Latest / BREAK/FIX the Motorsports & Vehicle Enthusiast Variety Show / From Scalpel to Steering Wheel: Dr. Lora Melman’s Journey from OR to HPDE

Transcript

From Scalpel to Steering Wheel: Dr. Lora Melman’s Journey from OR to HPDE · BREAK/FIX the Motorsports & Vehicle Enthusiast Variety Show

• 0:00
  Break fix podcast is all about capturing the living history of people from
• 0:04
  all over the auto sphere, from wrench turners and racers to artists, authors,
• 0:09
  designers, and everything in between.
• 0:11
  Our goal is to inspire a new generation of petrol heads that wonder.
• 0:16
  How did they get that job or become that person?
• 0:19
  The road to success is paved by all of us because everyone has a story.
• 0:27
  Some of you may know her as Dr.
• 0:29
  Laura Melman, a fellowship trained board certified and DaVinci robot
• 0:33
  specialist offering patients the latest in cutting edge surgical techniques.
• 0:37
  But we know her as, at Fast Track Surgeon, one of our heroes under the helmet.
• 0:42
  If you've followed her online, you know she's got a flair for bringing
• 0:45
  surgical lessons from the racetrack.
• 0:47
  A series of musings on the intersection of safety, precision, and skill, explained as
• 0:53
  a crossover between the art of surgery and the science of high performance driving.
• 0:57
  And with us tonight to explain how that all works is Dr.
• 1:01
  Melman.
• 1:01
  And as always, I'm your host Brad.
• 1:03
  And I'm Eric.
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  So let's roll.
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  Welcome to the show.
• 1:07
  Thanks for having me.
• 1:08
  Great to be here.
• 1:09
  So, Dr.
• 1:09
  Melman, before we jump right into motor sports, it's important for people to
• 1:13
  understand what you do as a doctor and how it relates to motor sports.
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  So let's spend a moment describing your specialty.
• 1:20
  Yeah, thanks.
• 1:20
  I think it's really important to take a little bit of time here to describe
• 1:24
  the things that I do because what I do as a surgeon affects many people.
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  I treat obesity, I treat hernia disease, and I treat reflux disease.
• 1:33
  Chances are you know somebody that has one or all three of these things.
• 1:37
  So, being that these are very common, I want to dispel some myths about obesity
• 1:41
  in general, so let's start off with that.
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  Obesity is a disease, and it's actually the disease of the body's
• 1:49
  inability to regulate the body weight.
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  So, basically what we have is everybody's body weight is
• 1:55
  set up at a certain set point.
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  Just like your body temperature remains at a relatively stable set point,
• 2:01
  that's your normal body temperature.
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  That's a parameter that's regulated by your body.
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  Your body weight is also regulated by your body as well, by various factors
• 2:10
  that are so numerous and complex that we don't have a simple way of understanding.
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  The people that suffer from obesity have an inability to
• 2:19
  maintain a normal body weight.
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  So they're actually stuck at the weight that they're at because of this disease.
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  And there's a lot of stigma attached to obesity and shaming and blaming.
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  And I think we really need to start to move beyond that and see this
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  as the disease that it really is.
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  We don't blame people for having hypertension or diabetes or
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  cancer or anything like that.
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  So we really need to start seeing obesity as a treatable disease.
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  Obesity happens to be a surgical disease, which means that there are surgical
• 2:49
  options to help people rein in that body weight regulation factor so that they
• 2:55
  can regulate a more normal body weight.
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  The surgeries that we offer are just tools to help people be
• 3:01
  successful with their weight loss.
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  There is no operation or any magic surgery or anything like that that
• 3:07
  just makes weight loss happen.
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  Obesity is also a lifestyle modification disease similar to
• 3:14
  other diseases like vascular disease and hypertension and diabetes.
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  Eating right and exercising are important to be successful in treating
• 3:22
  those other diseases as well as obesity, but it's not the only factors.
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  And when we help patients by GI tract, It helps them to achieve
• 3:32
  their success with weight loss.
• 3:33
  So it's important for people to understand that these operations are not cheating.
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  They're not the easy way out.
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  It's not a crutch.
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  It's none of those things.
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  They are treatment options.
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  to help people be successful.
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  So Dr.
• 3:46
  Melman, we've come to find out that your Instagram handle is a bit of a play on
• 3:50
  words where fast track is actually related to the type of surgery you perform.
• 3:56
  So how about we unpack that a little bit?
• 3:58
  You know, actually, if you don't mind, I'd like to describe Reflux surgery and hernia
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  surgery, because these are very important areas of surgery and they're very common.
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  I think there are also maybe some misconceptions about
• 4:10
  those, those with surgery.
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  People come in with sort of preconceived notions.
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  There's always the sort of, you know, don't confuse your Google
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  search with my medical degree.
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  That's kind of a meme between, you know, surgeons and doctors and such.
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  But people often come in with sort of a preconceived notion of what they want
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  or what they don't want based on what they've read on Google, which is not
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  always a good source of information.
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  So with that, reflux surgery.
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  is a very effective way to help treat reflux disease.
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  Reflux is very common.
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  A lot of people have it and a lot of people are on acid blockers.
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  But if you think about it, the stomach is supposed to have
• 4:45
  hydrochloric acid in there.
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  It's part of your immune system.
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  You think about if you eat like a piece of dirt or something like that, it gets
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  into your system and it gets sterilized in this bath of acid in the stomach and helps
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  protect you against pathogens and such that are out there in the environment.
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  If you're on acid blocking medications, there's potential that you could
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  become sick by things that get into your system that aren't adequately
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  killed off by the stomach acid.
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  So antacid medications aren't always the answer and they're not
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  always the long term answer in terms of what's best for patients.
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  Oftentimes reflux disease is a structural problem.
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  So the anti reflux barrier or what keeps acid in the stomach where it
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  belongs and out of the esophagus where it doesn't belong is so called lower
• 5:32
  esophageal sphincter and the diaphragm.
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  So the diaphragm has two pillars of muscles that are on the
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  outside, sort of between where the stomach and the esophagus connect.
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  And when those are not lined up properly, you have a disruption of the antireflux
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  barrier and you get acid reflux, which means acid is going up into the esophagus.
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  It's burning the esophagus, and you get the so called heartburn.
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  It also causes cellular changes to happen over long periods of time,
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  where the lining of the esophagus, if overexposed to acid, can become cancerous.
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  So that's the origin of esophageal cancer, is many, many years of exposure
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  to acid, where it's not supposed to be.
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  So treating this disease.
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  is a surgical correction in many cases.
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  It's not just a chemical correction with medications, but they need that sphincter
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  restored to its natural anatomic position.
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  The gap in the diaphragm has become a little too large, allowing
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  the sphincter to go up too high.
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  And that's called a parasophageal or a hiatal hernia.
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  So to restore that anatomy and repair the hernia and ensure that the valve stays
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  in its proper place is a surgical fix.
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  And a lot of people don't understand.
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  That aspect of treating reflux disease.
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  So I think that's very important to understand that.
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  Similarly with hernias, hernias are very common.
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  They can happen in various parts of the body through the belly button.
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  In the groins, they can happen at the diaphragm.
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  That's the hidal hernia that we just talked about.
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  But in terms of fixing hernias, people often think that, oh, it's just a hernia.
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  It's just something simple, and sometimes it is.
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  but sometimes it's not.
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  So we get a range of patients that come to our practice with
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  very simple, straightforward, first time occurrence hernias.
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  that can be fixed in a simple manner, but we also get people that
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  have had multiple failed repairs.
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  So that goes back to the pre optimization and success with surgery,
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  especially with hernia surgery.
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  Optimizing that patient for their particular hernia surgery will prevent
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  them, or hopefully prevent them to the least amount possible from
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  having a recurrence or reoccurrence of the hernia in the future.
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  Anytime a hernia occurs or recurs again, it's more complicated to fix.
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  So we want to get the best chance at a best repair the first time around.
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  Patients that have undergone different types of repairs with various materials
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  that are mismatched with the abdominal wall or not enough overlap or different
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  material, you know, could have been chosen that would have matched them better, that
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  would have gotten them a better result.
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  We see the results of these over time where hernias have occurred or reoccurred
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  or perhaps the patient didn't know that they needed to stop their nicotine use
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  and they have failed the hernia repair and the hernia has come back again just from
• 8:12
  the matter of fact that they're a smoker.
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  Um, so these are all things that need to be made aware of and the patient
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  needs to be aware of and they need to optimize, you know, on the preoperative
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  side of things in order to help them get the best repair possible.
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  There's a lot of, I would say, bad press out there now about hernia meshes.
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  And this goes back to the crossover between technology and materials, just
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  like cars have been developed over time and they're safer now than they
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  were 25 years ago because of all these safety devices and better technology
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  that we have in current models.
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  hernia meshes have gone through a similar evolution.
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  So modern hernia materials, the meshes that we have are much better
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  than we had 15, 20 years ago.
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  So sort of the older generation materials, some of have undergone recalls and various
• 9:00
  problems because of various construction issues been pulled off the market.
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  Those are sort of pervasive in the general public's sort of opinion of
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  what mesh is or what mesh should be.
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  So, it's a little bit outdated, and that's another sort of misconception
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  about hernia surgery and how to best achieve a hernia repair.
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  Oftentimes, it does require a mesh to be placed.
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  The best success with hernia repair is choosing the correct material.
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  putting in, in the correct plane in the anatomy and then matching it with that
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  area of the anatomy so that the physio mechanical properties of that area
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  of the anatomy match with the device that, or the material that's put in.
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  So that is sort of the art and science of of hernia repair.
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  Now you have me thinking that if I ever needed surgery like that,
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  that I would at least like my mesh to be made out of carbon fiber.
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  Fast track surgery is actually a concept in modern medicine.
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  It's actually one of the latest innovations in surgical care.
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  It started with the colorectal realm.
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  And what we found is that when we got people back to eating normally
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  and up and walking around as soon as possible, back to all their baseline
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  functions as soon as possible.
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  They actually recovered from surgery faster and there were less complications.
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  This has now been translated to all areas of surgery.
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  It is still pretty cutting edge in that not every surgeon group or practice does
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  this routinely, but in order to best help our patients to get better after surgery
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  and return to work with minimal downtime, less pain, less complications, and
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  minimize all the things that nobody wants.
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  Basically, we've developed a specific protocol to help
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  people get better after surgery.
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  One of the terms for it is actually fast track surgery.
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  The other term for it is enhanced recovery after surgery, or so called ERAS or ERAS.
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  So the two are basically the same thing, but it revolves around sort
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  of three phases of surgical care.
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  The first is the pre operative phase, and this is called pre
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  optimization or pre habilitation.
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  Everyone's heard of rehabilitation, that happens after the fact.
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  This is pre habilitation, so it gets you ready for surgery.
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  For the event, which is surgery, things that we do to prehabilitate
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  patients, we help them get into an exercise routine, fitness routine to
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  get themselves strong and ready for surgery, nutritionally optimize them.
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  That's a large part of the bariatric surgery program.
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  Stop smoking, smoking impairs the ability to heal after surgery.
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  One cigarette will decrease the oxygen delivery to the tissues by about
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  40 percent by just one cigarette.
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  So in helping people to attain and maintain nicotine cessation, we are
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  therefore increasing their success with surgery and decreasing their risk of
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  complications with wound healing failure.
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  Weight loss is also part of some surgeries prehabilitation.
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  This is where the bariatric surgery program and the hernia surgery program
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  sort of cross over, in that in patients that have hernias and certain complex
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  hernias, it's an imperative to help them get their body weight down in order to
• 12:02
  then undergo a successful hernia surgery.
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  Obesity and overweight is one of the greatest risk factors
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  for a hernia repair to fail.
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  So that's also part of the prehabilitation for the hernia surgery program.
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  There are other things like controlling other diseases, like making sure
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  that blood sugar and diabetics is relatively well controlled.
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  That's another thing that impairs the body's ability to heal after
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  surgery and puts somebody at risk for infections after surgery.
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  So all of these things in terms of getting people ready for
• 12:30
  surgery are very important.
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  Then we have the day of the surgery, and that's sort of thought
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  of as the perioperative period.
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  So they come in for their surgery, they get prepped, they get ready
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  for their surgery, they undergo the surgery, they're under various types of
• 12:43
  anesthesia, medications are administered.
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  So optimizing that part of the process is also very important, and optimizing
• 12:50
  the efficiency which that operation gets done is also very important
• 12:54
  in helping that patient recovery.
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  Minimizing time under anesthesia is also important in helping somebody recover.
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  from the surgery.
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  So if you can do a very smooth, efficient operation, it's going to be much better
• 13:07
  than unneeded time under anesthesia.
• 13:10
  Postoperatively, we get people up and walking right away.
• 13:13
  We start them on a normal diet or as close to normal diet as possible.
• 13:18
  There are variations with that, of course, with bariatric surgery and changing the
• 13:21
  GI tract that require different changes to the diet postoperatively, but getting
• 13:25
  people back to their baseline function, normal activities, walking around.
• 13:29
  Going up and down stairs right away, the day of surgery is very important in
• 13:33
  helping people recover from the surgery.
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  I tell my patients all the time, recovery is a proactive process.
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  It's not a passive process.
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  And in fact, if you are recovering from surgery and just laying
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  around on the couch all day or just sleeping all day, you're
• 13:48
  actually going to take a lot longer.
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  To recover from that operation.
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  Whereas if you get yourself ready for the operation, you choose a
• 13:55
  practice that does a very efficient, streamlined, um, operation for you.
• 13:58
  And then you get up and walk around right away, get yourself rehydrated orally,
• 14:02
  get yourself back on nutrition and everything that you're used to right away.
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  Your recovery will be shortened.
• 14:09
  Most patients in our practice take extra strength Tylenol, they do
• 14:13
  some ice packs, and that's it.
• 14:15
  So the other benefit of fast track surgery is narcotic reduction.
• 14:18
  And there's been a recent epidemic of narcotic addiction and all
• 14:23
  the downsides that come with that, including early death.
• 14:26
  So reducing the number of people that are exposed to narcotics and
• 14:31
  therefore then can become addicted to narcotics is also very important in
• 14:34
  general, in terms of global health.
• 14:35
  For more information visit www.
• 14:36
  FEMA.
• 14:36
  gov We've managed to decrease our narcotic use for patients to the
• 14:41
  point where they hardly get any narcotics in the hospital at all.
• 14:45
  And they really don't take any narcotics to recover after surgery.
• 14:49
  There are also bad side effects of narcotics, including constipation and
• 14:53
  rashes, vomiting, and that sort of thing.
• 14:55
  Not something you want to be dealing with right after you've
• 14:57
  had an abdominal surgery.
• 14:58
  So these are all benefits of fast track surgery.
• 15:01
  And we've managed to incorporate that into all the surgeries that we do.
• 15:05
  for weight loss surgery, for reflux surgery, and for hernia surgery.
• 15:08
  You keep mentioning pre operative, and I wonder if that translates to, let's
• 15:13
  call it pre track day or pre weekend.
• 15:16
  Is there some sort of steps that you go through to get ready for a track weekend?
• 15:20
  That's a really good question.
• 15:21
  Yeah.
• 15:21
  And in matter of fact, I have my little maps and my notes that I've made from
• 15:25
  prior track days at the same time.
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  You know, location.
• 15:29
  So I review that.
• 15:30
  I make sure that the car obviously is ready and the tires
• 15:33
  and the brake pads are okay.
• 15:34
  And the brake fluid is currently flushed and, um, you know, ready for a track day.
• 15:39
  And then I go through my mental visualization.
• 15:42
  If you, if you call it that of, you know, what do I remember
• 15:45
  from the last time I was there?
• 15:47
  And what was I thinking about at each part of the track?
• 15:51
  Like I'm thinking I'm doing this here and then I'm going to do that there.
• 15:54
  And then I set my goals.
• 15:55
  What am I going to try to do this time?
• 15:59
  Am I going to try to carry more, you know, mid corner speed here?
• 16:02
  Am I going to try to, you know, break harder and then accelerate harder here?
• 16:05
  You know, so what am I trying to, Achieve that's kind of where my thoughts for
• 16:10
  the series come out of in terms of, you know, things like the little things
• 16:13
  that I learned, you know, at the track days, but I do go through a process
• 16:17
  of sort of getting sort of like the physical ready, like the car and myself
• 16:21
  and packing my hydration and packing my snacks and sort of prioritizing,
• 16:25
  you know, what I'm wearing that day and making sure I have everything
• 16:28
  appropriately handled before I even leave the house to go to the racetrack.
• 16:32
  But I do want to lead us down more into your path and into
• 16:35
  your background of motorsports.
• 16:37
  I think this was really good, super informative.
• 16:39
  But let's talk a little bit more about how you got started in motorsports.
• 16:43
  Okay.
• 16:44
  So I got into motorsports basically through autocross.
• 16:49
  And this goes back to when I was in my surgical residency,
• 16:52
  where I trained at Wash U in St.
• 16:54
  Louis.
• 16:54
  Typically, the residents will do one or two clinical years.
• 16:58
  And then you go into the lab and you do some research here, it's like two or three
• 17:01
  years of publishing papers and doing, you know, lots of important research work.
• 17:06
  And during the quote unquote lab years residents typically have a
• 17:09
  little more time to do some things.
• 17:11
  So I was at lunch, right, so surgical residents never eat lunch, for one thing.
• 17:15
  So as a lab resident, we were out to lunch, I was out to lunch
• 17:17
  with one of my co lab residents.
• 17:19
  He had a book on autocross, and I said, what's autocross?
• 17:23
  So that's how I got started.
• 17:24
  We went out.
• 17:24
  I had a 1997 Nissan Sentra at the time that I took to the
• 17:29
  autocross and we just had a blast.
• 17:31
  My husband was there and this is, you know, a car like weighed a ton and it had
• 17:35
  like 110 horsepower or whatever it had.
• 17:37
  And I was like flat out going 40 miles an hour trying to navigate these turns.
• 17:41
  I had no idea what I was doing and we just had the best time.
• 17:45
  And so did a little bit more and that car actually broke down in the
• 17:49
  middle of the street on my way to one of my rotations where I had to
• 17:53
  be there at like 530 in the morning.
• 17:55
  And here I am without a car.
• 17:56
  And so I just kind of let it roll back into a parking lot that was
• 18:00
  near my house, ran home, woke up my husband, I said, honey, you
• 18:03
  got, you got to take me to work.
• 18:04
  I have to get to work.
• 18:05
  My car just broke down.
• 18:06
  So I need a new car.
• 18:08
  My husband at the time had a Mini Cooper S Clubman, thick shift, manual, right?
• 18:14
  So he said, okay, well, you know, why don't we think about getting you a Mini?
• 18:17
  And he convinced me to get a standard transmission car.
• 18:20
  That was my first manual car.
• 18:22
  And I remember going out just a few, you know, lessons in the parking
• 18:26
  lot, okay, here's the clutch and here's the, you know, how you shift.
• 18:29
  And I thought, okay, I'm, I'm good.
• 18:31
  I think I can figure this out.
• 18:33
  I tried to drive my new Mini Cooper S hardtop.
• 18:36
  Home from the dealership.
• 18:38
  And I got onto this hill that I'd driven up in my other
• 18:41
  Nissan Sentra millions of times.
• 18:43
  It's about maybe 20 degree incline.
• 18:45
  It's, it's, it's a little bit of a hill and I got stuck.
• 18:47
  I did not have the skillset to overcome this hill.
• 18:50
  To be honest with you, the first several months that I had that car.
• 18:53
  I was terrified.
• 18:54
  Every time I got in the car, I'd stall out in the middle of
• 18:57
  the intersection at stoplights.
• 18:59
  It just was horrible.
• 19:01
  And every time I drove that car to work, it was like a cardiac stress test.
• 19:04
  By the time I got to work, I was, I was so stressed just by driving the car
• 19:09
  that I thought I got to do something.
• 19:11
  I have to, I have to get better.
• 19:12
  I have to learn.
• 19:14
  Some way of just being a better driver in general.
• 19:18
  And it wasn't until I finished residency and got into fellowship
• 19:23
  that I found a book called Fast Girl.
• 19:26
  And I was looking up ways to help my, you know, residents that I was teaching as
• 19:30
  a fellow get better, faster, smoother, more efficient with laparoscopically.
• 19:36
  And I came across this book by Ingrid Stephenson, and she had a red and white
• 19:40
  mini Cooper and learned to drive high performance driving on the racetrack.
• 19:44
  And it's, it's a fascinating book.
• 19:45
  I recommend it to everyone, but it really kind of details her journey
• 19:48
  through going into and participating and being part of HPDE and the things
• 19:54
  that she learned and sort of the lessons she took away from the racetrack.
• 19:57
  And I thought, okay, well, I have a car that just looks exactly like that.
• 20:01
  I think I'm going to try this.
• 20:02
  And so we bought helmets and we went out to Hallett.
• 20:05
  Racing circuit in Oklahoma.
• 20:07
  I was doing my fellowship in Kansas city, Missouri, and we just had the
• 20:11
  best time ever shared the car, you know, alternated different sessions, et cetera.
• 20:14
  And we thought, okay, this is it.
• 20:15
  This is our new thing.
• 20:17
  Um, and so, as you know, I drove that car on the racetrack for, for many years.
• 20:21
  That was the car that I came up in.
• 20:23
  And so that was sort of my foray into motor sports.
• 20:28
  And that's how I got started.
• 20:29
  So it's funny you mentioned autocross it's touted as one of the more
• 20:32
  precise disciplines, but also one of the most Because you only have
• 20:40
  three or four attempts to get it right, much like surgery, right?
• 20:43
  Well, you really got only one attempt to get it right.
• 20:47
  You can see the draw there.
• 20:48
  It makes a lot of sense, especially when you dive into
• 20:50
  the technical side of autocross.
• 20:51
  I mean, doing laps at the track.
• 20:53
  You blow a lap, you got another lap to figure it out, right?
• 20:56
  You're really running against time at that point.
• 20:58
  So, okay.
• 20:59
  So we kind of understand what got you, what drew you into it.
• 21:02
  We heard some of the challenges, especially starting out with your first
• 21:05
  manual transmission car, but have you run up against any other challenges
• 21:09
  coming up through motorsport, even maybe with the education system?
• 21:13
  I mean, did it, did it work for you?
• 21:15
  Um, it worked pretty well for me.
• 21:18
  I found that, you know, for the most part, everyone was there to learn
• 21:22
  and to improve and to get better.
• 21:24
  So I liked that aspect of it.
• 21:26
  That was very refreshing, you know, honestly, you know, as a surgeon,
• 21:30
  I have so much information, you know, coming at me all the time.
• 21:34
  That the stress or whatever you want to call it, it being on track
• 21:38
  was actually pretty relaxing.
• 21:39
  I'm used to a lot of information, a lot of input and, you know, sort of sorting
• 21:42
  out and prioritizing bits of information, but that was just a completely different
• 21:46
  thing away from the OR away from anything.
• 21:49
  Medical surgical, you know, that I had to deal with.
• 21:52
  Um, and you can sort of get into this mindset or zone if you want to call
• 21:55
  it where that's all you're thinking about, that's all you're doing.
• 21:59
  And so that was sort of my release.
• 22:01
  So do you find yourself as a doctor, maybe overanalyzing the track a little bit?
• 22:07
  Does it seem to get in your way and take away from where sometimes it's not an
• 22:12
  exact science, or do you kind of give and take, and it's a bit of compromise
• 22:17
  When you put your helmet on, you're just having fun, and you let it all
• 22:20
  let loose, as you kind of alluded to.
• 22:22
  I think it's a little bit of both.
• 22:24
  You know, sometimes I get too much into, you know, did I do that turn as best
• 22:28
  as I could, or, you know, should I have had a little bit more steering angle,
• 22:31
  or should I have carried more speed, or should I have You know, done a harder
• 22:34
  breaking on this point, or, I mean, you, you can get sort of crazy with
• 22:38
  overanalyzing, you know, your laps or your session, but then you have to kind
• 22:42
  of remember, what are you there for?
• 22:44
  Are you really there to make yourself nuts?
• 22:47
  Are you there to have a good time?
• 22:48
  But then are you also there just to have a good time and not learn anything?
• 22:51
  It's not that either.
• 22:53
  Um, so I think there's sort of a good mix and I try not to get too over analytical
• 22:57
  or, you know, too down on myself and try to remember to have a good time.
• 23:01
  But you know, this, I think there's sort of a mix of both.
• 23:04
  So do you rely on data to help either confirm what you know about the lap or
• 23:10
  to maybe calm your nerves a little bit?
• 23:12
  Cause I find running data, I try not to over focus on it when I'm driving, but
• 23:17
  it's like, Oh, that felt like a good lap.
• 23:18
  And you look over and you're like.
• 23:19
  Yeah, it was a good lap and you keep going or you download
• 23:22
  and you look at it afterwards.
• 23:23
  I mean, telemetry is really important because saying to yourself, did
• 23:26
  I, did I mess up that corner?
• 23:28
  Could I have done that corner better without any sort of
• 23:30
  data there to back it up?
• 23:32
  How do you make that decision?
• 23:34
  That's a really good question.
• 23:34
  I actually have not worked with data.
• 23:36
  I have not worked with telemetry on the racetrack.
• 23:38
  So everything that I've learned, which is sort of like how I remember that felt.
• 23:42
  So I would like to work with data that would, that would really help
• 23:45
  me, I think maybe have somebody.
• 23:47
  that knows more than me in that area to help me look at the data.
• 23:51
  Surgery is a very data driven field.
• 23:54
  And medicine is as well.
• 23:55
  And we always look at the data, you know, what does the data show about doing this,
• 23:58
  this way, or, you know, why should we do it this way versus that way, or what
• 24:02
  mesh should we use in this hernia and why, you know, what, what is the, what is
• 24:05
  the support, what is the data for that?
• 24:07
  So I feel like that is something that I would like to get into, and
• 24:10
  I think I would learn a lot from it.
• 24:11
  Let's talk about how fast track surgery is linked to motorsport and how you came
• 24:17
  up with the surgical lessons from the racetrack series, what inspired you?
• 24:22
  And why?
• 24:23
  Well, I've been doing high performance driving for five, going on six years now.
• 24:28
  And every time I would go out and do a track day, I'd be out there,
• 24:32
  you know, doing the session and afterwards I would kind of reflect
• 24:35
  on, you know, what happened?
• 24:36
  What did I do?
• 24:37
  What could I do better?
• 24:38
  You know, what were the conditions on this lap that, you know, made me feel good or,
• 24:42
  or not so good and how could I improve?
• 24:44
  And I started to see that there were so many overlaps between what I do and what
• 24:49
  As a hobby and what I do as a profession.
• 24:53
  And when I started back in the OR and doing cases, I thought, you know, this
• 24:56
  is sort of like, you know, seeing the line in the, on the racetrack or seeing
• 25:00
  the wet line or seeing the dry line.
• 25:02
  And this is kind of related to how we're doing this surgery.
• 25:05
  And so there are similar things that came up in both disciplines that were
• 25:10
  so similar that I had to write about it.
• 25:12
  And so I started to, you know, capture images in the OR and on the racetrack
• 25:17
  Start to come up with little summary statements and try to match all of those
• 25:21
  images up with the thoughts that I have.
• 25:23
  And that's how the series was formed.
• 25:24
  So I picked up on a couple of things during your description of,
• 25:28
  of your practice and, and getting to this point in the conversation.
• 25:31
  There was a couple of key words that I picked up on smooth recovery, efficient,
• 25:36
  deliberate hydration, nutrition.
• 25:39
  These are all things that we use repetitively in the motor
• 25:42
  sport world and are different.
• 25:44
  Circumstances in a different context, those words are right there.
• 25:47
  They're prevalent.
• 25:48
  They're right up front.
• 25:48
  And I think we're going to unpack some of that and we've chosen some
• 25:52
  of, let's call it the top SLFTR quotes from your Instagram, as we went back
• 25:58
  through, cause this goes over several seasons and let's unpack why some
• 26:01
  of these are your favorites as well as some of the ones that we chose.
• 26:04
  So one of the ones first up is The details are important, but even more so, it is
• 26:10
  the decisions about what you do with those details that constitutes excellence.
• 26:14
  Yeah.
• 26:15
  So I think of this as the difference between being a trivia genius
• 26:19
  versus being an expert in something.
• 26:21
  Details are everywhere, right?
• 26:22
  Information is everywhere and you can get.
• 26:26
  You know, overloaded with information.
• 26:28
  So in order to help yourself in whatever discipline that you are trying to do
• 26:34
  or learning to do, you have to filter that information and with each piece,
• 26:39
  figure out what is the priority?
• 26:41
  Is this important?
• 26:41
  Is it not important?
• 26:43
  Am I going to use it to help myself get better at something?
• 26:47
  So as you go along and as you get better at things, you start to pick up on little
• 26:51
  details, and then you start to chunk those details together in larger pieces.
• 26:57
  sleeve surgery, for example.
• 26:58
  It's one of the most common surgeries that we do.
• 27:00
  There are a bunch of details going on.
• 27:03
  There's a bunch of things going on in the room, but with each load of the
• 27:07
  stapler that you're loading and firing, I personally pay attention to exactly
• 27:12
  how the tissue is responding to the stapler, to the load, to the dissection,
• 27:17
  and to how I'm retracting on the tissue.
• 27:19
  In order to get the best result possible.
• 27:21
  So bunch of little details that have gone into that result, just
• 27:26
  like a bunch of little details.
• 27:27
  If you're on a circuit, certain circuit or certain track that day, you have
• 27:31
  to kind of know what you're doing and where you're going, but then also you're
• 27:35
  taking in a bunch of new details and a bunch of new markers or reference points
• 27:40
  on the racetrack or things that you're learning on that day or on that specific
• 27:45
  session that you're using to help.
• 27:47
  yourself get better.
• 27:49
  So another one from the list, quote, you're either on the brakes or
• 27:53
  modulating the throttle, not coasting, coasting leads to an unstable platform
• 27:58
  because they, before she jumps in, I believe this is also part of the
• 28:01
  Sir Jackie Stewart quote as well.
• 28:03
  It's either you're on the brakes or the throttle.
• 28:04
  There's no in between.
• 28:06
  Right.
• 28:06
  I thought this one was kind of interesting because I was always taught, and you
• 28:10
  probably, uh, hopefully agree with this, that you're never just lifting totally off
• 28:15
  the power, because actually, physically, that's pretty unstable in terms of your
• 28:20
  goal as somebody driving on the racetrack is to keep the platform of the car as
• 28:25
  stable as possible with your inputs.
• 28:28
  So if you're just, It's totally not underpowered, not under braking,
• 28:32
  just kind of floating there.
• 28:33
  If you think about the physical forces at play there, so, you know, you don't
• 28:37
  have to be flat out all the time.
• 28:38
  Obviously you can't do that.
• 28:39
  You don't have to be under, you know, threshold braking all the time either,
• 28:42
  but just a little bit of in between.
• 28:45
  And that's where that sort of gray area, and that's where
• 28:46
  the fun is right of driving.
• 28:48
  But also with regards to building a practice and being, you know, an expert
• 28:53
  in certain areas, especially in surgery.
• 28:55
  Surgery is a very, very competitive field in general, especially
• 28:59
  in this area of the country.
• 29:01
  If you're not getting better and showing that you're better and your
• 29:04
  patients aren't happy with their results and, you know, talking to
• 29:07
  their friends about it, somebody else will take over and take your business.
• 29:11
  So it's worth it to us to really look at how we're doing every piece
• 29:15
  of every surgery every day and how we can continually get better.
• 29:20
  So I liken that to be sort of just on the sort of like
• 29:23
  maintenance throttle all the time.
• 29:25
  And sometimes you've got to speed up and really kind of
• 29:27
  push ahead and push through.
• 29:28
  And sometimes you have to, You know, really slow down and take a look
• 29:31
  at things and what you're doing, or just take a break altogether.
• 29:35
  But there is that sort of range of power versus breaking that
• 29:40
  you have to do in everyday life.
• 29:42
  And if you just start to just coast, completely take your foot off the
• 29:45
  power, then forces outside of yourself are going to start to take over.
• 29:49
  So one of my favorite words in motorsport is the word smooth.
• 29:53
  And.
• 29:55
  There's different schools of thought when it comes to smooth, but we're going to
• 29:58
  go with your quote and smooth is fast.
• 30:01
  The most efficient path is the one with the least amount of noise.
• 30:06
  Smooth transitions facilitate precision and minimize wasted movement.
• 30:10
  Right.
• 30:11
  So this is my favorite movie line of all time.
• 30:13
  It's from the movie shooter.
• 30:15
  I don't know if you saw that movie.
• 30:16
  The main character is trying to teach someone, I believe in the
• 30:19
  scene how to load a gun and how to do so smoothly and efficiently.
• 30:23
  And he says, Slow is smooth.
• 30:26
  Smooth is fast.
• 30:27
  You can't just be fast, right?
• 30:29
  So nobody is just fast out of the box.
• 30:31
  It's a process by which you build that speed.
• 30:34
  And how do you build speed?
• 30:35
  You take away the excess noise.
• 30:39
  Nobody can be fast going in multiple different directions at any one time.
• 30:43
  So you have to figure out what is the smoothest path to where you're going and
• 30:47
  how do you take away all the excess noise?
• 30:50
  Unnecessary movements.
• 30:52
  I call it noise.
• 30:53
  Um, so that you can attain that smoothest trajectory, but this
• 30:57
  translates to surgery as well.
• 30:59
  If you're doing a lot of perky jerky movements, you're, you're actually
• 31:02
  just wasting time and that's keeping your patient under anesthesia
• 31:06
  for longer than they need to be.
• 31:07
  And therefore they're going to have a longer recovery after surgery.
• 31:11
  So it behooves you as a surgeon to be very smooth and deliberate
• 31:15
  and have no transitions that are not beneficial to the patient.
• 31:21
  This translates directly, you know, to the surgical world.
• 31:23
  All my teachers have told me, just, Practice it slow, because
• 31:28
  you can't practice something fast and expect to be smooth.
• 31:31
  If you practice something slow to begin with, it then becomes fast,
• 31:34
  and that actually goes back to the biologic basis of learning.
• 31:37
  I don't know if you guys have read The Talent Code by Daniel Coyle.
• 31:41
  This is a fascinating book, and it actually goes through
• 31:44
  how expertise is created.
• 31:47
  It's not just born into existence, it actually is facilitated along the way.
• 31:52
  What happens when somebody learns a new task, a new technique, a new sport,
• 31:58
  plug in your word there, is that there are pathways between the brain and the
• 32:03
  muscles that are becoming myelinated.
• 32:06
  So nerves have myelin, some nerves do, and nerves that control motor movements
• 32:12
  have various degrees of myelination.
• 32:14
  As somebody is learning a new technique, Or a new skill, there's
• 32:19
  a circuit that's built in the brain and in the skeletal muscle.
• 32:22
  And as that person becomes better at that skill over time, those pathways
• 32:27
  in the brain and in the nerves of the muscles become better myelinated.
• 32:31
  That myelination process takes about six to eight weeks.
• 32:34
  So you can't just have that to begin with.
• 32:37
  You can't just make that happen instantly.
• 32:39
  It has to build and you have to build it over time.
• 32:42
  Some might say that bad habits are hard to break.
• 32:45
  Well, bad habits or any habit is actually impossible to break.
• 32:48
  You just have to build a new habit.
• 32:50
  You can't actually break a circuit that's already built in your brain.
• 32:53
  You have to just kind of pave over that with the new circuit.
• 32:56
  To that end, if you're trying to learn something new, actually the best, most
• 33:00
  efficient way to learn that is by going as slow as possible at first, then as
• 33:06
  those pathways become more myelinated.
• 33:08
  You will be able to do that task more efficiently and more smoothly because
• 33:13
  you've myelinated that connection.
• 33:15
  So that's a really interesting parallel and I want to stay
• 33:17
  on this topic for a moment.
• 33:19
  And the reason I brought up smooth is a bit of a trigger word, at least in
• 33:24
  motorsports, mostly for coaches, because I think there's a couple different schools
• 33:28
  of thought in how you approach smooth.
• 33:30
  I came up with an understanding that realistically all motor sports students
• 33:34
  pretty much start at the same point, you know, zero, zero on the X, Y axis.
• 33:38
  And we all ramp up and we all have a learning curve, but there comes a
• 33:41
  point where that arc, and I'm sorry, we don't have any graphs where, you know,
• 33:45
  this is audio only that it diverges.
• 33:47
  What I'm trying to explain here is that we all start kind of rough and tumble,
• 33:51
  and we have to learn these new habits and replacing maybe former ways of driving.
• 33:56
  And so a lot of coaches will stress.
• 33:58
  that they want to feel this concept of smooth and it really revolves
• 34:03
  around the vehicle and the vehicle dynamics and how smooth the
• 34:07
  vehicle is going around a corner.
• 34:09
  But you hit a point though where you can only go so fast by being smooth.
• 34:14
  And so what I've found though is As you mature as a driver, it's a transition
• 34:20
  from you making erratic motions behind the wheel to getting the car to be complacent
• 34:26
  and to be neutral, but to go fast, the car actually becomes extremely erratic.
• 34:31
  And then you are in this position of like full Zen, and you are
• 34:35
  completely calm when the car is.
• 34:38
  out of sorts, sideways, what would seem by the outsider, completely out of control.
• 34:43
  And so that's where I say that the arc, the learning curve diverges from what is
• 34:48
  being said to what happens in reality.
• 34:51
  And so I wonder if that plays in to surgery and to medicine as well.
• 34:56
  That's really fascinating.
• 34:57
  So I think it all has to do with skill sets and learning skills and your
• 35:02
  performance of doing those skills actually requires you to have a higher set of
• 35:07
  skill beyond that in order to cope with something that can happen sort of suddenly
• 35:11
  and suddenly you're out of control.
• 35:13
  So definitely translates to surgery.
• 35:15
  We train in all kinds of situations, traumas.
• 35:19
  And during my residency, I dealt with somebody that was shot
• 35:22
  with a bullet through the aorta.
• 35:23
  And that's a serious injury.
• 35:24
  And, you know, you have to know how to deal with that people that come in with
• 35:28
  these, you know, horrific injuries, you have to know how to gain control when
• 35:33
  things are completely out of control without being out of control yourself.
• 35:37
  Exactly.
• 35:38
  That's the skill set.
• 35:39
  Is it, can you maintain your calm?
• 35:42
  And can you maintain in control while everything else is out of control?
• 35:47
  And so that requires a skillset beyond just the basics.
• 35:51
  And that may be where the divergence happens is that are some people able
• 35:54
  to achieve that next set of higher skills so that they can not freak
• 36:00
  out if they suddenly are sideways.
• 36:02
  They already have that programming or they've developed that programming
• 36:05
  somehow to then regain control.
• 36:07
  Exactly.
• 36:08
  And that's where I've always stressed that there's two
• 36:10
  forms of smooth and motorsport.
• 36:12
  There's the vehicle being smooth and the driver being smooth.
• 36:15
  And I think we all need to get to the stage where we as a driver are smooth and
• 36:20
  we can make that car do anything we want.
• 36:22
  And that does lead us into a conversation about driving by feel
• 36:25
  and things like that, which is completely out of the realm of.
• 36:28
  What we're really driving towards here, pun intended, but I just wanted to bring
• 36:32
  that up as, as a notion there that a lot of people don't kind of split the
• 36:36
  two, you know, smooth is smooth, but in the context of motorsport, there's,
• 36:40
  it's really multifaceted, but you did allude to the next quote that we pulled
• 36:44
  out, which is the ability to perform well under challenging conditions
• 36:48
  is not acquired accidentally, nor is it a natural gift, but rather the
• 36:53
  result of years of dedicated study.
• 36:56
  And perfection of technique.
• 36:58
  It takes 10, 000 hours of deliberate practice to attain mastery.
• 37:03
  Right.
• 37:03
  So this comes out of that book, the talent code also studying
• 37:06
  experts around the world.
• 37:08
  Musicians.
• 37:09
  Professional athletes, et cetera, in terms of how do they learn and how do
• 37:13
  they become the best in their field?
• 37:16
  It does take about 10, 000 hours.
• 37:18
  That's what it's been studied to be in terms of dedicated practice, which
• 37:23
  means that somebody is deliberately practicing the sort of micro skills that
• 37:28
  are required to then have that skill set.
• 37:32
  So multiple different skills and a certain, you know, discipline, obviously
• 37:35
  there are just, you know, infinite number of, of things we could talk about here.
• 37:39
  But how does someone become concert violinists?
• 37:42
  You know, how, how does that happen?
• 37:45
  It happens over a long period of time.
• 37:48
  There are circuits that become myelinated over time and they have to be practiced
• 37:52
  in the right way in order to then.
• 37:55
  allow that person to have the next level of skill, and then they can
• 37:59
  attain the next level of skill.
• 38:01
  So similarly in surgery, we start out as trainees, just sort of observing
• 38:07
  and watching the surgery, seeing how everything is sort of coordinated
• 38:10
  within the room, and then maybe doing a very small part of the surgery under
• 38:15
  supervision of our attending surgeons.
• 38:17
  And once we perform adequately on that level, Then we're allowed
• 38:21
  to do more and more of the case.
• 38:23
  And as you graduate and you become a fully trained practicing surgeon, then
• 38:27
  you are the one doing the whole surgery and then training other surgeons.
• 38:30
  So that's how it comes 360.
• 38:32
  Of course, there are skills labs and training and such that everyone
• 38:35
  does that everyone should do.
• 38:37
  Even surgeons after, you know, they're done with their formal training
• 38:41
  because surgery and medicine in general are such a rapidly changing fields.
• 38:45
  There's new technologies, there's new devices, there's new
• 38:48
  materials coming out all the time.
• 38:50
  We have to be able to incorporate that in the best way possible in the safest
• 38:55
  way possible for our patients in order to help them the best way we know how.
• 39:00
  So that ongoing skills acquisition never stops, which is why it's kind
• 39:04
  of fun, but it does take a long time to develop that basic skill set.
• 39:09
  The 10, 000 hours is deemed to be your achievement of expertise.
• 39:13
  It does take a long time.
• 39:14
  It's not something that really anyone is Born with, or it can just do instantly,
• 39:19
  it's a process that's built over time.
• 39:21
  I often joke, I have that amount of time on a Shenandoah circuit.
• 39:25
  So it feels like 10, 000 hours, but what a lot of people don't realize about
• 39:30
  motorsport, especially the discipline of high performance driver's education
• 39:34
  is that it is a structured system.
• 39:37
  There is always room for improvement.
• 39:39
  There's obviously room to practice, but it's a continuing education program.
• 39:43
  When you jump in, you're not going to be Michael Schumacher or Ayrton Senna.
• 39:47
  You start as a beginner and you work your way up through the system.
• 39:50
  And every rank that you move up gets more difficult and more challenging,
• 39:53
  more techniques get brought on.
• 39:55
  And a lot of people think that the coaches.
• 39:58
  Just know it all because they wear the title of coach.
• 40:00
  And I hate to tell you guys, we're not infallible and we
• 40:04
  do continuing education too.
• 40:05
  There's plenty of coaching summits out there.
• 40:07
  There's plenty of documents and books and, you know, webinars by like Ross
• 40:11
  Bentley, his speed secret series.
• 40:13
  There's safety programs that we're involved in.
• 40:15
  We're always researching the latest nannies.
• 40:17
  We have to stay up to date on the latest cars that are coming out
• 40:20
  because you never know if you're going to be in the right seat of them.
• 40:23
  C9 Corvette, which hasn't come out yet, but as an exaggeration, you get the point.
• 40:27
  We need to know what we're stepping into.
• 40:29
  And I had one of those moments recently with a Tesla on track, which is a
• 40:33
  very rare vehicle to have on track.
• 40:34
  I wrote an article about it.
• 40:35
  You guys can check it out on our website, gtmotorsports.
• 40:38
  org.
• 40:38
  But again, it was a learning moment and there's tons of those in motorsport
• 40:42
  where you can continue to grow.
• 40:44
  You shouldn't feel like you've hit a plateau.
• 40:45
  And I think this is a really important point that mastery and motorsports.
• 40:49
  Is difficult to attain because there's so many different disciplines to motorsport.
• 40:54
  We talk a lot on this show about how they carry over in certain techniques,
• 40:58
  like learning a track very quickly.
• 41:01
  And to negate corners that comes from autocross racecraft comes from
• 41:05
  carting, the ability to handle very odd situations could be carried
• 41:09
  over from maybe rally corners.
• 41:11
  So trying different disciplines, exposing yourself to different parts
• 41:14
  of motorsport will eventually get you to that true master petrol head level
• 41:19
  that I think people would like to get to, but there's nothing wrong with
• 41:22
  mastering your particular discipline.
• 41:25
  If what you like is just club racing or, or rally or whatever it might be.
• 41:29
  So all good, but I do like this next one, which is driving.
• 41:33
  The camera requires a trained eye experience and steady
• 41:37
  hands that can also be quick.
• 41:40
  That goes to laparoscopy.
• 41:42
  So when we're doing a laparoscopic case, we're using small incisions
• 41:45
  and through one of the small incisions is a scope camera.
• 41:49
  And at the end of that is a beveled angle so that we can
• 41:52
  sort of look around corners.
• 41:54
  So we call it driving the camera.
• 41:57
  Typically, the surgeon will be operating with two hands and then the
• 42:00
  assistant will be Assisting with one hand, providing retraction, and then
• 42:04
  driving the camera with the other hand.
• 42:07
  And so the right angle or the certain angle that you need to actually see what
• 42:11
  you need to see is provided by your, your wing person, your wingman, so to speak.
• 42:16
  As a surgeon, you're actually not providing the view, it's
• 42:19
  actually your assistant.
• 42:21
  In order to have the best, most efficient surgery, the assistant needs to
• 42:26
  understand what the surgeon needs to see.
• 42:29
  So that's called driving the camera.
• 42:31
  So you have to know what the surgeon is looking for, what exact angle they
• 42:35
  need to be looking at the tissue at, and what they're trying to accomplish.
• 42:40
  And ideally, the assistant is going to drive the camera in a way
• 42:44
  that is completely transparent.
• 42:46
  They don't even have to think about it.
• 42:47
  They don't even have to tell you, you know, move in, move out, you know,
• 42:50
  go to this angle, go to that angle.
• 42:52
  The assistant should be able to achieve a seamless interaction with the surgeon
• 42:57
  so that they're showing them exactly what they need to see, exactly at
• 43:00
  the time that they need to see it, so that that surgeon can complete the
• 43:04
  surgery in the most efficient manner.
• 43:05
  There's a little bit of trained vision that you need to have in
• 43:09
  order to drive a laparoscopic camera.
• 43:11
  Also experience on both sides of the table, so to speak.
• 43:15
  So you have to be able to drive the camera, but you also have to have some
• 43:18
  experience doing the surgery in order to sort of know the other side of the coin.
• 43:22
  There, it's just sort of a, it's a learned skill.
• 43:24
  And like, I go back to the, the idea that first you learn sort of the basic
• 43:29
  skills and then you learn a little bit more advanced skills and then you
• 43:32
  sort of chunk those all together and then you have your skill set and I
• 43:35
  started learning to drive the camera.
• 43:37
  I actually couldn't see.
• 43:39
  The different directions that the lens was pointing.
• 43:42
  It took me a long time for my brain to incorporate that and see that
• 43:45
  the angle was actually different.
• 43:47
  It's actually pretty subtle if you ever look at a laparoscopic angled camera.
• 43:51
  It's not really that obvious, but once you get used to it.
• 43:54
  You can anticipate which angle the lens needs to be at to provide the
• 44:00
  most perfect view for the surgeon.
• 44:02
  It's not something that's actually that intuitive.
• 44:05
  You have to kind of learn it.
• 44:06
  I sort of just was thrown into it and I just kind of learned along
• 44:09
  the way, but there's a lot of things because we're working with straight
• 44:12
  stick instruments in laparoscopy.
• 44:14
  If the angle of the eye of the camera is looking down parallel to the shaft
• 44:19
  of the instrument, it's actually very hard to see what you need to see.
• 44:22
  So it has to be sort of at a.
• 44:24
  angle that's a little bit more away from sort of looking at what the
• 44:28
  instruments are operating on, not looking down the length of the instrument.
• 44:32
  It sounds a lot like the relationship between a coach and their student.
• 44:35
  So do you turn to your assistant and say early and late when they
• 44:38
  apex the camera the wrong way?
• 44:41
  Not really.
• 44:42
  It's, it's not, it's not like that kind of.
• 44:45
  Uh, well, there's one that I want to touch on this one.
• 44:48
  One of my personal favorites that I'd like to hear you talk about.
• 44:50
  It's don't blame the mirror if you don't like what you see.
• 44:53
  Okay, good.
• 44:54
  Yeah, that's a good one that I was just sort of more thinking of more like a
• 44:58
  personal reflection mirror doesn't lie.
• 45:01
  And so if you're looking in the mirror and it's you and you don't like it.
• 45:05
  It's not the mirror, but it also goes to, you know, paying attention
• 45:08
  to your mirrors and kind of knowing what's going on all around you
• 45:11
  having that 360 degree awareness.
• 45:13
  And if you have put yourself in a spot in the group that you don't
• 45:17
  like, and you should have pitted instead and just let everybody go by
• 45:20
  or give yourself more room and whose, whose fault is that sort of in a way.
• 45:24
  So multiple things can be sort of taken away from that.
• 45:27
  My first thought with making that little episode was if you're just upset
• 45:31
  with everything going on in the world.
• 45:34
  Some of that is actually you.
• 45:35
  So motorsport, we've said many times on this show, is
• 45:38
  unfortunately a male dominated sport.
• 45:41
  And I'm not saying that it's totally devoid of women, because it's not,
• 45:45
  but they are fewer and far between when you walk around the paddock
• 45:49
  and you look at all the other drivers that are there at an event.
• 45:52
  So I wonder, how did you find yourself?
• 45:55
  at these HPD events as a woman?
• 45:58
  Was it inviting?
• 45:59
  Did you find it to be a good experience?
• 46:01
  Were there some challenges there?
• 46:03
  Do you mind unpacking that for our listeners?
• 46:05
  Good question.
• 46:05
  It's really not that different from surgery.
• 46:07
  If you take a look at how many surgeons are women versus men, that basically goes
• 46:12
  back to implicit bias within the training system that did not allow women to have
• 46:18
  the opportunity to train to be surgeons.
• 46:21
  So that's the reason why there aren't many women surgeons.
• 46:24
  But can women be excellent surgeons?
• 46:25
  Of course they can.
• 46:26
  There's a study in the British Journal of Surgery showing that all other
• 46:30
  factors combined, women are actually better surgeons and their patients
• 46:32
  do better than, than male surgeons.
• 46:34
  So there's that, but you know, going into the motorsports world and going to the
• 46:38
  paddock and being like the only girl in the group or like the only, you know,
• 46:42
  one or two girls in the, in the whole entire event that day, you know, I have
• 46:46
  to admit, it didn't really bother me because I'm kind of used to it already
• 46:49
  being, you know, from Surgical background.
• 46:52
  I also have done Aikido, which is a martial art, mainly dominated by men.
• 46:57
  Um, not very many women in Aikido as a martial art in general.
• 47:00
  So I'm kind of used to it.
• 47:02
  So it didn't really bother me.
• 47:03
  Did I perceive that people underestimated me or didn't want me to be there?
• 47:09
  I don't know.
• 47:09
  I don't really care.
• 47:11
  You know, I just try to do my best.
• 47:13
  And if I'm, you know, somebody that's slowing down the whole group or something
• 47:17
  like that, then I don't belong there.
• 47:18
  I need to be in a different group and I'm, I'm fine with that.
• 47:21
  I don't have an ego with regards to showing that I'm better than anyone else.
• 47:25
  I'm just trying to be the best person and best driver and develop
• 47:28
  my driving skills as best as I can.
• 47:31
  I'm not competing with anyone or under the pretense that I'm, you know, racing
• 47:35
  people into corners or anything like that.
• 47:37
  And so I think that the HPDE community.
• 47:40
  Since that's not what it's about, what's a good place for me to grow.
• 47:45
  And so I found a good place there.
• 47:47
  And I found some groups that are very welcoming to female
• 47:49
  drivers and very encouraging.
• 47:51
  All my coaches have always been very, very encouraging and very helpful to me.
• 47:57
  You know, the breakout sessions in terms of just drivers talking to each other.
• 48:00
  I always find that very helpful.
• 48:02
  I think that the role of mentorship and teachers.
• 48:06
  is very important in general.
• 48:08
  In surgery, we wouldn't be surgeons without our mentors and teachers
• 48:11
  that taught us how to do surgery.
• 48:12
  So in the driving world, you wouldn't be where you are if you didn't have
• 48:17
  your teachers before you, and if they didn't have their teachers before them.
• 48:20
  So there's a tradition passing on that, that skill set and passing on
• 48:24
  the information, even in little bits, you learn something new and something
• 48:28
  valuable from every teacher that you have.
• 48:30
  Yeah.
• 48:30
  And one of our senior members always says that you are the byproduct of all of your
• 48:35
  coaches because the driving skills that you have today, you took something the
• 48:39
  best, or maybe even you learned from the worst of all those different coaches.
• 48:42
  And now that has become your driving style.
• 48:45
  So it's interesting.
• 48:46
  You bring that up, but I also wanted to ask if maybe let's just say you
• 48:50
  were a queen for the day and you could change some things about HPDE to make
• 48:54
  it more inviting, maybe break down some barriers and bring in more women.
• 48:58
  What.
• 48:59
  Changes would you make to kind of revolutionize the sport?
• 49:03
  That's a really good question.
• 49:04
  I think that just sort of raising awareness of the sport would be a place
• 49:08
  to start And representing it in a way that this is a sport that men and women
• 49:13
  do and men and women are good at So to have that representation, I think it
• 49:18
  would start with that a lot of times Maybe the images that we're seeing, um, in
• 49:24
  advertisements and such are, um, you know, buy this for your, you know, boyfriend,
• 49:28
  buy this for your husband, buy a track day or so that just sort of potentially
• 49:33
  very male oriented advertising.
• 49:35
  So maybe to sort of open that up.
• 49:37
  And be, you know, a Mother's Day gift or something like that, just to kind
• 49:41
  of broaden the interest of various people that might get into the sport.
• 49:46
  With every learning experience, there are trials, there are errors, there are
• 49:52
  achievements, and there are failures.
• 49:53
  So what would you say is your biggest oops moment?
• 49:56
  In motorsport.
• 49:57
  We won't talk about surgery.
• 50:03
  Biggest oops moment.
• 50:05
  That would go back to when I had my first BRZ.
• 50:09
  I run my cars pretty much completely stock.
• 50:12
  So I had the original tires on there.
• 50:14
  And, um, I was at the North course of Pocono.
• 50:18
  So if you know the North course, turn one kind of turns off of the infield
• 50:22
  and then goes back onto the Tri Oval.
• 50:24
  And it was getting dark and getting a little cool, track
• 50:27
  temperatures dropping a bit.
• 50:29
  And I just didn't think about things, obviously, before they
• 50:33
  happened too fast for me to control.
• 50:35
  Going in turn one, got a little into the marbles, got a little bit off, couldn't
• 50:39
  control the car, could not turn in.
• 50:41
  Boom, hit the wall about 60 miles an hour.
• 50:44
  Pulled the car and airbags went off and stuff.
• 50:46
  I was a little bruised.
• 50:47
  I was okay.
• 50:48
  I didn't lose consciousness or anything like that.
• 50:50
  But that by far was my biggest oops moment.
• 50:55
  I think it's important to take away from that when you have a moment like that,
• 50:58
  or even just little other, you know, non damaging, you know, to your car moments.
• 51:03
  Is it, what do you learn from that?
• 51:06
  My thing in life is that we make mistakes, everybody makes mistakes, but you
• 51:10
  should always try to make new mistakes.
• 51:12
  If you make the same mistakes over and over again, you're actually not
• 51:16
  getting better, you're not learning.
• 51:17
  So, there's something to be learned there.
• 51:19
  So, mistakes are going to happen if they happen and when they happen.
• 51:23
  Figure out why it happened and what you can do next time to avoid that.
• 51:27
  What I learned from that experience is to prioritize areas of the track
• 51:33
  where I was going to push myself and where I was going to not.
• 51:37
  And that is an area of the track where you don't push yourself, or at
• 51:40
  least I know, because that can happen.
• 51:42
  After that happened, and I came back to the paddock and, you know, the car
• 51:45
  was, you know, put on a flatbed and taken off the track and everything.
• 51:48
  A lot of people came up to me and said, yeah, I've seen that
• 51:50
  happen before at that turn.
• 51:51
  You know, obviously it happens or has happened at that
• 51:54
  point on the track before.
• 51:56
  And so on certain circuits, there are places where there is no room for error.
• 52:02
  And you have to be aware of that before you get in too deep.
• 52:06
  Just like in certain parts of a surgery, there are certain areas
• 52:09
  where there's no room for error.
• 52:11
  You don't want to be slightly off or too close to one vessel or the other,
• 52:16
  or because you can just wreak havoc.
• 52:18
  So you have to be aware of that.
• 52:19
  So that's what I learned is to.
• 52:21
  Think about the racetrack beforehand and where is it okay if I go off and
• 52:26
  not a big deal and where is it not okay and where I really want to just hone it
• 52:30
  down and really make sure I'm totally in control and if I get a little out of
• 52:34
  control, can I save it on those areas?
• 52:38
  So what would you say is probably the best tool when learning a new track for you?
• 52:43
  I've sort of gone back and forth with making little notes on a sort of
• 52:48
  like a hand drawn map or pre printed map versus the role of simulation.
• 52:52
  I don't have a Sim racing, you know, set up or anything like that.
• 52:56
  I've looked into that and I'm still thinking of getting one, but I think
• 53:00
  there probably is a good role for simulation, helping you learn the
• 53:05
  visual cues, learn what the racetrack looks like from on the racetrack.
• 53:09
  Cause it obviously is different if you look at a video of somebody else's
• 53:13
  in car video versus if you're the one sort of controlling, you know,
• 53:16
  sort of the inputs and the outputs.
• 53:18
  So I think that there's a great benefit to be had and you can
• 53:22
  shorten your learning curve.
• 53:24
  By sort of practicing a track in a completely safe environment of
• 53:29
  simulated computer environment, I think you can start to learn some basics.
• 53:33
  Of course, you don't have the physical feedback, you know, the seat feel, so to
• 53:38
  speak, if you have on a real racetrack.
• 53:41
  But I think that is a valuable tool that people can take advantage of.
• 53:44
  And I think it actually can help you be safer on the racetrack.
• 53:48
  So do you have a favorite racetrack of all the ones you've been to?
• 53:51
  That's a really good question.
• 53:52
  Um, I do like Lime Rock.
• 53:54
  That's kind of my first, you know, home track, because I used to live
• 53:57
  in Connecticut, and I had a Mini Cooper, and it was very good on Lime
• 54:00
  Rock, and so I like Lime Rock a lot.
• 54:01
  I like the, uh, the Pocono infield tracks, different configurations, etc.
• 54:06
  I like, uh, Lightning.
• 54:08
  All the short ones, huh?
• 54:11
  I tend to have lower powered cars, so I went from a Mini Cooper to a BRZ.
• 54:15
  And then I have an M2, which is, you know, relatively speaking to other cars,
• 54:19
  like the Ferraris and McLarens that are out there now on the racetracks,
• 54:22
  pretty low powered car still.
• 54:23
  So I tend to gravitate towards the faster tracks.
• 54:27
  So is there a bucket list track?
• 54:28
  VIR.
• 54:30
  It's a good one to pick.
• 54:31
  It's a, that's an IMSA track.
• 54:32
  It's a big one.
• 54:33
  It's a lot of fun.
• 54:33
  We were just there not too long ago, wrapping up our season.
• 54:37
  So I highly recommend it if you haven't done it.
• 54:39
  I know you've been to the Glen and a lot of other places, but what advice
• 54:42
  would you give someone starting out in high performance driving?
• 54:46
  Starting out, I think that it's important to understand hydration.
• 54:51
  This is something I address to my patients all the time because
• 54:53
  after bariatric surgery, it's actually very hard to stay hydrated.
• 54:56
  But as a performance athlete, your performance is going to decrease if your
• 55:01
  hydration is not as best as it can be.
• 55:04
  A lot of people don't understand what early dehydration feels like.
• 55:09
  You start to lose focus, you might get a little bit of a headache, feel tired.
• 55:13
  Those are all symptoms of dehydration.
• 55:15
  And so, what do you hydrate with is the other thing.
• 55:19
  Plain water is okay.
• 55:20
  I would say the sports drinks are a little bit overloaded with sugar.
• 55:24
  So if you dilute them a little bit, it'll actually be absorbed
• 55:26
  better into your system.
• 55:28
  Recently, there are some products that have come out that are hydration
• 55:31
  supplements, either in powder form and you reconstitute them in water.
• 55:35
  The classic example is actually Pedialyte.
• 55:37
  Pedialyte is marketed for babies because babies have a very narrow window
• 55:43
  where if they get dehydrated, you can still save them with oral hydration.
• 55:46
  Okay.
• 55:47
  And so it's marketed for the, for the small humans.
• 55:49
  Um, it actually works for, for any human being.
• 55:52
  If you are dehydrated, one of the best things to do, go to
• 55:54
  the pharmacy, grab a bottle of Pedialyte, open it up and drink it.
• 55:57
  It's actually proven that a little bit of natural sugar and electrolytes
• 56:01
  in the right amount in water.
• 56:04
  It's going to absorb and be absorbed by your system about
• 56:07
  three times more than plain water.
• 56:09
  So that's the way to best get yourself rehydrated.
• 56:12
  This knowledge and technology and development came out of the cholera
• 56:15
  epidemic when people were infected with the cholera bacteria and had diarrheal
• 56:20
  illness and were getting dehydrated and were dying from dehydration.
• 56:23
  What happened then, an invention was invented, and this was
• 56:26
  called oral rehydration solution.
• 56:28
  It's a powder packet of glucose, and sodium, potassium, magnesium, calcium,
• 56:33
  some of the electrolytes, that when reconstituted in water, absorbs more
• 56:38
  readily through the gut epithelium, and helps people rehydrate better.
• 56:43
  They couldn't go around and put IV fluids into these millions of
• 56:45
  people, but millions of people were saved by oral rehydration solution.
• 56:49
  So it's a, it's a real thing.
• 56:51
  Sports drinks are a little bit overloaded on sugar because athletes need that
• 56:55
  extra sugar so they don't deplete their glycogen stores during a game.
• 56:58
  So that's why there's more sugar in those sports drinks.
• 57:01
  Zero calorie sweeteners do not do the same function as real sugar.
• 57:06
  So all of the zero, you know, this, you know, non sugar, that, that is
• 57:10
  not actually hydration solution.
• 57:13
  That's marketing.
• 57:14
  Understanding hydration and how to best help yourself with hydration will
• 57:18
  in turn help you perform your best.
• 57:21
  So that's really important because you're learning, putting yourself sort of maybe
• 57:25
  a little bit outside your comfort zone.
• 57:26
  You're trying to, you know, learn new things, new, new sets of, of
• 57:30
  things, trying to put things together.
• 57:32
  If you're dehydrated, you're just not going to be able to do that as well.
• 57:35
  That's sage advice.
• 57:37
  And we do talk about nutrition and hydration at the track often.
• 57:40
  And there's a phenomenon we call the track hangover.
• 57:43
  And it's directly as a result of being dehydrated.
• 57:46
  And two of our members, one is a personal trainer as well as a nutritionist.
• 57:51
  And the other gentleman is also a weightlifter and former military.
• 57:55
  And so they bring different aspects.
• 57:57
  But to the same conclusion that you brought us to, which is make sure you
• 58:01
  drink, drink, drink when you're at the track, probably more important than
• 58:04
  eating when you're at the track is to stay hydrated or any motor sport, really.
• 58:08
  Because let's face it, there isn't a whole lot of shade
• 58:11
  unless you've rented a garage.
• 58:13
  That's also another mitigating factor.
• 58:15
  There isn't the fact that you're out in the sun being beat on all day long.
• 58:19
  So staying hydrated is super important.
• 58:21
  Let's look at some lighter hearted questions.
• 58:23
  We have some fun ones that we usually ask our guests as we
• 58:26
  kind of wrap up our segment.
• 58:28
  We ask questions like a million dollar lady in this case, or, you know, what's in
• 58:32
  your free car garage and things like that.
• 58:35
  So let's start with what are your top three favorite cars of all time?
• 58:39
  And these don't have to be ones you own.
• 58:40
  These are just ever been built from, you know, the model T to today.
• 58:44
  I'm going to say my top three favorites.
• 58:47
  These are the Ferrari 458 Italia, the naturally aspirated engine, because
• 58:52
  I think it just sounds beautiful.
• 58:54
  I don't think anything sounds as good as that.
• 58:56
  That's just my favorite engine of all time.
• 58:58
  And I happened to drive one, uh, maybe a year ago now, um, my
• 59:03
  husband bought me a birthday gift and it was a driving experience.
• 59:06
  So I got to drive the 458 Italia, they were all convertibles, the Alfa
• 59:09
  Romeo 4C, the Bentley Continental.
• 59:11
  That was also great.
• 59:12
  And that's actually one of my other favorites because I thought it was
• 59:15
  going to be sort of a stodgy stuffy.
• 59:17
  Car.
• 59:18
  And it was like a spaceship.
• 59:19
  It was awesome.
• 59:20
  So that'd be my second one.
• 59:21
  Third favorite car of all time.
• 59:24
  I'm going to say is the Mazda Miata.
• 59:26
  I think dollar per pound.
• 59:28
  That is the funnest car I've ever driven.
• 59:32
  Like it just does whatever it's happy to go.
• 59:35
  It's got enough power for the street and it's totally fun.
• 59:38
  It can be going 20 miles an hour.
• 59:40
  And having a blast switching to the million dollar lady question.
• 59:44
  If you could spend any amount of money, right.
• 59:48
  On a car and let's say that's the car you would have forevermore.
• 59:52
  What would it be?
• 59:54
  Wow.
• 59:54
  That's a really good question.
• 59:56
  Probably the 458 Italia.
• 59:57
  If you had to buy a new car, a 2021 model, is there anything that gets your attention
• 1:00:03
  that's coming out this year, next year?
• 1:00:06
  Yeah, not really.
• 1:00:07
  I'd probably buy another Miata.
• 1:00:09
  A 2021 Miata?
• 1:00:11
  Okay, I can do that.
• 1:00:13
  I've got a question for you.
• 1:00:15
  You keep going.
• 1:00:15
  I just popped in my head that how, how do you feel about the electric revolution?
• 1:00:21
  And if you had to buy an electric car right now, what would it be?
• 1:00:25
  Question.
• 1:00:26
  I think it's very interesting in terms of the technology and battery technology.
• 1:00:31
  So I only think that's going to get better with time.
• 1:00:34
  Um, I had the fortunate experience to drive the take on.
• 1:00:39
  So that was really cool.
• 1:00:40
  It was a little understeery.
• 1:00:42
  It's just that immediate power.
• 1:00:44
  That was awesome.
• 1:00:45
  So, uh, if I had to buy an electric vehicle, it'd probably be the Taycan.
• 1:00:50
  In your opinion, the most attractive car ever penned?
• 1:00:55
  Mm hmm.
• 1:00:55
  Most attractive.
• 1:00:57
  Usually we say sexiest car of all time, but I wanted it to sound
• 1:01:00
  more professional than that.
• 1:01:03
  You could have said beautiful.
• 1:01:04
  Yeah, that's true.
• 1:01:05
  I think the most beautiful car ever built.
• 1:01:07
  Is the F12 Berlinetta by Ferrari.
• 1:01:10
  The lines I just think are perfect.
• 1:01:12
  The proportions.
• 1:01:14
  The way that the air goes sort of through and around the car
• 1:01:17
  and helps with the downforce.
• 1:01:18
  I just think that's just, it's a work of art.
• 1:01:20
  So if we turn that on its head, the ugliest car of all time, ugliest
• 1:01:24
  car of all time, the Nissan Juke.
• 1:01:28
  You are not alone.
• 1:01:30
  You could sit down and have a glass of, Oh, I don't know,
• 1:01:33
  wine or whiskey or maybe a beer.
• 1:01:36
  With Clarkson, Hammond, or May, who would it be?
• 1:01:40
  Richard Hammond.
• 1:01:41
  Really?
• 1:01:42
  Why?
• 1:01:42
  I just like his sort of quirky personality.
• 1:01:46
  He's a little twitchy.
• 1:01:47
  I think that's fun and entertaining and funny.
• 1:01:49
  He'd be a hoot to have a beer with.
• 1:01:50
  I was planning on asking you what your favorite car color was, but we
• 1:01:54
  followed you on Instagram long enough.
• 1:01:55
  The answer is obviously white.
• 1:01:58
  That's a little bit of an inside joke, actually, the white paint thing.
• 1:02:01
  So when I got the M2, I got it in 2017.
• 1:02:04
  So I got it new.
• 1:02:04
  It's a 2018 model year.
• 1:02:07
  And I was planning to get the white cause it's basic white and
• 1:02:10
  I was going to wrap it in yellow.
• 1:02:12
  And so when I got it.
• 1:02:13
  I thought, man, it's actually kind of nice.
• 1:02:15
  You know, I don't mind the white.
• 1:02:16
  And then I learned about self healing, pain protection film.
• 1:02:20
  Right.
• 1:02:21
  And as a surgeon, I just thought that was so cool that the, you can get these
• 1:02:23
  little nicks and scratches and they heal.
• 1:02:26
  So I had to get that.
• 1:02:27
  And then I decided, okay, I don't want to wrap it and put the paint.
• 1:02:29
  So I'm just going to do the paint though.
• 1:02:30
  So I just ended up with a white car.
• 1:02:32
  Then my husband wanted to get a different car.
• 1:02:35
  And so we looked at an Audi TT.
• 1:02:38
  He was doing long road trips at the time and, you know, sleet and snow, and
• 1:02:41
  he wanted the Quattro all wheel drive.
• 1:02:43
  And the place that we go to is a specialist dealer in S and RS cars.
• 1:02:51
  And they had a white TT.
• 1:02:54
  So we ended up with two white cars.
• 1:02:55
  So that was kind of funny to us.
• 1:02:57
  And then after that, he wanted to sort of upgrade and get the TT RS.
• 1:03:00
  So we're looking around and looking at that same dealer
• 1:03:03
  and they had a white TTRS.
• 1:03:05
  So he got a white TTRS.
• 1:03:07
  So then after that, we decided to get a Mazda Miata and we said, okay,
• 1:03:11
  what color are we going to get?
• 1:03:13
  So we just, we stayed with the white.
• 1:03:14
  And then it's just kind of funny between me and my husband
• 1:03:17
  and everything that we have.
• 1:03:18
  And if we trade paint with the cars, it doesn't matter cause it's all white.
• 1:03:21
  So that's just our little joke.
• 1:03:23
  So room, desk or car, which do you clean first?
• 1:03:31
  That's awesome.
• 1:03:32
  I haven't cleaned my desk for like eight months and it's messy.
• 1:03:36
  I have just enough room to do my work and that's fine.
• 1:03:38
  I don't care.
• 1:03:39
  But if my car is messy or if there's like dirt on the floor mat or dust
• 1:03:43
  somewhere that I can see on my, my smear on the windshield, I can't stand it.
• 1:03:48
  I have to clean it.
• 1:03:50
  Well, Dr.
• 1:03:50
  Mellman, I cannot thank you enough for coming on the show.
• 1:03:53
  This has been a really interesting juxtaposition between surgery, the
• 1:03:57
  world of medicine, and motorsport.
• 1:03:59
  I love hearing about, uh, just all the, the surgical lessons
• 1:04:02
  and everything like that.
• 1:04:03
  Uh, I've been following you on Instagram for a long time.
• 1:04:05
  So yeah, it's, it's, it's good to, to, you know, to, to put a voice in
• 1:04:09
  everything to the stories and get a little more detail and background.
• 1:04:12
  As we look back over the plethora of quotes from SLFTR, I wonder,
• 1:04:17
  I guess you don't have a plan for where it's going to go.
• 1:04:19
  They're all reflections upon all your weekends at the
• 1:04:22
  track and things like that.
• 1:04:23
  So we don't know what to expect for next season, but I am looking forward
• 1:04:27
  to what you're going to say next.
• 1:04:29
  I think you've really helped to clarify.
• 1:04:32
  The overlap between the precision and the surgery, the precision and motorsport,
• 1:04:36
  really tying things together in such a way that I don't think many of our
• 1:04:39
  listeners really took a moment to think about before we had this conversation.
• 1:04:44
  And I just find it fascinating.
• 1:04:46
  And I hope that most of our listeners did too.
• 1:04:49
  So with that being said, if you want to learn more about Dr.
• 1:04:52
  Melman and her practice.
• 1:04:54
  So anybody that wants to learn more can go to our website.
• 1:04:57
  If you type in bariatric surgery, New Jersey as all full words, altogether.
• 1:05:03
  com, that's our website.
• 1:05:04
  We are advanced surgical and bariatrics of New Jersey.
• 1:05:07
  We're a six surgeon practice, very high volume with regards to
• 1:05:12
  bariatric surgery, reflux surgery.
• 1:05:14
  and hernia surgery.
• 1:05:16
  And we're one of the expertise centers in the area, but also be sure to
• 1:05:20
  follow her on Instagram at fast track surgeon, as she continues to update her
• 1:05:25
  surgical lessons from the racetrack.
• 1:05:27
  So again, Dr.
• 1:05:28
  Melman, thank you so much for coming on the show.
• 1:05:30
  We've really, really appreciate it.
• 1:05:32
  Thank you so much.
• 1:05:37
  If you like what you've heard and want to learn more about GTM,
• 1:05:40
  be sure to check us out on www.
• 1:05:44
  gtmotorsports.
• 1:05:44
  org.
• 1:05:45
  You can also find us on Instagram at grandtorymotorsports.
• 1:05:48
  Also, if you want to get involved or have suggestions for future shows, You
• 1:05:52
  can call or text us at 202 630 1770, or send us an email gtmotorsports.
• 1:06:00
  org.
• 1:06:00
  We'd love to hear from you.
• 1:06:02
  Hey listeners, Crew Chief Eric here.
• 1:06:03
  Do you like what you've seen, heard, and read from GTM?
• 1:06:07
  Great!
• 1:06:07
  So do we, and we have a lot of fun doing it.
• 1:06:10
  But please remember, we're fueled by volunteers and remain
• 1:06:13
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• 1:06:14
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• 1:06:29
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