Latest / In the Valley of Giants / Healing Angels, Saving Demons | Dr. Todd Zalut | ITVOG Ep. 16

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Healing Angels, Saving Demons | Dr. Todd Zalut | ITVOG Ep. 16 · In the Valley of Giants

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It's common, especially after October 7th, October 7th, there
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were many, no, not a small number of terrorists that were
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arrested and and captured and they had medical issues.
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They were building a big shift bomb and the bomb exploded in
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their hands. Since they had all sorts of
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different injuries to their hands there there is a wide
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spectrum of medical problems that terrorists and people from
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different jails can come to the emergency department to seek
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care. And the answer I one of my sons,
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when he was in high school, they had a Shabbat for the parents
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and and so they asked me to talk about the issue over the
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Shabbat. And I said.
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Hello everyone. We have a very exciting guest
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today, Doctor Todd Zalut. Doctor Todd Zolot is a
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pioneering emergency medicine specialist who served as
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Israel's first residency trained physician in the field and has
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led the Department of Emergency Medicine at Shahrizadic Medical
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Center since 2003. His extensive background in
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public service includes 17 years of reserve duty in an airborne
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rescue unit, service on the medical team for the President's
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office, otherwise known as the Bay Tennessee and a deployment
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to the field hospital on the Syrian border.
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A dedicated architect of community based care, he
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developed a salt system in Guschetzion and continues to
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advocate for medical accessibility through the
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development of affordable, critical and essential life
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saving emergency equipment. We hope you enjoyed the
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conversation today. OK Doctor salute.
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Thank you so much for being with us here today.
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My pleasure. Thank you for inviting me.
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It's very exciting for me. I feel like there's a lot that
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we can all learn from you. Thank you.
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Thank you. I'm quite sure, but we'll see.
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We'll find out right now. OK.
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The first thing I wanted to talk to you about is I especially I
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think it's true in any generation, but especially this
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one. Stress is something that we
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don't deal with well. I don't think humans ever have.
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But now we have a tons of escapes.
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We have Netflix, we have video games, we have Tik Toks and
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YouTube and whatever people are super interested in this days.
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We're really good at at running away from issues.
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As someone who is the doctor that manages all the other
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doctors in the ER, so you're going to know stress management
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I think better than anyone else. So what is it like working in
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such a high stress environment and what do you do to cope?
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So first I have to give you a little background.
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My training is in emergency medicine.
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That is what I trained in when I finished my medical school
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training. And that's what I've done for
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the last 40 years. So that's what I know, that's
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what I do every day, almost every day.
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And so for me, I have different kinds of stresses.
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For me, I get a lot less stressed when I'm taking care of
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a patient who's critically ill or I'm resuscitating them,
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because I do it so often and because.
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You're less stressed, you're resuscitating someone in your.
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I'm less stressed and in parentheses.
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I would just say that part of what makes Chariotic different
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from other hospitals and the emergency department of
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Chariotic is I put a big emphasis on the fact that my
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residents and my young doctors have to spend a lot of time in
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the ICU setting in the cardiac care setting.
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So they know how to take care of critically I'll patients.
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Though I say to them time after time after time, I want you to
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be able to take care of these patients without your pulse
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getting up, without your blood pressure rising.
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What makes me nervous is having to talk in front of cameras and
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having to talk in front of people.
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I get a lot less nervous when I'm taking care of patients and
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and even critical care of patients frequently, even in the
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field, in the field where my resources are a lot more
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limited. That can make me a little bit
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more stressed. But my family gets a big key out
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of the fact that I get stressed over different kinds of things.
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And that's really the bottom line, is that people get stress
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over different kinds of things and you have to learn how to
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deal with it because it's part of life.
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It's not just part of life here living in Israel, which is very
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stressful from the get go, but it's also part of life.
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Wherever you are, there's going to be stresses.
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There's stresses in interpersonal relationships,
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there's financial stresses, there's social stresses, there's
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work stresses. There's all sorts of different
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kinds of stresses in life and people have to deal with them
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and everybody finds their own way.
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Many people find it through hobbies, many people find it
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through exercise. Everybody has to find, I don't
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think there's a one cure fits all for stress, but it's been
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very interesting to me over the years to understand that people
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are stressed over different things.
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And what I find very stressful, my kids laugh at.
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They think, you know, that's nothing.
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And what they find very stressful for me is is less
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stressful. So let's, let's actually, I'll,
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I'm just going to break that down into two things that you
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said. So, so number one is for the
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example of that you gave of resuscitating a patient, you
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don't find that stressful. So I want to talk about that for
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a second. But also you also said that
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there are other things that you stress you out and then there's
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going to be stress, your own stress management there.
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So the first thing I want to talk about is resuscitating
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someone. How can you not find that
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stressful? And I don't say that in an
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accusatory way, but like, this is this is your job.
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It's something you've been doing for many years.
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And maybe I should also be asking doctor salute from 40
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years ago. But but but in a such a high
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pressure, high stake moment, why are you calm?
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Or how can you be calm? How, how, how do you construct
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the debt philosophically, whatever it is in your head that
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you're at peace at that moment? Well, first of all, you have to
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feel comfortable with the medicine.
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So you have to feel comfortable taking care of patients who are
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critically I'll. You also have to understand what
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tools you have to better understand why they're
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critically ill. And once you better understand
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why they're critically I'll, the treatment then follows because
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you have plus minus the not always the specific diagnosis,
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but you know the direction that you're going in.
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For example, a person who is being resuscitated after having
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a high fever and having a low blood pressure measured in the
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field and you know that they're probably have overwhelming
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infection that goes down path. A person who is a 5650 sixty
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year old person with different cardiovascular risk factors was
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seen clutching his chest and collapses.
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That goes down pathway B. But pathway A&B are very clearly
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defined and they can take you in different directions.
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As the results of the blood tests come back, as the results
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of the X-rays and that different imaging studies that we can do,
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the bedside ultrasound, whatever it's going to be, we have a lot
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of tools at our disposal in order to better understand
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what's happening to the patient. And once you better understand
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what's happening to the patient, then the treatment is a clearer
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path. Is that because of confidence,
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like you know that you're doing the right thing to the patient
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at that time? Well, you don't always know that
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you're doing the right thing. You.
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You. That would stress me.
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Out there is something like a gestalt, there is the Gestalt
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and there is the clinical. She called that the clinical
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decision making process. So you don't always know, You
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don't always know that you're doing the right thing, but
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you're doing it in a logical sequence.
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And so you're being presented with a certain picture and then
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based upon that picture, you decide AB and C.
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And as you do AB and C, you may get results and it may take you
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down a different pathway, but that's all part of the process
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and you learn after a while. First of all, it doesn't help to
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get stressed out and B, that you have to keep your head about you
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and you have to understand what everybody's doing because you're
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doing it as a team. And when I'm recessing somebody
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and I'm directing the team, I'm literally directing the team.
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I'm telling this person to do that.
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You're so busy and you're so caught up in what it is that
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you're doing that you don't really have time to think about
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the fact that it's life and death and the fact that that
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you're, you're the one that's directing traffic.
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It's a, it's a busy time and you have a certain number of people
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that you're directing and you're telling them what to do, give
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medicines, do CPR, check this, check that.
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And you don't really stop and think, well, this person's life
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is in the balance it, it's understood, but it's not really
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something that comes to the forefront of your consciousness.
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You're too busy taking care of the patient.
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Does that bleed into any other part of your life?
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Meaning, can you, can you be so busy that you're not going to be
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stressed out of something else that's going on in your life at
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the same time? So I don't know if you're aware
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of this, but many people will say that men do not multitask.
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And I always say that no doctors in the emergency department,
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even the men, the male doctors can in fact multitask.
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But I, I don't, I think that you do get tied up in things.
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You can get so tied up in something that you're seeing the
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tree instead of the forest, but frequently you have people
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around you that bring you back to reality and bring you back to
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seeing the total, the whole picture, or seeing the
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individual tree, whatever you may be missing.
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Lots of times people will bring you back down to reality and
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help you to see what it is that you're supposed to be seeing.
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But I'm trying to figure out, I'm trying to get to why and
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such what someone else like myself would find the most
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stressful point and perhaps my life resuscitating a patient.
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I remember what I have nothing to do with the medical field,
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but I I remember once just witnessing it.
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I was, I was a teenager and I was going to the store and I was
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picking something up and there was a woman that fell and she
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hit her head and you know, she coded and that, you know, there,
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but there was, it was a huge event, but it was like somewhat
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it was traumatic just to watch that thing.
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So what is it about that situation that is able to get
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you? I'm trying to figure it out to
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be calm. The difference is that you but
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you don't really understand what's happening.
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Of course I don't. So, and that's the difference.
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The difference is that you're seeing all of these people do
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things which may even be painful to the patient, but obviously
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they're doing it with the intent to try to help the patient.
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And you don't really understand and nor does the patient.
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And frequently there is a problem with that, but the
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patient doesn't really understand what it is we're
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doing and why we're doing it, especially with children.
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And they start to fight and they start to resist.
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And that causes a whole different loop of problems.
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But the difference between what you're describing is that you're
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not really understanding what's going on and what the paramedics
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were doing or the doctor was doing or whatever, whoever was
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working on the lady. And that's, that's the
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difference. I remember as a medical student,
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I went to AI, don't know. As a resident, I was a resident
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and across the street from the hospital, they had a fair for
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new cars. And I went with one of my
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attendings, one of my senior doctors, and I was just a
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junior. I didn't really.
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And because he was looking for a car.
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And we went and we saw on the other side of the auditorium a
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huge crowd and we thought there must be a great car there.
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So we went and we ran into a resuscitation and, and the
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senior doctor said, let's help, we're doctors.
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And then it was like the parting of the Red Sea, like everybody
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just split. And we went in and we
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resuscitated the person. But it's it's very scary, it's
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very traumatic for many people. But when you understand what
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everybody's doing and what role everybody's playing, because if
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they really are assigned specific roles most of the time,
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then it's much less traumatic. So then I would say your
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experience is as false, and correct me if I'm wrong, that
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anxiety or stress is having less information on your current
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environment, which therefore makes the next outcomes
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extremely unpredictable. So in that situation that I was
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describing, I was incredibly scared because I didn't
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understand anything and what was going on around me and I didn't
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know was going to happen next. But versus you, who is, you
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know, the doctor with a lot of years of experience under your
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belt, you see a situation and you're like, OK, I see the
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environment. I see all of the variables
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within the environment and I know where it's probably going
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to go. So your your confidence level,
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not necessarily in success or failure, but it's more like I I
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know what the next scene in this movie is.
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Is that it? It's very much, you hit it right
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on the head and it's very much like knowing what the next step
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is going to be. And it could be one of maybe two
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or three or four or five options depending upon all sorts of
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different variables. But you know what those five
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options are, and you know that probably you're going to go down
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one of those five paths. So as the other things that you
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find in life that are stressful, would you say that those are
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things that are dominated by variables that you don't know or
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don't understand? Exactly.
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For me to stand up and give a sheer would be horrific.
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I'd be scared to death I would have to take Valium for a week
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before, but that's because I don't.
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I'm not very good at putting together a sheer, taking it from
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the beginning to the end and driving home the points that
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need to be driven home. Right.
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It's because I have a better understanding, better training
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and better more experience. In those situations when you
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don't know what's going to happen next, is there a method
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that you use that you find is able to alleviate a lot of that
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stress, or is it just knowledge? So a lot of it depends on how
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fast things are happening. Sometimes you just have to close
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your eyes, take a couple deep breaths and plunge ahead.
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Sometimes you don't even have the opportunity to take a couple
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deep breaths and close your eyes.
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You have to just plunge ahead. Sometimes you have a couple days
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before decisions have to be made and before you have to have
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certain conversations. And so you can think about it
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more and you can relax a little bit and go into the hobbies and
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do your hobbies and try and take your mind off of it and think a
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little bit more about other things and other people and
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things that are maybe more important, maybe less stressful.
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Is that what you would teach people that are trying to to
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figure out stress and manage it? I think hobbies are extremely
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important. I think people can participate
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in different endeavours and I think that helps a lot of people
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to relax. I think a lot of it depends upon
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what is causing the specific stress, but I think they're
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everybody has to find their own little outlet and their own
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different way to release stress. Some people find it by running
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or bicycling. Some people find it by just
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walking out the door and screaming.
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But everybody has to find their outlet.
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And then once they do, the reintroduction of that stress
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should be like a learning process to alleviate the entire
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situation in general. So again, you have a little bit
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more of confidence of maybe where the situation is going to
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go. Does that make?
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Sense. So when you learn from your
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experience, then the next time you encounter the problem,
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you're going to be less stressed because, well, I've been here,
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done that. You can't always learn from your
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experiences. We try to, but we don't always
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learn from them. But certainly that's that is 1
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long term method to help deal with stress.
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Short term method, yeah, I think you have to find other ways.
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In in the ER setting, have you ever had doctors where they just
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weren't so great at managing stress and they had to go, they
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just couldn't learn it? There's a lot, first of all, in
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most emergency departments in the Western world, you have
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doctors who are medical medical students, you have interns, you
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have young residents from different specialties that
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rotate through. So you have a lot of people who
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are coming and, and working on any given day.
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And a lot of people have difficulty with the stress.
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And at the end of the day, they most of the time choose a
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specialty that's less stressful and and that's good, that's good
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for them. OK, so I want to pivot a little
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bit and talk a little bit about evil, evil, evil.
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So my brother, I'm OSHA, so he's an ER doctor in in Baltimore.
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And I always found it interesting.
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I'll say it this way. Everyone wants to ask a doctor
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in Aritis in Israel what's it like to take care of a patient
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who you know, is a terrorist, OK, who wants to kill you or
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harm you? And I think it's a very
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important question, but I don't think it's a fair question to be
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just asking doctors in Israel. I think that that there are ER
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doctors, doctors in general all over the world.
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And by the way, psychologists and psychiatrists as well, that
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you have to treat patients that you know are is the aggressor in
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any particular situation. And then that's a very, very
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difficult thing to do as people that aren't caregivers.
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We have no idea what that's like because we never are.
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We never have that sort of challenge.
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So So what is that like? What's it like helping someone?
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It doesn't necessarily need to be a terrorist, but inclusive in
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them as well. The terrorist is a good example.
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Yeah, it is so. Have you had that experience?
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Yes, yes, we, I think any doctor in any emergency department in
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this country has had that experience, but especially in
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Jerusalem, because if you look to see what's happened in the
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State of Israel over the last 75 years and in Palestine before
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the creation of the State of Israel, there was not a small
16:38
amount of terrorism. And when you look on a
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countrywide level, there have been more incidents in Jerusalem
16:44
than any other place in the country.
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So especially doctors in emergency departments in the
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city of Jerusalem have all had to take care of terrorists.
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It's that common? It's common, especially after
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October 7th, October 7th, there were many, no, not a small
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number of terrorists that were arrested and and captured and
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they had medical issues. They were building a big ship
17:07
bomb and the bomb exploded in their hands.
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Since they had all sorts of different injuries to their
17:11
hands there, there is a wide spectrum of medical problems
17:16
that terrorists and people from different jails can come to the
17:19
emergency department to seek care.
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And the answer I, one of my sons, when he was in high
17:27
school, they had a Shabbat for the parents.
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And, and so they asked me to talk about the issue over the
17:34
Shabbat. And I said, not sure how much it
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really is interesting to people, first of all, but many doctors,
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not all doctors took the Hippocratic Oath.
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And I did not take the Hippocratic Oath.
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We were not even asked to take the Hippocratic Oath in my
17:48
medical school. But if you take the Hippocratic
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Oath, then in theory you're obligated at some level to take
17:53
care of anybody who comes across your door at a more logical,
18:02
down to earth level. The logic is, is based on two
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points. 1 is that there was a, there was a incident in
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Jerusalem 25 years ago, I want to say plus minus during a wave
18:16
of terror attacks. That was the Intifada.
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And there was a bus that exploded.
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No, I don't even think it was a bus.
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I think there was there was a Pigou.
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I don't remember what the Pigou was, but everybody marked a
18:28
certain person as the terrorist. So when the paramedics arrived,
18:32
they were told that person over there is the terrorist.
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And in fact, he wasn't he was a Jewish victim and his care was
18:38
delayed because everybody thought he was the terrorist.
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And so they treated him last. And Bolton, he survived and he
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lived in the tale. But that tale is a is a common
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answer to the question is how do you know?
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Like if you don't know who the terrorist is or you do know who
18:55
the terrorist is and you think you know where the terrorist is,
18:57
you're not always 100% correct. And the other point is that the
19:02
Shabak takes these guys and gets information out of them to
19:06
prevent the next terrorist attack and to nab the guy who
19:09
drove him to wherever it is he did the terrorist attack so that
19:13
he can't drive somebody else in another week, month or year.
19:17
So there's a lot of rationale behind it that if I help this
19:21
person today and he survives, it could be that the information he
19:24
gives to the Shabak will help prevent another attack.
19:27
Yeah, but he doesn't need his hand or his right leg to do
19:29
that. Correct.
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But if if you don't save the hand or you don't save the leg,
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then he's at risk for infection and he's at risk for sepsis and
19:38
at risk for for dying from the complications of that.
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So you don't always know, again, where it's going to take you.
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And so you treat the terrorists because at the end of the day,
19:50
you're hopeful that you'll be able to stop the next terrorist
19:53
attack. Has all your years doing that?
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Have you ever asked yourself, should I have done that or you
19:57
never? Especially, oh, after October
19:59
7th, for sure, for sure. We had a lot of debates in the
20:02
department about it. We.
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What came out of those debates were some of the arguments.
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Well, the arguments are exactly as you were saying, that the
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nurses and the doctors had husbands, sons, brothers,
20:16
fathers. Everybody was off in the army,
20:18
off in Gaza fighting, and you never knew who was going to come
20:22
home. And we all went through that
20:27
experience. And to know that you're taking
20:31
care of a terrorist who an hour ago yesterday, a week ago, was
20:35
trying to kill your loved 1 is very, very challenging.
20:39
And we had a lot of discussions about it on the level of the
20:43
head of the hospital and the rabidim of the hospital.
20:46
And we have Rabbi Steinberg, who wrote the book on on medical
20:50
halafa and ethics. And he participated in many of
20:53
the discussions too. And it was a work in progress.
20:58
And we had many discussions just to complicate things.
21:01
On top of it all, you're taking care of these terrorists and you
21:05
have Arab doctors who are there taking care of them, or you have
21:09
Arab doctors taking care of the soldiers that came in by
21:11
helicopter because they were critically injured.
21:14
It's it's a very complicated issue.
21:15
It's a very complicated environment that you're working
21:19
in. And at the end of the day that
21:23
you have, you know that the Arab doctors are looking to see how
21:26
you take care of the terrorists and you wonder to yourself if
21:31
that is going to affect the way they take care of the soldier.
21:33
That comes in another hour. There's all sorts of different
21:37
thought processes behind the whole discussion.
21:40
And at the end of the day, we realize that you have to take
21:43
care of people regardless. And we went from a system where
21:49
5-6 years ago, we, we get notices on our telephones when
21:53
there's a trauma alert. And it used to be that you would
21:57
get the alert that it was a trauma and there's different
22:00
levels of trauma. It was a trauma.
22:01
And they would, they would write that it, this is the terrorist
22:04
is coming. And we stopped doing that
22:06
because we saw that the staff responded in a totally different
22:10
way. It was a totally different
22:12
environment in the trauma Bay. And now it's just somebody in
22:17
their 20s coming with a gunshot wound or a blast injury or
22:20
whatever. It would.
22:21
Be Do you think that that's right?
22:23
I think it's ethically correct. So then that's right.
22:28
I think it's ethically correct. Have you ever had to excuse a
22:32
doctor because you didn't think that they were doing the right
22:35
job with with a patient because of that issue?
22:38
No. Not a choice.
22:39
No. It's amazing.
22:41
I've had to excuse other, I've had to excuse doctors for other
22:44
issues, but not because of this. But no, not because of this.
22:49
Wow, that's amazing. Yeah.
22:51
Do you think that, oh, so you know, let's shift a little bit
22:54
because a lot of the argument on the other side is, well, the
22:58
Shabbat could use them or etcetera, etcetera.
23:00
What if it's someone that the Shabbat couldn't use?
23:02
Let's take tariffs off the table, you know, let's say a
23:05
murderer or, I don't know, someone of the like.
23:08
Well, yeah, but so the murderer or has not gone through the
23:13
system and not been found guilty yet of his crime or he's gone
23:17
through the system, he's been found guilty supposedly, and
23:20
he's now in prison, serving his time and paying his dues to
23:23
society. So just to give you a little
23:25
background, my father was a lawyer and a judge in America.
23:28
You're a good Jew. And so I actually wanted to go
23:32
into law, but he wouldn't let me.
23:33
But, but he, I had this conversation many times with him
23:38
because he did a lot of public defence work of people who
23:41
couldn't afford lawyers. And many times he found himself
23:45
defending people who he knew were guilty of the crime they
23:48
were being charged with. And I used to ask him all the
23:50
time how, how can you do this? And there were murder cases on
23:54
the list, like, how can you defend this person knowing that
23:57
he committed the crime, he committed murder and you're
24:00
trying to get him or totally off or a lighter sentence.
24:05
And he really believed in the system and he believed that
24:09
every person was entitled to a good defence and that was his
24:13
job and that's what he was being paid for.
24:15
And it really wasn't even an ethical issue for him.
24:18
It was on a level of the system requires this and so this is
24:24
what we do. And in some ways, maybe I
24:26
learned from him and that's really what I'm doing.
24:28
Interesting, interesting. OK, let's pivot a little bit.
24:34
I can't imagine a more nudnik place in the world to be an ER
24:37
doctor. Because Jews are nudnik.
24:39
So yeah, I'm sure we are. What's what's it like taking
24:43
care of predominantly Jewish patients, and especially
24:46
Orthodox ones? Are we especially difficult?
24:50
There are a lot of cultural issues that come into play and
24:55
having trained in Chicago where I trained primarily in three
25:00
different hospitals, none of which were in the Jewish
25:02
neighborhoods in Chicago, so predominantly in my population
25:07
was not Jewish, and then coming to Israel and taking care of a
25:12
predominantly Jewish population. So to I would like to answer
25:16
with two, two points. I'll give you an example.
25:19
A person comes in and he has a certain kind of arrhythmia of
25:22
his heart, his heartbeat, instead of being a normal
25:26
orderly heartbeat, it's erratic. And you want to give him
25:30
medications to try and get his heartbeat back into a regular
25:33
rhythm and also to prevent certain complications from the
25:36
fact that it's now irregularly irregular.
25:41
And he won't let, he won't take the medicines until he talks to
25:43
his rob. And that process of talking to
25:46
his rabbi can take hours because his rob doesn't know that he's
25:50
supposed to be answering the phone.
25:51
And so Plonia Almoni, Moshe Cohen calls his Rob.
25:55
He's in the middle of dabbing. He's in the middle of Ashir.
25:57
He's not going to answer Plonia almoni.
25:58
He doesn't understand that he's in the hospital waiting for his
26:02
suck to get treatment. So it can take hours.
26:07
And sometimes it's extremely frustrating, especially when you
26:09
see certain complications happen as a result of the delay.
26:14
But again, that's part of the it's part of the culture.
26:17
One of the things that my wife and kids have a good time
26:20
laughing at me about is that we're now in, in Israel, 80% of
26:26
the population is Jewish and it's a bell curve, right?
26:30
The intelligence quotient of the population is bell curve.
26:34
And so one of the things that's hardest for me is explaining to
26:38
patient over and over and over again what's wrong with them.
26:42
And they're just not understanding.
26:44
And I thought at the beginning it was because I just wasn't
26:46
explaining it well in Hebrew. But my Hebrew is sufficient now.
26:49
It's not great, but it's sufficient.
26:51
And I understand now that it's just different people are able
26:54
to absorb and understand different things.
26:57
And not everybody can understand the medical issues of what's
27:00
wrong with them. And so at the end of the day,
27:02
you just have to say, you know, this is what you need to take
27:04
this medicine twice a day, get somebody to help you with the
27:07
medicine and follow up with your regular doctor.
27:11
But it's it's two very interesting cultural issues that
27:16
happen not infrequently. Why is that second one a
27:19
cultural issue? Because Orthodox people in
27:21
general are less educated. No, not just Orthodox.
27:24
No, no, no, not. Not related to Orthodoxy,
27:26
related just to the Jewish population within the country.
27:29
Nothing to do. With that, wouldn't that be any
27:31
population in any country? Right.
27:32
But in Chicago, when 90% of the population is not Jewish, it's
27:38
much easier for me to understand that this person opposite me.
27:41
But in in America, the Yidden are at a certain level and it
27:46
was hard. It's still hard for me to
27:48
understand that not all the Yidden in Israel are at that
27:52
level. How do you manage the triage
27:53
with that? Like again, you have a patient
27:55
that needs to speak to Israel or rabbits in first or whatever,
27:58
Like how do you manage that in terms of triage?
28:00
Do you just kick them out of the ER?
28:01
No. No, no, you don't kick them out.
28:02
You, you keep them until they manage to talk to their Rav
28:06
because they need the treatment. You can talk to them and you can
28:09
explain to them, this is what I want to do for you.
28:11
This is why I want to do it. And you can explain to them the
28:14
medications you want to give them.
28:15
You can explain to them the test that you want to do, but many
28:19
times until he talks to the rod and you just have to be patient
28:21
with him and try very hard to make sure that the world doesn't
28:25
collapse around him. Have you ever had patients that
28:27
refuse treatment on religious basis?
28:34
I would word it a little bit differently.
28:35
With your permission, I wouldn't say refuse.
28:38
It's it's not necessarily refusing the treatment that
28:41
you're offering. It's choosing not to take the
28:43
treatment like you can always, you can always offer people
28:48
different avenues. Corona was a great example not
28:51
and it has something to do necessarily with from Kite.
28:54
It has to do with false information that's being
28:59
distributed. It had to do with all sorts of
29:01
different beliefs that people had about conspiracy theories or
29:04
whatever it might be. But many people chose not to get
29:08
vaccinated. Many people chose when they came
29:11
in and we tested them and they were positive for corona.
29:15
Many people refused to go into the immune biologi, we called
29:19
it, where everybody else there was positive for corona.
29:23
So that way they weren't infecting other people.
29:26
And that became a little bit complicated because we couldn't
29:29
keep them in a regular space because they would they would
29:33
infect other people, but they were refusing to go in with
29:36
everybody else. That was a bit of a challenge.
29:40
Is there anything specific to Eric Seestrong that that people
29:45
find it hard to accept certain treatments?
29:47
I'll give you just an example. I I think this is really an
29:51
assumption. I'm going to make it anyway.
29:54
OK. But I think that that people on
29:57
the more Keats on the end of the spectrum might refuse things
30:01
like vaccines in general or the sorts of, I think like basic
30:05
treatment where medical knowledge is pretty up to date
30:08
and there's a consensus about what people should and should
30:10
not be doing. And it's really painful when you
30:12
see the child who has polio because his parents didn't back.
30:15
So can you talk about that a little bit for especially for
30:18
our listeners like what, what, what are, what are some just
30:20
basic things that we're just really just ignoring?
30:23
So I never saw polio in America. Everybody was vaccinated for
30:27
polio. We're in the middle of a major
30:29
measles epidemic in this country because it's.
30:31
Major. It's major.
30:33
Major children have died. We have people.
30:35
Hearing your slime. Yeah, yeah, one, just recently,
30:39
a baby just died recently this week.
30:43
It's it's it's hard. It's it's heartbreaking.
30:47
It's heartbreaking because the child doesn't make the decision.
30:50
It's the parents that are making the decision for the child,
30:52
obviously, and their decision, however they came to that
30:55
decision was not to vaccinate the child.
30:58
And as a result, the child is sick with whatever they may be
31:00
sick with. I never saw polio in America
31:03
until I came to Israel. I saw polio.
31:07
There are just things that that we see not on a daily basis, but
31:12
much more than you would see in other Western countries because
31:16
people and again, it's not always even related to funkite,
31:19
it's frequently just bad decision making process or
31:24
different misconceptions or different taboos within their
31:30
why is. That prevalent?
31:31
I'm trying to figure out why is that prevalent here.
31:35
There was a study that was published in the early 70s, I
31:39
want to say maybe even in the 60s, where the bottom line
31:43
conclusion of the article was that certain vaccines can cause
31:47
children to be autistic. And that study has been
31:51
disproven. And in fact, the author of the
31:54
study later admitted just making it up.
31:56
He just made it up. But that study is still quoted
32:00
on a regular basis by parents who do not want to vaccinate
32:03
their children. And we I yes.
32:06
Do you get it? Why?
32:07
Like I find that confusing? I never understood.
32:09
That I don't understand it. I find myself frequently having
32:13
to step out of the room and take a couple deep breaths, close my
32:17
eyes a couple times before I can continue on the conversation or
32:19
the exam because it's so frustrating that these taboos,
32:24
which are not based on any science, continue because of
32:28
word of mouth and because of false ideas.
32:32
I also don't understand, but I can tell you they're frequently
32:35
young Western people in this country, people who either were
32:40
born in the Western world, Anglo world, or grew up in an Anglo
32:45
family and they still don't get it.
32:49
OK, give me some common ones or people are just not getting it.
32:52
So we have vaccines. What?
32:53
What other what what what? What else is are people just
32:55
stubbornly and arrogantly dismissing?
32:59
Vaccines is the biggie. There's, I don't know.
33:04
That's the one that comes somewhere right now.
33:05
I'm not thinking of anything else.
33:06
What's the way to combat that from the like, how do we it's?
33:09
Education, education, education. And it can't necessarily even
33:12
come from from the medical, medical people.
33:18
It needs to come in the from world, from the rabbanim in the
33:25
different cultures. It needs to come from the
33:27
leaders of those cultures. I'm not going to try and
33:29
identify one specific culture, but but it needs to come from
33:32
the leaders within those cultures.
33:35
They need to understand that most of the time it's the kids
33:39
that pay the price. The babies that pay the price
33:40
for the misinformation and the the mis ideas that they have.
33:46
Yeah. The issue is that I think it's
33:47
dogmatic, meaning I don't. As a teenager, I thought it was
33:50
interesting to watch these debates between, you know,
33:52
Israel versus Palestine and, you know, these really like hot
33:56
button topics, but they're really just a waste of time in
33:58
my humble opinion because it's the same conversation over again
34:00
and neither siders are going to agree with each other most of
34:02
the time. Not only that, but your chances
34:04
of convincing the other people are small, exactly are small.
34:08
But it's a little bit different on the universities now in
34:10
America because there's so many people that are demonstrating
34:13
against us and have so many misconceptions and they really
34:18
don't understand what's going on.
34:20
So there is at some level the ability to change a few people's
34:25
minds out there just based on education.
34:27
I'm not saying there's no value to it, but I'm just saying it
34:29
like I wouldn't address that sort of debate.
34:32
Like if I was sitting with OK, if if someone has a Hologic
34:35
discussion and they sit down with me on the table, OK, and
34:37
I'm going to have a whole lot of discussion them, I disagree with
34:39
their point. I'm very comfortable and
34:40
spending an hour bashing them to the best I can because and no,
34:43
and then me not because I'm not coming from a place of you're
34:46
wrong, because I'm right. It's like you have an opinion.
34:48
I have an opinion. I think my opinion is correct.
34:49
I'm going to try to convince you, but if you convince me
34:51
otherwise, I'll hop to your side.
34:52
Like it's a very honest conversation.
34:54
I feel that there are certain topics.
34:56
I just use it on Palestine as one of them.
34:57
But like vaccines where if you're speaking, it's rare that
35:00
you find an anti vaxxer that says yeah let's I'd I'd love to
35:04
have an open conversation about the topic.
35:05
What would happen if Robin Ian came out and said you should
35:08
vaccinate? Your, I really don't.
35:09
Honestly, I don't think it'd make a difference.
35:10
I really don't think it'd make. I don't think it'd make much of
35:12
A. Difference.
35:13
That's interesting. That's interesting because I
35:15
think it's deeper. I'll give you some examples.
35:18
I'll give you some. It's not the first time that
35:21
I've gotten the question Should I have my kid vaccinated?
35:23
OK, when I get a shy love, should I have my kid vaccinated?
35:25
I know whatever I'm going to say is not going to.
35:27
I always say yes, of course you should, but it's And then I
35:30
don't remember once making a difference.
35:32
I remember once, remember there was there was there was a woman
35:35
that asked me because she didn't believe in medicine.
35:38
And so she said, OK, I'm calling you.
35:39
She asked me the question. I said, yeah.
35:40
And then the father called me the next day and said, you know,
35:43
she thinks that you're really modern.
35:44
So so after she asked you, she's not could you ask this other
35:47
rabbi? And I said no.
35:48
And the reason why I said no, I said because it's going to be
35:50
the same thing. So he said no, I think it'd make
35:52
a big difference. He went and he, you know, went
35:54
the, you know, the level above me and asked that rabbit.
35:56
Of course it didn't make a difference at all.
35:57
And then so when the second round I gave the satin.
36:01
Didn't do anything. And what I'm saying is I think
36:03
it's I think there are again like you said, there are certain
36:06
people that will listen to reason and they are looking for
36:08
some sort of guidance. But there are some people that
36:10
it's just dogmatic. There's nothing that you can do
36:13
to easily sway them. So look, you're a rational
36:17
person. I like to think I'm a rational
36:18
person. Here's an example.
36:19
OK, so once I had a discussion about once I was when I was a
36:23
little bit more knowledgeable, not that I'm any medical, you
36:25
know, professional on any level, but about vaccines.
36:27
So I brought up, I think 5 or 6 studies and which I showed that
36:32
that it was really help not only healthy to take these vaccines,
36:34
but a lot of the, the, the noise that was going on in the world
36:38
was really baseless. I was able to easily use Google
36:43
Scholar for people who want to use it.
36:44
It's an excellent resource. But in any event, so the other
36:46
person said no, those, all of those from like 5 or 6 different
36:50
scholarly journals, all of those doctors in these peer reviewed
36:53
studies, they're all from people that have agendas.
36:56
So they're not going to tell you the truth, right?
36:59
So they're going to actively lie to you.
37:00
And what like, So what influence am I supposed to bring to the
37:03
table then? Because whatever I'm going to
37:04
bring to the table, I'm not a doctor.
37:05
So if I'm a doctor, just going to say that I'm lying.
37:07
And if I'm not a doctor, I'm going to quote some sort of
37:09
scientific study. You're going to say that those
37:10
doctors are not telling the truth.
37:11
See what I mean in terms of dogmatic?
37:13
Then there's no way you can win. Yeah, I, I wonder if have you,
37:17
have you had an experience you've been able to, yes,
37:19
convince the parents to do something else?
37:21
It's, I just feel like it's, it's really.
37:23
Almost always if they're. If they're from, I almost always
37:27
send them into a Rev. Do you find that that helps?
37:30
Sometimes OK, sometimes. I just feel like that that's
37:33
accessory should be 99.9% and I feel like it's 20.
37:36
A lot. I find a lot of it has to do
37:38
with the person, the parents connection with the Rav.
37:41
Like if the parent has a really tight connection with the Rav,
37:44
then the chances of success are much greater.
37:48
If if they go to a Rav that they don't really know, they don't
37:50
really have a Ke$ha with, he's just, he's a, he's a big quote,
37:54
big Rav and they just go and they ask the Rob, then I think
37:58
it's less likely. But if they go to somebody who
38:00
they have a personal connection with, I think the chances are
38:03
better. I mean, my success has been
38:04
better with those. Parents that haven't listened
38:07
and they've God forbid lost a child or child doesn't mean
38:11
whatever it is. Do they wise up afterwards?
38:14
No, really. Because it's a national mind.
38:17
Really. And you've seen that?
38:18
Yeah. Has there been one parent that
38:20
that's. No, most of them are just like.
38:22
The truth is that I don't, I haven't spent a lot of time
38:24
going into deep I I try to not address that issue.
38:30
It's already too late, right? I mean, it's not too late for
38:32
the next child. Yeah, but for the person in
38:35
front of me, for the child in front of me, it's already a done
38:39
deal. So I don't, I don't delve into
38:42
it deeply. But even what you do see, I just
38:44
find that so shocking. But yet it makes sense.
38:47
Like they're usually they say it's Amina Shamim.
38:49
I just, I don't see Hazal signing up to that.
38:52
It's hard, it's really hard. But you and you see, there's
38:57
different examples like the person with the heart arrhythmia
38:59
who frequently will suffer as a result of the delay because he
39:06
has to check with his Rob because he has to do this that
39:09
or the other people suffer and then they they have a price to
39:14
pay and they almost always say that's be a national life.
39:17
And that's why I think that there's a mistake and people
39:19
think people think that following halacha means that
39:22
they're very religious, which I don't think is true.
39:26
I think, I think halacha is, is way of God's way of giving us
39:30
guidelines and boundaries for us to follow him as a king, right?
39:33
But they're they're not a means to an end.
39:36
Underneath the halacha is an infinite amount of layers of
39:39
wisdom and understanding of God's knowledge, which we're
39:41
never going to completely get to.
39:43
If you're focused on observing Yom Kippur because it's a law
39:47
and and and observing laws is what makes you incredibly from.
39:50
So if a doctor tells you that you have to eat or drink, you'll
39:53
find like a conundrum because it feels like it's either God or
39:58
this right? However, if they're a deeply
40:01
religious person that like they they understand Rutzena, Karach,
40:04
Baraho and what the heart of the Torch trying to tell them,
40:06
Musser and Ashkafa, it's never a problem.
40:10
But I would hope that that Medicine and Halafa are always
40:13
in line with each other, like they should never be a conflict.
40:16
They definitely used, you know, it's clear to me that that
40:20
Khazal were up on the latest of medical knowledge 2000 years ago
40:24
or else they wasted a heck of a lot of time telling us about all
40:26
these like weird neonomedical stories.
40:28
You know, they don't teach medicine in pedarum now, right?
40:31
But so back it was, it was a major part.
40:34
And yes, all they were using leeches and a whole bunch of
40:36
other things back. That's because up on the latest
40:38
2000 years ago, if Rebbe Akiva was alive today, I don't see him
40:43
using leeches. You know what I mean?
40:44
No. And it should be the same thing.
40:46
You know, just like Rabin, we're up on the latest of technology,
40:49
just they don't have to use it just to be aware of it, to
40:52
understand, to understand the right and medicine the same
40:55
thing, you know now. So I remember when we were
40:58
bringing computers into the emergency department, Acharya
41:00
Sedek and we brought the rabbanim in to see exactly how
41:03
it was working. And they were asking all the
41:04
different kinds of questions about how it's going to work and
41:07
what's going to happen on Shabbat.
41:08
It for me, it was fascinating. And and then at the end of the
41:12
day when they give their suck that obviously, especially in
41:15
the emergency department, it's all pikuak net vision.
41:17
So. Like, like people that know me
41:20
know I'm very against like intranet for young kids.
41:23
And I don't think most people should have smartphones unless
41:26
they're married and, and professionals and even with
41:29
like, but at at the same time, you need to know you just have
41:32
basic knowledge. You have to have basic medical
41:34
knowledge, basic technological knowledge.
41:36
Or listen to the people who do when they come and advise you
41:40
on. For sure.
41:41
Absolutely. Like, I don't really expect a
41:43
lot of people to have a lot of knowledge about the disease
41:46
process that they're that they're suffering from.
41:49
But when the doctor comes and explains it to you and says,
41:51
this is what we think you should do, then you could say, OK, I
41:54
want a second opinion. Maybe I don't need the surgery.
41:56
Maybe I don't need this medicine.
41:58
You go get a second opinion and the second doctor tells you the
42:00
same thing. At some stage you have to relent
42:02
and you have to say, they really do know more than I do about
42:05
this. It's just like coming and asking
42:07
a lot of Shiloh, like, you know, the luck much better than I do.
42:11
And so I'm going to come and ask you a question and I'm going to
42:14
listen to what you tell me. If I go to a financial advisor
42:17
or he, this is, that's his job, that's what he learned, that's
42:20
what he does. So he's going to tell me how to
42:22
invest or what not to do and what he has to do.
42:25
You have to find people and, and at some level trust them to say
42:30
that they know more. They learned more than you did.
42:33
They know more than you and trust them when they answer your
42:37
question. So then I would say that there's
42:38
two ways maybe to help that. Number one is and, and you, you
42:41
said this before, I do think I do think at a younger stage,
42:46
ribonim should be more pro praising doctors and, and by the
42:51
way, praising themselves because also people can get too wise to
42:54
listen to Ribonim at certain points, which is the problem.
42:56
But like respecting teachers, respecting medical
42:58
professionals, technological professionals, I think that as
43:00
ribonim, we can start talking about that not at age 25, but
43:03
you know, younger age as well, to instill in kids that are
43:05
people that you can trust, that are professionals that you can
43:07
trust in general. That's number one.
43:09
But #2 although this is looking for the future, but maybe there
43:12
can be a role in a hospital that literally that persons job is
43:16
after a doctor has explained like, OK, this is the treatment
43:18
that person needs. Then that person's job is to
43:21
just have an open conversation with with the patient.
43:24
And if the patient wants to like debate them, they can say, OK,
43:26
there's this study and we can go through it.
43:27
And I know it sounds like a waste of time, but I really
43:29
don't think it is. Especially with difficult
43:31
patients. Imagine if you had someone that
43:32
that's the role is to just manage, you know, these
43:35
difficult cases and, and kind of slowly walk them towards the
43:38
truth. That would be a great idea.
43:40
So it would be a little bit challenging to build a program
43:43
like that because then that person who comes after the
43:45
doctor is going to have to know the medicine.
43:48
Yeah. And so and they're going to be
43:50
able, they're going to need to be able to discuss it at the
43:53
level of the patient, but with the knowledge of the disease
43:57
process and the treatments and the work up and the testing that
43:59
needs to be done. So that's a little bit more
44:01
challenging. But one of the things that we
44:02
did do at Charred Civic was that we have a group of volunteers
44:07
who are more mature and they've been in the system long, for a
44:10
long period of time. And they know how the system
44:11
works. And they walk around and that's,
44:13
and they do talk to people. They can't talk to them about
44:15
the medicine because they don't have the knowledge.
44:18
But they talked to them about OK, did first of all, are you in
44:21
pain? Did you get something for your
44:22
pain? Did the doctor talk to you about
44:24
your, your problem? Did he talk to you about what
44:26
tests he wants to do, what medicines he wants to give you,
44:28
what treatments he wants to give you?
44:29
And they they do it on their level, not on a medical level
44:33
because they don't have the medical knowledge, but to try
44:36
and interact with the patients to try and see where the
44:38
problems are going to be and try and nip it in the butt, if you
44:42
will. And know that Pony Ammonia in
44:45
room 10 isn't so sure that he needs a the antibiotics for the
44:50
large pneumonia that he has in his chest.
44:52
Yeah, but what if you created, I was implying more like an
44:54
artificial intelligence. What if you were able to train
44:56
artificial intelligence model that was available at hospitals
44:59
that people could access, you know to have that sort of
45:01
discussion. So there going to be a great.
45:03
Idea there are there are artificial intelligence programs
45:07
just for medicine. Really.
45:09
Oh, I was unaware. Open.
45:11
Excuse me one second. Open evidence, it's called and.
45:18
Have you used that? Yeah, I just, I just learned
45:20
about it last week, actually. Oh, really?
45:22
OK, from, from my son-in-law who's a medical student.
45:25
But in the last week I've had the opportunity to go in a
45:29
couple times and I've enjoyed it.
45:31
Really. It saves a lot of time as far as
45:34
searching the literatures for different questions and
45:37
different answers. It just summarizes everything
45:40
right on the spot. Everybody always says that you
45:44
have to be careful with with AI because sometimes it makes
45:47
things up and sometimes. It'll absolutely lie to you.
45:49
And, and you have to check the facts that it's that you're
45:52
being given. But on the big scheme of things,
45:54
it's, it's been much easier. I'm, I'm happened to me that I
45:58
had this whole discussion with my son-in-law.
46:00
The day after, I had a discussion, a heated discussion
46:03
with a director of a different department.
46:05
About what? Well then I can't tell you
46:07
because. Let's be clear what's wrong.
46:09
OK, OK. That's.
46:09
Fine. No, actually not the the system
46:16
at charts that it relies on the emergency department to do
46:20
certain testing because it's easier and faster than having
46:24
those same tests done upstairs in the wards.
46:27
And we just don't have the staff to do it.
46:29
We're just not keeping up with with the Ek GS and the X-rays.
46:33
And so there's a lot of medical literature that talks about who
46:37
needs that EKG in the emergency department before he goes up to
46:41
the floor, before he goes up to the admission ward.
46:43
And the directors of the different departments weren't so
46:47
keen on the idea because it means that then they're going to
46:49
have to devote resources for doing those tests.
46:52
And so I was starting to look it up through the resources that I
46:58
usually use. And if you don't word it exactly
47:01
the way you want, you get something totally different.
47:03
And so I was spending a little bit of time on it.
47:05
And the next day I was sitting with my son-in-law and he said,
47:08
you're crazy, just use this. And we opened it up and
47:12
literally 90 seconds later, I had a whole list of articles
47:17
supporting my opinion. And then when I went back and I
47:20
checked them because everybody says you have to check and make
47:22
sure it's not making things up and they were real articles and
47:25
and it was right on the money. Well, what if, what?
47:27
So what if we were able to just edit it a little bit to train it
47:30
knowing that it's going to talk to patients, right.
47:33
I think like this thing open evidence, if you're able to use
47:36
that with a language model that would that know that it's
47:38
talking to patients, make it a little bit simpler and perhaps
47:41
know that it needs to, I don't know, not lying and make stuff
47:45
up. I think that'd be a fantastic
47:47
resource for dealing with really difficult patients.
47:48
It's a startup. I'm with you.
47:50
Let's do it. Thank you so much for coming in.
47:53
Oh, it's my pleasure. Thank you very much for inviting
47:55
me of. Course I learned a lot.
47:56
Me too.