and it's harder to like sit down and like teach about something is because I know I've got 12 more patients left to see. But for some reason, you know, the night's seam, the flow goes a little bit better. But I really enjoy teaching residents, you know, bringing up the next next group of our, you know, colleagues. Sure. Has anything surprised

you about this generation of residents, physicians? You know, it's that, you know, I walked up uphill both ways to get to residency and I worked 36-hour calls, you know, all three years. And I had four days off a month. It wasn't even four entire days. It was four 24-hour periods. I could get off a 36-hour shift at 6 a.m. and have to be back the next day at 6 a.m. That's not a day off. Yeah. But at the same time, I got really sick when I was in residency. I got septic. I got RSV and I was working night shift. And I had a 10 or 11-month-old baby at home. And I kept telling them, I was like, I just don't feel good. I feel like I need to go home and like rest. And they're like, you're fine. You're still here. And for like, so motivating. Really.

For three or four days, I just was like, I just feel really, really bad. And then the next day when I was supposed to go into work, I could not. Like, I physically could not. I went to the ER. My blood pressure was in the tank. I got started on pressers. I got a central line. Yeah, I got some Norepep pumping through my veins.

And, you know, got my blood pressure up enough. Oh, good. And but my chief resident was like, I just want you to know that we have to call in backup coverage for you now. Like, there was like a total guilt trip about it. And so part of me, like, I walked up both hill. ways so I get to work. But at the same time, when a resident's like, I'm just not feeling going to go home.

Yeah, yeah. Like, let's not, like, if you're running to the bathroom every five minute, go home. Yeah. We can handle it. You know, it's really important for you to take care of yourself and not end up in an ear bed like I did. So, you know, there's that like, you know, I want, I see what I did and I'm, you know, frustrated that they're not suffering like I had to suffer.

But I also don't want them to suffer. I want them to be able to learn in a safe environment. So it's like one of those typical pendulum swinging potentially too far. the other way where maybe during your time of training, they were like, we don't care if you're dying, literally. But now it's, oh, you know, today I feel like I need a tired day. Yeah. And I'm not going to come in.

So maybe there's something in between. Something in between. Yeah, where we can be reasonable and rational. I remember when they switched some of the duty hour requirements. And we were so worried about handoffs and all these errors and stuff that were going to happen with handoffs. And I'll be honest, like we just didn't end up seeing it. And it ended up, you know, I think the interns had to work like six days.

in a row and no overnights or something when they were doing some sort of shift. But it ended up being okay and we were able to make it happen. So I know that there is like good things are happening and we're keeping our residents safer. But at the same time, like, need to make sure that they're trained well enough. Yeah. And you were in Buffalo at the time. I did my fellowship in Buffalo. Okay. So where was this training program where you had your... It was in Florida. Okay. So it was in Florida. And how does the difference in training between the two states feel to you? Is there any specific geographic differences or not really? You know, geographically, like, we saw definitely different pathology in Buffalo.

We had a very large Amish population that we pulled from. President Trump told me that they're really healthy, so. Yeah. You know, when it's the same thing, you know, for adult docs, when a farmer comes into the ER, it's the same thing when an organophosphate. Well, it's like when a farmer comes in willingly to the ER, like they're really sick. or like a rancher. When a kiddo that's an Amish kid comes into the department, A, you know, we get really concerned about underlying genetic stuff, metabolic,

just because of the genetics there. But also, like, this kid is really sick. Regardless of how they look right now, this kid is really sick. If the family is willing to get them here, we need to be on our best because this kid is not well. They're self-pay. They don't have insurance. And so the community has to get together and make sure that they can fund the trip. and the group that we worked with

didn't fly in helicopters for some religious reasons and so we would have to transport them long distances from outside hospitals don't say by horse and carriage no we would they would usually go to an outside ER and then we would go and get them as a transport team

and I got to ride with the transport team a lot which was cool kind of getting some experience in inter-facility transports And were those patients having a higher risk for vaccine preventable illnesses? Absolutely. Yeah. Absolutely. We definitely saw, we definitely saw metagitis.

Cortosis, whooping cough, bacteremia, mostly like pneumoccal. Oh, yeah. Mostly that. There were also just a lot of like environmental type injuries. Like a car runs into a horse and carriage. We saw that, unfortunately, quite a bit. And then farming equipment-related injuries as well. orthopedic type stuff.

What about when it snows like 100 inches in Buffalo? What happens then? Oh, you still go to work. You still go to work. You don't have a snowmobile. I know you got four-wheel drive cars. We did. We did have to buy new cars so when we went to Buffalo because my Honda Civic was not a four-wheel drive.

But it was, there were some days that it was really, we had some lake effect snow happening and it was, you know, I got to the hospital and I just stayed. It wasn't safe to go home. Were there spikes? I mean, perhaps in the pediatric ER, you wouldn't have seen it. but were you seeing from your colleagues on the adult side heart attacks when it did, when it did snow, that typical shoveling snow exerting yourself? We did.

And I was on, we have to, as a pediatric ear, we have to do some adult medicine. And so I was working at the kind of cardiology hospital when we had a big snowstorm in like November of 2014. And they're like, I made some joke about like, oh, at least nobody's going to be coming in because of all the snow. And they're like, no, everyone with the heart attacks, like they're going to be really sick people that come in. I was like, oh, okay.

No, I'm sorry. They were really serious about it. And we did. We saw a ton of angina, chest pain, heart attacks, some really not great stuff that shift. When does, I know it's different group to group, practitioner to practitioner. What is the cutoff for when you should no longer be seeing a pediatric physician? That's a great question. In general, most pediatric facilities are either 18 or 21.

So our hospital goes up to, we see patients until they turn 21. There are some exceptions for certain patients on, you know, if they have congenital heart disease or if they have, you know, certain type of cancer that's already been managed. But for the most part, under 21 years of age, happy to see anybody. That being said, if you have an adult problem and you're 20, I mean, you know, 18 and up, you can go to an adult facility as well. Sure. That there's some crossover and care there. Makes sense. Yeah.

In working in Buffalo, did you become a huge NFL fan? I was already, I'm a big football fan in general. I started fantasy football when I was in medical school. Okay. And I win a lot. But I didn't win this year, but I was close. Okay. I did become a big time Buffalo fan.

Like the Bucks have struggled for many years, you know, up until that point. And then we get to be Bills fans and also enjoyed the struggle. Yeah, yeah. And now it's feeling better these things. It is. Like the Bucks, you know, they had some Super Bowls there. And then the Bills have had some great seasons. You know, I'm still waiting.

hear the good luck charge i'm still waiting for a super bowl win as a buffalo fan but um they're josh allen's just a rock star their whole team i just i love yeah for sure um when you're working in the pediatric er uh are there certain cases that you get excited about treating and teaching about uh what gets you like really empted up you know it's it sounds silly but i think everyone loves a good nursemaids elbow um so nursemaids elbow is the radius gets pulled out of the little cartilage ring, and we just do this little maneuver to help get it back in. But the kids look like they have a broken arm. They're acting like they have a broken arm,

and I don't even need to do an x-ray. I can just, doop. They cry for a second. I come back in five minutes with a popsicle, and they're waving it all around. And, you know, the parents think I'm a magician. So it's this really cool feeling, like, I'm fixing them. Everyone's happy.

I didn't have to do any radiation or hurt the kid, you know, no IVs. And so I think everyone loves a good nursemaids elbow in our department. And I love teaching them too because there's different ways to do it. And I usually have to grab someone. I don't want to hog them all. So I usually grab like a resident or a student. Have you done one before? Let me show you. And kind of demonstrate it on them and then let them do it on the kiddo. And it's cool. Yeah. What about, I know you're passionate about disaster medicine. Tell me about your passion for that. How'd that happen? Yeah. I don't really know how it happened. I just, I think I fell into the drama of, you know, getting ready for a disaster.

and obviously we have a lot of hurricanes in Florida, and that kind of falls into it as well. But I think it is so important that we're prepared to take care of kids and disasters because a lot of hospitals have disaster plans that just don't include kids. Kids are a fifth of the population. And afterthought in these areas.

And afterthought in a lot of these things. And a lot of hospitals may or may not have the equipment ready. So there's like initiatives of like pediatric readiness. We've got our Centers for Excellence, like the Gulf 7 and wrap them. in Region 5 that are just groups that are focused on pediatric readiness. And so I've kind of started working with some of the different groups and just trying to push readiness in our communities

and then making sure that our hospital specifically is ready. There was a couple years ago. It was actually right after Yuvalde. It was like two days after Yuvalde. We got a call that said there was an active shooter in one of the middle schools. And I had two kids in middle school at that time. And I, you know, it was. And I immediately message them, which is probably not the right thing to do.

And then just started setting everything up just in case. And they ended up, it was a prank and there wasn't really anything. But just making sure that we have everything we need, the people, the staff, the stuff, the equipment, the space to take care of all the kids that we need to. Because there's going to be problems in disaster. You're not going to have all the resources that you need. That's just the way it works. Yeah. And speaking of weather-related disasters, you've had one of your...

own. Care to share that story? Yeah. I've actually had several of my own, unfortunately. So we live in a pretty flood prone area when we bought our house. We bought it without seeing it because we were living in Buffalo and moving down. And it turns out it's pretty low-lying. So we had a small flood in 2020 with Tropical Storm Ada. We got decent flooded with Adalia in 2023. And then with Helene this last 2024 we had about four feet of storm surge flood our whole house and it just

you know three floods in five years it was like we have to we got to figure something out so what's the solution what does one do when you just repeatedly get flooded yeah so the first two times we kind of just put it back together and we were trying to find ways to fix it but we ended up raising it up 12 feet in the air there's a rule in our area because our flood insurance is backed by FEMA because no one wants to give us

flood insurance, which makes sense, that if you sustain more than 49% of the damage of the value of your home, you can't rebuild. So we weren't able to get permits to rebuild. So you either have to tear it down or raise it up to be compliant with the flood code, the most recent flood code. So we tore, we raised it up 12 feet. Obviously, the whole inside has to be redone. How does one lift the home?

That's a great question. It's really cool. It takes time, but they kind of like dig out underneath these like trenches and then they put these big metal beams, you know, going, you know, side to side and then back and forth. And then they literally just put jacks underneath. And they just slowly? Yeah, like six inches or a foot at the time. Yeah. And they use these, like, called railroad ties, but there's another name for them. And you just stick them underneath the house as you're going up and then you move the jacks. And it's just, it's crazy just to watch it. They do it all in one day. So is your house sitting on four beams,

basically? There's more beams underneath. There's like, I don't know, 12 or 16 of them. Because I saw, I forgot what it was on National Geographic or Discovery where they show how skyscrapers here in New York City, they're just basically dug poles really deep into the ground. And the building itself is not super deep. It's just these poles that are super deep. And I'm like, oh my God, this is super scary if you think about it when you're in one of these buildings. I mean, like we are right now. It's crazy. They do have to do soil testing ahead of time because they do put these big poster beams in the ground.

to like keep the house up and not. Do they have to like drain the water from? Because there's wells, I'm sure, that are like pockets of water and stuff. So the problem in Florida, we, you know, you basically live at sea level. If you dig six inches like the water, the water table's right there. And so you kind of have to like pump the water out of the trenches when you're digging down. But there's, most of us don't have wells, especially on the coast. Got it.

Just because you're. Wow. It's ocean water. And that's actually part of how you go. got your social media stardom sharing these intimate stories of what it's like going through repeated flooded episodes. How did the audience connect with that? Why did you actually even make the choice to share that? Because I know when doctors get on social media, they're like, I'm going to share information, but not what I'm going through personally so that there's a layer

of separation there. Yeah. What's that decision like? I started social media with COVID, talking about like the science and the misinformation. And the comments that I was getting was, I trust you, you feel very authentic. And I continue to make content. And just, you know, I was at home and my kids were just running around. And I did include my kids in some of the initial content just because like they were there and every, you know,

where are we going? We're sitting on our butts at home. And so I just kind of shared a, you know, a little bit of that. And I think when people get to know you a little bit as a person, they trust you more rather than I'm a doctor, I'm a talking head, I'm just talking about this. They know me a little bit more. They feel like they can trust me a little bit more.

And then I've gotten little bumps here and there from different things. There was a grill brush video I made a couple years ago. That went pretty big viral. I think I doubled my following, like almost overnight. What's the scariest thing that can happen in a barbecue? Metal wire grill brushes. If you use those to clean the grill, there's these little pieces of the brush that can break off

and get into the burger or the food, whatever you're cooking. And if you swallow it, it can end up kind of anywhere from your lips, your tongue, all the way down. And we've had some get lodged in tonsils and in the intestines. And it can cause some pretty bad problems. And that's probably not top of mind when people are coming in with an obscure non-specific symptom like belly ache. Yeah.

Oh, I vomited, et cetera. So how do you get there? Or is it you did some imaging and luckily you found it? Yeah. The patient that we had, it was kind of, we ended up doing some imaging, but it was the kid had to present a couple different times. His complaint was ear pain. He was, and the family had thought he had gotten stung by a bee. And so they said he got stung by a bee.

Which makes it even more complicated. And so we kind of maybe a little bit of anchoring initially on this like idea of he got stung by a bee in his ear. You know, we looked, looks fine, gave him follow up. And then he presented back. We did a cat scan of the mastoids because he's complaining of ear pain. Of course. No mouth or throat symptoms. And the CT of the mastoids was negative.

And then came back again. And then he had started having fevers and throat pain. And so we were able to kind of localize it at that point. We did a CT with contrast of his neck. The contrast obviously wouldn't have mattered either way, but we were able to see it on the neck image. It was just lodged kind of down in the tonsil a little bit and referring the pain to the ear, which it's wild.

And in the comments, everyone's like, you should have CTed him the first time. And I was like, if you see TZE every kid with an ear pain, That's too easy to say after the fact. I've even run into this with, let's say, appendicitis. Someone comes into an outpatient setting. I see them, they have mild abdominal pain. They're not vomiting.

They're non-febrile. Their appetite is starting to improve. You press on their right lower quadrant, no pain. They said, oh, but my loved one's worried about appendicitis. I'm like, look, I'm not worried about appendicitis based on these symptoms. But if XYZ happens, follow up. and then they develop appendicitis, it ruptures, and now they're really mad.

Yeah. What is the, what do you supposed to do? It's the Monday morning quarterback, you know, oh, you had belly paint. But, you know, we're going with the information and the exam we have at the time. Yeah. I actually have a friend who's been on the channel before

to share a story with me, similar to the metal grill brush, but it was a fish bone, and you're not going to believe this. The fish bone was stuck in so long inside thisophagus. it migrated out and came out protruding out of the skin. So a fistula formed.

Wow. And I have a picture of it. I'll show you later. Isn't that wild? That's wild. He sent me this picture. I'm like, no, you're making this story up. Nope, absolutely true.

I have another related story. So right after the grow brush happened, this is rough. I don't know if we can handle this. I haven't talked about it on social media. This is a medical podcast. So this is safe. So I have to make the video real quick before you're supposed to do. the podcast. So we had this kid come in and it was like six months after the grill brush thing and it

happened. So there's a kid that's eating a burger from a local joint or eating something, let's say a sandwich, eating a sandwich from a local joint. And as he's eating the sandwich, he suddenly starts to cry and complain. His throat hurts. Like something is sticking in his throat. And they, they looked. They couldn't really see anything. They came in. We looked. We really couldn't see anything, but like we're going to start with an x-ray. If it is a meadowar, grow brush, It wasn't anything that would make sense that it was real. There's an epidemic of grow brushes. Everyone was like, get the extra.

I look for the grill brush wire. And it wasn't there. But you could kind of see a little something, kind of in the peritonsor tissue. So we ended up calling ENT, and they're like, we're going to have to scope him because he's like kind of gagging and irritated. So they took him to the O.R.

And they did a scope. Are you ready for this? Okay, wait, hold on. Can we, do we know what sandwich it is? I think it was like, it wasn't something that was. Okay, is it a toothpick? No. So that was what we were thinking. Toothick. It was like a deli meat sandwich with some vegetables on it. Sharp object. You're not going to sleep well tonight. I can tell this. Oh, no. Is it like a pig tooth or something?

The leg of a cockroach. It's got these like little like spikes on the outside. It's like speculated. This whole time I was eating them thinking I was safe. Yeah. And it just like the leg was like just lodged right in the tonsil tissue. I know. Like, like, cockroach leg. It's the leg of a cockroach was just embedded in the... See, that's the first one that I feel is appropriate to call foreign body.

When we say metal grill brush, that doesn't seem weird foreign. This is foreign. This is foreign. Yeah. And it was a body part. So it was foreign body part. That's like, have you seen the book? It's called like weird ICD10 codes?

I, I've Googled some. Oh, you have. There's one called Bidic. by Orca. Oh, God. And I think that's the title of the book. And I'm like, hold on a second. Where, in what part of the WHO ICD10 classification are Orca's biting people that we need

a code for? Yeah. Yeah. Like trying to code for like a kid getting hit by a car like, you know, unfortunately. Oh my God. Even those. And it's like in past. Four wheel drive sport utility vehicle.

Train like pedestrian struck by a non-traffic accident. Like what are we? Can we just? I don't know what the benefit of getting that, I guess for record keeping, but then read the note. I don't know. Yeah, I don't know. Yeah, those are really rough. Wow, I can't believe you had a foreign body cockroach.

Yeah, it was rough. It was, I again, I still don't sleep well night thinking about it. Zooming back to residency. What was, because it seems like you bring on unique cases, anything unique that happened to you during residency or fellowship that sticks out in your mind? Oh, I had a lot of. crazy cases. I think probably the best one was a kiddo that presented with like stroke like symptoms. Adnormal speech and weird movements and we were trying to figure everything out. And we had this really, really smart infectious disease doctor. And so we did all the imaging.

And then the kid, I don't remember they spiked a fever. They had a rash or something. They're like, we need to, we need to strip the kid down. So, you know, we're looking in all the clothes. And they start to look in the hair and there's a tick. There's a tick that was a. adhered. So the kid had like a tick paralysis. And we took the tick off and the kid had a recovery like within a couple days completely. I don't even know what tick paralysis is. Yeah. You can get bit by a tick and then as long as the tick is on you, you can continue to have persistent symptoms. And then, you know, obviously kids are weird and they do weird things. They don't read the book and know what they're supposed to do. But, you know, once you take the tick

off, the symptoms can improve. And so it was just knowing that we had to look for it. And it was, But he's just, he knew, like, just, yeah, you have to explore. Talking on the phone, he was like, I had an idea and he came and he was just like, but was he looking for the tick or he was just looking for the tick. Oh, wow. He didn't tell us he was looking for the tick. And, you know, and then he, like, when he found it, he was like, there it is. Told you.

Wow. That's like some house level. Yeah, it was really cool. Well, speaking of house, are you a fan of any medical dramas? I mean, obviously besides the pit. We're going to say that. Yeah, the pit, yes. But anything pre-pit.

Um, Scrubs. Scrubs, Scrobs isn't, it was incredible. It was an incredible show. Um, I love Grace and Adaby, but more for the drama. Right. Um, and now that we're in pit season. Yeah. Obviously, we get to hang out at the pit premiere. That was awesome. That was so cool. That was awesome. That was so cool. Like, how are you? And I was like, you don't even know me. And he's like, I'm so happy you're here. Yeah, I have yet in doing the social media thing for like a decade now, you're going to some of these things sometimes. No one has ever been as nice as the crew of the people on the pit. They were so cool. Unbelievable, actually. When you first watched it, did you watch it already knowing that this was going to be an accurate show? Or did you start watching and go, whoa, this is good? I don't think, I watched it very early, like the first, I think only like one or two episodes had come out.

so the hype hadn't really started yet. And so one person that said, I think it's a pretty accurate show. Like, let me know what you think. And so I was like, oh, go watch it. And then I was like, oh, this is like, this is literally what I do every day. And there's a couple things, you know,

obviously for show reasons. Yeah, okay. Well, hit me with the criticism. I love to see it. Because my biggest criticism is they don't have a pediatric ER doctor. That's. But most places don't. Oh, okay.

Interesting. Most places don't. Maybe the pit doesn't have the actual pit. Yeah. But still, I would love to see the representation. Call me. Yeah. So I think, you know, one of the most obvious is the charting.

I spend quite a bit of my times, you know, sitting at the computer, putting the orders in. But then how do you show that on a show without putting the audience to sleep? Right. And that's 100% the reason why they don't show them sitting and charting. And they do a little bit here and there, but, you know, makes sense. And I love that in the first season, the administrator came down and was like, oh, you need to improve side and side. I'm like, so real, so real all day long.

We have this whole committee that works on it, yes. I think that there are a couple little things like representation-wise of like the respiratory therapist. Like we work very closely hand in hand with our RTs. They're helping managing nebs and vents and that kind of thing, helping, you know, if I'm intubating, like they're handing me supplies. So I think there's a couple like things like respiratory therapy. Obviously they had great representation of social work,

which I thought was awesome. child life. It's not a pediatric ER, but I would love to see like some child life representation because what they do is so important and the fact that parents don't know about them, I think, is a criminal? To walk into an ER and be like, hey, is there a child life person who could help me with, you know, an IV placement of my kiddo? So showing that I think would would help my heart to feel better. But really, what they do is just so accurate to what I do on a daily basis. Yeah, the core of it is so realistic and valuable. Do you feel like because Pitt is so omnipresent in culture, it would actually have a bigger impact than perhaps some of our educational stuff on the general public because it is so mainstream of how people relate to doctors or expect to be treated in the ER?

I think it shows like I can tell you all day what a day of my life is like. And I can do I can do like to get ready with me. But I can't take you along on my day in the ER where the pit is showing you, you know, HIPAA compliantly, what life is like and you're seeing their feelings and you're seeing, you know, the different pressures and stressors that they're dealing with. And I think they do it in an entertaining way that's really fun and just holds your attention. I think they, and I think they do a really great job at it. I'd love to make a call officially on this podcast with you to get either HBO or S&L

or whoever it is to put some money behind shooting one episode or half an episode with only medical influencers as pit characters. That would be really entertaining. How fun would that be? That would be really fun. Even if it's just on SNL. Yeah, that's what I'm saying. Or if they want to just put it on YouTube to promote the show, yeah.

That would be cool. We all collab post it. Maybe I need to fund that. I'll throw in. Let's do it. got to hit up one of the execs, Scott or someone, and say like, hey, can we borrow the set? And I know it's ridiculous, but can we borrow the set? I know you have screen actors guild rules and all that, but can we borrow the set? Just after, in between seasons. Yeah, yeah, in between seasons.

Since there's going to be a four, I'm assuming. God, that would be so fun. After season three, we'll write it. Yeah. After season three is finished filming, because I know they haven't even started yet, then we'll go. God. Which character would you want? Who is this is tough? Who would you play on the pit? Uh, maybe Trinity Santos. Okay. Yeah. Yeah, what drives you to that? Um, I think she's just like, uh, she's got that adrenaline seeking.

Like, let's go. Like, I'm going to go do this. Like, let's, and just like that. I want to do it. I want to get the procedure. I want to do the stuff. That's, I mean, I think I have some of the male characteristics probably of like the, uh, what, you know, a little spectrumy.

Got a hint of the tism. She's, uh, she's my favorite character on the show. I love her. And I also feel bad. I'm not fully caught up on second season because when I watch them on YouTube is my first time seeing them with the exception of the premiere that we got to see. So so far I've seen her get really hurt and assaulted. Which makes me sad in knowing that she has to go to this deposition when she's like the nicest character.

She's like literally the best. She's so sweet. Like we need to save her. I don't want to. I want to hold her hand. I just feel like we're going to be okay. I want to go to the Renaissance Fair with her. Like that would be good times.

Yeah, it would be good. Okay, so the pit is there. The pit's doing a good job trying to educate the world about the struggles that we face in health care. But do you see that the world has changed in the last few years with increasing distrust of not just perhaps providers, but also specific treatments, vaccinations? What's been your experience with that? Yeah, 100%. And I'd say it's probably been growing even before, like, the pandemic. I think the big shift was obvious during that time.

And I think there's two parts of it. I think people are looking things up themselves and asking questions. And I love that. I want our patients to be educated and informed. And like I want to be a resource to like have that conversation. I think the trouble comes when people already have kind of made up their decision based on information that's not necessarily correct or sometimes accurately interpreted. And especially when it comes to kids like it gets it gets a little challenging sometimes. because, you know, obviously we have vaccines and we have things like if you have a newborn with a fever

and, you know, you and I know how serious that is and the risk for serious bacterial infections, bacteria in the bloodstream, urinary tract infections, meningitis. And so we follow these standard treatment protocols. You know, and families, a lot of times now are refusing the workup. They're refusing blood work or lunger puncture, things that we have data and evidence and, you know, kind of risk ratios to show that like, you know, the risk of having bacteria in your bloodstream is really high and, you know, these are the things that we should do. So I think we're seeing a lot of the kind of distrust and making up their mind about things, you know, without maybe having

all the nuance or the information. And it's made our job challenging. Yeah. Not just challenging. I'm curious if you have a specific example of a child who potentially was hurt. by the decisions made based on misinformation. Yeah. We see more and more vaccine preventable illnesses, and we're starting to see some pneumococcal bacteremia. So obviously pneumoccal is, bacteremia is a really serious, we vaccinate against it.

You can have, you know, strep pneumo in the bloodstream. You can also have, like, ear infections and pneumonia. And when we started vaccinating against it, the numbers started to plummet, but we're starting to see them grow again, again, mostly unvaccinated kids. And some of these kids, unfortunately, are really sick. And it can be very challenging. We also, and I made a video about it a while back.

I had a kiddo that came in that had a cough, really, really, really bad cough, and the mom was really worried about the kiddo. And I heard the cough, and I knew immediately it was pertussis. And I talked to the mom about, you know, I think he's got whooping cough. And, you know, right now he's okay. I don't think we need to admit. he's, you know, keeping fluids down. He's not in any distress.

And she's like, well, how do I sleep at night? You're probably not going to for a while because this is going to be a couple months, potentially, even that he's going to be doing this almost constantly. And she made a joke about, you know, I guess I did this to myself. Yeah. That's why I think it's valuable. Perhaps you could tell the audience, if a child comes in with, let's say, a fever, not feeling well and fever. How does your workup as an ER physician change when you know the child

has not gotten vaccines? Yeah. Especially in kiddos under three, the risk of serious bacterial infection like meningitis or bacteria in the bloodstream, mostly the bacteria in the bloodstream is higher. And so if a kid comes in that hasn't received vaccines or is significantly delayed, hasn't received like the first couple, especially of like pneumococcal or homophilinza B.Hib, I want a blood culture. I want a blood culture and a CBC. If the white counts elevated, we get concerned of, you know,

potentially that we do need to give a dose of something like a Cephtraxone, potentially admit to the hospital. We have to be more worried about sepsis. If that kiddo has a headache and neck pain, then we also have to be concerned about meningitis. And if a kid has a simple febrile seizure and they're not vaccinated, we also have to have a higher threshold to think about meningitis. So the workup absolutely.

changes when it comes to vaccines. And so it's one of my questions, you know, do you have any medical problems? You take any meds. You have any allergies. You have any surgeries or your vaccines up to date? And I actually stopped asking it like that. I just said, tell me about the vaccine status, because so many of them are not up to date. And then, you know, we get into that. Have you noticed, what percent change have you noticed of folks being, not fully vaccinating their children? Yeah. In the past, I could go days or weeks without having, without a kid with, No vaccines. Almost all their kids that we were saying were vaccinated.

And now I would say it's maybe 75% of the kids under two were vaccinated. Wow. Like it's not, it's huge. Because for like measles, you need 95% because it's spread so easily. And when you're in the 70s. And what we're seeing, you know, the data that we have for the MMR is for kids that are entering kindergarten in the United States. And we've already started to see that number drop.

But I think in the next maybe two or two. or three years, we're going to see that really plummet, unfortunately, unless people start kind of taking this information seriously, taking this measles outbreak that we're having right now in South Carolina seriously, because it's really, it's really contagious. For patients who are skeptical of vaccines, the medical industry, what's your approach? How do you handle that situation? I love skepticism. Like, let's talk about it. Like, what questions do you have like, let's have a conversation about it. I think that the problem is people have already made up their minds. And when you've already made up your mind, you're not open to hearing the

new information. You're not open to having a conversation. You're not open to asking questions about it. And so that's where a lot of people are. They've already made up their decision. They're not changing their mind. We're like, you know, we can, let's just talk about it. Like, what kind of questions do you have? What are your concerns? Like, ask. Have you had successes doing that? Most people are not open to talking about it. Wow. And, you know, I have had patients that when I've had the conversations about, you know, your kid doesn't have any vaccines, they have a fever.

I'm concerned about, like, you know, these things, bacteria in the bloodstream and meningitis and things. And they start asking questions. Oh, what vaccine prevents that, you know, and don't always know that, like, these vaccines prevent against these certain things. And so I have had some, you know, and they said, well, you know, to prevent having to do this in the future, like, what are the vaccines that you would prioritize? I say, these are the ones that I think, you know, at this age are the most important,

but I think we should have a conversation or talk to your pediatrician about all of them and what we're preventing and what the disease actually looks like. Yeah. What about in terms of just keeping your ER more busy? Because I think about how overflowing so many ERs are across the United States, and now you're adding all these vaccine preventable illness visits that require a lumbar puncture, extended stays. Do you see that having an impact? Yeah. Yeah, we're having to do, unfortunately, more workups. And one of the things that we have to be really cautious about is we want

to protect all the kids in the department. And so if we have a kiddo that comes in, we're concerned about measles. We don't want to be exposing everyone in the department, everyone that's sitting in the waiting room. And so we're trying to do screenings. We're trying to get those kiddos in a room that is airborne so that we're not going to be spreading it around, that we can exhaust that air outside and not be exposing other people. And so we're having to be like really cautious about the rooms we're putting patients into. Where have they traveled recently? Do they have their vaccines? What type of symptoms are they having? Is it cough, runny nose conjunctivitis and haven't had our ash yet? So it makes the flow of the

ER a little bit more challenging and it does create kind of more, a little bit more backups on occasion. Yeah, that's so scary to me. Have you noticed being so popular as you are across social media, have you noticed that be a positive thing in your toolkit to help convince patients or parents? Or do you feel like neutral? What's been your experience with that? I feel like it's neutral. And I'm actually surprised at how many people will come see me in the ER and, oh my gosh, I know you from social media. How cool. It's nice to meet you. And, you know, we go into the thing. And then I start asking, those questions and I ask about vaccines and they say their kid doesn't have any vaccines,

but they love my content. I'm like, I talk so much. You're like, what do you like about the content? Do you like the hurricane stuff? Like, what do we? What content? Do you love so much? And so I try not to be too pushy. But at the same time, like, you know, broach that conversation a little bit, especially if it's pertinent to the visit. It's a little harder if it's not pertinent to the visit if they're here for a broken arm or something. But I, you know, I try to ask the questions or inquire a little bit, but, you know. That's so hard. Yeah, it's tough.

Because you're, how on one hand can you not be pushy, but on the other hand, advocate for this child's protection? How do you balance that? Well, and I think that, you know, my job really is to care for the patient in that moment, and I'm not their primary care provider. Right. And so, you know, we really need to address. I need them to trust me for what we're doing right now, whether it's getting the labs and

the IV or whatever it is. But just trying to drop those little, drop the seeds to see if we can grow something, see if they ask questions so that we can open that conversation a little bit. But I also know that like I need them to trust me for right now because I have to sedate their kid with ketamine and I need them to trust me that. Right, right, right. Yeah, that's really tough. Especially with the changes recently coming out from the CDC on the vaccine schedule, the amount of confusion that has caused everywhere. because if you look at probably all of our content from the pandemic, we're like, trust the CDC, go on the CDC website and now don't.

What happened? Like, what changed? And to get into that without flaring political issues and making people feel ostracized is so hard. How do you do that on social media without getting people upset? Or are people upset you don't care? I think people get upset no matter what because you're going to upset. If you don't have to take a strong enough stance, you're going to upset this. group. And if you take any stance at all, you're going to upset this group. But I think what I've

tried to focus on is just the evidence. What does the evidence say? What does the science say? You know, the science says that hepatitis B is a concern and that we should be vaccinating patients as soon as they come out and there's potential exposure. I think it's important. And what I've been saying, my kind of tagline is that the evidence hasn't changed. The science hasn't changed. There's no new paper that's come out to say anything new about vaccines. So the CDC has changed their stance. In fact, good data has come out. Right.

Great date. Like, we have data that supports what we're doing. And so the AAP and so many other, you know, medical organizations, leading medical organizations have supported this same vaccine schedule. And so that's what I as a pediatrician stand for as well. Yeah. What I find interesting is when our administration changes the vaccine schedule to mirror, they say, Denmark.

But then Denmark has the last. largest study of childhood vaccines proving that there is no tie to autism. They completely ignore that fact, but focus on the vaccine part. So I'm curious how they're cherry picking and choosing what they want to learn from Denmark. And I think that the point is that they're just kind of making things up as they go. They're not focused on data or science. They're focused on politics and do you have a theory? Because I've tried to put myself in people's shoes. And I'm like, Well, you know, sometimes people have an ulterior motive. I don't understand the motive.

Like, I don't even know what's happening. The person who's leading it as a lawyer. Yeah. You know, it's not someone who's going to be focused on looking at the papers and looking at the data. Sure. You know, digging through the statistics. It's an emotional response. Yeah.

We're making decisions based on other things. Vibes. Vibes. Yeah. Back to the interview in just a second. But first, I want to tell you about Microsoft Dragon co-pilot, an AI clinical assistant, build to simplify and transform the way care teams work. I've wanted something like this forever.

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Also, if you happen to be heading to Hymns next month in Las Vegas, pop by the Microsoft booth to take a look at Dragon Co-Pilot for yourself. All right, let's get back to the interview. I've been critical of some of the major medical organizations about their lack of investment into social media. And as someone who's invested a lot into social media and has gotten a lot for it, meaning a lot of education for so many people,

millions of views, probably billions. What do you feel, what grade would you? would you give the major medical institutions on their use of social media? I think it's tough. I, obviously, I think some of them are dabbling now. I'm, you know, we're starting to see their Instagram, you know, pages pop up and I'm getting followed by, you know, some of them are like, cool.

Hey, welcome. Nice to meet. Yeah, good to see you. But at the same time, social media, when it comes down to, is generally for education, or not for education. Social media is for entertainment. Oh, okay. I thought you were going to say that's how I used it for education.

And so I think when people are on social media, you know, they're not like, oh, I'm going to go study medicine. I'm not, you know, they want to be entertained. They want a quick video that makes them feel some feelings or giggle or whatever. And yet people do look up like, you know, what's the best way to treat a cough? But a lot of it, a lot of the reasons that they're on is for entertainment. And so I think a lot of the medical organizations and even like the disaster organizations are struggling to gain a following.

And if you don't have a following, what are you doing? Well, that's what my hope is that they would work with someone like you to collaborate and bring that fun because clearly they can't and have failed. And to me, I feel like that's the largest failure out of all of this. Because if you look at what makes people who are spreading misinformation so effective, is that they've literally leveraged the tool way better than we have leveraged the tool, and that is social media.

So when they make a post and they get a million views saying something inaccurate and one of the major medical organizations fact checks in gets 10 likes, not comparable, doesn't quite equate in that sense. So it's great that we have doctors like you fighting back on this cause. And it's something I've been screaming for a long time.

I think I actually wrote an op-ed on this for the American Academy Family Physicians in like 2017. saying that the absence of people like you on social media is going to be the reason why something bad will happen. And it sort of played out that way. I know you got on to social media during the pandemic. Did you ever have thoughts of using social media as a tool prior to that?

And then the pandemic pushed you over the edge? Or what was your relationship with social media before? I was a consumer. I never even dreamed of making content. This entire thing was just a complete accident. Like this was not intentional. But a good accident. It was an all happy accident.

The fact that this has happened, like the fact that I'm sitting here talking with you, I'm like, oh, this is pretty solid. I love that I'm accidentally good at this. I love that I'm accidentally good at this. And it was never intentional. What makes you good at this? I don't know. What do you think? I really have no idea, Mike.

I would love if someone had, I hear. Well, what do people tell you? I hear that I'm authentic. Okay. Do you believe you're authentic? It seems like you have a little bit of disbelief about it. I don't think I have a mask. Okay.

So I think what you're seeing is... That's very authentic. Yeah. And you come off very authentic, so I just want you to believe in it because you definitely deserve that praise and titles. Yeah. And then I don't use a lot of the big words. Okay.

So I think I speak in a way that people understand. And those are the things that I hear. And I, yeah, I was like, oh, yeah, that fits. But I'm an introvert. So, like, talking to people is not my strong suit, is not my forte. But a camera, a cell phone might be a little different, right? Right. And so it's worked out that I can sit in my room and make a TikTok.

I don't let my husband come in. If he's out. You need to be in the living room. You can't be watching me make a TikTok that I'm going to show to millions of people, you know. So it's an accidental that I'm good at it and that it's worked out. And I'm thrilled. And I love that I can spend time and educate people and connect with people. make a difference and potentially like open people's minds up to, you know, like let's talk about the.

I don't, you don't even need to accept vaccines. Like, well, let's just talk about it. Let's just have a conversation or, you know, whatever it might be or just even awareness about like testicular torsion or, you know, croup or respiratory distress like retractions. I made a video about that a couple days ago. People go, oh my gosh, I saw that and I knew my kid needed to go to hospital. And so I think it's just a really cool opportunity to provide education for people in a way that like, you know, 15 years ago wasn't an option. Yeah. Being a mom, does that improve your ability to communicate with people online?

Sometimes, I think. I've got a lot of kids. A lot. Yeah, so, like, I think... You have four kids, right? I have four kids. And I think, you know, talking to them and, you know, communicating, like, world issues to my kids has helped me be able to communicate, you know, to people not using the big medical words and just

in a way that makes it somewhat understandable. What about community feedback from other moms, parents? Moms are big fans of me. That's a good shirt. Do you know who? That's your slogan. That's your slogan. Or a book title.

Grandmas are bigger fans. Why grandmas? Grandmas aren't social media? Grandmas are on social media. And they are big fans. So many people, actually like three people at the pit premiere were like, my mom is going to be so excited. I met you.

It's everyone's everyone's mom. Wow. Yeah. Like 97% of my followers are women. Okay. Probably similar. Well, you know what's funny?

When I first started on social media, especially Instagram, I started under this BuzzFeed moniker and People magazine stuff. So it was very superficial. At that point, my following was 80% female. So in this demographic split on Instagram specifically. Now, on YouTube, we're 60% male. Oh, that's impressive. And Instagram is now leveling out to like 70, 30, 65, 35.

So it's interesting to see the transition of how these things change because the algorithms have gotten smarter. For good and bad. So it's interesting to see that evolution of it all. Where do you want to take it from where it is now? You know, I don't know. I think the good and the bad of social media is that, you know, I'm always, one video away from being canceled. You know, one bad take from just everyone going, nope, she's done.

Do you think that could happen, though? I think it's possible. But, you know, I don't know. It's a concern I share all the time as well. It feels natural in our place where we exist to experience that. But at the same time, I have to do a little CBT on myself and be like, how rational is this? If you say something inaccurately and you explain your reason for your mistake, if it came with good intentions.

Will the world really never want to see your content again? Right. And it's a good exercise to do that because sometimes it's overwhelming having the responsibility of making content that even though we say don't make health care decisions based on this content. Right. People inevitably do. So how does that land for you knowing that you're putting out content that has such an impact on people's lives?

Yeah. I think it's hard for me to like internalize it and I don't know if that comes from like a growing up and you know being taught like humility is so important um so I I don't internalize a lot of it and it's just like okay I'm going to make a video today and post it and there's going to be comments and I don't internalize a lot of the like you're making a difference type of thing what would allow you to internalize it more I don't know if I can't completely I, we're just here talking. Like, you know.

When a little kid runs up to you and hugs you and says, thank you for all that you've done. A parent comes up to you and says, I found a metal grill brush inside my child's throat because of you. Doesn't pull it to heartstrings at all. Feels good. You know, and I can have that moment of feeling good. And then I go back to being just myself and not the Dr. Beach gem, you know, who makes the videos. And I'm just, you know, me walking around. So are those two different people?

Those aren't. No. I wouldn't say they're two different people, but Dr. Beachgem, you know, talks on my phone and makes videos and posts. And then I go out and I make, you know, I don't make dinner. My husband does. But I go out and we eat dinner and we spend time together as a family and we play games. And that's, you know, I feel like that I don't have to be like on. I can just, you know, being on, you have to like. Sure.

Turn it up a little bit. Turn it up a little bit. But it's still me. Yeah. Do you get feedback, emails, testimonials? What's some interesting ones you've gotten? I've, you know,

I've made, there's kind of two videos that stick out, and one of them is I made a video about diagnosing a friend's kid with new onset, type one diabetes. He was in DCA in car circle at the school. Car circle's like pickup?

Pick up, yeah, pick up. Non-parent. Yeah, it's, all of us parents would stand under a tree. Like we would park and then walk up and pick up the kids and mom was talking. and she was just dropping all of the symptoms of type 1 diabetes.

He's been drinking a lot. He's losing weight. He's really tired. And I was like, I'd like to smell him. And I smelled him. And he smelled like ketones. I'm a hyper-smeller. I can smell ketones from a mile away.

And I said, you know, you need to go to the ER. And I've talked about that pretty much every year in November for Diabetes Awareness Month. So many people have said, I diagnosed my niece, my friend, my kid, my student, you know, because of the symptoms and I smelled them. And, you know, I think that there have been a lot of kids that have probably been picked up earlier because of the awareness of those videos. And those videos perform, you know, pretty well. I usually get quite a few views.

And then the other one, you know, on social media, you make, you know, online mutuals. And one of the kiddos that I talked about was a kiddo that was having morning vomiting and headaches and not acting appropriately. ended up getting diagnosed with a brain tumor. And so I talked about some of the symptoms on a video. And then I've gotten a couple emails of, you know, I saw your video and then I realized, you know, my kid's been waking up with headaches in the morning.

And so they ended up getting the imaging and had, you know, a mass or something going on. So those two videos, I feel like, and I've made a couple of those videos a couple times, have made a difference and help kids get diagnosed sooner. And I think those are probably things like that are more impactful than some of the other content that I've made. Yeah, what I find is when you're sitting at a speaking to a camera, in some ways it's easier. In some ways it's harder because it's a little awkward to fill dead air and essentially act like you're talking to someone.

But what you miss out on are those responses. And when you get them in real life, it kind of pushes you to keep doing what you're doing. Because when we're practicing in our respective. hospital areas, we are feeling the improvements, as you noted. Kids get better quickly because on family medicine, I have that continuity so I could see the improvement in their lives. That gives me that reassurance to keep going. With social media, you don't always get that feedback.

And we use likes and views in lieu of that to some degree, but it's not the same. It's not the same as hearing that one story where you change someone's life and you're like, wow, I got to take some time and zoom out and realize that there is a reason why this is important to do because you are going far above what you're supposed to do as a pediatric ER physician. It's hard enough as a job as it exists today, but you're doing that and you're continuing to do the work once you get home at a scale that's having huge impact. You have to let yourself at some point feel that. Yeah.

Yeah. It's hard to explain. It's just one of those like, okay, and just keep going kind of thing. Well, nonetheless, I want to thank you for doing that because I truly want more physicians to see the value in this. And part of them seeing and hearing the stories that you've been told will hopefully motivate future physicians to do it better than us. To be like, ah, Beach Jam and Dr. Mike, like they did it okay, but I'm going to do it better. better than them. And they can do something truly special that can have a worldly impact. So I'm excited about future generations making use of social media.

What's your relationship like with the health care system as a patient? You know, I think I'm not one that's above the challenges of dealing with the health care system as a patient. And I think it helps me understand what our patients are going through, you know, having to deal with that. Creates another level of empathy. Yeah. they come in and they say, I've been trying this for so long and I just can't get anywhere. And like, all right, well, let's see what we can do to take those next steps because I know, I know the struggle.

Yeah. What's been that struggle? So I recently, I wasn't even that recently, I started having some symptoms with my right breast. Are we allowed to talk about breasts? Okay. We don't set the rules. So if you two bans us, they ban us. All right.

So my right side, and I started a couple years ago and I went through like a partial workup, my doctor was very concerned initially about the symptoms and she wrote me a stat mammogram and I went to try to get a stat mammogram and it turns out that a stat mammogram does not exist. So they were able to schedule the ultrasound but the mammogram was going to be in like four to six weeks. Diagnostic not screening. Diagnostic not screening. Which I've gotten in trouble for before. Right. Because I was symptomatic and it was going to be quite a bit of time and I was kind of freaked out.

my doctor was kind of freaked out. And so I ended up, you know, tapping into a local pediatrician or physician mom's group. And I just said, does anyone who does breast radiology have any openings? And somebody had an opening later in the week. So I had to drive, that's probably hour and a half, almost two hours away, for a 730 appointment. But, you know, I was happy to have the appointment. It was an opening. I didn't take anybody else's appointment.

Got it done. Pretty reassuring. and then kind of I had knee surgery, the floods happened, life happened. Oh, my God. And then I kind of went back and repeated the workup because we didn't have any answers. The symptoms were back. And I was having, that's a weird symptom. I was having like black discharge, which, you know, it's alarming.

Of course. Alarming, yeah. And there's a chance there that it could be something that's more concerning like a malignancy. And so I went through the ultrasound and the mammogram that, we got scheduled reasonably quickly and then wanted to do like a something called a ductogram where they, you know, kind of inject dye into that duct just to see what it is. And I had this, the doctor wasn't able to express the discharge. And because it was sterile, they wouldn't let me touch the area.

And then kind of came off the table. They said, you know, we'll just, we'll circle back next time you're having the discharge. And I was like, I'm active, like, I can show you. And I did. and they were like, well, don't worry about it. You know, follow up. Just, you know, this doesn't seem like a common symptom.

No, and they, you know, I'm right here. I can show you like, and it was a very frustrating moment. And I felt like, I almost felt like they didn't believe me maybe. Like, we're on the same team. Like, you know, I'm one of you guys. And you don't even need to be one of them. Right. Right. That's an added thing that they should.

An added layer, you know, and I don't expect more because I'm a health care person. but I'm like, I expect my team to do well. And when my team is letting me down and letting other people, it's just frustrating. And so I just, in that moment, I felt, and I was already, I think I worked till like four in the morning and then woke up at seven for this. And so I was exhausted and hungry. And it was just not a wonderful day. And I ended up finding another breast radiologist, a breast surgeon, actually, who was wonderful.

and we went through the data and the recommendations for people who are having the symptom. And the next test wasn't even a ductogram. It's actually to excise the duct, which I had done two weeks ago. To excise the duct completely or for biopsy purposes? Both. Both. So you're taking it. You're not going to have that symptom anymore.

And you're making sure that there's no malignancy. So diagnostic and therapeutic. Diagnostic and therapeutic. Okay. And so I had that two weeks ago. And the reason I'm able to travel is because I'm on medical leave technically, which is wonderful. I feel great and the biopsy, everything came back benign, which I feel great about. Interesting. You know, we don't have to worry about this situation. Was the diagnosis ever placed?

Yeah, we got pathology back. It was kind of like a chronic inflammation. Oh, God, it's nothing specific. Nothing, yeah. Non-specific, basically, inflammatory changes. Yeah. Great. Yeah. I guess great to hear in one way, but annoying. We went through this for two years. I had surgery. I had all these for Cedric. I'm sure you look this up. What was in the differential for having black discharge? So, but a benign papilloma is probably one of the more common. Duckdactasia is also something, but then you can also have, you know, malignancies associated with that. And a lot of times it's black because it's old blood. And so I'm so, you know, bloody discharge. There's malignancy. Got it. Got it. Is in the differential as well. Wow. So that probably didn't reassure you of our

healthcare system much that you had to fight to get care at this level. Yeah. I mean, it was frustrating and just, you know, feeling like dismissed and not believed. And I think, you know, when you feel that for the health care system and the people that are supposed to be helping you, it's just like, I just want to throw in the towel. I don't even want to do this anymore. And when I came out of that visit, I actually made a video and I was just like, I don't want to do this anymore. I'm done. I'm sick of it. I don't want to talk to them.

I'm never coming back to this place. Like they hurt me emotionally. I'm not coming back to this place. And granted, this facility is not a bad facility. like they're wonderful people. I know they take really good care of people and it was just, it was a bad day for them, a bad day for me and it just didn't work,

but I was not going to be walking back into that place. You know what's interesting, I hear so many of these stories where patients are not believed, dismissed, cared for poorly, and a lot of times the people who fall victim to misinformation are those same group of people. And in my content,

what I strive to do, I'm curious how you deal with this is say like that's not what's supposed to happen. So doctors should do X, Y, and Z, and they should care about you. And the people who are critical are like, but that doesn't happen in a lot of cases. So the fact that you're this nice doctor saying these nice things online, and it doesn't match my reality, what should I do? And I'm like, good question. It's tough.

And there are so many doctors with so many ways of communicating. And one of the issues that I've seen in kind of just differences in patients is, you know, I can have an idea, oh, you have the symptom. I would like to do these things. Like, this is the workup that I would recommend. That's one way that I can approach a situation. And then one of them is that, like, I can kind of ask the family about, like, their, what are you, you know, what are your thoughts about what you want to do today? Or, like, I'm doing this. What do you think about that?

or give them some options. We can either do a chest x-ray in some labs or we can just start with a nose swab and see what we think. But sometimes the wrong parent is going to get upset. Like, why don't, I'm not here to be the doctor.

You're the doctor. You tell me what to do. But then, you know, this other family where I told them what to do is going to say, well, I don't want to do that. Why are you? So, you know,

and I think it's hard to kind of, how do you present it to the patient so that they feel heard and understood and that they feel like they're partnering in care with you. And so, you know, it's not always easy to, you know, which direction do we go? How do we present this so that they feel the feelings? Which is why it's so great you set expectations early

because you probably avoid a lot of that discomfort that could happen during a visit. I try. I try. Because it's not, you know, we don't always have the things that we would, I would love to just do all of the tests for all of the people. Yeah, yeah. And not have any restrictions or anything like that. That's why people online are like, oh, you could just check all the blood. And I'm like, check all the blood. For what? You know, there's issues with checking all the blood that will confuse me, misdiagnose you, open you up to more harm down the line. So that really gets confusing.

And I've made mistakes on this in the past with patients where family medicine, I'm trained to always tell the patient what's happening, to really walk them through procedures. And I remember I was doing an I and D. Someone's abscess on their back. And I'm walking them through everything. And he goes, can you just stop telling me what you're doing? It's freaking me out. And I'm like, oh, yeah, yeah, sure.

And I thought he meant, like, maybe don't say the word sharp or needle. So I said, okay, I'll just use different words. That's how I took it in my head. And then I continue on saying, okay, I'm about to, you're going to feel my whatever. And he gets so mad. He's like, dude, I told you, stop telling me. And the funny thing is, like, I'm trying to go out of my way to be a good doctor like I'm trained.

But that's not the patient's experience. patients like, this guy doesn't even want to listen to me. So it's funny how good intentions sometimes in health care can have bad outcomes. Yeah. So that's a funny story. In your experience in treating patients, especially patients who can decompensate quite quickly, does that ever take a mental toll? Oh, of course. Yeah.

How do you deal with that? So, you know, on shift, it's hard to kind of deal with it. And there are certain times that like if there's a bad diagnosis or if there's a patient that, you know, passes away or something like that. I have to step away. I have to compose myself, wash my face in the bathroom, get a cry out. Oh, yeah. That's not a medical drama thing. No. Like, and we're human when it comes down to it. Like I'm a doctor, but I'm a human first. And I have emotions especially, gosh, you know, seeing a, you know, a parent lose their kid, that's, that sucks. But at the same time, I have a waiting room full of people. that I have to prevent any of them from going through the same thing. So I take a moment, get what I need out, wash my face, go check the board and go see the next patient. And a lot of times those next patients are not happy because they've been waiting a bit. And so you have to kind of like pull those emotions down, get yourself right and go do

what you have to do. And I have a scenic route that I can take for the way home, you know, windows down, radio up, just let the feelings out. taking that more often? You know, in pediatrics, we do pretty well. You know, we don't have as many. You know, we're able to save a lot more than an adult medicine. So I don't have to take it that much, luckily.

But I do sometimes, unfortunately. What are your colleagues like? Oh, they're rock stars. I have a great group that I work with. They're just, they're really, really cool. They're a really, like, different bunch. They're into all kinds of different things. They're all different ages.

but they're a really cool group and I kind of feel bad sometimes because patients will come in and some of them know where I work and they're like oh they kind of get disappointed that they didn't see me and I'm like this person's cooler than I am

like I know I know that like I'm on TikTok but like this kid's a really he's a really great doctor like she's a rock like she's I am solidly mediocre at my work like I'm not a rock star I am solidly mediocre but I work with a ton of people that are just competent.

Use competent. You're not mediocre. Come on. I'm confident. But I'm like, I'm middle of the road when it comes to like most of the stats. But like the people that I work with are just awesome. And they've just been, you know, going through like the floods and, you know, the pandemic. And like all the things, they've just been really supportive. They're just a really, really cool crew.

Yeah. What's their takeaway or what's their feedback from your social media success? You know, I don't think it. They're not really impacted that much other than I think that they have to deal with patients, you know, being disappointed that they didn't get to see me. So I think that that's probably a little bit of frustration for them. But they're just in general supportive. Yeah, they're supportive. They're awesome. You know, sometimes they'll be like, oh, you know, I've seen a couple of these cases this this week. Like, you know, I think you should talk about this just for some awareness, maybe so that we

can prevent other kids from dealing with whatever this is. Or, hey, you know, we've been seeing a lot of, you know, protasus or, you know, whatever it is. And so just kind of creating. some awareness. There's not a lot of pediatric emergency medicine voices, you know, and we do have, obviously, we have some voices on social media, but it's, there's a lot of other voices as well. And so I think, you know, them being able to say like, hey, if I tell Megan and we talk about this, then we can, you know, tell the world about it. Tell the world about it. Yeah, you could act as they're like bullhorn, basically, which is what, when I started family medicine, social media, I was thinking, I'm not the expert in any of these things.

But I can be the family medicine doctor that spreads that message on their behalf, translate the complex specialists' opinions to the individual. And I think that's a very valuable underrated position. Do you feel when you're – because patients aren't making appointments with you. Are you ever getting frequent flyers of people coming into the ER because they're like, oh, I know you're on this shift and I get to say hi. Generally not. though, you know, sometimes people will go walk in to triage and ask, is that, is the TikTok

doctor? Is that, is that, is that, is that, is that, is that, is that? A lot of times, they'll say the TikTok doctor or, you know, I think it's probably a little bit more now like Facebook and stuff, but I've been on TikTok the longest. So they'll ask if I'm there. And I, as if they're not going to take their sick child to the ER if you're not there. Well, you know, honey, you can wait. I know you're having trouble breathing, but the TikTok doctor is not here.

I try not to, you know, for safety reasons, I try not to advertise when I'm actually there. Sure. Like I'll post after I'm gone or something like that. So, and the front. How did you learn to do that? Because most people that are not on social media a lot will make that mistake once or twice before. Or you just proactively. I think I proact.

There was a very early, there were a couple threats that were from people that had been in the ER. I don't know how to say this hippocompliantly. But, yeah, so there were some threats that, you know, it could, they could actually go through with it. Got it. And so I was like, I probably don't want to tell them where, when I'm working. They know where I'm working. And so I probably just want to be a little bit cautious about that. And luckily, I think that they're probably not pediatric aged patients anymore.

So it shouldn't be an issue. But, you know, I think it was just like, all right, yeah, I probably don't want to necessarily advertise that I'm there at the this point. But also that comes with the downside as well, because if I make a post the day after I worked a night shift about working night shift, then people like, oh. Oh, they come in. Now I can, I know she's there. She just posted about it. Okay. But my front desk is well aware of, you know, who I am and if I'm working or not working. And so they, they tend not to give it away when I am or when I'm not working. Even though you do such great work, do you get any haters or criticism on it? Oh, so much hate. You do? Oh, so much hate. No way. Oh, yeah, a lot. Like vaccine related? Or

Anytime I talk about, you know, anything vaccine-related, even anything that, like, is slightly a hint political, you know, then you get, I'm going to unfollow it. Don't do politics. Politics is in medicine, medicines and politics, unfortunately. Public health is policy. So, you know, it's that kind of stuff mostly. Got it, okay.

You know, back when I was doing more COVID-type stuff in that early pandemic talking about masks and stuff, that was obviously. Yeah, yeah, triggering for people. Well, and I think that, you know, there's people that believed masks work and people that, you know, didn't necessarily. And so, yeah. If you had to have a magic wand and change one thing about being a doctor on social media, what would you change? I would like to be able to regulate comments better. Okay.

Yeah. Did the comments, like, impact your mood somewhat? Well, and sometimes, like, you know, you see somebody will make a comment that is. very benign. And then like there's this, you know, the next person is kind of like upset with them about this fairly benign comment because maybe they misunderstood it or something. And then there's just like 44,000 comments under this one and then they're yelling at each other about nothing. And so I'm just like, delete the whole thread. Yeah. Like delete the thread. And so I, I, but it's hard when, you know, it's hard to. You're doing that scale. Yeah. Yeah, that is tough.

It's interesting that negative comments will make you feel some type of, of weight, which is natural. But then the good ones don't give you the up. So you're off balance. You got to find that happy equilibrium where at least the good ones will cheer you up. Sometimes people will say things and I'm like, oh my gosh, that just that made my day. Like it'll, you know, I posted a picture of we were walking through the airport and my husband was carrying my backpack and both of our suitcases. And I took a picture from behind. What I didn't realize was that there's a group, there's a table of people and all four people are looking right at me kind of in the background. And as we walked by,

they said, oh my gosh, hey, hello, you know, but I didn't realize when I posted the picture that I was just looking at my husband because he's cute in the picture. So everyone in the comments is like, why is that whole table of people staring at you? And so one of the comments said, you know, you've made it when people look at you like that table of people is looking at you. And I was just like, that makes me really happy. Like, it makes me happy. Like, give me the warm. and fuzzies, you know. Yeah, that's awesome, especially when it's for something meaningful, not just, like, I imagine if you're a pro NBA player, you're really good and people idolize you. It's like, okay, cool, like I'm good at my sport, but this has meaning. This is lives being saved.

It goes so much further than that. I was talking to someone about, God, I'm going to say it wrong, Ikigai, have you heard of this Japanese principle that exists? I'm saying it probably wrong, but the idea is that you find something that is equal in your passion, your skill set, community meaning, and I forgot the fourth square already because I'm a bad student. But the idea is that all these things match up. Does your day-to-day splitting time between the ER and social media, is that your Ikega? I think so, probably. I think it's the social media.

The social media is like the coping mechanism for like the rest of the life. How so? Stuff. I think it's helped hold my compassion, if that makes sense. Like, avoiding the burnout of the ER, where you just, like, you lose your compassion and you just, like, you lose your drive and your excitement. And social media has totally, like, lit that fireback where I, like, I hear from the people. I can talk to the people. I can connect with the people.

I'm excited to talk about the education. And I'm excited to talk about cases and help people. And it's like the coping mechanism. that stopped all of the negative burnout stuff. Yeah. Why do ER doctors burn out so quickly as compared to other medical specialties? Oh, it's a tough job.

Interestingly, when we started this podcast, you said it's not so tough. But pediatrics is, I feel like pediatrics is different. Like the pediatrics has like the, you know. I'm curious about the stats actually. I know ER, there's a high burnout. Pediatric ER, you think it's not as bad? It's not as bad. I know for a fact it's not as bad.

cool. We have decent happiness rates. We tend not to regret our life decisions as much. Okay, fair. I think it's the sleep, the sleep problems that we have. I think it's partly who we are because we tend to be adrenaline junkies that are moving and I think that in, unfortunately, that subgroup of people, there tends to be some substance abuse as ways to cope and obviously like Dr. Glockham Fleckin, you know, we got the Diet Coke's and the Red Bulls and stuff. Like, we're just, you know, we're doing it. Is that your secret to keeping energized on a night shift? I love Red Bull. I love a Red Bull. Call me Red Bull. Doesn't even have that much.

It doesn't. It really doesn't. 80 milligrams or something. Yeah, 90, 80 to 90. And it's calories like 110. It's fine. Yeah. Why Red Bull? You like the taste? I like the taste. It reminds me of college. Okay. I don't know. It just, it works. It's just the right amount of pop. And I don't know. It works. I like it. So that's my night shift. My night shift vibes,

Red Bull. What's your go-to snack that you keep? Because I remember when I had my ER rotations, I always had a snack. You always need something in case you're hungry. So I usually, I pack a lunch for most of my shifts. And so I really like frozen soups or frozen chili. Okay. And I can just pop in the microwave.

But when I need to run to the lounge or when I need like a quick snack, cereal is like the, it's easy. Oh, you got to pick the cereal. What's a cereal? It depends on what's in the lounge. But cinnamon, I mean, cinnamon toast crunch is the obvious favorite. That's the best cereal. The unhealthiest thing probably. Absolutely. But it's got the sugar that's going to keep you going. It's a little bit, a little pop to keep you. Keep you rolling. But also like, you know, graham crackers, peanut butter and bananas is like the classic ER treat. Yeah. God, I miss cinnamon toast crunch. I used to eat it as a kid's. I actually was on a podcast the other day where, where they make all sorts of meals for you. It's called Last Meals. I saw it. Oh, you've seen that show.

Okay. So they asked me what my last meals were. I gave it to them. And as I'm eating the meals and some of the meals I selected based off childhood, I'm like, oh my God, I ate the unhealthiest diet ever, like chicken rolls, snicker bars, muffins from Costco. I'm like, God, I used to eat like 10,000 calories as a 10-year-old with 100 grams of saturated fat thrown in there. I'm like, no wonder my cholesterol is not good as an adult. So what's your favorite? I know your way that you calm down after an ER shift if it was rough is taking the scenic ride.

But what do you do for fun? What's your de-stressor? I've kids. Okay. Usually that's the stressor. My kids, I'm out of the trenches right now. My kids are kind of later elementary school, middle school, and high school. Okay.

And so I can actually like hang out with them and have fun. Like we can go bowling or we can like whatever we do. We can compete a little. We can, yeah. And like we can play games. We played Taco Cat, Goat Cheese Pizza. I don't know if you played this game. It is really fun.

Taco Cat goat cheese pizza. Taco Cat. It's a really simple card game. It's a hard game. And you kind of like, you say Taco Cat, Goat, Go cheese pizza as you're putting down. And if you match, then you slap and you do this like narwhal and gorilla and like you do these little moves and you're slapping and fighting for cards. Okay. It's just, it's fun.

But just the games, just hanging out with them. And that's probably the biggest distress right now. That's my hobby is just spending the time with them. How much of an edge is it being a pediatric physician, pediatric ER physician and having kids? I think it's, I honestly think it's a good at. And I think there are a great pediatrician. and PDR docs that don't have kids and that know their stuff.

But I do think it kind of gives me a bit of an edge. Because, you know, I think the classic example is pool fingers. I don't know if you've seen pool fingers or pool toes. So it's usually the beginning of the season. It's usually like April, May, June, when kids are first getting into the pool and they're hanging on the edge of the pool kind of sliding around and they're walking on the bottom

and the pads of the fingers get like bright red and irritated the next day or their toes like are bright red and irritated. And I don't know if I learned about that. I definitely didn't learn about it in fellowship in Buffalo. I don't remember if I learned about it. There's probably a few pools of Buffalo. Not much many people are swimming in Buffalo.

But my kids had it. They have snow toes. They have snow. Right. They got frost nip. But I remember, like, there was one of the years that my kids were in the pool and then like, oh, they got out and I noticed it. And then like, I had three patients the next day present with the same thing. Really?

And I was like, I literally just saw this in my own kids. Let me show you a picture. This is from the pool. everything's going to be fine. Oh, that's great. No big deal. So now that's the advantage of being a parent to being a pediatric ER doctor. What about the other way?

Oh, I think it's a little easier sometimes, sometimes, to have discussions with their doctors. Okay. You know, where we can just kind of cut to the chase. But I think it does make it a little more complicated sometimes because, you know, if I'm seeing a specialist, I want them to talk to me like a parent and not a pediatrician. Sure. But I kind of go between like, do I do too much or do I do too little? There's not a middle ground for me. Like I'm either going to like let you bleed at home or I'm going to stitch you up at home

or like we're going to go to the ER for like appendicitis when you said my, you had a small belly cramp and now it's gone. But I can't get appendicitis. Is it like a med student syndrome where you read about a case or you experience a case in the ER and you're like, oh my god is this what's happening yeah a little bit but i think it's just like you know you get concerned about the bad thing sure my oh my gosh my kid was i think he was 11 and um he got sick uh he was on the top bunk of the bed and got sick over the edge and um it was like in the morning and i was like why what are you doing and he's like well i had a headache and i was like you had a headache and

you vomited have you been have it like where and he's like i've been having headaches every morning and right and so then my brain goes no Nope, we're doing this. I'm concerned that you have something going on in your head. And we were actually supposed to start him on growth hormone like the next day. And so I was like, I don't want to start you on growth hormone if you have a brain tumor. Right. Right. So we ended up, I was like, we're getting pictures.

Like we're just going to go to the ER and we're just going to do this. And he didn't have a brain tumor. Thank God. He did have a mass. Oh. Which we ended up having to get worked up. been the neurosurgeon. I love him to death. He's a wonderful man. But he said, um, listen, I put kids with brain tumors on growth hormone all the time. And I was like, but

you, no. Please don't say that. Please don't say that. I don't want to talk about brain tumors and my own kid. Um, so like, you know, sometimes it's harder, sometimes it's easier, but I feel like there's no middle ground for me when it comes to parenting. Having a parent who's a physician and went through medical school and residency in front of me because I was 10 years old and I got to witness it. Oh, wow. My dad basically not neglected me, but it's one step shy, you've neglected me that. You're not dying. I do not care. Yeah. You don't experience that ever where you're like, come on. You're going to school. You're fine. Yeah, I do that a little bit. But it's usually like, I've assessed you and I think you're fine. Yeah, okay, got it. I will do the

assessment. I will do a brief assessor. But like you have you're not just going to be like oh I don't feel good I'm staying home today like you have to prove to me that you're sick Like show me the fever do they try and like finagle that process a little bit they know I think they know okay yeah like You're going to school what's the most challenging thing about being a parent? I mean I don't know probably all of it all of it none of it being a parent being just being a parent in general is tough I think the constant self-doubt probably you never know if you're doing the right thing. And even if you might have done the right thing,

you're going to doubt it for your whole life. Sure. You know, like, you know, we're trying to make the decision now for the next kid down about do we start him on growth hormone because he has grown zero in the last six months. He has literally grown 0.1 inches has had less than half a pound a weight gain.

He passed his growth hormone test. He's actually smaller than his brother who has documented growth hormone deficiency. Wow. So, and we might have to pay out of pocket. Okay. Because insurance.

Because insurance probably isn't going to, because the stem test, he passed by one point. So, you know, he probably has it, but do we do it? Do we not do it? And so, like, we're going to go back and forth. And if I start it, if I don't start him, I'm probably going to have doubt that decision forever. Like, oh, we should have done this or we should have done that. How much money could we save? I don't even care about the money.

I just want him to be fine. So it's just, it's hard. Like, you never know if you're making the right decision or the wrong decisions. Yeah, that's really hard. What's a piece of advice you'd give to parents in order to keep their kids out of the pediatric ER? I think probably one of the most important things is talk to your doctor. Like, call your pediatrician. I thought you're going to tell me how much you hate trampolines. Oh, I do hate trampolines. I hate trampolines. I hate e-bikes and e-skirts. Oh, my God, e-bikes right now on the vein of my existence. They're the worst. Are they hitting kids or

kids on them falling off? Both. Okay. And most of the time when the kids are getting hip- by cars, the kids are not following, like, kind of the rules of the road. They're, you know, not stopping in a stop sign or whatever it might be. We do have a decent amount. I'd say more e-s scooters are the falls. They're hitting, like, the wheels are so small. They're going so fast. They're hitting a crack or a hole.

But, man, these injuries are, like, rough. The trauma alerts. And, you know, just looking at the news, we've had multiple kids, you know, pass away. From scooters. From scooters. And it's... I remember when the... worst injury you'd get on one of those razor scooters is hitting your shin.

Oh, those bad. Those hurt, but man, it's different now. Yeah. They go fast. They go fast. Like the highest class that's unmodified is like 28 miles an hour. Most bike helmets are only rated for 20. And are they wearing helmets?

Most of them know. Most of them know. Some of them do. I'd say it's probably like 80 to 90% not wearing a helmet. I mean, that's a huge majority. Yeah. Wow. So, e-scooters.

e-bikes, and then why trampolines? Everyone breaks their legs. Everyone. Everyone breaks their legs. If you get a trampoline, you're breaking your leg. I mean, the kids that come to me, it's everyone, you know, because they're the ones that broke it. Is there a safe trampoline?

Like, is there a version of a trampoline where they don't, why are they breaking and are like, are they frail? Do you have a rickett's population? I did see one recently. But it's mostly the forces on the trampoline. And a lot of times it's because they're getting double-bounce. There's a bigger kid as well. Sometimes it's because they're doing stunts like flips and stuff.

But even just coming down wrong, you're putting this extra force. The force is coming back with more force against your bones. And it's a lot of like lower leg, like tip, lower tip fib for the bigger kids. For the little kids, the like toddlers under five, it tends to be proximal tibia. It's actually called a trampoline fracture. Really? And then we see a variety of like head, neck back things from like the flips and stuff. I've seen a sternal fracture.

So like the chest bone fractured from landing on something? I was doing a flip and then they came down kind of putting pressure on the chest. Oh, from the chin? Well, it was kind of like just then bending. Yeah, kind of bending. Well, because you know what's right behind, that's your heart. And so if you, it was bad. Wow.

Yeah. I'm never going on a trampoline again. Not that I ever planned to. Yeah. How do you feel about? giving advice about having pets. Have you seen any unique things with pets? We see, you know, probably almost a dog bite a day with pets.

Yeah. Puppies or? No, just dog bites. Dog bites. You know, a lot of times it's a provoked dog bite. You know, they're near the food or something like that. Sometimes it's, you know, a stray dog or a neighbor's dog that's a little bit more aggressive that, you know, gets out of the backyard, the kids walking or riding a bike or something. Do you have rabies in your area?

Yeah. Well, disease, I'm not. Not much. Yeah, the animals maybe. Yeah, but we do the rabies vaccines. Yeah. That's annoying. Oh, it's, you know, it's not annoying for me, but it's.

Yeah. It's annoying for the patient. It's annoying, and it's expensive when they have to pay. So we have to have conversations, you know, can we talk to the health department? You know, can we quarantine the dog? Do we need to do this? But, you know, sometimes. Where's the dog?

We don't know. Go catch it. Yeah. Which you'll get bitten and then get another patient. No more patients. I didn't know that we. also had it in our area. We had a patient come in with a cat bite and someone had the thought that, oh, no, no, cats in our area don't have rabies. No, no, no, no. Cats are the number, in my area,

are the number one domesticated animal that spread rape or have rabies. So I was like, whoa, I didn't know that. Foxes also. So who knew about rabies? Yeah. Yeah, it's like still a thing, even though, well, will we see vaccine denialism in animals? I need to ask that to a vet problem. there are, they are seeing some. I don't think it doesn't seem to be as extensive. Because a lot of them will not vaccinate their kids, but they will vaccinate their animals. Because we, you know, and a lot of dog bites,

we have to ask, is your dog vaccinated? And I know that the kid's not vaccinated because I had to ask for tetanus. But there's also rules that your dog has to be, right? To get their license and stuff. Yeah, yeah, yeah. So maybe that's why. Yeah.

Are we going to have a license for children soon? Oh my God, the libertarians are going to have a field day without one. I've been meaning to ask you this. Oh, boy. You're creating a medical drama. Okay. And you need three Hollywood-level cases. What are the three conditions you're choosing?

Is this a dramatic drama? Or is it like a Grey's Anatomy, like just sexy drama? It's Dr. Beach Dem 10. Okay. Drama. If we're going for like, you know, where we're at right now with the world, I would probably do the grill brush. Okay. I would do a vitamin.

Well, of course. That's like the statement piece. You have to do that. You have to do that. A vitamin K deficiency bleeding. I know why. Yeah. Which is interesting because they're like the population that has exhibited vaccine

denialism in the past, notice how I prefaced that question, has a high rate of liking natural supplements, natural supplements. Right. And yet, and yet vitamin K does not fall under that spectrum. Yeah. Interesting. Sorry, okay, yep. I would probably do a trauma for the last one.

Okay. E-Scooter? Probably an e-biker and E-Scooter. Yeah, okay. Okay, that's really good. I feel like we could do some good education with this medical drama. Yeah, my God. Has there ever been a fully staffed medical drama,

staffed by real professionals? I doubt it. I mean, they did a movie, I remember watching on an airplane, a military movie where all the actors were former or active military members. That's pretty cool. So, come on, Hollywood. You want realism.

Let's go. Right? I'm ready. I feel like that would be a, man, we're going to do something with this. I got to just come up. I did a commercial this,

I did have commercial this Christmas. I could act. Oh, yeah. How was that? It was really fun. It was for figs. Are you able to say? Oh,

it was figs. Yeah, it was like, me, I was like opening and closing a curtain. Okay. When it was like, oh, e-bike injury, you're back. And I, you know, it's kind of back and forth with the different things.

Oh, you can't put a candy cane there. It was really funny. You had Will Ferrell level lies. Yeah. How do you feel on a set in front of the cameras? Because you said you like being alone with the phone. Yeah. Is that different?

So I've actually, I've done three commercials. So I did one for figs and I did two for good nights. The overnight underwear. Okay. For kids that are still having issues with bedwetting, which is a totally normal thing. So the first time I did it, I was super anxious. I was freaking out the whole time. Were you like propranol?

No, I mean, I probably should have. But I, like, I was, and I guess I did great. They're like, you know, this is, you did awesome for never having stepped on a set before. And then with each one that I've done, I've gotten less anxious and it just feels more comfortable. So you're ready for the medical drama. I'm ready for the, that's not, calm me. Yeah, easy. I'm ready.

Let's go. I did a water bottle commercial in China. Oh, wow. I had to speak Mandarin. No one should ever see that. It was so bad. It was so bad. Did you get like training ahead of time to like accent training?

Forget training. I think I was either just out of my residency or still maybe even in my residency. And I had to fly there, which was a really long flight to Shanghai. And then film, sleep, film and fly out to make back to the hospital at time. So not only no training. Like it was just like good luck and it was like a weird commercial because it was almost shot like a soap opera where it was like episodes one minute episodes of this soap opera e-esque thing of check out this water. And I'm like well whatever it's water, it's hydration pretty benign. Let me try it. Were you in medical school when you started like social media type stuff?

Instagram on medical school, while I was in medical school. But then YouTube, I was already on my last few months of residency. Yeah. And YouTube was where I really took it more seriously. The Instagram stuff was just kind of casual. I wasn't even doing a lot of education at the time. But YouTube was where I wanted to do the majority of education. And then from there, it spread out. And that was in 2017 with Dan here. He reached out. He's like, why aren't you doing video? And I'm like, I probably should. So that was a unique time to start because it gave me a little bit of repetition before pandemic hit where you really needed to be present.

And that was a whole new learning opportunities. Yeah. It changed it for a lot of people, but I think it also gave, it was a lot of, it was motivation for a lot of medical providers to start. It was like, I'm not doing anything else. Let's just download TikTok. Very true. And you were saying before I rudely interrupted you with the trampoline joke.

What is the big takeaway for parents that you want them to know? Call your pediatrician. It is, there's a lot of times that we can avoid an ER trip, which, you know, you might pick up a stomach bug or something in the ER waiting room. You know, we do our best to keep them clean, but it's still dirty out there. Of course. That your pediatrician may be able to call in some Zofran and see you in the morning or, you know, a steroid or abuterol or whatever it might be, or they may be able to recommend

the best place to go because not all ERs are the same. like we talked about not all ERs have a pediatric ER doctor and not all of them have the resources that like a pediatric ER one does. And we're following very specific evidence and science-based guidelines where at, you know, if you go to an outside ER, they're going to be treating a kid like an adult. They're going to be following the adult guidelines most of the time. So the care is not the same. Kids are not small adults.

So a pediatrician can be really helpful in guiding you, you know, do we need to go to the ER? Where should we go? Yeah. Why is it, and I'm going to give you a little complaint here, when we as family medicine doctors and are on our pediatric rotations where we essentially function as a pediatrician alongside other residents in pediatrics, why do we always get sick on the pediatric rotation? Oh, it's tough. Yeah, no, everyone does. Yeah, what is that?

So you have to get through your complement of pediatric illnesses. And once you get through like the 10 or 12 illnesses, then you pretty, much never, you get like, you're like one or two a year until you become a parent. And as a parent, you will get sick with your child for the first year and a half of their life as long as they're in daycare. And once, if they're not in daycare, then you'll do it when they go to kindergarten. Yeah. It's annoying though. It's the worst. Yeah. And it happens to all of the kids that come rotate with us. Every single one, right? Yeah. Yeah. The med students. Yeah. It's just, it's, it's across the board. It's tough. And you know what's interesting, what I find myself having to tell, uh, parents,

when we do see a child in our practice, sometimes their child is sick, usually mildly because they're in an outpatient setting. I tell them that is good that they're sick because it's training their immune system. And that message lands so differently for different people. So you're like, how dare you want illness upon my child? And some people are like, oh, well, then yeah,

like throw them in the mud and let them just eat the dirt, the cow manure. And I'm like, balance homeostasis. We need a little bit of in between. What's your message when parents are overly concerned and you're like, no, no, this is good? I think it's important, again, to talk about the expectations. And it's almost always, you know, they'll come in and they'll say, oh, my gosh, they have been sick nonstop for the last six weeks. And my next question is, they started daycare six weeks ago. Is that correct?

And they look at me like, how did you know? Like, was it seven weeks ago? It might have been seven weeks ago. You know, it's pretty close. And as a kid that's just starting daycare that's never really been around a bunch of sick kids before, they're probably going to get sick one to three times a month lasting seven to ten days each for about the first year and a half. And it might be in the wintertime, it might be three times. And if you three times for 10 days, that's all 30 days of the month.

Yeah. And so it's tough. And, you know, when they come in, we're trying to say like, where they're, you know, I know you were sick initially, then they got a little bit better, then they got a little sick again. So trying to distinguish where these separate illnesses or was this one disease process that's been the same. So it's a little tough to distinguish and to kind of get through that. But I think it's important to set those expectations of it's wintertime. They just started daycare. Like they're not going to have a not running nose.

Their nose is going to run constantly until March. Yeah. Well, that's a great full circle moment there where we're ending right where we started. I'm curious, where do you want people to follow along your journey? So I'm on TikTok at Beach Jam 10 and then YouTube. Facebook and Instagram at Dr. Beach Gym 10. Cool. And what can people expect?

What does the next 10 years look like? That's a great question. Stand by. No idea. So no spoilers yet. No spoiler. I mean, hopefully we will be back in our 12-foot-tall house. Okay.

That is probably the most exciting thing we can anticipate the next year. And maybe we can somehow motivate a movie studio or a Hollywood studio to do a medical drama with health care providers. Yeah. On the set of the pit. save some money. You already have it. They're not filming right now.

Let's use it. Let's go. Cool. I got some friends. We can just make it happen. Doc, thank you so much for your time. Seriously, thank you for the work that you're doing because we need more Dr. Beach Jems across the globe to motivate parents, to provide that accurate information.

And most importantly, even though you don't want to buy into it from an authentic place as you do with all of your content. So thank you for that. Thank you very much. Huge thanks to Dr. Beach Gem for coming on the show. after we finished taping the episode, we actually hung out at the AHA Red Dress Concerts here in New York,

where we actually helped teach people about chest compressions, chest compressions, chest compressions. It's always great to make another friend in the medical influencer space. And I'm super grateful for the work Dr. Beach Shem is doing. She's also not the only ER doctor we've had on the show. I actually interviewed Dr. Ed Hope,

who is an ER doctor from the UK. We talked about the differences between the American and UK healthcare systems and spoiler alert. They both have a lot. of problems. Scroll on back to find that episode and I would really love it if you could give us a five-star review only if you love this episode. Maybe leave us a comment so we can communicate and as always, they're happy and healthy.