I Love Propofol | Michael Jackson Was Right!

After a few raindrops, a wrong venue, we pick up a med student on the way to a DC conference and dig into the pivot from vascular surgery dreams to anesthesiology, the culture of training, and the real cost of compartmentalization. Along the way we trade stories about trauma, access, and how to keep empathy alive without losing yourself.

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Transcript

Meet-cute in the rideshare

SPEAKER_00 0:10

Welcome to another episode of Ride Fair Road Talk Conversation Development. A podcast where we create unfiltered talk space that examines the meaningful lives of my passengers while engaging in personal and topical discussions. Let's drive. A couple of minutes, no big deal.

SPEAKER_01 0:34

Thank you.

SPEAKER_00 0:35

Anything fun going on for you tonight? Those are the best nights when you get dragged out. Just remember that.

SPEAKER_01 0:44

I have a friend visiting from Mexico.

SPEAKER_00 0:46

Oh god, okay.

SPEAKER_01 0:47

So yeah, yeah. And I was gonna see them. It's like two of them from Mexico. I was gonna see them tomorrow, but then it's gonna, and we were gonna go to like this outdoor concert together, but then it's sort of it's gonna be raining, so I was like, okay, I'll come today. I was like, kiss my arm. All right, how's your night?

SPEAKER_00 1:05

Oh my god. Well, full disclosure, I do this just for a podcast. Yeah, it's been the cool do you want to be on it, by the way? Yeah, um, I normally do it down in DC. You're my first ride into DC.

SPEAKER_01 1:19

Oh my god.

Conferences and the Mexico connection

SPEAKER_00 1:20

So tell me about this whole Mexico angle.

SPEAKER_01 1:23

Yeah, so I'm in medical school and uh these people I I did a lot of research in vascular surgery. Um I'm going into anesthesiology, but did a lot of research in that. And I met these, or I just I went to um the vascular annual meeting and met said like an awesome group.

SPEAKER_00 1:43

Said like no one ever, by the way.

SPEAKER_01 1:44

No, literally, yeah. Um met some really awesome people and um you know kept in touch with them. And this week, this weekend is the um national or something, it's the Hispanic Vascular Surgeon meeting in DC. So this weekend, like all the big specialties are having meetings. So the anesthesias in uh in San Antonio, um, the hand surgeries in Vancouver, uh the neurosurgery societies in LA, like all the societies are having meetings this weekend. It's like a huge weekend.

SPEAKER_00 2:19

Okay. I get it. I mean, I I drove someone who was in the grant monitoring world. That's crazy. Well, it was boring as shit, was what it was. And she would acknowledge it. But it's so funny. Same kind of deal where everything was spread out nationally, and each little department had their own little thing. Um, certainly not as sexy as vascular.

Why medicine over law

SPEAKER_01 2:40

Oh my gosh, no, these people hate their lies. Like, I was I'm texting my friend right now. Um he's the vascular surgeon. Oh my gosh. I'm not here, not hispanic, so he's not here. But um, yeah. All right, I have questions.

SPEAKER_00 2:52

I have lots of questions. Number one, you're obviously smart as hell.

SPEAKER_01 2:55

I'm not.

SPEAKER_00 2:56

Oh, perfect. I feel so much better now. Please give me the gas. Oh my god. Um uh undergrad, grad, med, what did you do? What was your trajectory there?

SPEAKER_01 3:07

Um so I studied neuroscience in undergrad. I always thought I was gonna go to law school. Um I wanted to do patent law, so getting something in um science. That's what my dad does, so that's like um kind of what I knew. Like growing up, he's my role model. Um, and then I like volunteered a lot in the hospitals, volunteered a lot in the community, and realized I wanted more one-to-one human interaction. I thought med school was um the best way to go. And here I am.

SPEAKER_00 3:36

Okay, so let me guess. Does your dad think you're like slumming being a vascular surgeon or wanted to aspire to that?

SPEAKER_01 3:42

Oh my gosh, no, he was like, I wish you would did something easier. Like anything easier, like not law, not medicine, just like something. They wanted me to be an English major in college, and I was like one class away from it. But I'm I'm like not good at English, I can barely like read and write.

Money, mortality, and anesthesia

SPEAKER_00 4:00

Okay, you're painting this fantastic picture of like why I hate hospitals.

SPEAKER_01 4:04

Really?

SPEAKER_00 4:05

Um well, I know you're joking. You're obviously very bright, very bright and smart, but um, you know, I know a few anesthesiologists, and as a lay person, that seems to be like the money game. Like, that's where you can make really good money being an anesthesiologist. I mean, I'm sure a surgeon does quite well also, but from what I've heard, yeah, that's the thing. Um but I've also heard like how do you balance the whole, like, oh well, we we lost them and it might have been my fault kind of a thing. Oh my gosh, there is in the operating room and yeah, because I mean obviously it does happen, and if you're the person responsible for maintaining this person's sedation or whatever it is, the cocktails or whatever's happening. Um I knew one guy who actually took the work home with him quite a bit.

SPEAKER_01 4:58

Oh my goodness.

SPEAKER_00 4:59

Because of that reason.

Compartmentalizing in surgery

Trauma, download mechanisms, and numbness

SPEAKER_01 5:00

Yeah, so I think so. A story that reminds me of, because for me, I feel like there have been patients, I I'm only a medical student, but even like for my exposures, like there have been times like I've cried over patients because I've just been so affected. And like I know like my role as a med student, I'm just so far removed from doing anything helpful or quote unquote harmful to the patient, you know. Yeah, yeah. Um, just because like my hands aren't on the patient. I'm not, I'm just basically observing. That's the med student role is to observe and learn uh from the patient and from the interactions. But one of the stories that I heard at the vascular conference that I met um the people I'm meeting tonight at, they told a story about they were really lauding this vascular surgeon who he was operating, and then someone told him his son died in the middle of that surgery, and he just he just had no reaction and finished the surgery. Oh wow. So I I don't know what to make of that story. I still can't like really process. Um, well, so that's a big reason I'm not gonna be a surgeon, but it's so much compartmentalization. And I I was told in medical school, like I don't have the personality to be a surgeon. Um yeah, yeah. I I was told that um, like straight up from one of the chiefs, like she was a and I was like, that is so fair, that is so so fair, right? Like that's the feedback you need. Um, but I think for you know people who are in that position where like lives are literally in your hands and something like vascular surgery where your patients like on the table, they're gonna die or live because of you. It's so much just like put putting it into a place where you're in your head where like nothing else matters but the task at hand.

Culture of surgical training

SPEAKER_00 6:44

Um, I think they're really good at doing that, but for me, I don't well there yeah, there has to be a certain component almost like um a civil servant, like a a police officer or a firefighter, where you have to have a download mechanism because you or even like a therapist, you can't hold on to that trauma without it affecting you at some point. People can people can flex and say, Oh, I'm fine. Well, no, you're not because you're human, and there has to be an outlet for that, right? Yeah. Um I've I experienced that in my in my other career. Oh my goodness. And so through exposure, I mean, just calamities, earthquakes, hurricanes, 9-11, you know, murder scenes, the whole thing, it does pile up and it does affect you, it makes you a little numb. Um, and I would always kind of trick myself, you know, I look at the world through a black and white viewfinder, or at least I used to. And that used to be my shield. Because if you really kind of take a step back and look at the world around us, which is kind of like a filmmaking beat sheet kind of a term, yeah. It's it sets up the stage for your story. I can't live there. Because if you really absorb what's happening, like you just you just fall apart. But at some point you do have to do a download, and I'm sure there's a mechanism in in the medical field for that, obviously.

SPEAKER_01 8:07

Yeah, exactly. And like what I said, like I'm a medical student, whereas like I haven't seen that much, you know. So like all these things are it's like kind of fresh to me.

SPEAKER_00 8:15

Oh, chest weight, yeah, yeah.

SPEAKER_01 8:17

So it's like these people have seen like seen it for years and years and years, and that's what they do all day. Um I have like utmost respect for them, but it's like you sacrifice so much for your personal life to be a surgeon.

SPEAKER_00 8:30

I can see that. I mean, is there have have there been discussions anywhere on your journey so far about that subject? You know, like the the the the byproduct of doing this that you have to absorb and you know, you're saving a life and you might be inadvertently, you know, saying goodbye to one. Um is that a thing? Or is it like home economics in high school, like no one uses the bake and cake anymore?

Off-ramps and choosing anesthesiology

SPEAKER_01 8:58

Like, you know, yeah, when I was doing my surgery rotations last year, um one of my preceptors literally said, like you have no life out of this, outside of this, like you were here 110 hours a day, nothing matters. If you want to match, like you shouldn't be in a relationship. Um like all these, or it's there's some specialties where I think anesthesia's not so much, as much as you know, these very like the surgical subspecialties, nursery, classic surgic vascular surgery, yeah. Where it's in order for you to like get into these specialties, you're told that you really need to dedicate a thousand percent of your life to this, um, and nothing else really matters.

SPEAKER_00 9:39

Okay. Um so as a lay person, again, I mean if you if you're on this track, you're down this funnel and you've done all your schooling and now you're specialized, and you're like, oh wait, I don't like this. Can where's the off-ramp?

SPEAKER_01 9:58

That's there an off ramp I actually I delayed graduation because I thought I was gonna do surgery because I that was a lot of my life during medical school where all my mentors were surgeons. Yeah, um, a lot of people like today I'm meeting these people. Um, like so many people around me were surgeons, and obviously there's some awesome things about being a surgeon, right? Like that is it's so badass. It's probably the coolest job you can have. But there's so much sacrifice that goes into that. I you know, going to a specialty that's um and anesthesiology is so hard and so rewarding in in and of itself, but I think the culture is just a little different, yeah.

SPEAKER_00 10:34

Um that but did you really weigh that though, like along along the journey of like you kind of have to, right? Otherwise, like what are you doing?

Residency hours and pay realities

SPEAKER_01 10:45

And I think that for the people that do it, it's so and some people do it all, right? You can be that some people are female surgeons with kids, um, who are like present for their children, and but I think that is so so hard. Just seeing the way like my friends who are went into surgery are working right now. Um it's just it really consumes your life because you're working, you know, like on like one of my friends, she literally just texted me today. I was having a text conversation. Um she goes, I go in at four every day, I leave at I'm supposed to leave at six p.m. Um, obviously I'm there until nine, and they tell me to record. I only work from six to six to not break the hours.

SPEAKER_00 11:29

Yeah, so it's that those are like those are like television hours, to be to be honest with you.

SPEAKER_01 11:34

Yeah.

SPEAKER_00 11:35

Um that's brutal.

SPEAKER_01 11:37

It's so brutal. Even when I was a student, you'd be you'd be you're expected to be the first one there, last one out. And it it's really like it's really consuming to your life. But on the bright side, it's like you're working with your if you're you have good co-residence or you have good attendings, like you're with your best friends 24-7, basically. So that's another great part. Yeah, it can be.

SPEAKER_00 12:01

You could drive a desk or a cubicle and be like, wait, like, no.

SPEAKER_01 12:05

Yeah.

SPEAKER_00 12:05

Do a research or something and be like, no, I need stimulation.

Empathy, patients, and the system

SPEAKER_01 12:09

Is that they don't like they get paid less than minimum wage for that because the salary is set. Oh my god. So you get paid less than so you if you work a hundred hours a week, you're still only making you know, the whatever amount they give you for the year. Yeah. It's a salary, it's not by the hour. So I think that's like really crazy to me because they work so hard.

SPEAKER_00 12:29

Okay, here's the next question. Do they make you take the drugs that you have to administer?

SPEAKER_01 12:37

Oh my god, no, no.

SPEAKER_00 12:39

That's bullshit. You have to. Oh my god, we have never thought about that. I mean, think about it. Like, the the few procedures knock on wood that I've had, um, you know, I had like the cocktail and then the propofol.

SPEAKER_03 12:55

Exactly.

SPEAKER_00 12:55

And when I woke up and I was like, oh, I get it now. Like the whole Michael Jackson thing. I'm down, I totally get it. It was the greatest sleep I've ever had in my life.

SPEAKER_01 13:03

Oh my gosh. Yeah.

Personal stakes: family, fear, and care

SPEAKER_00 13:04

And I'm like, wait, wouldn't it be fair to be like, alright, well, here, you have to do this. It's kind of like in the military, you have to go into like a uh like a gas chamber kind of a thing with and and change out face masks and kind of get exposed to it so you actually know what you're dealing with when it's time to be in a crisis. Kind of that kind of a thing. Um, I don't know. Tongue in cheek, but at the same time, maybe it makes sense. I don't know.

SPEAKER_01 13:34

That is because I've I personally I've never had because we're we're taught to say, oh, the probo fall feels spicy going in. Right. Um, right? And um you give the cocktail and you're like, oh, this feels like four glasses of wine. Um, this is what you're starting to feel.

SPEAKER_00 13:51

Yeah, see, there's see there's something there.

SPEAKER_01 13:53

Yeah, and putting the mask on, you're like, oh, it's supposed to smell like a beach ball, you know, little things like that. Um that I've just picked up.

SPEAKER_00 14:00

Um my god, that's so funny. Yeah, I I have been cursed with kidney stones.

SPEAKER_01 14:07

Oh no, those are so painful.

DC detours, speed cams, and sign-off

SPEAKER_00 14:09

And my whole thing is it's ridiculous. Like I was I was begging my wife to shoot me in the face on more than one occasion. I'm not even kidding. Um, and I've done everything diet change, everything possible. Nothing works. Um, but it's like there's this glaring hole in healthcare, specifically with uh urology and kidney stones, where there is no middle ground because you have these factory type uh urologists in these conglomerates, and if you're in an acute situation, they're like, Oh, I can see you in December. So just go to the ER. What if it's not you know, time for the ER? I need some kind of and then you're dealing with the pain and everything else, and then maybe you're dealing with a third-party call center in the Philippines where there's literally no attention to care or detail whatsoever.

SPEAKER_03 15:11

Yeah.

SPEAKER_00 15:11

Um, it's really crazy. So now you're becoming my punching bag for my frustrations in the medical.

SPEAKER_01 15:18

No, it's so because I like I've been in the when I get a needle stick or something, I'm waiting in the emergency room. Um, what else happened? I got I got bit by a dog uh during my first year of med school, and I had to wait in the emergency room, and it's so frustrating.

SPEAKER_00 15:32

Wait, what kind of dog was it?

SPEAKER_01 15:34

Um it was it was a large dog. Really? It was like a large mud. I was just like running in the woods. Um or I was like on a trail. I was just running on a rock.

SPEAKER_00 15:42

Like running with like pork chops in your pockets. No, literally, yeah.

SPEAKER_01 15:46

Um it was it was I think one of like the rover walkers, so she had like multiple dogs, and one of the dogs just like like she lost control of the dog and it pounced on me. Oh no. Um yeah, it doesn't matter, but just like that experience is crazy. And just like being like and being on, and I did like emergency medicine rotations, and you hear so much frustration from your patients because they're like waiting so long, and it's expensive. I'm sure every time you have a kidney stone, it's like a huge bill.

SPEAKER_00 16:16

Well, I mean, it's it's not, but it is to somebody, yeah, which is indicative of the larger problem of what's happening now in the world with health insurance and everything else.

SPEAKER_01 16:24

Oh gosh, yeah.

SPEAKER_00 16:26

Um yeah, not a big fan of the uh of the urologist. And to my point, yeah, I don't think you should be a urologist until you actually have a kidney stone. And if you don't have one naturally, then you should have a procedure where someone puts one in you because it's just not fair.

SPEAKER_01 16:43

Yeah, because I think it's not fair. I think like everybody what teaches you empathy or everybody thinks that like a doctor, like one of the big components you should have is empathy, right? But I think a lot of these like really hardcore specialties, they kind of like feed it out of you because you're so like you're burdened with so much work. You're probably seeing like 10 people a day who are quote unquote complaining about kidney stone symptoms, where to the to them they're like, okay, like it's not they're not really empathizing. Right, no, totally.

SPEAKER_00 17:14

And it becomes like kind of like um supply chain versus healthcare, where you're just checking boxes and moving people through your your your supply chain and or your blockchain, and then off you go. Yeah, yeah, pretty much.

SPEAKER_01 17:30

And it's so and it's so frustrating being on the other side, because when my um grandma needed surgery, it was like the scariest moment. Like it was so scary to me. Um, and that this was before I started like my rotation. So it was like I want like I want to vouch like my patients, like when I'm an anesthesiologist, that when I'm there with the patient's family to you know give them my hundred percent. Cause I remember how like scary that moment was to me. And I agree, not everybody has those moments, not every medical student, not every resident has that moment where like it feels so urgent and dire and personal to them. Um yeah, and a lot of it is luck about like what kind of doctor, like who you get, like everything in life is, I guess.

SPEAKER_00 18:11

Yeah, yeah. I mean, there it's it's a it's like a relationship, right? You have some people that get it, and some people are empaths, like you said, and some aren't. And you know, I try to I mean I'm just turning 57, so I don't pull any punches um with my specialists or my doctors, or if they don't like it, you know, I'll go somewhere else. But um I have a really I have a good primary who does a uh what's it called? Like a uh call when it's like an executive I just pay him a flat fee for the year.

SPEAKER_01 18:48

Oh yeah, concierge something like that.

SPEAKER_00 18:51

Yeah, and like I have the guy's cell phone.

SPEAKER_01 18:53

Oh, that's incredible. Oh, it's amazing.

SPEAKER_00 18:55

Yeah, and uh I mean it got to the point where like more often than not, it's like I can tell, like, we both want to like go grab like a beer and some pizza because we're kind of like cool like that. But I'm like, hey doc, you know, I'd say let's go, you know, get a beer and a pizza, but at some point you're gonna have to check my prostate, and I just don't want to have to deal with that. So let's not.

SPEAKER_01 19:19

Yeah, oh my gosh, I know. We can't be friends. It's scary, it's scary.

SPEAKER_00 19:24

We can't be friends, I'm sorry. Oh boy. Um all right, so anesthesiology. Are you numbing yourself this evening at the uh at the Mad Hatter?

SPEAKER_01 19:36

Oh my gosh. No, I actually um I read it wrong. It's um it's a Mayflower. Okay, no, I think it's like a one, it's a one-minute walk.

SPEAKER_00 19:45

I I know where both are, and I can get you wherever. It's no big deal.

SPEAKER_01 19:50

I like I was such in such a rush. I um I literally was like debating on staying in, and then I was like, and the thing started at eight, and I was like, oh my god, I'm gonna be late.

SPEAKER_00 20:01

I was saying Mad Hatter seems a little lowbrow for the uh crowd. So interesting connection point. Um my family used to know the people that owned the Mad Hatter.

SPEAKER_01 20:16

Wait, what?

SPEAKER_00 20:16

Yeah. Um, and then one of my sisters actually got married at the Mayflower.

SPEAKER_02 20:22

Um that was a long time ago.

SPEAKER_00 20:24

Well, yeah, I mean we could talk about that, but you know, quite a place for a wedding even 30 years ago. It was a nice time.

SPEAKER_01 20:33

Wow. So you're local.

SPEAKER_00 20:35

Yeah, yeah. I actually was born in DC and grew up in like around Rockville, that area.

SPEAKER_01 20:40

Oh my gosh, yeah.

SPEAKER_00 20:41

Went to school in Florida and I was very fortunate when I came out of out of school. I got my first job in broadcast journalism right here in DC, and I never had to leave.

SPEAKER_01 20:52

Oh, that's amazing.

SPEAKER_00 20:53

Yeah, I mean, because I I I mean I've had friends that went to the middle of nowhere to get that first job and they were never seen or drama games.

SPEAKER_01 20:59

Oh yeah.

SPEAKER_00 21:00

So very, very fortunate.

SPEAKER_01 21:02

Oh my god, especially I it's such a like doggy dog's wor doggy dogs world in like media. Because my one of my friends, uh, he's in he's trying to go into media law, but even then, like it's so yeah, it's so hard. Um he interned at like MSMBC back in the day, uh, when we were in college. Um, and that was like such a high point for him. Yeah.

SPEAKER_00 21:27

Um you know, I I caught the the tail end of the good old days in air quotes, um, before things got really kind of squirrely, and that was the writing for me to switch gears and go into the corporate side. Um you know, right around I don't know, I'm dating myself and you're still at school technically, but right when YouTube first was starting. And you know, HD video had these places to live, whether it was a server or YouTube or whatever. All of a sudden I s you start seeing like, you know, on the evening news, instead of like these traveling documentary stories like Charles Carole, Ted Koppel, those type of folks who were my mentors and my um you know, my inspiration for a lot of storytelling and things. Um all of a sudden we started seeing like the squirrels water skiing on popsicle sticks, yeah, and just like stuff like that, and that started becoming kind of like normalized in the evening news, certainly at the local level. I just didn't want to do that shit anymore. I just didn't. And uh So I I was at the White House for like three years during Colin Admin and State and DOD and traveled a ton. And I was like, alright. And then 9-11 happened, and that was really the the last push I needed.

SPEAKER_03 22:47

Yeah.

SPEAKER_00 22:48

And I was like, I got two small kids, and I'm like, you know what? I don't know if I want to do this.

SPEAKER_01 22:53

I know, yeah, you have to prioritize your family. That's you do. That's like at least the rule like I I want to live by. Yeah. It's like I think a good miss. Yeah, yeah. Always like prioritize, like, I missed our little offshoot here, so I'm gonna just Oh my gosh, I could totally get out here. Like, this is totally fine. It's I can just turn spin you around.

SPEAKER_00 23:11

It's no big deal. This circle's always weird.

SPEAKER_01 23:16

I know I hate driving in DC. It's like I get really scared.

SPEAKER_00 23:20

I don't mind it, but what they've done with all the cameras is just it's crazy.

SPEAKER_01 23:25

It's like Big Brother.

SPEAKER_00 23:27

It's like, you know, the red the right turn on red cameras are out now.$100. Speeding is$100. Oh, yeah. I um if you make your way to the podcast, which I hope you do, it's cool. Oh yeah, give it called uh it's called Rideshare Road Talk.

SPEAKER_01 23:42

Rideshare Road Talk.

SPEAKER_00 23:43

And it's on Apple and Spotify.

SPEAKER_01 23:45

I'm going on Apple right now. Wait, I'm obsessed. I can't wait to listen to these. I love podcasts.

SPEAKER_00 23:51

The title, the titles are the best part.

SPEAKER_01 23:52

The titles are amazing. Oh my gosh. Wait, yeah, these are incredible.

SPEAKER_00 24:02

Just double park right here, and then I think you'll be okay here. Thank you. You're quite welcome. Okay, it was great chatting with you. Good luck with school, and I hope I never see you again. Thank you for listening to this episode of Rodcare Road Talk. If you've enjoyed what you've heard, we'd love for you to review the podcast on your favorite listening platform like Apple or Spotify. Your support helps us so much, and don't forget to reach out on Instagram with your feedback or topic suggestions. Until next time, let's try.