The Taproot Podcast - 👨‍⚕️James Waites on Physician and Healthcare Burnout

Starting point is 00:00:00 Call a doctor and tell him I'm down Call a doctor and tell him I'm down Well, so let's get into it. I am here with Himes Weitz, which... Am I pronouncing it right? Is that right? That's right. Himes, actually.

Starting point is 00:00:23 Yeah. I'm here with James Waits, who's a social worker, and now he's going to start part-time at Taproot. We're going to get into his specialty. Yeah, I don't know. What is it? Have you ever seen the Oliver Stone, like Alexander, where

Starting point is 00:00:38 the accents are just like the actors are just going crazy? Angelina Jolie was weirdly miscast as a Macedonian, like her choice for ancient Macedonian, which is just pretty similar to Greek. It's not that. It's just to roll every letter.

Starting point is 00:00:56 So the whole movie, she's just in the beginning, and then there's like flashbacks to her or whatever. But just every scene with her and Alexander is her just being like, never will there be an Alexander likeander like you alexander the great wow oh she's all her r's yeah i oliver stone i wonder um i wonder how he's doing yeah i heard out i heard his jfk movie turned out to be turned out to be true did you do you hear that is that right no i don't know i'm just i'm just teasing let's make it a joke i uh when we have like the a lot of the like a lot of the bigger guests uh i feel like there's kind of like an arc in the middle where everyone's kind of uncomfortable oh yeah if i ever get like a college professor or something i'll just do like

Starting point is 00:01:38 a cold open or something where they're just laughing before i hit record so they're like oh so they're just coming in like all right like and it just looks a little more natural yeah uh like with james mappy or somebody like right before i hit it like yeah i mean you wrote all this stuff about the aspects but like how do you know that were you there i mean he's making that up wait are you saying i'm not a big speaker yeah they're like what i'm a big guest so uh we're talking about doctors, MD burnout and health care. I mean, so James's specialty is going to be taking care of. And this is your specialty is interesting to me for a lot of reasons that don't get talked about in social work school. But like he wants to talk about the way he wants to treat like when MD and correct me where I'm wrong here, like MD fatigue,

Starting point is 00:02:27 you know, the stress of preparing for medical school residency and those big complex systems. And also, you know, a lot of your skills apply to academia, high performance executives, you know, people that are operating in a sector where a whole lot of balls are bumping up against each other. There's a whole lot of things that they have to be aware of all the time and then just the long-term kind of fatigue and strain that that does um especially when those systems change or are in the middle of changing like like maybe health care is i don't know if um you got a couple jumping off points there is there anything i'll just hand it over to you what do you what do you how do you uh how do you describe what you do yeah no uh that's perfect.

Starting point is 00:03:10 Yeah, all that plus just any type of just health care worker and mental health kind of aspect. We don't talk about that in social work school as much. I kind of want to tell a brief story about how I got into it. Basically, back in 2019, I i went to a i went to a training it was a compassion fatigue training out in the red barn in leeds which is awesome it's equine therapy it works with kids a lot but they're partnering with jc duggard i thought equine therapy worked with horses well i'm sorry you're gonna you're gonna have to roll with it oh Oh, damn. You derailed me. Go ahead. Already. So, yeah, J.C. Duggard.

Starting point is 00:03:49 I don't know if you're familiar with that. You probably know more about that than I do, which she was kidnapped as a kid in like 1991. But during like my first year in college, she was rescued. I mean, that's 18 years later. I'm pretty sure. Yeah. 2009. So anyway, so she's rescued and, you know, she got rehabilitated and back into everything. I mean, she had two kids and she got reunified with those

Starting point is 00:04:12 kids over time. I mean, there was a lot of trauma, obviously that had to be worked out there, but now she turned to kind of like, um, basically her foundation has a lot of aspects of like reunification with families and children and parents and that type of trauma. This training was here. She came to Alabama. We were working on compassion fatigue specifically with law enforcement. Mainly because I remember she telling us that the biggest issue coming back once you got rescued is how many people were like not on the original case anymore um they just kind of it burnt it burned them out i mean it's

Starting point is 00:04:53 like searching for you know 18 years you can't imagine one cop sitting on a case for 18 years and how much like how that works in movies, you know, and true detective or something, the guy is just skinnier and smoking more cigarettes and his wife's left him. And then, you know, year 20, he solves the case.

Starting point is 00:05:11 But I mean, realistically, I mean, these people can't, can't do that, you know? Yeah. I mean,

Starting point is 00:05:17 they, they get, they burn out to get. And so, and then, but that creates, so not only is that initial burnout pretty bad, but it creates this thing, you know, compassion fatigue where they just don't want to do anything else.

Starting point is 00:05:29 I mean, they just go, you know, status quo, mediocre, like I just want easy cases or I want out of law enforcement kind of thing. We weren't there specifically because I had compassion fatigue at the time, but we were learning kind of just the ins and outs of how to be more aware of it. Um, and so that compassion fatigue got me thinking a lot of like, holy crap. Um, I'd spent a lot of years in community mental health and I can see where this applies, um, across the board. So, um, and then obviously transitioning over to, you know, big, you know, hospital work and things like that. You see that all the time of the system that we're kind of set up in kind of like ruins us. I mean, it ruins kind of like, I think it takes away, it takes away your passion um and you know i i unfortunately i witness med students who are not even in residency just feel so bummed about the world because of what you know it's already set

Starting point is 00:06:32 up for them yeah yeah that is i'm glad you're getting into everywhere that i what i see on my end you know because you're you've been in a hospital you know like you know been in therapy but i mean that that does seem to be the thing and like i'm not a conspiracy theorist and then i think there's like a guy in a back room smoking the cigar moving the chess pieces but i do think a lot of things that are bad about the systems that we inhabit they continue to get worse are sort of allowed and enabled because they're useful for the system having more control and more money and whatever and just so many changes with health care like um the amount of paperwork that doctors have had to do.

Starting point is 00:07:07 There were some, I was like listening to some clip yesterday. Somebody was saying it's gone up over like 350 times or percent, you know, percent, 350% more paperwork that you're expected to do around all these sectors, especially insurance. And I think he was in family, just family practice. But I believe that because it's like we would we have all of this insurance stuff on our end where claims aren't paying and we're having to go and the insurance we're having to call and see what's

Starting point is 00:07:34 up and the insurance company's like well they haven't seen a primary care doctor this year we don't know what their cholesterol is and it's like well why do you need a referral from a primary care doctor if you were sexually assaulted and and this person's in therapy, and there's a time limited thing. And, you know, but it's just another hurdle that they can throw up, like the health screen or whatever, that the more people who don't do it, the more money that they make, and now healthcare is getting pinched, insurance is getting pinched, there's not as much room for middlemen. And they their answers to throw it to doctors. But I think a lot of people get angry with their doctor, because that's what we hear from patients as people are like angry why would i have to see my doctor it's like your doctor had nothing to do with this you know unless they work you know

Starting point is 00:08:11 and you see like they're not but people are pissed basically they have to go which i think when people that you're interacting with are hostile or think you're part of the problem even if that's erroneous that also does some some psychic damage there you know you want to use dnd language yeah no uh and and it sucks um it mainly because the fact that you know they're learning this system um that they don't know how to get out of it and there's really no way out of it um and i i sit on a teaching team team at the hospital and I kind of give basically a talk every week about, you know, you have to push through in this aspect. Like this is something you can't control and kind of get them back to where they do have control, which is taking care of patients better and having these things. And they actually learn through that of like how their interactions with these patients and when these patients get better, that brings them back to a good spot. But then, you know, at the end of the day, it's just like, crap, you know, there's nothing left for this.

Starting point is 00:09:15 We can't offer anything more. We can't do this. Like, what was the, you know, what was the point of today if tomorrow is just going to suck. Well, and I think that what the amount of bureaucracy and BS and that you used to be allowed to get away with was self-limited for MDs by the fact that they could just leave. They were usually people who were bright and upwardly mobile, and if not, had the capacity to be and could say, okay, I'm going to go do something else. But what we've done now is we've saddled that process to so much money that there's no one who has it lying around even if you are incredibly wealthy. So you're under all this debt that you've already taken out.

Starting point is 00:09:50 And now that filter of how much basically you can abuse, the system can abuse these candidates, is that filter is removed because I just borrowed $300,000. And unless I finish this thing, then I have no hope of ever being able to pay that back. And that seems like a scary development to me in the way that those systems are run. Yeah, they're locked into it pretty much. I mean, I just had a conversation with one med student the other day

Starting point is 00:10:17 and they're just thinking like, after I go through med school, I don't even know if I want to enter residency. And I'm like, why? You know, I mean, how are you going to make back? You know? Yeah. Yeah, you know if i want to enter residency i'm like why you know i mean how are you gonna make back you know yeah yeah you know you gotta do something i mean you can go i don't know what they could do after that i mean they become md after but no i i had to sit down with them i was like no you just pick something find a passion if it's not this or that you know uh then make back your money or you're gonna always gonna be sitting in this place where um yeah that debt is wild um yeah but what i'm seeing is it's it and even with

Starting point is 00:10:53 mental health workers and things like that we're creating these like robotic entities of people not necessarily shells of people but they they just are so routine and so like accustomed to this bad system that they don't work. Well empiricism connected to no humanity no soul no anything I think is another one of those things that just gets uh it it's not like there's one guy doing it but it does benefit a lot of entities and it has kind of gotten out of control when you're you're saying that it almost like breaks candidates is that what you mean or are there other ways that that happens? No, that's no, that's it. It's just it.

Starting point is 00:11:28 They fall into the trap. Like you said, they just kind of like. Go throughout the rest of their life, you know, not really exploring how to regain their self inside of it because they don't feel like it's worth it. Right. Because the more and more you branch out and try to regain a passion, there's always something that brings you down again. And that sounds so terrible, but that's the whole point of this is that we have to – like being in a burnout mode isn't bad as long as you process it and try to get through that

Starting point is 00:11:59 and figuring out what actually is. And I want to, yeah, basically say that. Like being in burnout doesn't mean you're a bad person or that you suck at your job or that everyone else around you sucks. It just means that you're just in a spot where it's like a life cycle. There's some death and rebirth at the end of that.

Starting point is 00:12:19 Well, I think it's a way of burnout is maybe a general way of thinking about it is that it it does. Yeah, it doesn't mean that you're acting incompetent. A ton of people are like, well, I'm not burned out because I'm not acting incompetently. I'm still doing my job while I'm still functioning. And it's like, yeah, that's great. But burnout is describing that you're coming in through it in a way that is not sustainable.

Starting point is 00:12:40 Yeah. So like while you still got a little energy left, let's figure out a plan to make that sustainable. So like, while you still got a little energy left, let's figure out a plan to make that sustainable. Could you, could you go through just like practical tips or techniques that people, um, that you would use with somebody who's in academia, who is an MD, who, um, you know, is an executive who isn't healthcare and they know that that's them, you know, but they're also sitting back and being like, yeah, I, you know some books i've read some podcasts i've heard some podcasts and i know what cbt is i know cbt works so like i don't want to go into therapy and make a list of my emotions and point at my emotion on the pillow or um you know no yeah uh what can you do to help me yeah so you know obviously the mindfulness um based stress reduction kind of things. I think the first is defining it, like in processing the actual burnout in itself, right?

Starting point is 00:13:30 I think if we, what I see a lot, sorry, I'm going off, but what I see a lot is we start kind of like treating symptoms of burnout and not necessarily actual burnout, right? We treat people operating in an unsustainable system with a kind of treatment that also is not sustainable, you know? Yeah. Like let's say, you know, if I just go, if I just work out five times a week, my stress will be reduced. If, you know, I have low mood, if I start changing my diet, um, and I'll, you know, change my diet, drink less, right. Uh, my mood will improve. Well, those are healthy things, but like you're not processing what's actually causing those things,

Starting point is 00:14:09 much like, you know, anxiety and symptoms of trauma after that. You know, we tend to just focus on the symptoms, but not actually the root. And so in getting back to that self of like centering, like it being accepting that it's okay to have burnout, right, getting'm getting that. That's the first part is that acceptance and then running through and having sustainable plans of

Starting point is 00:14:30 how to prevent that and reduce your stress. Is it meaning that you can accept one thing at work and then try to do something differently? You don't have to change everything all at once, right. Um, and basically having a good plan in place to kind of recognize like your symptoms of burnout you know whether it's or uh compassion fatigue whether it's somatic you know symptoms or you know you just feel angry all the time it's right it's being able to recognize those things and i think we're not obviously recognizing that type of symptoms in our life. Like we just, we, we, you know, we kind of, our pause, we're like, oh, I'm just so mad, you know, well, how do you get rid of that anger? And it, you know, if you don't know the root of

Starting point is 00:15:16 the anger, you're never gonna get rid of it. So those obviously CBT things like that are really good. Cause you have to change. One of the things is you have to change your thought process on the system kind of thing, right? And being acceptance, accepting that, you know, your system may not change now. But when you redevelop and find yourself and find your passion again, you're your current change you said just defining the problem I'm thinking of the Joseph Campbell's you know the hero's journey or circle wheel or whatever I think Dan Harmon calls it that but the the first that just naming your pain gives you power enough over it to begin to heal the perspective itself is healing you know oh yeah absolutely

Starting point is 00:16:05 i get umberto echo i think i think that's him and the name of the rose says something about like blessed are the poor for um like at least the rich have the language to know who their enemies are or something like that no um that's across the board of just naming things in general yeah power yeah and and i what i see because i i think i see i've got a couple mds but like more um more kind of like executives i've seen and they're thinking that there's going to be like the the therapist who's like 22 who graduated from like the you know mom and dad paid for college and they have no life experience and they went straight from the sorority to the like small you know christ, Christian master's program. And now they're coming

Starting point is 00:16:48 out and they, you know, they're just learning how to like decorate an apartment and somebody who has an enormous compromise that they're making all the time with like wealth and power and systems and all this stuff is going to come in and just have no capacity to be understood. And that's what they're afraid of. And but there are therapists who have backgrounds in these things, you know, like you and me, I don't have your background, you know, I have a different background in psych, but like, who can say, Oh, my gosh, yeah, the system is changing so much, like the world that you thought healthier, you thought you were going to be in when you were going in when you were a kid is not there anymore. And now you're starting to accept that and grieve that and where do you think it'll be in five years and how can you prepare for that you know just somebody who can

Starting point is 00:17:30 have that kind of conversation and and systemic perspective is like something you can't see when you're just in it all the time you know and it's like too scary to look down yeah and the conversations i've had with you like it seems like that that seems like it might just be most of what changes in the first session is that somebody's like oh you're right like i'm allowed to think this i'm allowed to see that i'm allowed to label these things you know yeah um no yeah it's you know i didn't think talking about that basically burnout and compassion fatigue uh you would think that that would like ruin me you know just hearing all of the the problems of the system um but uh i don't know the best problems you know it's not like we're not saying healthcare is bad you know you know people still

Starting point is 00:18:14 have to be doctors people still have to be you know it's understanding them you know yeah and it's giving a safe space for it i I mean, just imagine, especially in residency, when you're about to, you're not an attending yet, and you have to, who do you complain to? We're not complaining, but who do you even reach out? If you tell all your cohort or your attendings that you're facing burnout as a resident, what can that do to you as a person? You wouldn't want to do that. It kind of closes some doors for you. Well, and it's political too, in a way that you can't be terribly vulnerable with the people who might understand what you're talking about. I mean, I think academia is lonely for the same reason

Starting point is 00:18:55 is that it's like, okay, let's take all the people in the world who know enough about this teeny tiny little thing, area of oncology or you know like medieval texts or whatever and then we'll put them in like we'll and then we'll make them all compete against each other so it's like everybody who who could be my friend man i'm kind of you know like that's the thing academics navigate you know health care is political in a different way there's not that kind of direct competition but yet you can't be super vulnerable i mean you you know you're you're kind of a politician in a hospital oh yeah and you you know, you're kind of a politician in a hospital. Oh, yeah. And then, you know,

Starting point is 00:19:26 then you get kind of paranoid because the moment that you feel like you're your that you feel this certain way, you know, you feel like somebody is going to step over you to get ahead because they're saying, well, they can't handle that right now. They're in a tough space. And that's not for everyone. That's not everyone that I come in contact with. But you can just imagine, yeah,

Starting point is 00:19:44 the political nature of everything of, of wanting to succeed. You know, you're not in your peak of your career just yet. So you have to gain, you're still gaining and you're still trying to win. The social work thing is kind of, you know,

Starting point is 00:19:58 like you go to school, if you have a bachelor's, then the, the master's degrees, you know, two years, and then you get out of it and then you have to work for something. You can't take insurance. You're not very useful. So, or you're

Starting point is 00:20:10 not very profitable. So you're working in these places that have a lot of problems. A lot of the more toxic people never get out of that level of practice. And the first two, three years of social work practice is like pretty chaotic for most people. And then you can get the LIC and you can get out but that like that is draining like working with i work with a lot of social workers and just preparing for like how to do it how to go through it to know this isn't going to last forever to stay motivated to study for the licsw so you're not there for six years you know yeah we do that a ton but for doctors i mean that's like that's almost a decade by the time you're going through school and

Starting point is 00:20:42 resident i mean you you don't even know who you're going to be on the other side of that and i think therapy is indicated when you're going through a change where you forget who you are you know yeah or might you know lose touch with it no it's it's a it's a wild it's a wild party for the for the mds and um i mean like i said third-year med students don't even know what medicine they're going to be in i ask them every week you know what medicine are you going into and in. I ask them every week, you know, what medicine are you going into? And they'll say, well, I haven't figured that out yet. And it's just like, well, I mean, you're coming close to it, but if they can't even know what, you know, what profession that they want to pick, and this is not on them at all. This is just, they're still in a spot where they're trying to figure out themselves, and it's really hard to combat.

Starting point is 00:21:22 Like, I'm trying to figure this out, but I'm also burning out at the same time like so it's a it's it's sad and like I said it's not just them like yeah it is academics and and even you know mental health and social workers I mean they they do have those rough jobs I mean I experienced that with community mental health I mean it's great and you do learn a lot but when you stuck, because the person that you're helping is limited by a parent or something like, you know, I worked with children a good bit. I couldn't do it. I couldn't do it. Not. Yeah. Well, I loved it. And I still do. I'll revisit that. That's part of my burnout is,

Starting point is 00:21:58 you know, I'm taking some time and realizing that I had to take a break. One of the biggest things in community mental health and children services was that these children get better but as soon as like the parents stops engaging with that type of work kids don't get better and seeing that over and over again really takes a toll on you and so I've set back you know I've just kind of said you know I'll give it some years before I revisit children and working with them. And I'll still work with them now, but like on a small, you know, tiny basis. But it is.

Starting point is 00:22:30 I just when I was doing individual therapy and they kept trying to put me with kids because I was male. And there's a lot of people that there weren't very many male therapists at the big at the big practice that I was at before Taproot. And so like I was talking to one of the child therapists when i finally was like do not give me another teenager like i i can't do it because they would always be like no no there's no family problems with this one it's fine it's a wealthy family and they have this they just he's just having a little trouble whatever and i'd be on the phone with the hr until two in the morning and then the case would blow up and then of course i'm gonna come back to individual therapy or something and I was talking to one of the child

Starting point is 00:23:07 therapists and I was like because all he did was trauma with children and I was like look I can't do this like I can take a 40 year old and say let's go back to when you're 12 and when we go back to when you're 12 let's heal that right yeah but I don't want to take a 12 year old and say all right yeah let's use in mindfulness and I'm going to be here with you and i love you and i care about you but you're just going to have to go back into this house where the problems don't change for the next six years like i can't do that yeah and he was like oh i love that he was like that's why i do it is because i get to be there with him and it's like i was wild i realized like so many people have different skills than me in that conversation and are looking at things from this different angle as i was trying to solve a problem and he was trying to be there in the middle of

Starting point is 00:23:47 pain you know that he couldn't change and I think that's much more yeah you know I don't know it was it was wild but I take yeah it that skill set I uh I'm so glad we have such a diverse kind of like skills across you know therapists and social workers and things like that, just because I'm glad that some people enjoy that type of work. Um, but it, it, I wonder, I haven't,

Starting point is 00:24:11 I haven't met anybody who has said, oh man, I'll, I'll work with kids forever. Right. And, and I'm waiting, I mean,

Starting point is 00:24:18 I'm sure there's somebody out there. I just haven't met anybody. And I really want to pick their brain. It's like, you know, wow. Um, and there's some great people who, especially the kids who kind of need a lot of work.

Starting point is 00:24:30 I mean, there's some kids who come out on top. And to this day, I have, you know, clients that I saw, you know, eight years ago that are 24 and they're 16. And I see them and they've done really well. And, you know, and I've asked them, you know, you know, you're doing well. How, why? And, or not why, but, you know, we worked on you for a long time.

Starting point is 00:24:54 And, you know, what's, and it's, I got out of the house, you know, or I left, I went to, you know, and that's just, I mean, that's wild. I mean, just think if, when you're working with a 12 year, yeah, 12 year old, you've got six years before you have the opportunity to leave the house. And I liked family work. I mean, when the whole

Starting point is 00:25:08 family's there, which Becky Mills said in our practice says that and she's really good at involving the family and getting everyone to communicate. But it's like, when you when you have like, the parents are like, I don't know how to do this. I want to understand what the child's emotion means. Or how can I do a parent plan? That's a whole nother thing. I mean, now I was doing it, it was someone was bringing a child to individual therapy and basically being like make them stop doing this i'm gonna change nothing and it's like well you're you're in the counter all right i don't know what i'm supposed to do like i it wasn't for me um when the family wants to change that's wonderful um yeah too many of the especially like the child diagnoses

Starting point is 00:25:46 well i know i mean no the whole thing but it affects children in a different way we just we've moved like especially even like the dsm has moved further away from the icd-10-11 because it wants to concentrate on how american wants americans want to do research and not really like what how what the symptom is but just the way we want to conceive of it or as useful for our system to conceive of it. And part of that has just taken away the focus on the environment at all and try to be like every, every symptom is just sort of happening genetically or by bacterially in

Starting point is 00:26:17 somebody's head. And with the child diagnosis, I can't even read some of these new ones that got asked when they do some five, you're just like, they're like, Oh, you know, the child totally not the parent's fault that it does that disorder yeah like why did you add this um and i don't know um so can you say anything about like those systems like the way that we don't really want to critique an environment but we put more and

Starting point is 00:26:42 more responsibility on the individual like in a way that's breaking health care do you see that like i don't know um if that's relevant to stuff that you see um actually say that again like the the way that i think it's like useful for health care to put more and more like responsibility that isn't fair on the provider to like fix an environment that they have no control over, you know, oh, yeah, I mean That's the thing. So Prince. Yeah, I see that all and that is relevant Mainly because it there are really good Docs and I don't I don't think they're in burnout But let's say let's say a trauma surgeon You know, they have three days to basically discharge a person from their bed yeah and and you're talking

Starting point is 00:27:27 about a wide range of a wide range of trauma uh physical trauma that you know it could be a gunshot wound it could be someone that has 90 burns but the way that their system is set up is in insurance it's just like we need that bed in three days yeah yeah and and that isn't the doctor's fault as an individual you know it may be the ama's fault as as an entity made of doctors but that isn't this one person's yeah it's it's insurance as well um and so yeah it it's not that doctor's fault but that the doctor has to do i mean they can stretch it but i, there's incentives for that 3A rule kind of thing. I'm not entirely sure how it works out, but then again, you know, if they're medically, you know, clear, it's just like, well, they can discharge home. Well, are you discharging a,

Starting point is 00:28:15 you know, person without a home to the streets with 90% burns? Like that's, that's wild. And our system in our state is not set up to really help out that population. And I say that all the time. It's like we can't, you know, I say this, you can't think about this because you can't work harder than our system allows. Specifically the state system. There's literally no resources for that type of population. And so, yeah, and that's out of their control. That's not even part.

Starting point is 00:28:43 I mean, that's Alabama politics at that. And I say that all the time. Why don't we just march down to Montgomery and try to fix it? Well, backlash, you know, I've come conspiracy theories on that. And I'm not talking bad about it. I mean, you know, I love Alabama.

Starting point is 00:28:58 It's just, we are, you know, I wish the awareness there for that type of, those types of interactions need to be seen. I mean, cause that puts a toll on all these, you know, whether it's nursing staff or the social workers, working these families have to figure out, you know, Oh my God, like this patient's ready to go. What do we do? Well, I think politics has used more of a scapegoat than a solution.

Starting point is 00:29:19 I mean, I'm like thinking of all this stuff that like happens on my Instagram. It'll just be, somebody will like film a homeless person in like California or Portland and then be like, Democrats do this. And you're like, I'm in a red state,

Starting point is 00:29:30 man. You want me to, you want a video? Like what, what, what is your solution to this? It doesn't look like anyone's doing much, you know?

Starting point is 00:29:38 Yeah. So yeah, I mean, I think the politics is, is something that is bipartisanly not, not, I mean, I think the politics is, is something that is bipartisanly, um, not, not, uh, not effective, you know? And, and, and a lot of my colleagues, I mean, they get to the point where, you know, they, if they try to, you know, stick their neck out and try to give a different alternative solution, I mean, they're, they're like hammered down,

Starting point is 00:30:02 like, no, that's not, no, we can't keep this person two more days no you gotta figure out a way to get them out especially our social work colleagues at uab i mean i i sorry the hospital workout yeah um so it's on you man i don't work there anymore i love it but it's just like there's so much there that uh they they do work hard and they do try hard uh but they're i mean it's expected of them to like get this person out get them do this but if they can't it's it seems like it's that social worker that you know that case manager's problem but it's not i mean they're literally hands are tied behind their back to where they are and that gets a lot of people into that space of just like this is nothing i

Starting point is 00:30:45 don't care about not necessarily i don't care about the person anymore but like if this is all we got this is all we got and yeah like i said that robotic they just they just one track mind just keep going right they just do what's asked of them um i think that culture is changing at you know the hospital with having to realize that you know we have a little bit more power to say like no um and right now there's not like to say no to like bad plans um and i have to kind of like walk you know people through those plans of like what's better you know what's better for the patient what's better for you um mainly because yeah i't know. My colleagues, they endure so much. That's one reason why I want is awareness to burnout and compassion fatigue, just because the system and

Starting point is 00:31:33 where we are, it's a great place to be. But I mean, we are not immune to that type of... Well, and I don't think that a lot of the problems that you're talking about are unique to something that UAB is doing or that even healthcare at this point is doing i mean a lot of uh this stuff you can read stuff from you know the 70s or the 40s and the the in the bureaucratic insecurity is the same you know it's like because the bigger and or what's the there's like a joke that we always make about how like they put up the posters in the school. They're like, don't take our word for it. Think outside the box, like never stop learning how it actually works, you know.

Starting point is 00:32:12 And then if you do any of the things that are on the posters on the wall of the elementary school, like you will be an alternative school. Like you have to put it on the poster. Like, don't do that, kids. You know, and the hospital's kind of the same in that a bigger bureaucracy gets. I'm thinking of, I really like the HBO Chernobyl show. It was really good. But you get that sort of end of the USSR insecurity of like,

Starting point is 00:32:37 but you're saying, yeah, you make a very good point and you have lots of evidence, but you're saying that the party is wrong and the only problem is the party can't be wrong. So you must be in trouble you know there but you get that where it's just like i remember being in these meetings that they would make us go to that would go on forever and they were like we really want to have a solution we really want to do things different we really want to improve and we need y'all's feedback so could you you give us some like advice? And but the but the only thing was you couldn't say that they weren't perfect. Right.

Starting point is 00:33:09 And you couldn't say that something needed to change. So that was the unspoken rule. So I was always like, especially when I knew that I was going to be in private practice here, I was always like, OK, if you do these things, doctors will burn out less. You will make more money. There will be less met errors. There will be less staff turnover. And the downside is that somebody might not like that you change something who hasn't worked here

Starting point is 00:33:28 for 13 years and then they would come at the end and be like why did you say that you know we asked for your feedback but you can't say things like that you can't yeah and because they wanted you know a room full of people to be like we should have more gumption and more integrity yeah no and i've been part yeah part of this meeting as well you just you try to come up with a solution and your solution is like kind of the costlier one and that's the thing too it's all i don't want to say it's all about money but like it comes down to mds have no control over and like executives kind of like how the company just functions as a whole. And, uh, it's wild because, you know, the solution is, you know, hire this type of specialist or do this,

Starting point is 00:34:11 you know, y'all are asking the wrong people for the solutions. Why are you not, you know, why are you not asking the right people for the solutions? We don't want to ask those people. Right. And then those I've literally been in a hundred person meeting, brainstorming a certain topic at UAB. And within six months, it's just, they shut it down. Well, the VA is kind of notorious for that too,

Starting point is 00:34:32 which I think the VA is probably the most nefarious kind of bureaucracy is it's like every time you ever heard, I mean, I remember you can look up, like sometimes I'll be Googling something that I want to know. Like, I think the last one was like, I was like,

Starting point is 00:34:43 Oh, I wonder if anyone's ever applied D and D to PTSDd like if anyone's ever said like you can role play or whatever and i searched it and it's like yeah okay here's a guy who's doing a pilot study for the va who's had wild success and they're publishing the paper and it's like in 1992 or something and like that will always happen where like because that particular case is kind of interesting that the people were applying this might be a fun episode if we could find somebody who does that but they they do like um they would take it was it was kids um where they would because it was like family program or something but they would take kids that had this real negative self-image and make them do like a

Starting point is 00:35:18 team and dnd you're describing your action like dungeons and dragons you're describing your action so the kids would have to be like i get so angry i do this and then now they're thinking about emotion and they're like well you're getting angry and doing that actually just messed your team up yeah and then their self image would change and they would be like i hate him but i have self-control so i don't do the thing you know and then um like it was like this kind of fascinating thing but you know there's ketamine psilocybin there's a bazillion kind of brain-based medicine interesting psych interventions that aren't cbt and tons and tons of benzos yeah um that have been done and you can google the ted talk that the doctor did and i mean it literally goes back to like 1985 to i mean a ton of them in the 2000s none of them ever changed the way that the va

Starting point is 00:36:00 practice medicine the the way that it's done it's still cT and tons of benzos for psych and PTSD and people getting diagnosed with PTSD. They don't even have it. They're just a little anxious or something. And so none of those things that they said, we really want to do it and change ever got big enough to do the system, even though it got national news and made somebody's career and had a bunch of publishing and was validated by all the research.

Starting point is 00:36:22 So why, you know, why, why not? You know, I got the email yesterday. and was validated by all the research. So why, why not? I got the email yesterday, Biden was like, your plans on my desk, do a study. There's all this prize money if you, I mean, they do that every five years

Starting point is 00:36:36 and it doesn't change that system. Why is that? Yeah, that'd be very interesting to look into that type of system versus a system like UAB. Thankfully, we sit on consult psychiatry, and I'm glad I'm learning so much. It's like playing house, like the show House. We sit around this table, and it's consult psychiatry. So there's someone in medical that's probably having some crisis, and we've got to figure it out.

Starting point is 00:37:04 And just going through everything and trying to figure out exactly the problem is wild. And everybody leans on psych for a lot of things, good histories and hey, make this person behave kind of thing. And I think hospitals are starting to just take psych to mean like we don't like what this person is doing, call psych. And it's like, is it a psychiatric issue is it a bit like what what is it one of the reasons why maybe we shouldn't call psychiatric all psychiatric facilities and psych services behavioral health care because yeah behavior is

Starting point is 00:37:35 is not um maybe the best way to separate uh you know somebody who is a sociopath from somebody who has schizophrenia yeah i mean from personal experience i mean i had a like a nose procedure done in 2020 and i woke up from being under and i was like confused and i walked out the recovery room naked trying to find my clothes and thankfully i was in i was still part of uab but like an outpatient had i been inpatient and did that they would have called psych until yeah get me back to the room yeah drug seeking yeah i was so confused when i had to like bring me my my clothes and they're like hey can you just help like get him back into his room and i'm just like searching for clothes because i didn't have i was confused i don't remember any of that that was just kind of the story but well i i think economically and the end of the there's

Starting point is 00:38:26 economic factors and structural factors but then also just the way we conceive of psych is changing and hopefully going back to uh sort of the way some stuff was you know before the cognitive revolution and and that's becoming part of health care but um one good thing i mean one thing that's maybe exciting if you're a doctor if you're a resident is like this system is broken and not working and so it has to be different like there's no way for this to continue to decline for another 10 years like someone's going to have to come in like we need to be able to build these structures and like yeah you know maybe you are in this place that you don't want to be in or maybe you are in this place in the the profession that's really inconvenient, but it's, that's also really exciting. You know, it's like, we just tend to not fix systems until they completely cannot be fixed until they're

Starting point is 00:39:13 completely broken, you know, and, and we're sort of getting there. I mean, I think that this is a time where the good ideas that we've been able to ignore for the past 20 years, we probably can't ignore for another 10. Oh, yeah. And that's one of the exciting things with psych and these psych residents is I have a couple of them like, I just, I'm tired of like the medication route. We got to find something different, right? I'm like, hell yeah, we do. Like, yeah, medication can't solve everything

Starting point is 00:39:36 in some of these patients. And it's just like, it used to be focused on that type of, this is the only thing psychiatry can do. And you're getting these young residents that want to exit. And that's what I'm lost people who had capacity to understand healing in another way because you took away every single tool other than pills. So now every tool, every you know, if you're a hammer, everything looks like a nail and you lost all the institutional wisdom of the irvin yalums of the people who could do talk therapy because you turned health care into a service and that service meant everyone's looking at psych being like what do you do we're procedure

Starting point is 00:40:14 oriented health care now there's no procedure here it's just talking like yeah like we want you to deliver babies and don't cure it because that that would be expensive but just treat cancer forever please like yeah you know like that that thing made these sectors of health care very profitable and it made anyone wonder why you would go into psych and psych just kind of be chronically underfunded everywhere yeah but the the more nefarious thing about it to me is that it took these services and made them 5 to 15 minutes long oh yeah you don't know anything about me and now you're putting me on drugs that affect my brain. Well, that's what the therapists working 45 minutes are for. But then the therapists working 45 minutes aren't part of it.

Starting point is 00:40:53 You know, you're not pairing. Even the people who are like, well, research went that way or something. No, it didn't. Research always said, I mean, taking aside all of the things that we made up to make antidepressants look more effective than they were like it always said that these things were in most cases only effective and in all cases

Starting point is 00:41:13 almost all cases more effective when you combined antidepressants with therapy yeah so it wasn't evidence-based don't tell me that because you weren't saying go out of the therapy office and then talk to the psychiatrist that isn't what you did you know yeah and weren't saying go out of the therapy office and then talk to the psychiatrist. That isn't what you did, you know? And now we've lost all of the institutional knowledge of the people who knew how to talk to somebody for an hour in this whole field of medicine. So that's scary, but also exciting if you're an MD and it wants to blow that world up. Yeah. And that's and that's something that I'm doing. Every conversation that I had is kind of saying, like, if you do want that change, you got to be you got to be okay with one feeling

Starting point is 00:41:46 symptoms of that type of compassion fatigue and burnout um because you're going to run into brick walls with that right you want to change right now but is you can't you're a resident and then outside of residency you're looking for that good job to like figure out and do you become another cog you know in the system or are you going to you know put a screwdriver in it and try to do something different um and it's kind of filling those out but it's it's like them being okay with some of the um and everyone in general just being okay with some brick walls um and you know those brick walls come down at some point in time and it's just when uh and it's how to maintain that resilience,

Starting point is 00:42:25 uh, through it. It's kind of the serenity prayer of that. How do you accept the things that you can't change and change the things you can and, and just having somebody help you go through that, you know, sometimes it's more of a Venn diagram,

Starting point is 00:42:37 like you're saying, some of those brick walls come down with time, but we, we do, I think we can, we tend to beat our head against walls that we haven't accepted are there yet. Yeah. And when you get in therapy and somebody says, yes, you can't do that, we do, I think we can, we tend to beat our head against walls that we haven't accepted are there yet. Yeah.

Starting point is 00:42:46 And when you get in therapy and somebody says, yes, you can't do that, you know, but where can you redirect that energy? Where can you redirect times? That's when things change. Yeah.

Starting point is 00:42:54 I mean, that's, that's kind of what it is. It's, you know, and we have to redirect the energy to the right things. I talk about productivity a lot is, you know,

Starting point is 00:43:02 everybody thinks like being productive is doing everything all at once. But it's really just about doing the right time, right things at the right time. Exactly. Yeah. Yeah. And no, go ahead, please. I was just saying that. And that's kind of the focus on burnout is like everybody thinks. Yeah. So everybody thinks we have to do everything and this is what we can achieve. But it's really about kind of picking the right thing and being OK with that. But it takes somebody with your depth and kind of existential bent to be able to understand that. I mean, I think why a lot of just higher performance professionals that are, you know,

Starting point is 00:43:33 bright and have already kind of ruminated on these things that are hard and they are paradoxes. There's not an easy solution. You know, they're afraid that they're going to end up with, you know, sort of avoidant, cognitive only, you know, cognitive behavioral supportive counselor. That's just like, well, maybe that was there for a reason. Well, you know, do you know, maybe you should just be grateful for the wall that you're beating your head against, you know, instead of just like, yeah, that's a bad thing, man. That's bad. And it's not going to change. And maybe it will change in five years. But what can we do now? You know, what can we do? Unfortunately, the most therapy just doesn't start there. In my

Starting point is 00:44:04 experience, it's people kind of trying to talk you out of your emotion which seems weird you know but no they'll let you label it but you know then you gotta zing away from it yeah there's so much there yeah um yeah i'm lost so if i'm sorry oh yeah sorry you're good if you've got so if you've got you know 10 5 10 just concepts that a doctor comes in you know somebody in one of these systems comes in you know it's not an acute trauma it's not like they're having one thing happen but it is strain trauma and that there's just too much energy activated all the time i mean where do you where do you start i mean what are the first you know five things you go through screen forward to just you know practically as a

Starting point is 00:44:50 therapist that's treating that stuff yeah uh basically how much is it has it affected kind of like your functioning right um and what have you kind of sacrificed uh in order to maintain what you are doing now um and trying to redirect you know basically how has it affected you as a person and how has it affected people around you um does it create you know comorbid diagnosis is are you depressed are you how much is your anxiety level or you know rate it right um but how much are you attuned to yourself right um have you have you noticed how it makes you feel like what is burnout you have to kind of notice and kind of walk through what that feels like for you and it's different for everyone um let's see uh yeah it is different for

Starting point is 00:45:41 a lot of people but really it's it is of the, how likely are you to continue on? Like you have to ask that question. Like if you're in this space, right, do you want to continue in this space? Do you want to keep feeling like this? Do you want this to keep going? Purpose. Why are you doing this? Do you remember or have you thought about that?

Starting point is 00:45:59 Yeah. And then kind of redefine your passion. Your passion may have changed from med school to now, right? Let's help. Let's help figure that out. Your passion is still people like you don't become a doctor just because you want to do surgery. Like you're, you're still helping somebody or, or just big leagues, right?

Starting point is 00:46:18 You, you, you have a company, you're passionate about something to grow something, right? Your passion, your Your passion was there. And then when you start losing it, it's not necessarily, you know, and that's something you have to talk about too. Are you losing that type of passion or is it just being redefined as you go? And are you okay with that redefinition? And so, you know, there's a lot of, I mean, yeah, there's a lot of things that you look at and screen for during this, but it's definitely how you are, where it hits you, like physically, right?

Starting point is 00:46:55 And then your thought processes. Yeah, there's so much in it. And like I said, it's per person. It's going to be different every time because that burnout looks different different in that you know that compassion fatigue looks different to everyone and it's just talking about where were you or is there a time when you didn't feel this way right and where you are now and what was different um and things like that yeah and just knowing we're allowed to change like it's been a long time i mean and doctors too i think that's one of those professions where some people are just told that they're going to do that that they're going to go into it

Starting point is 00:47:28 and kind of putting down somebody else's goals or you know the family legacy to say what do i want to do is like a big thing that a lot of people start to uncover i'm now i'm really excited for when you uh start to do brain spotting and we can go over slt because a lot of what you're talking about it's like it's so much fun when somebody you get them to notice an emotion and there is this huge somatic reaction of like every time i feel this my back does this my heart does this my stomach does that and just with the pupilometry like with the eye movement that you can just pop that in 10 minutes and then it it's gone and then they start feeling all those feelings and and come back the next session i mean like that's such a neat thing it's like one of the reasons why um i don't know a lot of the stuff at

Starting point is 00:48:10 tabry just like works really quickly because you're just jump starting and it's like you would have gotten there eventually in therapy but a lot of your brain-based medicine stuff just make change happen so fast it's really yeah i definitely think brain spotting and and your slt is going to be a huge like factor in helping people uh specifically yeah reaching that part and just kind of unlocking that part of the brain just to get through that because that's another thing too like burnout could be a symptom of past trauma really yeah i mean and that old relationship but not even knowing you know yeah there's something there and it's kind of like figuring it out and like I said if you haven't named it like if you have not sat

Starting point is 00:48:51 back and named it then you'll never be able to overcome that kind of thing it's trying to get back to that route and just and really do anything possible to kind of really get you to a place where you need to be and that and that means going back or talking about trauma talking about you know getting through it working through it processing it um but yeah brain spotting is going to be it's going to be pretty good when you when you have the training or wouldn't you yeah that's next week to each you know oh cool i hope yeah let me know how it goes and if you want to sit down and play with it for a minute we uh we always like do consultations and like uh play with like tips and different things um because i don't know it's it's really neat it changed it let me do everything that i was already doing faster yeah and with you know very little

Starting point is 00:49:36 kind of uh i don't know it's not a protocol heavy thing it's it's a pretty natural thing yeah it's yeah it's uh it'll be good to dive into and just kind of see where we can expand it really i mean you don't see it often um do you notice that like a lot of physicians or a lot of those kind of high performance personalities like have just kind of a chronic but highly functional you know they've learned how to manage it in adhd or other kind of like complex trauma you know there's a lot of disorders that kind of come from a chaotic childhood where there, there was either trauma or you just kind of weren't getting enough. You know, I think ADHD is one of those things where there's definitely a correlation.

Starting point is 00:50:12 And I remember the hospital, so many of the doctors, like they weren't medicated for it or anything, but it was like their whole board would have post-it notes and 16 alarms are going off. And it was because they, they had just figured out a way to environmentally control this thing um but i think you know i would imagine if you're dealing with mds that you're also seeing a lot of adhd oh yeah that i mean that and there's this kind of like idiopathic and narcolepsy that i'm dealing with too that it seems like everybody's getting these days and it's uh i think it's linked to kind of like past trauma and then

Starting point is 00:50:46 yeah and they're not dealing with it right so yeah it's a spectrum of what i do see and there is like yeah there's there's definitely a pattern there so well um is there anything that we don't get to or you feel like is is an important part of approach and how you want to, I don't know, anything there? Yeah, no, I'm here to attack everything, right? And it's not just, you know, yeah, not just burnout and some compassive fatigue. I help a lot with anxiety and trauma. So I'm not, you know, I like it all. I think it all goes hand in hand at some point in time.

Starting point is 00:51:25 And so that, and it's something I'm just passionate about and make sure that we all kind of get more aware of it and just, and I'm here to help. So. Well, sounds good. Is there any, anything that has to do, you know, not just with your specialty, you think would be like kind of a fun, fun topic or anything you want to do an episode on in the future.

Starting point is 00:51:48 And the next couple of things I'm excited that with, cause Alice got underwater, she was going to, she co-hosted like once or twice and then she got busy. But when everybody's in network and everybody's going, I'd like to have more of just kind of a round table, whatever, not have to,

Starting point is 00:52:01 it'd be neat to get some, some different topics and, and things on there on the table we all have different perspectives on yeah i listen to your conspiracy ones and they're so funny uh matthew rinsky and them yes and uh the cults and uh those are so wild you never think about like just talking about the psychology of those types of things but they're great that was kind of the direction i wanted to do with the podcast and the blog. Like I just, I had no interest in, in being like, it feels like the two ways that you can do like a podcast on mental health or to be like, all right, gentle friends,

Starting point is 00:52:34 remember to eat ginseng under the moon or like the other one is to just be like, all right, 10 ways that the government is making your gut inflamed by you, not whatever. Also, like I just got cancelled you know while i was recording i go i get a bunch of emails about that one guy i don't i don't know anything about him i mean it looks like the kind of thing where like half of it is kind of like yeah that seems like smart you know forward-thinking anti-establishment medicine that makes sense and then the other half is kind of like i don't know man does sunscreen really give you cancer i haven't seen those

Starting point is 00:53:06 numbers. That Huberman guy, do you know who I'm talking about? I don't know anything about him, but I just get emails where people tell me to listen to it and I don't have any time. It just came out that he had 10 wives or something. What was the scandal? I've not been that in depth, but I do

Starting point is 00:53:24 know that I did see some something he got. I think he had a bunch of secret girlfriends or something and they all talk to each other. Sounds like a cult. I thought everybody that had a mental health podcast was allowed to do

Starting point is 00:53:40 that, but I guess it's good. I just have 10 cats. I'm happily married. Really boring in that regard i don't know how do you have time that's the thing that gets me is like i i've heard of like there are people in my family you know businesses or whatever and you have like stuff just comes up you're like i'm like doing stuff all day like i imagine that this is a time-consuming thing like how are you this duplicitous? I don't have time for lunch.

Starting point is 00:54:10 I'm a social worker. Exactly. Going on dates with 10 people? How do you do that? I've made that joke with my wife several times five years ago. She's just like, are you sure you're here? You're only're only for me i was like i don't have enough energy for you well i mean i i should probably figure out what andrew huberman actually did before i talk about oh yeah what if we're yeah but like i mean i think that was that he just had like a bunch of girlfriends or something but it was like i i really don't understand how uh yeah i've got

Starting point is 00:54:43 two kids like i have i have a wife or we have a cat box to empty we have a you know fish to feed like i just how do you do that like there was a guy when i worked with um people that uh were treatment resistant like schizophrenia there was a guy that he would have a good relationship with you and then you know five or six weeks in he would go through every case manager because he would start to get paranoid and he would be like well you came and we brought the food and you gave it to me and that was very nice but i heard when you were going to your car that you like quickly looked over your shoulder and you said you know butthole and that was about me and and and i know that they are getting to you now and making you do this or whatever so i'd worked with him for a while and they were like

Starting point is 00:55:21 you know just be aware i was like the only one that worked with him for like more than a year but like we're like just be aware he's gonna like the only one that worked with him for like more than a year. But like, we're like, just be aware. He's going to start doing this thing. And I came in the door at some point and Violet had just been born and I looked terrible. And he was telling me about how he knew the CIA was like giving me orders or something. And it's like, dude, I have a newborn baby. Look at my eyes. Look at me.

Starting point is 00:55:41 I walked out of the house without shoes on today. I'm not wearing a belt. And he was like, oh, OK, yeah okay yeah you're right no it's like i don't have time to be running the world like he was like he like grounded me and i looked terrible enough that he became you grounded him to where he was he's like oh shit he's right this guy's off yeah the same he doesn't hire people that look like this yeah this guy looks awful this guy came off the street yeah well i don't know um yeah but i think like part of the thing with the podcast was like i wanted to be able to get like people who were smarter than me to talk about how there's inherent psychology and all these things like oh yeah and architecture and

Starting point is 00:56:20 then it isn't just kind of like we go to therapy to do the psychology but then we pretend it's not real when we're doing the rest of our life i think is a lot of the problem that I'm trying to with therapy point out we shouldn't do like, you know, that that psychology is a part of us and kind of learning to hold that is is a. I don't know, I would like to change the way that we think about it you know oh yeah we i think we do need to change i mean i think that's a that's a given right now is we do need to kind of change the way that we think about a lot of things um and bring bring young back you know oh yeah yeah yeah some of it some of the young and stuff um i mean the the problem with that kind of psychology is because i like i like you a lot but it's like what you're doing is saying that we're only half empirical that the other half is subjective and that you can sort of have best practices for dealing with that but you can't quite have rules and measurable objectives because you can't see it you know there is this

Starting point is 00:57:16 objective thing that um yeah like you have to just at some point make a jump that somebody can know that another person is having an emotion and feel what they're doing and read them and they don't need 50 screeners for anxiety maybe we should just hire people that sort of know if someone else has anxiety that they're talking to you know in the field but when you have something that's half empirical and half subjective it's inherently ripe for kind of abuse by nefarious parties because yeah you can't prove it you know and um a lot of the things that were i mean i think that's the rudolph steiner thing is like a lot of the stuff that we're the most insecure about as a society is some of the most important

Starting point is 00:57:53 but it's not measurable and it's not visible and because we can't represent it objectively we tend to neglect it kind of you know yeah i mean that's a that's a good point especially like spirituality right you know and that being part of a person you know how do you you know someone comes in and they're saying i'm just wrestling with i'm wrestling with this i'm wrestling with being a being here and a being elsewhere it's like how do you how do you how do you tell somebody oh you know your spirits looks pretty good you know yeah yeah yeah well yeah. Yeah. Well, yeah. And that'd be a fun one. I'd like to do another episode with Alice where we just kind of like round table, talk about spirituality from different perspectives. Cause I mean, the thing is like,

Starting point is 00:58:32 I would talk about spirituality a lot in therapy with people who are atheists and I'm just like, yeah, you know, like the purpose of your life and a greater energy when you feel your intuition and you know, but I hear so many therapists say like, like oh well you can't talk about that because um i don't know if they believe what i believe and it's like most people probably know people believe what i believe like i'm i'm i don't why why would you assume that you would need to you know like you don't need to try and tell the patient that their spirituality is bad or hit it with a newspaper that they need to convert to another religion but it's fine to just be like you know some people are going to very naturalistic in their language you know they're going to say like i feel the presence of jesus i feel held i feel good

Starting point is 00:59:13 that's a good thing you know other people are going to say i went and i grounded and i talked to the earth and it whatever i don't need to jump in and say whoa whoa what do you mean how much of that is empirical let's let's go ahead and list all of your assumptions there like why can't i talk about that with somebody even if you know like i am agreeing with them that that's their experience and that's like a good thing and these parts may not be the right you know maybe trying to solve like your tax return to spirituality is not great you can wave the amethyst at the irs but i don't think they're going to go away so maybe let's put spirituality in this sector of your life that single man yeah yeah i i mean i maybe i'm missing a gene but i just hear that over and over where people are like well you don't know what they believe religiously or they don't know so i can't talk about it it's like why would you

Starting point is 00:59:59 not talk about it i don't get it yeah that's still part of the person that we can that we're talking to right now like yeah um yeah and and i think we we can understand each other's like humanity but we don't have to understand every person's exactly you know unique perspective like we to a certain extent we can't you know i don't know well um i really appreciate your uh time I don't run too much over you'll have to shut me up on these like I need I need like a you know you know yeah or maybe I just we should have a cough button but it's y'all's so you can just hit it you know my mic or not but yeah this is a this is great'll uh we'll get it out and then if you have any other topics or anything that'd be fun let's try and do one of these more more free definitely we'll have to we'll see how um yeah especially after brain spotting uh just see kind of how that

Starting point is 01:00:56 we can incorporate that and talk about that so well thanks man we will get together with you and talk again soon somebody call for a doctor I think I'm sick you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you you Well, that sounds great man. We will follow up with you soon.

The Taproot Podcast - 👨‍⚕️James Waites on Physician and Healthcare Burnout

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