Latest / I Am Wiser Podcast with Dr. Laura Purdy / A Pediatric Neurosurgeon on Leaving the Traditional Path

Transcript

A Pediatric Neurosurgeon on Leaving the Traditional Path · I Am Wiser Podcast with Dr. Laura Purdy

• 0:00
  SPEAKER_00: I'm having to turn down opportunities because the only way to say yes to everything would be to not be at all anything like that.
• 0:10
  SPEAKER_00: And that's not what it's about.
• 0:12
  SPEAKER_02: We have to drop the wrong stuff.
• 0:15
  SPEAKER_02: Welcome to the I Am Wiser Podcast, where the biggest questions in healthcare and wellness meet the collective wisdom of industry leaders and innovators.
• 0:24
  SPEAKER_02: I'm Dr.
• 0:25
  SPEAKER_02: Laura Curry, and here we explore the intersections of AI, care delivery, health health policy, and more.
• 0:33
  SPEAKER_02: Through the lens of those who are reshaping healthcare.
• 0:37
  SPEAKER_02: This is not just about theory, it's about lived experience and real industry insight.
• 0:43
  SPEAKER_02: Let's dive in and get wiser together.
• 0:46
  SPEAKER_03: So I think this is a really cool conversation to have because we're both doctors, we both work in the healthcare industry, but like completely polar opposite ends of the spectrum.
• 0:58
  SPEAKER_00: Your pediatric neurosurgery.
• 1:02
  SPEAKER_03: So he operates on the brains of children and adults until there's enough volume of children to provide for our entire family of five children.
• 1:11
  SPEAKER_03: So adults and children.
• 1:13
  SPEAKER_03: And I am, I say, the internet doctor.
• 1:17
  SPEAKER_03: So I work in the digital health tech startup industry and do exactly the opposite of what you do.
• 1:24
  SPEAKER_03: I actually don't even really practice anymore.
• 1:26
  SPEAKER_03: I manage the business of healthcare.
• 1:28
  SPEAKER_03: So I'm a healthcare administrator.
• 1:31
  SPEAKER_03: But let's take a walk down memory lane.
• 1:35
  SPEAKER_03: So, what was it like for you being a mainstream neurosurgeon, a surgeon of the brains and spines and children, getting to know and like starting to date this like digital health tech founder, which is a really interesting persona that you had had no interaction with at all.
• 1:57
  SPEAKER_03: What was that like for you?
• 2:01
  SPEAKER_00: I would say, you know, it was it was fun.
• 2:04
  SPEAKER_00: It was fun, it was interesting.
• 2:07
  SPEAKER_00: Um, it was, you know, a unique perspective to kind of see um someone working within medicine that was in a slightly different realm than my own.
• 2:18
  SPEAKER_03: Completely different than like the metaverse of Doctor Strange variations.
• 2:25
  SPEAKER_00: And I would say that it went from cool to terrifying when it started kind of becoming uh when my reality of work started shifting away from what was or what I consider to be the normal pathway for what a neurosurgeon goes, um, and kind of venturing more off into areas that you're more familiar with.
• 3:01
  SPEAKER_00: Um and so for me that became a little bit terrifying and uh a new experience to say the least.
• 3:08
  SPEAKER_03: Terrifying health.
• 3:11
  SPEAKER_00: When you go through any surgical residency, you go through an academic training program, and you really are exposed to academic medicine.
• 3:24
  SPEAKER_00: Um when you are, especially within, you know, within surgery, you are kind of sent down the pathway of well, you go on to typically get an academic job.
• 3:39
  SPEAKER_00: And unless you're in certain certain subsets of surgical practices, right?
• 3:44
  SPEAKER_00: Certain plastic surgeries like cosmetic things, or maybe like certain spine surgeries, and there are others as well, but you tend to, you know, in those cases you have kind of the private practice routes and things like that.
• 3:58
  SPEAKER_00: But otherwise, a lot of times you're kind of pushed into and really only familiarized with academic-like institutions.
• 4:11
  SPEAKER_00: And anything else is you're not really exposed to it because that's not in the setting where you're learning.
• 4:19
  SPEAKER_00: And so once you go out into practice on your own, uh, that's a very can be a very terrifying experience.
• 4:28
  SPEAKER_03: Terrifying though, why?
• 4:31
  SPEAKER_03: Like, like why was it scary for you to meet someone like me who has an abundantly atypical non-traditional career?
• 4:44
  SPEAKER_03: Why was that scary?
• 4:46
  SPEAKER_03: What was scary about it?
• 4:47
  SPEAKER_03: Because I met you at the end of your residency before you even applied to fellowship, long before you had a job, and for the record, did not have a job locked in by the time I met him, because that would have changed things just a little bit.
• 5:03
  SPEAKER_03: But by the time I met you, none of that was set into place for you.
• 5:08
  SPEAKER_03: So, what about it was terrifying specifically?
• 5:14
  SPEAKER_00: I think again, it was you know, your specialty and your area of expertise wasn't terrifying.
• 5:25
  SPEAKER_00: To me, it was interesting to kind of learn that and watch it while I was going through, you know, residency and fellowship training.
• 5:34
  SPEAKER_00: Um, but then when I started right after fellowship was completed and I started shifting over into actual attending hood, if you will, um, and realizing that there aren't jobs available where we live, and that I don't have the picture that was portrayed during training, I didn't have that option available to me while staying, you know, while uh staying living in this area where we were.
• 6:18
  SPEAKER_00: And it became terrifying because it is a career path that is not taught, that is not really uh we're not given as much exposure to.
• 6:32
  SPEAKER_00: And even though I've seen you do it successfully, it's scary going through something that you yourself have not seen for your specific situation, right?
• 6:53
  SPEAKER_00: You can see someone else doing something similar in a similar situation, but not seeing someone within your subset, within your special subspecialty, and even you know, it there's still kind of this sense of doubt, and will I actually be able to make something like this work?
• 7:18
  SPEAKER_03: You didn't have any mentors, or examples, or people, let me rephrase that.
• 7:24
  SPEAKER_03: He has lots of mentors.
• 7:26
  SPEAKER_03: So many surgeons that do all the surgery, he's got a million mentors, okay.
• 7:30
  SPEAKER_03: Don't get me wrong.
• 7:32
  SPEAKER_03: But mentors of people who had intentionally chosen a non-traditional path in your subspecialty and been successful in a non-traditional path.
• 7:45
  SPEAKER_03: You didn't have that.
• 7:49
  SPEAKER_03: So I could imagine that that would be terrifying, but I didn't have that either.
• 7:54
  SPEAKER_03: So I've been in attending a little bit longer than him.
• 8:00
  SPEAKER_03: 12 years, one year.
• 8:03
  SPEAKER_03: So I have a little bit more experience, but to be fair, family medicine finishes the residency in three years, and neurosurgery has to do residency in 27 years, and so like the math balances itself out.
• 8:15
  SPEAKER_03: By the time you finish your fellowship, you're then applying for AARP, and then you're putting in for your retirement, and then you know that's how that works as a neurosurgeon.
• 8:25
  SPEAKER_03: So you were were different in a few ways because number one, most people in your position don't marry a senior physician in an atypical industry who's had an alternate career path for the last 10 years.
• 8:41
  SPEAKER_03: True.
• 8:41
  SPEAKER_03: That is atypical.
• 8:42
  SPEAKER_03: Number two, most of them don't have five children in their first year as an attending and don't have to think about the costs that you incur moving an entire family from a great place like great place like Miami to another part of the country.
• 8:59
  SPEAKER_03: Like, where were the jobs available?
• 9:01
  SPEAKER_03: West Virginia, South Dakota, Oklahoma, Iowa.
• 9:07
  SPEAKER_03: Love you guys.
• 9:08
  SPEAKER_03: I'm I'm super happy that you're servicing patients there, but I was not going to uproot my family and move them to any of those places.
• 9:15
  SPEAKER_03: So that was immediately not an option.
• 9:19
  SPEAKER_03: But number three, you didn't really have, and there didn't really exist anyone in your field who was willing to step outside of the normal box that you get put inside of to say it's okay to try something different.
• 9:38
  SPEAKER_03: It's okay to explore other options, it's okay to say that doesn't work for my family.
• 9:43
  SPEAKER_03: So what else can I do?
• 9:45
  SPEAKER_03: Right?
• 9:47
  SPEAKER_03: So what was it?
• 9:49
  SPEAKER_03: What was it about your relationship with me?
• 9:52
  SPEAKER_03: Because we have a personal relationship.
• 9:55
  SPEAKER_03: Obviously, we're married, we have children together, we have a lot of personal um intertwinings, but we do have a professional relationship as well.
• 10:03
  SPEAKER_03: We are starting a neurosurgery practice in Miami in about four months, and that was something that we had to decide to do together.
• 10:10
  SPEAKER_03: But what was it specifically that allowed you professionally to be able to override that adherence to the traditional norms and values to be able to say, like, okay, I'm I'm willing to try this to do things differently?
• 10:28
  SPEAKER_00: I mean, one of them was respect, um respect for you, for the family.
• 10:37
  SPEAKER_00: Uh, I know that you yourself have kind of gone through a lot between moving for the military, you know, et cetera, um, and having to uproot your life plenty of times and give up a lot, not by choice.
• 10:52
  SPEAKER_00: And so choosing, you know, to live in Miami where we do, um, and or finally having that choice to yourself is something I didn't necessarily want to take away from you.
• 11:10
  SPEAKER_00: Um, and because I have family here too, and so family for me is important.
• 11:15
  SPEAKER_00: And so respect, I think, was one of the first things that made me say, what can I do to make it work for us to stay here?
• 11:28
  SPEAKER_00: Um and you know, once I had decided, okay, geography is important and we'll kind of stay here, then it became how how do we make that happen?
• 11:42
  SPEAKER_00: And at that point, that's where the whole idea of it being terrifying kind of came in.
• 11:48
  SPEAKER_00: But I, you know, my respect, my love for you, um, and my trust in you is what kind of led me to the next steps of my career, um, or at least the beginning of my career.
• 12:06
  SPEAKER_00: Um, and I would definitely stay say that each step of it is still terrifying.
• 12:15
  SPEAKER_01: Sure.
• 12:16
  SPEAKER_00: I mean, I I trust in this in the process and I trust in you, and I trust in kind of uh the way that these things go, but it is every step is still scary because um I still know only a very, very minimal number of people that have done non-traditional things, and um I'm learning kind of as as I go, and I'm very slowly becoming more comfortable with these non-traditional things as I go.
• 12:55
  SPEAKER_03: Okay, well, let's prove it.
• 12:58
  SPEAKER_03: How long did it take you to get your first job after fellowship?
• 13:03
  SPEAKER_00: Days.
• 13:04
  SPEAKER_03: How many?
• 13:06
  SPEAKER_00: Four, three, whatever.
• 13:09
  SPEAKER_03: Three, three days, and but you know what?
• 13:13
  SPEAKER_03: Okay, let's pause.
• 13:14
  SPEAKER_03: Just because you choose a non-traditional career path, just because you choose a high-paying cash pay job that pays twice as much as employed hospital positions, doesn't mean that you don't have to make sacrifices, right?
• 13:29
  SPEAKER_04: True.
• 13:30
  SPEAKER_03: So the first job that you got right out of fellowship was three days after graduation.
• 13:36
  SPEAKER_00: Yes.
• 13:36
  SPEAKER_03: And what did we have to sacrifice?
• 13:38
  SPEAKER_00: Family trip.
• 13:39
  SPEAKER_03: A huge family trip.
• 13:41
  SPEAKER_03: We had all of our family, three babysitters, our friends, our friends' kids, and our friends' parents that were all gonna go on a huge trip to celebrate Stacey's 7,432 years of education.
• 13:56
  SPEAKER_03: We were gonna celebrate.
• 13:57
  SPEAKER_03: We were gonna take our first vacation after the baby was born.
• 14:00
  SPEAKER_00: Yes.
• 14:01
  SPEAKER_03: And then we got an email on a Friday afternoon at 2 p.m.
• 14:07
  SPEAKER_00: And it said Can you cover next week starting for the 4th of July?
• 14:12
  SPEAKER_03: Can you cover starting on Thursday?
• 14:14
  SPEAKER_03: And I said, Hold on, we've got a trip planned for the last six months.
• 14:19
  SPEAKER_03: Show me that letter by 5 p.m.
• 14:21
  SPEAKER_03: on Monday, and I'll consider it.
• 14:25
  SPEAKER_00: They did.
• 14:25
  SPEAKER_03: They did.
• 14:26
  SPEAKER_03: And you did.
• 14:28
  SPEAKER_03: And what happened on your first day as an attending neurosurgeon three days after you graduated from fellowship?
• 14:36
  SPEAKER_03: What'd you do?
• 14:38
  SPEAKER_00: I don't be shy.
• 14:40
  SPEAKER_03: Tell them, tell them what you did.
• 14:43
  SPEAKER_00: I saved a four-year-old's life.
• 14:47
  SPEAKER_03: He saved a four-year-old's life that he wouldn't have saved if he had bought into the traditional mindset that everyone must attend to finding a traditional academic neurosurgeon job and go work for the machine and be a slave to the man.
• 15:03
  SPEAKER_03: I can say that.
• 15:03
  SPEAKER_03: He won't.
• 15:04
  SPEAKER_03: I'm allowed to say that.
• 15:05
  SPEAKER_03: But he broke away from what was considered the traditional norms, and because of that gave a family their four-year-old son for the rest of their lives.
• 15:22
  SPEAKER_03: But also, we sacrificed, we gave up our trip.
• 15:25
  SPEAKER_03: It happened.
• 15:25
  SPEAKER_03: We had the letter by 10 o'clock in the morning, and I said, if you can give it to me by 5 p.m., I guess we'll cancel our trip and get a refund.
• 15:33
  SPEAKER_03: And we did.
• 15:34
  SPEAKER_03: We did that.
• 15:35
  SPEAKER_03: And everybody was cool, everybody understood, everybody was like, oh, we're so mad at you, but also great.
• 15:41
  SPEAKER_03: You get to work.
• 15:42
  SPEAKER_03: And also, fast forward a year later, that has continued to benefit us because now we are doing some new things and some new exciting projects, but I'll hold on to that for a few minutes later.
• 15:56
  SPEAKER_03: So for you, coming out of the traditional mainstream garden variety, academic, neurosurgical career, and having to kind of tell people like I ain't working for nobody but myself.
• 16:13
  SPEAKER_03: That's my impression.
• 16:14
  SPEAKER_03: He doesn't talk like that.
• 16:15
  SPEAKER_03: But how has that been received as you've communicated with people and talked to people and told them that this is what you're doing?
• 16:23
  SPEAKER_03: How has that been received by your industry?
• 16:28
  SPEAKER_00: Um, I actually would say not well.
• 16:35
  SPEAKER_03: Not well.
• 16:36
  SPEAKER_03: Tell me more.
• 16:39
  SPEAKER_00: Some people uh still have the mindset of you're not doing the right thing.
• 16:46
  SPEAKER_00: Um other people get a little bit uh insulted when they feel that they don't necessarily have full control like they would like to have.
• 17:05
  SPEAKER_03: They don't own you.
• 17:08
  SPEAKER_00: Um but again, you know, it is an It is a specialty where the vast majority of people work within academia or within centralized locations of you know pediatric specialized care.
• 17:32
  SPEAKER_00: Um, and you know, there are definitely good reasons, and I'm not discounting that because uh I I do think that it's you know important.
• 17:43
  SPEAKER_00: Um but I do think that there is still certain care that can be given at you know with good um with good standards that is a slight deviation from that normal.
• 18:05
  SPEAKER_00: Um but I think that a lot of my mentors still do want me and other people to succeed, and but it is a little bit unusual for them to kind of see this pathway.
• 18:23
  SPEAKER_00: Um but you know, for those about, you know, for the side of it that is where people can't, where they feel that they don't have control, it's a little bit challenging for them.
• 18:34
  SPEAKER_00: Uh but that's more of a it's hard.
• 18:37
  SPEAKER_00: That's more of just like a scheduling sort of an issue, I think.
• 18:42
  SPEAKER_03: But okay.
• 18:44
  SPEAKER_03: Now let's share the flip side of the coin.
• 18:48
  SPEAKER_03: How many people have been happy and grateful that you are available to provide the services that you do?
• 18:57
  SPEAKER_03: And before you answer that, let me ask a question first.
• 19:01
  SPEAKER_03: How many lives have you saved since you graduated fellowship?
• 19:07
  SPEAKER_00: I honestly I I don't know.
• 19:10
  SPEAKER_03: Why don't you know?
• 19:12
  SPEAKER_00: I I don't keep track of the numbers.
• 19:15
  SPEAKER_03: Because it's been so many that he's lost count.
• 19:20
  SPEAKER_03: If it hold on! Hang with me.
• 19:24
  SPEAKER_03: If it was one, you would know.
• 19:28
  SPEAKER_03: If it was two, you would know.
• 19:32
  SPEAKER_03: Stop me if I'm wrong.
• 19:34
  SPEAKER_03: If it was three, you would know.
• 19:41
  SPEAKER_00: Agreed.
• 19:43
  SPEAKER_03: But the reason why you don't know is because it's been so many that he can't keep track.
• 19:50
  SPEAKER_03: How many hospitals are you credentialed to provide care at right now?
• 19:58
  SPEAKER_00: Six.
• 19:59
  SPEAKER_00: Six?
• 20:01
  SPEAKER_03: How long does it take the average neurosurgeon to be credentialed at six facilities?
• 20:09
  SPEAKER_00: I mean, I I don't have an answer for that because I don't know how m most don't tend to be credentialed at multiple places.
• 20:18
  SPEAKER_03: Yeah.
• 20:19
  SPEAKER_03: Why?
• 20:21
  SPEAKER_00: Most of them work in the traditional, you work at one facility and that's it.
• 20:26
  SPEAKER_03: So that means strictly by definition, your ability to impact the lives and care of patients, adults, and children across the country has been exponentially grown because you've chosen to do things differently.
• 20:50
  SPEAKER_03: Am I wrong?
• 20:52
  SPEAKER_00: No.
• 20:52
  SPEAKER_00: I mean, I'm able to provide care in far more, you know, in far wider reaches of the country because of it, for sure.
• 21:05
  SPEAKER_03: Yeah.
• 21:06
  SPEAKER_03: Now, we've heard about the haters.
• 21:08
  SPEAKER_03: I get it.
• 21:08
  SPEAKER_03: There's always haters.
• 21:09
  SPEAKER_03: I have haters.
• 21:10
  SPEAKER_03: I have a lot of haters.
• 21:12
  SPEAKER_03: But the bigger you are, the more influence you have.
• 21:16
  SPEAKER_03: What is it that you always tell me?
• 21:19
  SPEAKER_00: Oh, that uh the bigger you grow, the harder swings people will take at you.
• 21:24
  SPEAKER_03: Yeah.
• 21:24
  SPEAKER_03: And you've grown pretty big.
• 21:26
  SPEAKER_03: Six hospitals.
• 21:28
  SPEAKER_03: So many lives save you can't even remember.
• 21:32
  SPEAKER_03: But at the same time, there are people who really appreciate and are genuinely at the soul level grateful for you.
• 21:44
  SPEAKER_03: So if we're gonna talk about the haters, let's talk about the ones that are grateful.
• 21:50
  SPEAKER_03: Tell us about those people.
• 21:53
  SPEAKER_00: I mean, there are other neurosurgeons attending.
• 22:01
  SPEAKER_00: APPs and just overall hospitals and hospital staff that are, and patients for that matter, but that are appreciative of you know going to certain areas and either providing additional support, providing care where it's really kind of an isolated area.
• 22:30
  SPEAKER_00: People are just appreciative of you offering your time and skill sets in areas that need it or that don't always have it or that have it, but maybe someone just needs a minute to breathe or to also spend with their own family.
• 22:55
  SPEAKER_03: And that's a real story.
• 22:57
  SPEAKER_00: I mean they're all yeah, they're all real stories.
• 22:59
  SPEAKER_03: There are surgeons, neurosurgeons, that are your peers and colleagues in remote rural parts of the country that have no backup.
• 23:10
  SPEAKER_03: They have no help, they have no one raising their hand to volunteer to show up and give them a break.
• 23:18
  SPEAKER_03: And you have been directly thanked by these people for being willing to give of your time even being willing to give of your income because they can't pay the best.
• 23:32
  SPEAKER_03: They're in the middle of nowhere.
• 23:34
  SPEAKER_03: They can't compensate like some of these major city, large hospitals, huge academic centers.
• 23:40
  SPEAKER_03: They just can't.
• 23:42
  SPEAKER_03: But you've been willing to sacrifice your time, your income, your stability, your presence with your family to go and be the one delivering care to people who otherwise would not have it if you weren't there.
• 24:01
  SPEAKER_03: In my opinion, that matters more than other people's matters.
• 24:06
  SPEAKER_03: That's my opinion.
• 24:08
  SPEAKER_03: Of course.
• 24:08
  SPEAKER_03: The opinions of me do not reflect the opinions of him.
• 24:11
  SPEAKER_03: I'm just I'm talking here because I can't.
• 24:14
  SPEAKER_03: But do you regret it?
• 24:18
  SPEAKER_00: No.
• 24:19
  SPEAKER_02: No.
• 24:20
  SPEAKER_00: I mean, no, I I don't regret it because again, I I know why I made the decisions that I did.
• 24:31
  SPEAKER_00: And I'll be honest, right?
• 24:35
  SPEAKER_00: Had I, and I think we both know it, had I had the opportunity for a more traditional route while staying in, you know, in the location where we lived, I think that we likely, or yeah, that we likely would have taken it and not at a second thought about it.
• 24:57
  SPEAKER_05: Yeah.
• 24:59
  SPEAKER_00: But because it wasn't available, it kind of forced my hand into taking that non-traditional route.
• 25:10
  SPEAKER_00: Um, and it has been uncomfortable every step of the way.
• 25:16
  SPEAKER_03: Except for the steps that involved you saving people's lives.
• 25:20
  SPEAKER_00: Sure, yes.
• 25:21
  SPEAKER_00: Um, but I mean, you know, I'll I'll be honest, those are not unique necessarily to my situation in the sense that you could take a job at a traditional route and still have those sorts of exchanges.
• 25:44
  SPEAKER_00: But yes, I've had those, you know, those cases and I've had those situations, and I've had them across the country, which has been more unique and rewarding.
• 25:57
  SPEAKER_00: Um, but it the entire process has been uncomfortable and scary, and a learning process at the very least.
• 26:07
  SPEAKER_00: Um, but I'm not, I wouldn't say that I regret or that I'm unhappy, or that I feel that this has been the wrong choice.
• 26:21
  SPEAKER_00: Um I think that I am just developing the the pathway kind of as as I go.
• 26:30
  SPEAKER_00: Um and as we get new information, as we get new opportunities, um we're just kind of moving forward and continuing on with that.
• 26:45
  SPEAKER_03: But you've got more work than you know what to do with.
• 26:49
  SPEAKER_00: That's true.
• 26:50
  SPEAKER_03: So much work, you have to say no.
• 26:52
  SPEAKER_00: Yeah, at this point, I'm I'm having to, yes.
• 26:59
  SPEAKER_00: I'm having to turn down opportunities because the only way to say yes to everything would be to not be at home and see my family.
• 27:09
  SPEAKER_00: And that's not that's not what it is about.
• 27:17
  SPEAKER_03: We have to draw the line somewhere, correct.
• 27:19
  SPEAKER_03: Right?
• 27:20
  SPEAKER_03: However, one of the principles, or maybe I'll say the next principle, right?
• 27:24
  SPEAKER_03: Because we've already kind of done the principle of like you can control your own destiny and you can find your own work, which was easier for you than it was me.
• 27:35
  SPEAKER_03: There are less neurosurgeon jobs than there are family medicine virtual health jobs.
• 27:40
  SPEAKER_03: So it's actually you're like you get basically every job you apply for.
• 27:46
  SPEAKER_03: It's pretty rare that you get told no.
• 27:48
  SPEAKER_03: And if you do, it's probably because they've done an internal hire and like that was the plan the whole time, right?
• 27:54
  SPEAKER_03: And especially now that you've got experience.
• 27:56
  SPEAKER_03: Like it's kind of interesting because at first they were like, well, you're applying for this job, but you don't have experience.
• 28:03
  SPEAKER_03: It's like, well, he just graduated like yesterday.
• 28:06
  SPEAKER_03: So how can you get a job if you've just graduated and you don't have experience?
• 28:10
  SPEAKER_03: Because you have to have experience in order to get the job, but to get the job, you have to have experience, and it's this like weird like loop, right?
• 28:18
  SPEAKER_03: So part of what you've had to do is volunteer to help out when other people are hurting.
• 28:26
  SPEAKER_03: But the next step after you know, writing your own story, fulfilling your own destiny, finding jobs for yourself is creating jobs for yourself.
• 28:40
  SPEAKER_03: And we're kind of standing here at the precipice of the next big thing, which I'm sure is terrifying for him.
• 28:48
  SPEAKER_03: So let's talk about that.
• 28:51
  SPEAKER_03: What are we doing?
• 28:53
  SPEAKER_00: Opening up a private practice, pediatric neurosurgery.
• 28:58
  SPEAKER_03: Uh, it's a group practice and it's adult and pediatric, because we haven't earned the right to say that we're pediatric only yet, but we're gonna get there.
• 29:08
  SPEAKER_03: So let's talk about that.
• 29:10
  SPEAKER_00: I mean, it is the next step of how do we create a job where there isn't a pediatric neurosurgery job available?
• 29:24
  SPEAKER_00: How do we create something so that we can basically continue staying in the geographical location that we want with our family and doing, you know, for me to be able to do the things that really kind of I want to do uh in order to make a difference.
• 29:47
  SPEAKER_00: And it's I mean, like you said, it's true that if there isn't a job, either you move or you kind of create one.
• 29:57
  SPEAKER_00: And um, that is kind of the next step.
• 30:00
  SPEAKER_00: And yes, again, it is terrifying because uh pediatric neurosurgery is not something that we in training ever really get exposed to as a non-academic or private practice rather uh type of trajectory.
• 30:25
  SPEAKER_03: But now that you've been out of fellowship for nine months, have you met any private practice private practice pediatric neurosurgeons neurosurgeons?
• 30:38
  SPEAKER_03: That's a hard word to say.
• 30:40
  SPEAKER_03: Private practice, pediatric neurosurgeon.
• 30:43
  SPEAKER_03: Have you met any?
• 30:45
  SPEAKER_00: Yes.
• 30:46
  SPEAKER_00: Um Yesp.
• 30:50
  SPEAKER_03: No way.
• 30:53
  SPEAKER_03: Have you really?
• 30:55
  SPEAKER_00: I have.
• 30:56
  SPEAKER_00: I have met I've met one, spoken with another.
• 31:00
  SPEAKER_00: Um, yes, I have.
• 31:02
  SPEAKER_03: Tell me more about that.
• 31:04
  SPEAKER_03: What are they up to these days in the world of private practice pediatric neurosurgery?
• 31:11
  SPEAKER_00: They, I mean, they are doing just that, right?
• 31:15
  SPEAKER_00: They do pediatric neurosurgery, um, they are still involved with the academic systems where they operate or the the children's hospitals where they operate, they still get involved with the various other subspecialties and even the uh actual, you know, in-house uh pediatric neurosurgery specialties, uh, you know, when they're there.
• 31:47
  SPEAKER_00: And there is a form of kind of collegiality and uh just working together and uh this kind of cohesive environment.
• 32:00
  SPEAKER_00: Um and so there is a way to kind of uh make it work and to find a symbiotic relationship, if you will.
• 32:15
  SPEAKER_03: Of course there is.
• 32:17
  SPEAKER_03: Because at the end of the day, we all want the same thing, which is to help patients to increase access to care, and to provide high quality health care delivery services, regardless of the specialty.
• 32:35
  SPEAKER_03: It doesn't matter if you're asynchronous cachet telemedicine or if you're a pediatric neurosurgery, they all want the same thing, right?
• 32:48
  SPEAKER_03: Don't you think and you've also started to become known as that person that people go to if they're looking for jobs, if they're thinking about doing logos, if they're exploring, or if they suddenly find themselves out of a job and have to go into the marketplace and find a place to work because there aren't jobs available, you're becoming the person that they call, right?
• 33:23
  SPEAKER_00: That's true.
• 33:24
  SPEAKER_03: Um what's that like?
• 33:28
  SPEAKER_00: It's uh it's an interesting it's an interesting feeling.
• 33:32
  SPEAKER_00: Um again, because coming out of training, you are the type of person, or you're you're usually the one that is seeking help.
• 33:41
  SPEAKER_03: Subjugated.
• 33:43
  SPEAKER_03: And not I can say whatever I want.
• 33:45
  SPEAKER_03: He has to be a little more careful, but I have complete freedom of speech.
• 33:49
  SPEAKER_03: So, you know.
• 33:50
  SPEAKER_00: But you're you're you're typically subjugated.
• 33:55
  SPEAKER_00: Seeking help.
• 33:57
  SPEAKER_00: Um but now it's starting to kind of get to that point of where I also have something to offer that other people uh would find useful.
• 34:09
  SPEAKER_00: And it's uh it's a nice feeling of being able to help someone, um, but it's just it's a new feeling too.
• 34:19
  SPEAKER_03: What are they asking?
• 34:20
  SPEAKER_03: Like when people reach out to you, because sometimes it's strangers, sometimes it's former attendees, sometimes it's peers and colleagues.
• 34:28
  SPEAKER_03: But what are they asking you?
• 34:29
  SPEAKER_03: What why do people call you in your less than one year out of fellowship?
• 34:35
  SPEAKER_03: Why are people calling you for career advice?
• 34:39
  SPEAKER_00: Because a lot of times it's either you know they are inquiring about one of the places that I've been to kind of know what it's like there, um, or they're asking about non-traditional routes and what you know certain kind of the climate is like, you know, going down these pathways, um and basically just kind of people come to you to get a lay of the land as it stands, you know, in the places that you've been.
• 35:17
  SPEAKER_00: And so that's kind of the the reasons that they reach out.
• 35:22
  SPEAKER_01: Did you ever imagine that that would happen to you?
• 35:28
  SPEAKER_00: Not necessarily at this stage in my early career.
• 35:34
  SPEAKER_03: You must be doing something right.
• 35:38
  SPEAKER_00: I'm doing something.
• 35:39
  SPEAKER_03: He's doing something.
• 35:41
  SPEAKER_03: All right.
• 35:42
  SPEAKER_00: Whether I'm doing something right, that's for other people to decide, but I'm doing something.
• 35:46
  SPEAKER_03: Well, you're saving lives, you're working at hospitals all across the country, he's making twice as much money as he would if he was employed.
• 35:54
  SPEAKER_03: Think about that for a minute.
• 35:56
  SPEAKER_03: And people are coming to you because they respect you and they value what you have to say.
• 36:02
  SPEAKER_04: True.
• 36:03
  SPEAKER_03: And they're begging you to help them.
• 36:06
  SPEAKER_04: True.
• 36:06
  SPEAKER_03: You've been begged to help people on more than one occasion.
• 36:12
  SPEAKER_04: True.
• 36:12
  SPEAKER_03: To the point of escalating beyond the clinical leadership chain to the administrative and hospital and departmental leadership chain.
• 36:22
  SPEAKER_03: That's how valuable and sought after you are.
• 36:30
  SPEAKER_00: I can't.
• 36:32
  SPEAKER_03: I was right.
• 36:34
  SPEAKER_03: So enough about you.
• 36:37
  SPEAKER_03: Let's talk about me.
• 36:38
  SPEAKER_03: So you are a neurosurgeon, but you're also the spouse of a digital health tech startup founder who has quite literally never worked in mainstream healthcare.
• 36:48
  SPEAKER_03: That's not true.
• 36:49
  SPEAKER_03: I I worked like for five minutes in mainstream healthcare after leaving the military, you know, before quitting mainstream healthcare.
• 36:57
  SPEAKER_03: I did one shift per six weeks per year and a half.
• 37:04
  SPEAKER_03: I did, I did that like ten times.
• 37:06
  SPEAKER_03: I did like 10 shifts in real world medicine.
• 37:09
  SPEAKER_03: So that counts.
• 37:11
  SPEAKER_03: But what was it like for you when we met and you're like stuck in your like rigid, you know, traditional, paternalistic, patriarchal.
• 37:19
  SPEAKER_03: I'm bad limiting.
• 37:21
  SPEAKER_03: He's never said any of that.
• 37:22
  SPEAKER_03: This is just me.
• 37:23
  SPEAKER_03: He's never said that.
• 37:25
  SPEAKER_03: He doesn't think that, he doesn't believe it, he wholeheartedly disagrees with me.
• 37:29
  SPEAKER_03: I'm just saying that like it can be rigid, traditional, patriarchal, prejudiced against people who are dios.
• 37:38
  SPEAKER_03: My words, not his, just saying.
• 37:40
  SPEAKER_03: Um, but what was that like for you meeting me who's entirely a horse of a different color, to use a Wizard of Oz analogy?
• 37:50
  SPEAKER_03: What was that like for you?
• 37:53
  SPEAKER_00: I think it was interesting.
• 37:54
  SPEAKER_00: I think it was cool and fun to watch from from the sideline.
• 38:00
  SPEAKER_03: And then I got my hooks in you.
• 38:02
  SPEAKER_00: Yeah.
• 38:03
  SPEAKER_03: And then it became more interesting.
• 38:06
  SPEAKER_00: I mean it's it's uh it's still interesting.
• 38:08
  SPEAKER_00: I think it's still interesting to I I think it's still interesting to watch the again that non-traditional route.
• 38:19
  SPEAKER_00: It's been interesting to watch the business, you know, the business kind of administration and healthcare administration type of just career trajectory and just everything that goes into it, and also then the aspect of kind of having your own business and um your own startup.
• 38:40
  SPEAKER_00: And I mean, there's so many components of it.
• 38:43
  SPEAKER_00: Uh, it's just been a very unique and interesting and gratifying experience to kind of get to see all of this, right?
• 38:53
  SPEAKER_00: I mean, you even the less than ideal moments of it all, which there are plenty of them, but it's it's it's an interesting journey to be on.
• 39:05
  SPEAKER_03: Yeah, we've had like more, we've had more less than ideal moments since I met you than we've had ideal moments.
• 39:12
  SPEAKER_03: I mean, what is an ideal moment?
• 39:14
  SPEAKER_03: We've had like sabotage, blackmail, extortion, bribery, federal fraud, theft.
• 39:28
  SPEAKER_03: I mean, I even got defamed, you got defamed, that happened.
• 39:34
  SPEAKER_03: You got defamed because of me.
• 39:35
  SPEAKER_03: Yep.
• 39:36
  SPEAKER_03: Yeah, you got defamed.
• 39:38
  SPEAKER_03: Um, yeah.
• 39:39
  SPEAKER_03: It's been a lot.
• 39:41
  SPEAKER_03: Yeah.
• 39:42
  SPEAKER_03: Misrepresentation.
• 39:44
  SPEAKER_03: Should actually make a list.
• 39:45
  SPEAKER_03: I should make a list and keep it in my pocket and just like read about it.
• 39:48
  SPEAKER_03: Like these are all the things that have happened business-wise, right?
• 39:52
  SPEAKER_03: But to go back to the previous conversation, like how was that received by your peers, by the people that know you, by the people that are in your inner circle that you network and rub elbows with at the conferences, which, dude, there's so many of them, I can never remember all their names.
• 40:07
  SPEAKER_03: But how has that been received by the people in your niche?
• 40:13
  SPEAKER_00: In the sense of like, when these things happen to me.
• 40:16
  SPEAKER_03: When they figure out who I am and what I do, and the fact that we're together, like, that's gotta be weird.
• 40:21
  SPEAKER_03: I mean, most neurosurgeons' wives are definitely not digital health tech startup founders and industry pioneers and innovators, like most of them kind of probably defer to the neurosurgeon as the prominent career of the family.
• 40:39
  SPEAKER_03: So, how has that been received by your peers and superiors?
• 40:43
  SPEAKER_00: I think people get interested because again, just like for me, um, it is a well, I think just like it was for me at the beginning, it it's it's something very out of left field for what we are used to.
• 41:01
  SPEAKER_00: Um and so it's interesting and kind of like, whoa, this is like strange.
• 41:06
  SPEAKER_00: It's weird.
• 41:07
  SPEAKER_00: Um and you know, obviously now for me it's I mean, this is the norm, and like I under, you know, this is what I come to expect.
• 41:16
  SPEAKER_00: Um but for other people it's I think it's still kind of uh interesting, like, ooh, what's going on?
• 41:23
  SPEAKER_00: Like this is something, you know, there's got to be something juicy, something gossipy, or something like, you know, it it's it's unique and strange and exotic, maybe when other people look at it from the outside.
• 41:39
  SPEAKER_00: Um but for me now it's kind of it's still every day, still brings something new, um, but it is there is a component of it being um an expected unexpected every single day.
• 42:01
  SPEAKER_03: Expect the unexpected, or what we say, get comfortable being uncomfortable.
• 42:06
  SPEAKER_03: Yeah, that's true.
• 42:06
  SPEAKER_03: It's it's a life of uncomfortableness.
• 42:09
  SPEAKER_03: Yes.
• 42:09
  SPEAKER_03: It's it's gonna take us probably 10 years to really be comfortable because that's how long it takes to produce that kind of comfortable lifestyle doing what I do, which is being a digital health tech founder.
• 42:20
  SPEAKER_03: Yeah.
• 42:21
  SPEAKER_03: Yeah, that's fair.
• 42:22
  SPEAKER_03: Yeah.
• 42:23
  SPEAKER_03: But as someone who is a partner, a fiance, a boyfriend, a spouse, a baby daddy of a digital health tech startup founder, I mean, what do you think?
• 42:39
  SPEAKER_03: Like, what what do you think are some of the unique skill sets or key differentiators that sets you up for success in being in a relationship with me?
• 42:50
  SPEAKER_03: Because it's hard.
• 42:51
  SPEAKER_03: It's hard being the spouse of an entrepreneur, a startup founder, working in the health tech industry.
• 42:56
  SPEAKER_03: Like, that's a lot.
• 42:58
  SPEAKER_03: So talk to me about what sets you up for success as the supporting role in this relationship.
• 43:11
  SPEAKER_00: I mean, I think that one of the things that has definitely helped is that for us, when I say us, I mean those that go through surgical specialties, we're consistently throughout training.
• 43:29
  SPEAKER_00: We go through this idea of we're never available, we're always in the hospital, we're always working, and our families will never really see us.
• 43:38
  SPEAKER_00: And wait, what we have children we didn't know about.
• 43:40
  SPEAKER_00: What children?
• 43:41
  SPEAKER_00: Yeah, exactly.
• 43:42
  SPEAKER_00: Um, I don't even know their names.
• 43:43
  SPEAKER_00: Oh, yeah.
• 43:44
  SPEAKER_00: But you go through this.
• 43:48
  SPEAKER_03: We have a lot of children, by the way.
• 43:50
  SPEAKER_03: There's a lot of children.
• 43:51
  SPEAKER_00: But you go through this entire thing of you don't really um, you know that your time is not always going to.
• 44:00
  SPEAKER_00: Your own.
• 44:01
  SPEAKER_00: And when you are dating people and are meeting someone, a lot of times part of the difficulty is that other people don't really understand that sort of a lifestyle and that sort of a sacrifice.
• 44:20
  SPEAKER_00: But I think that in this situation your role for different reasons, but still requires a very similar type of a sacrifice.
• 44:30
  SPEAKER_00: And I think this was kind of more of a, you know, like begets like, and you kind of understand that sort of similarity where your time isn't always your own.
• 44:49
  SPEAKER_00: And so I think because I, and my career path rather, requires that of whoever I'm with, I think that it is I need to be in the exact same that I am just as understanding with that idea reversed.
• 45:10
  SPEAKER_00: Um, and I think that's actually been one of the most helpful um aspects of everything.
• 45:18
  SPEAKER_00: Um, because it's true that I think since the day that you and I have met, there has not been a day that you have been able to disconnect from your phone or from your email.
• 45:33
  SPEAKER_00: Even in the best, I mean, even on vacation in Mexico or wherever, like you've never actually been able to disconnect.
• 45:42
  SPEAKER_00: Um I can't.
• 45:44
  SPEAKER_00: And yet.
• 45:45
  SPEAKER_00: You won't be coming.
• 45:46
  SPEAKER_03: It's coming! I'm going to do it.
• 45:48
  SPEAKER_03: I'm going to disconnect.
• 45:49
  SPEAKER_03: I'm going to do it.
• 45:51
  SPEAKER_00: Yeah, no.
• 45:52
  SPEAKER_00: Um, you're only fooling yourself.
• 45:54
  SPEAKER_00: But but that but that's the thing, right?
• 45:57
  SPEAKER_00: Is I think that was one of the things that made this um at the beginning, and even now, still uh, that has always made it like a mutual understanding, um, and made that process easier because it is daunting and eventually I think that that's one of the things that wears on people the most.
• 46:25
  SPEAKER_00: Um, but when you both have that sort of similar understanding, uh I think that it makes it easier.
• 46:36
  SPEAKER_00: It's still difficult, but it does make it easier to you know to manage together.
• 46:42
  SPEAKER_03: But it's okay.
• 46:43
  SPEAKER_03: Okay, I I I agree with you completely, but I've never once, and I think that you would agree, I have never once in three years felt like work your work is more important than me.
• 46:59
  SPEAKER_03: And I don't feel like my work is more important than you.
• 47:02
  SPEAKER_03: I don't feel like my work is more important than the kids.
• 47:05
  SPEAKER_03: It's just that the level of duty, responsibility, loyalty, and commitment that we choose to sign up for for like for me, I would say my clients, my employees, my patients, my staff members, and for you, your medical teammates, your facilities that you're contracting with, your co-attendees that you're operating with, your APPs, your patients, whoever, it's that we place such a high value on the duty and the values and the qualities that are involved with that, that it's not more important than, but it is very important.
• 47:50
  SPEAKER_03: And sometimes the time with the job displaces the time with the family because that sense of duty, responsibility, loyalty, integrity is so strong that we have to continue showing up, even if it means we don't show up again.
• 48:10
  SPEAKER_02: Thank you for tuning in to the I Am Wiser podcast, where each episode brings us closer to a wiser, more human approach to healthcare.
• 48:19
  SPEAKER_02: If today's conversation inspired you or sparked new ideas, share it with someone who's ready to rethink healthcare.
• 48:26
  SPEAKER_02: And if you have a story or innovation that could light the way for others, reach out.
• 48:32
  SPEAKER_02: We'd love to hear from you.
• 48:33
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• 48:35
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• 48:39
  SPEAKER_02: Until next time, stay curious, stay courageous, and stay wiser.