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The Pace of Life · White Coat Black Sheep

• 0:00
  Welcome to White Coat, Black Sheep, where science gets curious and dogma
• 0:04
  gets uncomfortable.
• 0:10
  I'm Dr. Civelli, and today I have Tim Pace with me.
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  We're going to talk about physiology, evidence, and real-world
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  medicine, plus all the questions you're not supposed to ask but
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  probably should.
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  Mm-hmm.
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  If you care about health and think there's a better way, welcome to our show.
• 0:27
  Absolutely.
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  Thank you so much for coming on today.
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  No, thanks for having me. It's great to be here.
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  I am just so excited to have you because there's been so much time
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  that's passed since
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  we were working in Bakersfield, seeing our
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  elderly sweet patients.
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  They're lovely.
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  They're so lovely.
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  It's a joy.
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  And they think we're so young because they're just really much older.
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  They are. I feel so old, and they think I'm so young, and I'm just like, "Ugh."
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  We're young pups to them.
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  Sometimes I'm dying inside, but there's
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  a few lively ones out there. I got to say, I had a dancer this morning.
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  Did you?
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  Yeah, you don't see that very often. I think she was 96.
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  I know. That's my grandma.
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  Yeah. She was like cruising down the hallway, ready for dance class.
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  So-
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  I wonder what her lifestyle was.
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  It's got to be something amazing. She
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  probably has some secrets that she doesn't want to share.
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  Right?
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  I think it's movement. Movement is the key.
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  She's dancing. She's still dancing.
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  She's a mover and groover, yeah.
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  Man.
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  Absolutely.
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  I think that's definitely the answer.
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  It's got to be.
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  Well, okay. So you are a doctoral candidate for
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  2027.
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  Yes.
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  And you're almost through your first semester.
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  How's it going?
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  Oh.
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  Tell us, what is- ... a doctorate of lifestyle medicine?
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  So lifestyle medicine-
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  I love it
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  ... is basically whenever you look at it, there's six
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  pillars. So you've got adequate nutrition, you've
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  got avoiding risky substances, restorative
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  sleep,
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  maintaining physical activity, and my two favorite ones are
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  stress management-
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  Oh
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  ... and social connectedness.
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  Oh my gosh.
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  So those are the ones. And so when you look at this from the
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  outside, it's like
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  these are the things you're supposed to be doing that people-
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  Yeah
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  ... already know about. They're like, "Well, why is that a field of medicine?" But
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  certainly-
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  Yeah
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  ... it goes way deeper because-
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  Because we're not good at it, people. That's why.
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  Exactly. People don't do it.
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  Look at me.
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  And yeah.
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  I've been so stressed.
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  Yes.
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  I had to deep breathe-
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  Mm-hmm
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  ... literally before we started this session.
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  You saw it, and you're like, "You're good." I feel stressed.
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  Yes. And you know, it's the hardest thing to
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  implement these things.
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  It is.
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  And so from a lifestyle medicine standpoint, you
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  interview people, you listen to them.
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  Yeah.
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  There's these long forms that you fill out that you don't see on a regular medical
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  intake, and you find out where people are on their human connection side.
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  Wow.
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  Where are they at physically, but also mentally?
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  What kind of barriers do they have in their life?
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  And then you start to address those.
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  You got to find out what stage people are at.
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  Do they want to change? Are they like, "Oh, no. I'm not changing.
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  I'm not here." Are they at this pre-contemplation stage-
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  Yeah
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  ... or are they motivated-
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  Mm-hmm
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  ... and they're at a further stage?
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  And so you actually give them, it's
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  non-medical prescriptions for activities to do.
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  They're called fit prescriptions.
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  I love it.
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  F-I-T-T. So frequency, intensity, time, and
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  these are the things to help people move through the stages
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  to ultimately make this a lifestyle, a habit.
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  And it's harder than you think. I mean, really.
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  No, it is so hard. And I don't know really what's more
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  challenging right now.
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  Because to be successful, to be fit,
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  to have the look that you want, to have-
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  Mm
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  ... the life that you want, to,
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  I don't know, the family, the vacations,
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  I mean, come on.
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  Yes. So it's the small changes that you
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  make. You're not flooding somebody with-
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  Thank you
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  ... you're not just, somebody's like, "I want to get into exercise," and you're
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  like, "I'm going to prescribe you a marathon a week," or whatever.
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  You got to examine what their lifestyle-
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  I would fail
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  ... entails. And so, it's interesting, when you first
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  come in as a patient, you do this lifestyle medicine long form, and it's
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  asking you all these questions about how you perceive things.
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  And then you score it.
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  Wow.
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  And the biggest
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  surprise for me when I did it, and went back and reviewed it, is I found out
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  I had anxiety. I scored off the charts on anxiety and
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  stress.
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  You mentioned that.
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  Yes. I knew I was stressed. And you're like, "Oh, life is stressful.
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  It's this-"
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  It's so hard.
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  I never considered anxiety as a thing.
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  And those-
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  Because that's the diagnosis.
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  Absolutely.
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  That changes it.
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  Yeah. And it's just how you perceive a certain situation, how you feel about it,
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  and then it's-
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  You just gave me an anxiety breath. Did you see that?
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  I just got anxiety for you.
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  Yes.
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  Oh my gosh.
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  But I think the first step is recognizing it, right?
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  Yeah.
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  And then you can address the things, and-
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  I'm ignoring mine.
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  Oh, yes.
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  I'm not ready.
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  Well, it's really difficult because the stats are
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  astounding how many people are so stressed out-
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  Yeah
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  ... over work, social media, life in general,
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  responsibilities, and it builds up.
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  And then-
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  Yeah
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  ... as you know, there's these
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  detrimental effects-
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  Yeah
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  ... physically-
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  Yeah
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  ... chemically in your body from stress.
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  Predictably.
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  Right.
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  Predictable health problems.
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  Yeah. So you got to find some interventions there before it gets out of hand
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  and leads to
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  psychosis or depression or-
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  I don't want that.
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  Yes.
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  I don't want down there either.
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  Or total burnout.
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  I don't need that one.
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  Oh, yeah. Because we've experienced burnout before.
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  Oh my goodness.
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  There's nothing that is-Worse than
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  just sitting there thinking there's nothing I can do.
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  And then you just isolate, right?
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  Yeah.
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  You're just like, "I don't want to hear anybody.
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  I don't want to hear anything." And then you just crawl in a corner.
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  Yeah.
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  So, you-
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  And then nothing happens for you in that corner.
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  Exactly. Yeah.
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  You're just hiding from everything.
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  The thing in the corner-
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  Which taking your time can be great, but you want to do it in a
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  healthy way, right?
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  No change has happened while you're in your corner.
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  No. You just put off all your problems and let them build up.
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  So,
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  yeah. It's very interesting, and it's cool to see
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  little techniques that you can throw in here and there that can make a big
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  difference.
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  I love it. Well, I do hope that throughout our entire session, that
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  you do throw some of those little techniques.
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  I am going to teach you a very easy one.
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  Please.
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  And so, when you're ready, we can do it.
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  Mm-hmm.
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  Okay.
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  Okay. So, before we learn how to fix anything,
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  you acknowledge that I have anxiety, right?
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  Because you did,
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  I guess, a questionnaire.
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  Yes.
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  So, there's been a lot of different talks even especially about depression, about
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  how we poorly diagnose it, and how we are using these
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  old-school techniques to treat it with SSRIs or whatever.
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  But really, we don't have any other tools.
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  It is a subjective assessment, but look at what it did for
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  you, right?
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  Yes. Absolutely.
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  Questions that request you as the
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  person taking that to look inside, stop
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  what you're doing, and to just
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  read, "Do I actually have this?"
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  It's weird. It's a different experience.
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  It is. And that's one of the big rules of the American College of Lifestyle
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  Medicine. It's they really hold their providers to
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  living the lifestyle.
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  That's the phase I'm in, so I guess I'm-
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  Yes.
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  Yeah.
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  It's just like you go into your physician and them preaching to you about
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  losing weight if they're overweight, or them preaching to you about stress if
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  they're like a total stress ball. And so it's like,
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  you've got to live the life.
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  Yeah.
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  And for me, I think it's been a huge therapy session-
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  Yeah
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  ... going through.
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  I love that for you.
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  Absolutely.
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  So it's fun?
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  I'm not going to say school's fun, because there's a significant amount of
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  writing.
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  Okay.
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  I think for people who love writing, that might be super
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  fun for them. I'm more of a talker, as you know.
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  Just
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  get it flowing, and we'll sit there and talk forever. I hate texting.
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  I hate-
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  Yeah
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  ... any form of written communication.
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  Interesting.
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  And this is a lot of writing. And-
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  Are your thumbs slow? You think maybe that's part of it?
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  Or as a guy, maybe your thumbs are big?
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  Thumbs are slow.
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  Show me your thumbs.
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  I
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  think I have average thumbs, but
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  basically I get around
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  it.
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  Mm.
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  Like if I'm writing a paper, I have it on dictate mode.
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  Yeah.
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  And I'll just sit there and talk about the whole thing, and write the paper, and
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  then go back and fix all that.
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  It's like Microsoft Word?
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  Yes.
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  Okay.
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  Yeah.
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  Whenever I was in my paper-writing era, that feature didn't work.
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  And so it was like- ... your voice tech's gone really
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  wrong. It just is so bad. I'm just like, "You are a
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  useless feature."
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  It is. I think it's gotten better.
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  Good.
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  It does a decent job. And-
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  Okay
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  ... yes.
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  Yeah.
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  There's room for improvement, though, because it'll still put some
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  weird things in there.
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  Still does.
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  You can't just let it fly without proofreading it, that's for sure.
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  You could definitely go down a little wrong road there. So.
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  Oh my gosh.
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  Well, okay. Are we any steps closer to the
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  farm? Because I know that's on the list of the future, like wellness ventures.
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  Yes. So, that's the mission.
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  As you well know, I've ventured out to
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  Idaho looking around for this perfect farm for the miniature donkeys and
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  alpacas, and all the fuzzy little things.
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  Which I love it.
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  Yeah.
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  It's such therapeutic intervention.
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  Exactly.
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  I think that would work for me.
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  Yeah. And it's much easier-
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  They're like fluffy, innocent, sweet, can't talk.
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  Absolutely. That's the key there, can't talk.
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  You just come home to your animals. They just love to see you.
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  They run to the fence. They're super happy.
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  Yeah.
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  Which interestingly enough, we talk about that,
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  biochemically for us, for humans, and for
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  dogs even. They did a study on the release of oxytocin by petting your
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  dog-
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  Oh
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  ... and the release of oxytocin in the dog itself coming up- ...
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  and freaking out. Theirs is way higher.
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  They're way happier than we are.
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  Yes.
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  So they just get-
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  That's why we're so bonded.
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  Yeah. That's the thing.
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  It's amazing.
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  Little Jax comes in and just loses it.
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  I just made him high.
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  Yes, exactly.
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  So, it's really cool to learn. You think of it as just,
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  "Oh, it's an emotion, just being happy." But it's actually, you break it down, the
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  science, it's a chemical process-
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  Yeah
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  ... that you're dealing with there.
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  Just gave him drugs.
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  All of these things are. No matter what the emotion you're feeling, there's a
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  process going on chemically in your brain that's doing it.
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  Do they talk about cats? Like why they just don't care?
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  Have they got to the cat part? I
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  would love to know
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  their level of-
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  They're like, "I could not."
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  Yes, exactly. Yeah. Or they just look at you in
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  disgust and walk right by. Maybe slap something off the counter.
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  But that's their way of showing you.
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  It's either a big F you or it's like-
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  That's just savage.
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  But you know how they'll just look at you sometimes, and they know-
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  Judgy eyes
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  ... they want you to make eye contact, and then they just stare at you and slap
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  something off of the counter. I know Leo, our cat, was
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  like that, and she just knew she wouldn't do it, but she would
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  just-Boom, and just wait for you to react.
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  Oh my gosh. If we have any veterinarians or anybody in this industry of
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  science, if you happen to know the chemical differences, I would love to
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  know.
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  Yes.
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  Okay, so just fun fact. While I took Jax to his cardiologist, because I
• 12:00
  think he was faking a heart issue just for attention, for more oxytocin
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  because he was fine. But I learned that dogs are
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  more parasympathetic, so their heart rates are
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  slower, and they have a natural
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  AFib.
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  Really?
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  Because I heard it, and I was like, "Oh my gosh.
• 12:18
  The sounds are regular," but then technically you're not supposed to be able to
• 12:21
  hear
• 12:22
  atrial fib.
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  Mm-hmm. Yeah.
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  I'm like, "Okay." I just knew this is a murmur.
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  And then it was irregular. So, yeah.
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  And then cats, on the other hand, stay sympathetic.
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  Okay.
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  So, just in their heart rates are different.
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  A normal for cats is different than normal for dogs.
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  Yes.
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  Anyway.
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  I don't know.
• 12:43
  Yeah.
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  Like we were talking about, there's all of these nervous actions.
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  Yeah.
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  The release of the chemicals, everything you do.
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  So when you're stressed out, you're stuck in this sympathetic-
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  Yeah
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  ... pathway.
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  Yeah.
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  You're in fight or flight-
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  Yes
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  ... essentially.
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  Yeah.
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  Even when you think of a scenario. So this is
• 13:01
  things that we're running with. So
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  maybe, I'm not judging gender-wise, but I've heard many
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  times that people wake up mad out of dreams, and I've been the
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  recipient of somebody being mad at me because of a
• 13:15
  dream.
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  I know.
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  And so
• 13:16
  Holy crap. I
• 13:20
  probably shouldn't say I never anything, but I don't think I've ever done that.
• 13:23
  Yes. Well, it's fairly common. It's happened to me multiple times.
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  Okay.
• 13:27
  And so these dreams, I obviously do something wrong.
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  Somebody wakes up and is very mad at me, and then I have to
• 13:35
  suffer the consequences-
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  It's like a ghost
• 13:36
  ... and apologize for whatever Dream Tim
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  did. Yeah. So it's
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  Dream Tim.
• 13:43
  Exactly. It's like
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  nightmare or however you want to put it, but the same is true.
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  So
• 13:51
  when you're thinking of a scenario-
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  Mm-hmm
• 13:54
  ... in your head, and it may not be true at all.
• 13:57
  Say you're running a scenario, you're going to confront somebody or say something.
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  That elicits that chemical
• 14:05
  release of stress and sympathetic activity and-
• 14:07
  Yeah
• 14:08
  ... oxidative stress in the body-
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  Yeah
• 14:10
  ... just thinking of the scenario. The scenario doesn't even have to happen.
• 14:13
  Right. But it's like a neural link was formed, like there's
• 14:17
  a circuit that was formed.
• 14:18
  Yes.
• 14:18
  Why do we have to remember it? That part makes it weird to me.
• 14:22
  Mm-hmm.
• 14:22
  But I guess it's also because it surged a catecholamine, or even
• 14:26
  an anticholinergic surge.
• 14:30
  Both of those, any of those, could cause a memory.
• 14:33
  Absolutely. Yeah.
• 14:34
  Which is crazy.
• 14:35
  Yeah. And yeah, when people say, "It's all in your head,"
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  it's there.
• 14:40
  It is.
• 14:40
  It's there.
• 14:41
  Physically.
• 14:41
  There's so much control. You think about these Buddhist monks that sit there and
• 14:45
  meditate, and people that are just-
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  Are they really happy?
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  So-
• 14:48
  Have we asked them?
• 14:48
  Well, I think it's about
• 14:51
  being present, being in control.
• 14:53
  So they don't even ask questions.
• 14:53
  Controlling your memories, controlling your thoughts
• 14:56
  to your advantage to
• 15:00
  not being at the mercy
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  of the wild brain. The wild brain's out.
• 15:06
  Somebody's got to tame it. Somebody get a whip.
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  I'm a straight victim.
• 15:11
  Oh, right here too. This thing goes 90 miles an hour.
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  Wake up in the middle of the night, and it's like, "Beep, beep, beep." Starts
• 15:17
  firing off all these stressful things.
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  Oh my gosh.
• 15:18
  I'm like, "Ooh. Let me put on some 'Ancient Aliens' real quick and kind of distract
• 15:22
  myself," so.
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  Okay. So on that note, so then you do
• 15:28
  recognize it. You feel a little bit of a surge, a spiral in
• 15:32
  a sense.
• 15:33
  Absolutely.
• 15:34
  Overwhelm, anxiety, and you know that you need to go back to sleep
• 15:37
  health-wise.
• 15:38
  Mm-hmm.
• 15:39
  And that you can catch another window, so you put on something
• 15:42
  to...
• 15:44
  The higher center of you, your frontal lobe then chooses that.
• 15:47
  Yes.
• 15:49
  So that's the cool part.
• 15:50
  Mm-hmm. So you've got to make these decisions, right?
• 15:54
  Yeah.
• 15:54
  Otherwise, you'll lay there inside your head and start going around in circles,
• 15:58
  and you're-
• 15:59
  Which is a loop
• 16:00
  ... it's a loop, and then you're laying there, and then you're starting to
• 16:03
  fear-
• 16:04
  Mm-hmm
• 16:05
  ... out of your, let's say, is it the prefrontal cortex or the
• 16:08
  amygdala?
• 16:09
  Amygdala.
• 16:09
  The amygdala, your fear center. Yes. Yeah.
• 16:11
  So
• 16:12
  you start fearing that you're not going to go to sleep-
• 16:15
  Mm-hmm
• 16:15
  ... and that you're going to be tired the next day.
• 16:18
  Yeah.
• 16:20
  And then
• 16:21
  it elicits anger.
• 16:22
  Sleep stress.
• 16:22
  Yes.
• 16:23
  Yeah.
• 16:23
  You're angry because you can't go to sleep, and then your heart rate's up, and then
• 16:26
  you're-
• 16:26
  Yeah
• 16:26
  ... oh, man. So-
• 16:28
  Yeah
• 16:28
  ... there's ways around that. Obviously, and probably you've heard of it,
• 16:32
  like Calm app and things like that.
• 16:34
  They've got-
• 16:34
  Calm did not make me feel calm.
• 16:37
  I've got a funny story about Calm. So I signed up,
• 16:41
  and they have-
• 16:42
  It made me mad that it made me feel un-calm.
• 16:44
  Have you tried the bedtime stories?
• 16:47
  No.
• 16:49
  Wait, does it have a purple cover?
• 16:51
  I don't know. It's on the app, but I
• 16:55
  had never tried a bedtime story. So there was this one, I just picked a
• 16:59
  random one, and it happened to be Harry Styles telling a bedtime
• 17:03
  story.
• 17:04
  He does that.
• 17:04
  And he's like, "Imagine us cuddled underneath the
• 17:08
  stars." So here I am cuddling with Harry Styles underneath the
• 17:12
  stars.
• 17:13
  Were you smiling?
• 17:14
  I was like-
• 17:14
  Did you sort of like that?
• 17:15
  I laughed. I was like, "What?"
• 17:18
  You laughed because you were like, "No."
• 17:20
  No, it was just
• 17:22
  so random. And I think Matthew McConaughey has one.
• 17:26
  Oh, wow.
• 17:27
  There's different
• 17:28
  Hollywood stars that have started putting out-
• 17:31
  Interesting
• 17:31
  ... these bedtime stories.
• 17:33
  Huh.
• 17:34
  Yeah.
• 17:34
  Based on the voice that you want.
• 17:36
  It's their voice, yeah.
• 17:38
  Huh.
• 17:38
  I think a good person that could do it would be Morgan Freeman.
• 17:41
  He does a really good one. I could listen to him.
• 17:45
  I think he reads the Bible or some book, or I could just listen to
• 17:49
  him. He's got a very calming aspect.
• 17:51
  I just think the bass in his voice.
• 17:52
  Yeah, it must be.
• 17:53
  He's got a very deep voice. I think most people would like that.
• 17:57
  Yes.
• 17:58
  Very manly.
• 17:59
  Yeah. My favorite is David Attenborough.
• 18:02
  I have to look up who he is.
• 18:03
  He's a
• 18:04
  British guy that narrates all these nature things, and
• 18:08
  he'll tell you random facts about animals, just random.
• 18:11
  I love random animal facts.
• 18:12
  And the weirdest animals, and just the facts about them and what their behaviors
• 18:15
  are.
• 18:15
  Yeah.
• 18:16
  And then it bounces to another animal, and so there's no storyline that you get
• 18:19
  caught up in. You're just listening to his voice tell you facts about animals, and
• 18:23
  that, for me-
• 18:24
  I like that
• 18:25
  ... that's great.
• 18:26
  Yeah.
• 18:26
  And you don't have to worry about the TV, even though-
• 18:28
  Yeah
• 18:28
  ... "Ancient Aliens" works good. I think the blue light from the TVs
• 18:31
  disrupts your sleep patterns-
• 18:33
  I know
• 18:33
  ... and your REM sleep, so
• 18:35
  that's-
• 18:36
  And I choose all... Okay, not me, but
• 18:38
  Crystal choose all these murder-type shows.
• 18:41
  Yeah.
• 18:41
  And I'm like, "All the violence." Jack's my dog. He can't even handle it.
• 18:44
  He hears a few-
• 18:45
  Man
• 18:45
  ... one gunshot, he's out.
• 18:47
  Oh, no.
• 18:47
  He's like, "This is ruining my sleep score."
• 18:50
  My mom does that. My mom listens to the ID channel and serial
• 18:54
  killer type stuff to sleep. Yeah.
• 18:56
  She's just a man.
• 18:56
  I incorporate them out in my dreams, so it's a little weird.
• 19:01
  I'd rather dream about random little animals doing their thing.
• 19:05
  I love that.
• 19:05
  Yeah.
• 19:06
  Or even in real life, not sleep, or going to sleep to this stuff.
• 19:10
  I like just random animal facts. I find it-
• 19:12
  Yeah
• 19:12
  ... calming, interesting, always relevant to no matter what is
• 19:16
  the situation.
• 19:17
  Yes.
• 19:18
  It's therapeutic.
• 19:19
  Right.
• 19:19
  So you guys, if you're around us, just, "Hey, did you know?"
• 19:24
  Yeah.
• 19:26
  Just
• 19:27
  like random facts about the galaxy, space, anything like that.
• 19:30
  Yeah.
• 19:30
  And I think everybody has to find their calming thing, right?
• 19:33
  Yeah.
• 19:33
  I'm very interested in space and alien stuff.
• 19:36
  I hope to get-
• 19:37
  Yeah
• 19:37
  ... abducted one day. And that is, I listen to these
• 19:41
  things that don't have a storyline, because you start listening to a storyline, if
• 19:44
  I'm listening to an interesting book-
• 19:46
  Yeah
• 19:46
  ... I'm just going to get into it. So there's little tricks to sleep, but there's
• 19:50
  also-
• 19:50
  Yeah
• 19:50
  ... breathing exercises that are really-
• 19:53
  You need to breathe better. No, I agree with you.
• 19:55
  It's just so effective, but it's easy to disconnect and
• 19:59
  forget that part.
• 20:00
  Absolutely. It is. And that's where you have to
• 20:03
  integrate, see what people's situation's like.
• 20:07
  Yeah.
• 20:07
  If you've got a high-stress job, you're
• 20:10
  already behind all the time. There's things coming up.
• 20:13
  Oh, yeah.
• 20:13
  You got to find quick little interventions.
• 20:15
  I need quick interventions.
• 20:15
  And so one of the easiest things-
• 20:18
  Yes
• 20:18
  ... is called box breathing.
• 20:21
  Okay.
• 20:21
  Have you ever heard of that?
• 20:22
  So when I did my first cold plunge, the guy was like, "You should box
• 20:26
  breathe."
• 20:27
  Yes.
• 20:27
  And I was
• 20:29
  just flooded because the cold plunge is just so cold.
• 20:32
  Yeah.
• 20:33
  So, no. I guess the answer's no.
• 20:34
  Okay. All right. So easy thing. So what you do,
• 20:38
  you don't have to close your eyes and do this. It helps me to do this.
• 20:41
  Okay.
• 20:41
  And so you visualize this box, okay?
• 20:43
  And visualize something going around the box.
• 20:45
  So you inhale for four seconds,
• 20:50
  and then you hold it for four seconds.
• 20:54
  Then you exhale for four seconds,
• 20:58
  hold it for four seconds, and repeat. So it's a four, four, four, four.
• 21:01
  Okay.
• 21:02
  Right?
• 21:02
  And you're drawing a box.
• 21:03
  You're just drawing that box. You're just watching a little thing go around the
• 21:07
  box.
• 21:07
  Interesting.
• 21:08
  And there's actually videos online doing that.
• 21:10
  I might have to look that up.
• 21:10
  So that's the easiest one. And then you can do that
• 21:14
  less than a minute. You can do one round, you can do
• 21:18
  10 rounds, however much you need to calm yourself down.
• 21:22
  And so I've got a little list here of all the
• 21:27
  benefits of box breathing.
• 21:28
  Please tell.
• 21:28
  What's going to happen?
• 21:29
  Let's hear it.
• 21:31
  So obviously you're doing this deep breathing, so you're going to increase your
• 21:34
  oxygen level. You're going to decrease your blood pressure.
• 21:37
  You're going to increase your parasympathetic, which is the relaxing.
• 21:41
  You're going to decrease your fight or flight, because say you're stressed out,
• 21:45
  you're getting to a point, somebody's made you mad, you're starting to do this.
• 21:48
  So you got to shut that off, okay?
• 21:50
  Like you feel the flood. You feel like a flood of... Oops.
• 21:52
  You feel-
• 21:52
  Yes. Mm-hmm
• 21:54
  ... all those feelings.
• 21:54
  Yeah, you feel this going on. And so it increases your
• 21:58
  GABA, which is your calming chemical.
• 22:01
  Decreases your cortisol-
• 22:03
  Okay
• 22:03
  ... which is that very detrimental stress chemical.
• 22:05
  Yeah.
• 22:05
  Right? And then decrease the
• 22:09
  adrenaline and noradrenaline.
• 22:10
  Okay.
• 22:10
  So therefore,
• 22:12
  from the adrenal. So you're decreasing your heart rate and your blood pressure.
• 22:16
  You're activating your prefrontal cortex-
• 22:19
  Okay
• 22:19
  ... which increases focus-
• 22:21
  Right
• 22:21
  ... and helps with decision-making, clear decision-making.
• 22:23
  Oh, thank God.
• 22:24
  Okay?
• 22:25
  Right.
• 22:26
  And then lastly, you're calming down your amygdala, which we talked
• 22:30
  about earlier is your fear center.
• 22:32
  Which sucks. Just on that note, that your amygdala
• 22:36
  is a lower function. It is a lower
• 22:40
  level of function. When I learned that in neurology,
• 22:44
  I was just like, "Oh my God." That's why they're like emotional
• 22:48
  decisions, they are not wise decisions.
• 22:50
  Exactly.
• 22:51
  They're not.
• 22:52
  Exactly.
• 22:52
  They could not-
• 22:53
  Yeah, because when you're stressed out, you're not going to make the most rational
• 22:56
  decision.
• 22:56
  Mm-hmm.
• 22:57
  You're not going to think through it clearly, because here you are, this
• 23:00
  adrenaline's flowing. All this is-
• 23:02
  Mm-hmm
• 23:02
  ... you're going to be reactive.
• 23:03
  Yeah.
• 23:04
  Your blood pressure's up.
• 23:05
  Yeah.
• 23:05
  Calm, thinking, decisive, and so it's-
• 23:09
  Prefrontal
• 23:09
  ... interesting that just doing this box breathing a
• 23:12
  couple times around, less than a minute, and-
• 23:15
  Mm-hmm
• 23:15
  ... you can feel the psychological high that you get from it.
• 23:19
  You can-
• 23:19
  Wow
• 23:19
  ... feel it, right?
• 23:20
  Yeah.
• 23:21
  And it will recenter you, and it's such an easy little thing.
• 23:24
  There's tons of techniques, there's tons of breathing and breathwork out there,
• 23:28
  but that is,
• 23:31
  I found, the easiest one to explain.
• 23:33
  That's awesome.
• 23:34
  It's not complex, and people can implement that at a red light.
• 23:38
  Oh my gosh
• 23:38
  You're getting some road rage, do some box breathing for a second.
• 23:41
  Totally.
• 23:41
  I just did it on the way here, so
• 23:47
  Oh my gosh.
• 23:49
  So when it comes to if you
• 23:53
  compare that to say, the
• 24:00
  Mm-hmm
• 24:00
  The out breath
• 24:01
  Yes
• 24:02
  Specifically will lower the heart rate.
• 24:04
  Yes.
• 24:05
  The difference with box breathing is
• 24:09
  giving that a fair and equal square, right?
• 24:13
  Yes.
• 24:14
  So it's like you're giving energy to the parasympathetic to balance on the
• 24:18
  seesaw with the sympathetic.
• 24:20
  Right.
• 24:21
  Because they're always in competition.
• 24:23
  And a lot of the times, the tool that's in there is also the focus.
• 24:27
  So we were talking about distracting ourselves to go to sleep, right?
• 24:30
  Yes.
• 24:30
  So you're not thinking about these things you got to do the next day
• 24:33
  Yeah
• 24:34
  ... or what's stressing you out. So
• 24:38
  by focusing, and the reason I said visualize this box-
• 24:42
  Yeah
• 24:42
  ... in your head is-
• 24:42
  So that helps me a lot
• 24:43
  ... there you go. Now your focus has changed-
• 24:46
  Yeah
• 24:46
  ... totally off of the thing that was causing you to get all raged up.
• 24:50
  Oh my gosh.
• 24:51
  So, it's very-- And there's tons of techniques.
• 24:53
  Yeah.
• 24:53
  You could go into breathing exercises and breath work for a long time,
• 24:57
  and it's great.
• 24:59
  Yeah.
• 24:59
  And once you put that into practice-
• 25:02
  Mm-hmm
• 25:02
  ... and can implement that in your daily, that's just a little tool that you have
• 25:05
  in your pocket.
• 25:06
  I'll just stop talking to patients.
• 25:09
  Like, I'll have a stressed patient, I'll just like, "Hold on."
• 25:12
  Yeah.
• 25:12
  "I am seeing a box at this moment."
• 25:15
  Or let them keep talking, because they're probably not talking about anything
• 25:18
  relevant to the visit.
• 25:20
  I'll draw a box around their head.
• 25:23
  We've talked about this before, how it's just like you're in a
• 25:26
  visit with a patient, and the last thing they're talking about is the relevant
• 25:29
  things. They're talking about their cousin or where they-
• 25:31
  Why?
• 25:31
  ... lived 30 years ago. And you're like, "You're wasting both of our times
• 25:35
  right now. Let's get this thing done."
• 25:37
  You guys.
• 25:38
  Nothing like chatting it up with somebody, but you have an appointment, you have a
• 25:40
  certain length. Let's address the problem and work on it here-
• 25:44
  Yeah
• 25:44
  ... not fly off the handle and talk about such irrelevant
• 25:48
  things. Yeah.
• 25:49
  Yeah. If I could give any piece of
• 25:53
  advice to non-medical people-- No, I don't even
• 25:57
  want to say that, because even outside of--
• 26:00
  So
• 26:02
  you're a physician assistant, you're going for your doctorate, clinical for
• 26:06
  20 something years, right?
• 26:07
  Right.
• 26:07
  In orthopedic surgery. And then, MP,
• 26:11
  MD, DO, doesn't matter, we have to document a
• 26:15
  certain way. And there's no way that patients will--
• 26:19
  You won't know how we have to
• 26:23
  gather the information and put it in so that it's proper, but
• 26:27
  we have to, at some point-
• 26:28
  Yes
• 26:28
  ... gather specific details and put them in an
• 26:32
  exact format that is medically proper, and legal, and
• 26:36
  medical, and useful. And if we don't do that, then
• 26:40
  it's like we just wasted... I don't know.
• 26:43
  You're at risk of so many things.
• 26:44
  Yeah.
• 26:44
  Like medical legal.
• 26:45
  Absolutely.
• 26:46
  And so whenever you, as a
• 26:50
  patient, don't give us anything that is
• 26:54
  relevant to-- Like, this is your moment.
• 26:58
  There's no other time. This is the time for you to
• 27:02
  say exactly what you want, feel, how you are doing, how you're
• 27:06
  not doing. The rest of it doesn't fit into our note.
• 27:10
  It doesn't help us. Maybe I get to know you a little bit better, but you
• 27:13
  are wasting your time.
• 27:15
  Absolutely. Yeah.
• 27:16
  It's just so-- I don't even know how else to say it.
• 27:19
  Right. If you have extra time, you know me-
• 27:23
  Come on, say it
• 27:23
  ... I'm a talker. I'll chat with anybody.
• 27:25
  But when you're
• 27:27
  on 20-minute time slots or 15-minute time slots-
• 27:30
  That's not even real anymore
• 27:31
  ... Yeah, I know.
• 27:32
  You know, I was trained-
• 27:33
  You don't have that much of documentation, right?
• 27:34
  So I don't know about yours, but we were trained to do a seven-minute
• 27:38
  start to finish.
• 27:40
  Oh, please.
• 27:40
  Your note, everything.
• 27:42
  Yes.
• 27:42
  That means two to three minutes with the patient, and
• 27:46
  then next orders, next
• 27:49
  do your note, and then sign.
• 27:50
  Yes.
• 27:51
  Like, we're just real timed.
• 27:52
  Mm-hmm.
• 27:52
  And these are formal.
• 27:53
  That's crazy.
• 27:55
  That means, don't tell me 31 years ago when I
• 27:59
  was
• 28:00
  in Oklahoma and I,
• 28:04
  my, you know, I-
• 28:06
  Then you're distracted.
• 28:07
  Woo
• 28:07
  "My uncle, he lived there, and he did this."
• 28:10
  I just-
• 28:10
  It's like, that's fine.
• 28:12
  I died.
• 28:12
  Yeah.
• 28:13
  I can't. It shuts all systems-
• 28:16
  Catch me outside and conversate with me. Just don't do it here in the office.
• 28:19
  Cut me
• 28:21
  to the bottom.
• 28:22
  Yeah, see me at the grocery store, then we can chat, but
• 28:26
  yeah,
• 28:27
  don't waste the office time doing that.
• 28:29
  Yeah. And I don't know about how you handle these, but
• 28:33
  whenever somebody tries to throw the ball back to me, because we
• 28:37
  walk in, we're the provider, "Hey, how are you?"
• 28:41
  "Great. How are you?" "I'm wonderful.
• 28:44
  How can I help you?" "Oh, what's new with you?" "Nope."
• 28:48
  Irrelevant.
• 28:50
  Yes.
• 28:51
  We are both here for you.
• 28:53
  Yeah. This is my new... This is what we do right now.
• 28:56
  This is what's new. So let's get back-
• 28:59
  Yeah
• 28:59
  ... on it, right?
• 28:59
  What's new with you? I'm going to always bounce it back and I just
• 29:03
  wish that somebody had maybe a pre-visit video.
• 29:08
  It's not a bad deal. Yeah. You just do that.
• 29:11
  Or you have one of those big red buttons where you just hit it, and it's like,
• 29:15
  "Focus."
• 29:17
  So you don't feel like you're interrupting somebody,
• 29:21
  but if you hit the button, I think they'll get the point.
• 29:23
  Yeah. Would you guys think it's rude if we throw up flags or cut-- Like you are in
• 29:27
  a yellow zone. You are in the irrelevant zone headed towards a
• 29:31
  red zone where it's like, eh.
• 29:32
  Yes. And we're doing that, it's not to be rude,
• 29:36
  it's to get you the most out of your visit, right?
• 29:39
  I can't help you-
• 29:40
  Yes
• 29:40
  ... if you've just spent your entire time, and I've just given you the
• 29:44
  best of my energy, and the last person gets scraps.
• 29:48
  Yes.
• 29:49
  Especially when you go home, that person really gets scraps.
• 29:52
  Oh, exactly. Well, medical
• 29:55
  professionals are-Burned out.
• 29:58
  Mm-hmm.
• 29:58
  Burning out is a huge thing. There's so many articles on it right now.
• 30:02
  Yeah.
• 30:02
  The percentage is going up, up, up, along with documentation and
• 30:06
  EMRs and-
• 30:07
  Ugh
• 30:08
  ... and social media, all of these things.
• 30:10
  And people in general, in life, the anxiety, the
• 30:14
  depression, the stress levels, they skyrocketed
• 30:18
  after the internet, and especially if they were on a trajectory like this after the
• 30:22
  internet, then after COVID, they were like this.
• 30:25
  Oh, totally.
• 30:25
  There was a grand change in society, and so it's a
• 30:29
  huge medical problem.
• 30:31
  Yeah.
• 30:32
  It's a psychological and physically medical problem because, as we
• 30:35
  talked about, the psychological effects affect your physical-
• 30:39
  Ugh
• 30:40
  ... your cardiac, your metabolic-
• 30:41
  It does. We can't separate it
• 30:43
  ... metabolic disease. And just the going back to
• 30:47
  the basics-
• 30:47
  Yeah
• 30:48
  ... with lifestyle-
• 30:49
  Yeah
• 30:49
  ... and getting things in order can prevent up to
• 30:53
  80% of chronic and metabolic
• 30:57
  diseases.
• 30:58
  Wow.
• 30:59
  If you can just-
• 31:00
  I believe it
• 31:00
  ... follow this.
• 31:01
  Yeah.
• 31:02
  And it's really interesting. Yeah.
• 31:05
  In your doctorate, do they
• 31:08
  focus on more of the provider
• 31:11
  side to not burn out or the patient
• 31:15
  side, or both?
• 31:17
  It's-
• 31:17
  Like bringing that together
• 31:18
  ... it's really focused on both. I've
• 31:21
  never been in-- Throughout any of my medical
• 31:26
  training, throughout whatever, it's all been about the patient.
• 31:29
  Yeah.
• 31:30
  And then you're automatically supposed to be okay as the provider.
• 31:32
  We're the asset.
• 31:33
  Right. Yeah, we are the tool.
• 31:35
  Yeah.
• 31:35
  You're just supposed to be okay. But then, as you know, I've seen it myself, but
• 31:39
  we take-
• 31:40
  Yeah
• 31:40
  ... the least care of ourselves. People around me, it's not just me, but
• 31:44
  I've been like eating-
• 31:45
  No, we've trashed ourselves
• 31:46
  ... chugging Mountain Dews and eating Snicker bars at 3:00 in the
• 31:50
  morning trying to get to the next surgery.
• 31:51
  And we laugh about it.
• 31:52
  Yeah.
• 31:52
  I used to smash Red Bulls, like three of them-
• 31:55
  Yes.
• 31:55
  ... and be like, "I don't feel anything."
• 31:56
  Yes, just pots of coffee. Just all the things that are horrible for you,
• 32:00
  and then you're trying to give-
• 32:02
  Disgusting
• 32:02
  ... your energy to other people. So you can't be your best as a provider if you're
• 32:06
  not taking care of yourself. So
• 32:08
  it's very unique that this program
• 32:12
  focuses, and there's things, it's like here's a provider section.
• 32:16
  You're taking a survey or you're taking the same thing a patient
• 32:19
  is on the monthly to see where you're at.
• 32:22
  Because if you're down here-
• 32:23
  Yeah
• 32:23
  ... how are you going to get somebody up here? How are you going to lift them up?
• 32:26
  Oh, I love that.
• 32:26
  Yes, absolutely.
• 32:28
  Ooh, that's really good.
• 32:29
  Yeah.
• 32:29
  It's almost like the other side to the
• 32:33
  comment that we hear over and over, and over.
• 32:36
  Maybe we've even said, who wants to see the doctor
• 32:40
  that is
• 32:41
  not the image of health and wealth, right?
• 32:44
  Who wants to be the patient of somebody who's like, "You need
• 32:48
  to exercise and work on your diet and stress," but then
• 32:52
  they look very unwell. They look-
• 32:54
  Yes
• 32:55
  ... very unhealthy. They look sloppy and not put together, and it's
• 32:58
  like
• 33:00
  they're giving too much to you.
• 33:02
  Yes, yeah.
• 33:04
  To somebody-
• 33:06
  Mm-hmm
• 33:06
  ... they have given too much, and they need to look at themselves now.
• 33:09
  Absolutely.
• 33:10
  And so it's like on our side, obviously, we're in
• 33:14
  this industry, so we're preventing from ever getting to that point.
• 33:17
  But I could see how easily it could happen.
• 33:20
  Oh, yeah. I was down that road.
• 33:22
  Yeah, same.
• 33:23
  I entered burnout.
• 33:24
  I, same.
• 33:27
  I just finally burnt out and just took off.
• 33:30
  Yeah.
• 33:31
  But luckily, I had that luxury to do that, and kind of squirreled away and
• 33:35
  just took off for- ...
• 33:38
  months at a time, isolated, random countries, and just walked around.
• 33:42
  But you were also in the surgical-
• 33:43
  Yes.
• 33:46
  What's worse?
• 33:47
  Lots of surgery.
• 33:48
  What's a less kind, soft place than surgery?
• 33:52
  Like a surgical OR.
• 33:53
  Yeah.
• 33:53
  Oh my God.
• 33:54
  Yeah. But at least you don't have to worry about what you're wearing because you
• 33:57
  have your surgical scrubs.
• 33:59
  That's true.
• 33:59
  And they may be wadded. They look very wrinkled,
• 34:03
  like they were just wadded, and-
• 34:05
  Yeah
• 34:05
  ... you just walk around looking like that all day.
• 34:07
  Just-
• 34:07
  Like a slob
• 34:08
  ... grumpy and just-
• 34:09
  Because it's sterile
• 34:10
  ... there might be blood stains on your pants that you don't realize that are
• 34:13
  there, and you're just walking around with a piece of somebody's knee stuck to
• 34:18
  your pants.
• 34:20
  That's just life, right?
• 34:22
  Well, from a non-OR perspective, but family medicine, I remember my
• 34:26
  first inpatient rotation. I saw my senior, and she was wearing
• 34:30
  the surgical scrubs, and I was like, "Why are you in surgical scrubs?" And
• 34:34
  she looked awful. I
• 34:38
  don't know, like she just worked out or something.
• 34:40
  Yeah.
• 34:40
  And had that look is... And so she also had like this dry--
• 34:44
  This is so bad. She had some dry stuff, it was kind of cracked on her
• 34:48
  neck.
• 34:49
  Yeah.
• 34:49
  And I was like, "Where are you coming from?" And she's like,
• 34:53
  "Oh, I just had to deliver a baby. And oh, God, that's amniotic
• 34:57
  fluid."
• 34:57
  Oh, yeah.
• 34:58
  And I was like--
• 35:00
  I knew the field of medicine had to do OBGYN,
• 35:04
  but you get splattered by amniotic fluid, and
• 35:08
  then you don't even shower, and then you're still wearing this.
• 35:11
  There's just so much.
• 35:12
  Yeah.
• 35:13
  We can do better. But when? Because she didn't even eat.
• 35:17
  She was exhausted.
• 35:18
  You never know when this stuff is on you.
• 35:21
  Sometimes-
• 35:21
  She was out
• 35:22
  ... a pretty big surprise.
• 35:25
  The shocking was if I'm wearing my glasses, right?
• 35:27
  I don't know about-- You're wearing the whole outfit, but-
• 35:30
  Yeah, in total joints. But-
• 35:32
  Yeah
• 35:32
  ... trauma, you typically don't wear the space suits, but when you're in-
• 35:35
  Yeah
• 35:35
  ... total joints, yeah.
• 35:36
  It splatters-
• 35:37
  There's a lot of power tools going on there.
• 35:39
  Yeah.
• 35:39
  So the high RPM power tools, there's stuff
• 35:43
  everywhere, yeah.
• 35:44
  Oh my.
• 35:44
  Which is part, it's really the fun part of it.
• 35:46
  Yeah.
• 35:47
  When you break out these saws and the drills, that makes you feel
• 35:51
  like you're doing something.
• 35:52
  It really does.
• 35:54
  It does.
• 35:54
  I did one OR day for ortho.
• 35:58
  Yeah.
• 35:58
  And I was like, "Pass me the drill." So they let me do some hammering-
• 36:01
  Yeah
• 36:01
  ... which I wasn't strong enough for any of that stuff, but-
• 36:04
  Oh, it would come with time.
• 36:06
  Yeah.
• 36:06
  You can stick it out. I'm sure you can pick it up.
• 36:09
  Oh, man.
• 36:09
  Put the rage into it. It's very
• 36:12
  therapeutic, right?
• 36:13
  Oh, it really is. It is.
• 36:15
  It's basically woodworking.
• 36:16
  Yeah.
• 36:16
  You are woodworking. You're using all the same tools and-
• 36:19
  Yeah
• 36:20
  Just making it happen.
• 36:21
  So post hip replacements, arthroplasties, it's
• 36:25
  like, "Oh, you're having pain? Well, honey, that's
• 36:29
  normal." Have you seen what happens?
• 36:32
  I'm surprised you're not in more pain, right?
• 36:35
  Yes.
• 36:36
  Drilled. Yeah.
• 36:37
  Yeah.
• 36:38
  Totally.
• 36:38
  It's pretty amazing what the human body can endure.
• 36:41
  A little achy?
• 36:43
  Babe.
• 36:44
  Yes, exactly. Exactly. So.
• 36:46
  Normal.
• 36:46
  People are resilient when they want to be.
• 36:48
  But once again, it goes back to your mindset, and if you
• 36:53
  know you're going to do well and you're motivated-
• 36:55
  Yeah
• 36:55
  ... after surgery, you're going to do well.
• 36:56
  Yeah.
• 36:57
  You go into it like, "Oh, this is going to be horrible.
• 36:59
  And no, I don't want to do therapy.
• 37:01
  No, it's going to hurt," well, you're probably not going to do so well.
• 37:04
  Yeah.
• 37:05
  You're going to stiffen up.
• 37:05
  Harvard has done a study that was actually pretty...
• 37:09
  I don't know. It was a little much, even for the other Harvard professors.
• 37:12
  They were judging the person that did it, like, "That's a little extreme." Because
• 37:16
  these people were wearing whole body suits, so even if they passed gas, that would
• 37:20
  be
• 37:22
  equated for.
• 37:23
  Yes.
• 37:23
  So everything in and out was equated for.
• 37:26
  And so anyway, that was-
• 37:28
  Wow.
• 37:28
  Actually, I'm going to find the name of that study.
• 37:29
  Oh, that would be-
• 37:30
  I want to just bring it to the table
• 37:31
  ... very interesting.
• 37:32
  Yeah.
• 37:33
  There's a study for almost everything out there.
• 37:35
  There is.
• 37:36
  And people are looking for reasons to do a study.
• 37:40
  Well, okay, so they're looking for reasons to do studies, but also, we need the
• 37:44
  information.
• 37:45
  We need... Yes, absolutely.
• 37:45
  And we need also people to better understand the studies.
• 37:49
  So yesterday, for example, I had a study given to me, and I was
• 37:53
  just talking about progesterone with somebody, and they screenshot
• 37:57
  something from Mayo Clinic. Love it.
• 37:59
  Mayo's a great source to cite. But the way that they put together the information
• 38:03
  of what we were talking about,
• 38:06
  not correct.
• 38:07
  Ah, okay.
• 38:07
  So people make leaps because we still speak in a different language
• 38:11
  than what we did prior to all of this training.
• 38:14
  Yes.
• 38:15
  So being able to read all the studies, understand
• 38:18
  them, and then apply them into useful ways that you can get a
• 38:22
  medical relevant,
• 38:26
  I don't know. You have to make it relevant.
• 38:28
  You're deciphering it.
• 38:29
  Yeah.
• 38:30
  You've got to take this accurate information, and then you could take a study-
• 38:32
  Turn it to action
• 38:32
  ... and you can turn it to bias.
• 38:34
  Yeah.
• 38:34
  So you have to be very careful.
• 38:36
  Yes.
• 38:36
  You may go in with a preconceived idea and look for things in there that-
• 38:40
  Yeah
• 38:40
  ... are trying to prove your point.
• 38:42
  Yes.
• 38:42
  No, the study is not.
• 38:44
  Yes.
• 38:44
  And so that's one big thing when you're writing.
• 38:47
  You got to-
• 38:47
  Yeah
• 38:47
  ... decipher and write it correctly.
• 38:49
  Yeah.
• 38:50
  And so that's podcasting as we're doing-
• 38:53
  Mm-hmm
• 38:53
  ... or YouTube or posts.
• 38:55
  Yeah.
• 38:55
  Those are ways that we can get this information out to the public.
• 38:59
  Yeah.
• 38:59
  But you can
• 39:01
  see it a lot-
• 39:02
  Yeah
• 39:02
  ... where people have taken these and kind of construed...
• 39:04
  It's almost like the media, right?
• 39:06
  Yeah.
• 39:06
  They're just like, "I'm going to spin my own little storyline here.
• 39:10
  I'm going to take a piece of this-"
• 39:11
  Yeah
• 39:11
  ... "a piece of this, and I'm going to glue it together, and then this is going to
• 39:14
  be the truth."
• 39:14
  Yeah.
• 39:15
  So that's really a risky thing when
• 39:19
  you're listening to people who
• 39:21
  may not
• 39:23
  have the integrity to not be biased.
• 39:25
  Right. I at least hope to always, always,
• 39:29
  always... So yes, right now we control the message, right?
• 39:32
  Right.
• 39:32
  We're talking into this microphone, you guys are all watching,
• 39:36
  and you are hearing what you hear, and we're controlling the
• 39:40
  message. But I hope to always just give
• 39:43
  exactly my interpretation of information.
• 39:47
  Look it up yourself. I would love to just create conversation.
• 39:50
  Absolutely.
• 39:51
  And if I'm wrong, then I want to be corrected.
• 39:54
  Yes.
• 39:55
  So I'm not afraid of being wrong. I'm not afraid of saying, "Oh, you know what?
• 39:59
  I did say that, and
• 40:02
  oops, thank you for telling me."
• 40:04
  Right. Yeah.
• 40:05
  I want to be corrected. I want to do better.
• 40:07
  And there's a lot of stuff that's available for access, too, for people who-
• 40:11
  Yeah
• 40:11
  ... want to do their own research.
• 40:12
  Yeah.
• 40:12
  There are libraries out there that are free access. There's paid access.
• 40:16
  Yeah.
• 40:17
  There's research AI now that makes it so much easier,
• 40:21
  right? So there they'll go... You can give it an idea, and it's going to bring up
• 40:25
  all these articles that relate rather than having to go I
• 40:29
  know my li-
• 40:30
  That's old school.
• 40:30
  Yeah. The library old school was like-
• 40:33
  Oh, my gosh
• 40:33
  ... you better search exactly what's in the title
• 40:36
  or-
• 40:37
  Yeah
• 40:37
  ... or in the abstract, or it's not going to pop up.
• 40:40
  So-
• 40:41
  Man
• 40:41
  ... common sense is nice.
• 40:43
  And as somebody who has written a lot of papers and published
• 40:46
  several-
• 40:47
  Yes
• 40:47
  ... you know your title is actually the most important.
• 40:51
  And sometimes a title is very long-
• 40:54
  It is
• 40:54
  ... with the intention to get snags like that.
• 40:58
  Yes, exactly.
• 41:00
  And the more specific, like a 14-year-old female with
• 41:04
  coccydal meningitis to the brain stem, basal ganglia.
• 41:08
  You can really just make it very, very specific.
• 41:12
  Absolutely.
• 41:12
  And that's how I would name my papers.
• 41:14
  That's-
• 41:17
  You're one of those writers, are you? You just love writing.
• 41:20
  I don't love it, but it was a tool.
• 41:23
  Oh, yes.
• 41:24
  I think.
• 41:24
  It's definitely worth the work. You do learn a lot by going through
• 41:28
  this, even though it can be painful with the busy work on top of life.
• 41:32
  Painful.
• 41:32
  But-
• 41:32
  Yeah
• 41:33
  ... that's what we grind for. If it was easy, everybody would have one.
• 41:36
  That-
• 41:36
  Everybody would do it.
• 41:37
  Is true.
• 41:40
  Okay, so for your lifestyle
• 41:43
  tips, is there anything that you would recommend
• 41:47
  that's... So we know our box breathing. We have that.
• 41:50
  We know why it would be helpful.
• 41:53
  Yes.
• 41:53
  We're redirecting with when you're trying to fall asleep, or if you
• 41:56
  are asleep, then you wake up, how do you bring yourself back into sleep?
• 42:01
  Really, it's about recentering. I think
• 42:05
  the breathing is there, but everybody's different, so you have to
• 42:09
  find your avenue.
• 42:10
  Mm-hmm.
• 42:10
  If you can do it by meditation, that's the cleanest way, right?
• 42:13
  Yeah.
• 42:14
  Turning the TV on, which is what I've done all my life, and I'm trying to wean off
• 42:18
  of it, but "Ancient Aliens" makes meAt peace.
• 42:21
  It works but-
• 42:22
  But do you listen to it?
• 42:23
  I do. I listen to it. If I look at the screen, it doesn't work.
• 42:26
  So I just listen to it. So listening to something, that's the
• 42:29
  easiest thing. Just don't do anything with a storyline, I would say.
• 42:33
  There's a reason they say
• 42:37
  practice yoga and practice meditation, and if you've ever done
• 42:41
  yoga, yoga's hard.
• 42:42
  It's really hard.
• 42:42
  That's why you practice. Has somebody mastered yoga?
• 42:45
  There might be a yoga master out there, but you practice at yoga-
• 42:48
  Mm-hmm
• 42:48
  ... because you can continue to get better. Meditation is even further.
• 42:52
  Yeah.
• 42:53
  These people that center on
• 42:57
  meditation, monks or whoever-
• 43:00
  Yeah
• 43:01
  ... they work at it all their life trying to reach the
• 43:04
  pinnacle of their control.
• 43:08
  You know what?
• 43:09
  It exists.
• 43:09
  I used to think that was so abstract.
• 43:12
  I think the closest thing I can really
• 43:16
  bring that into a more tangible form,
• 43:21
  for board exams or tests or anything that you know you
• 43:25
  have to get through,
• 43:28
  it's hard to sit down and
• 43:30
  an eight-hour test, or I had an eight-hour test for two days.
• 43:34
  So to train yourself to, you're going to sit here, ignore the
• 43:38
  world around you, and just focus on this one question,
• 43:42
  next question.
• 43:43
  Exactly. Living in the moment.
• 43:45
  Yeah.
• 43:46
  Without distractions.
• 43:48
  But to go back to that way of thinking,
• 43:52
  it's different.
• 43:53
  It is. And it's hard.
• 43:55
  It's hard.
• 43:55
  And people are like, "Oh, meditation." I get people all the time, "Meditation.
• 43:59
  Oh, do that."
• 44:00
  It feels so intangible.
• 44:02
  It's the worst.
• 44:03
  It's like-
• 44:03
  It's hard
• 44:03
  ... this thing.
• 44:04
  It's not bad when you do it, but it is difficult
• 44:08
  to shut down and just live in the present second, the
• 44:12
  nanosecond, and-
• 44:13
  Yeah
• 44:13
  ... entirely focus. So it's something you definitely have to practice with.
• 44:17
  So, you got your sleep, nutrition,
• 44:22
  all the evidence-
• 44:23
  Oh, nutrition
• 44:23
  ... has just pointed to whole food
• 44:26
  plant-based. And so before anybody loses it, it's
• 44:30
  not vegetarian, it's not pescatarian.
• 44:32
  People are like, "I'm not giving up my meat." I'm like, "Nobody said you had to."
• 44:35
  I'm just saying plant-based, right?
• 44:37
  Yeah.
• 44:37
  And then all the bros that are like, "I'm getting my protein." I'm like, "Where do
• 44:40
  you think that cow came from? You think it's out there eating steak?" No, it's
• 44:43
  eating plants. There's tons of plants with-
• 44:47
  That's true
• 44:47
  ... very high amount of protein in there.
• 44:49
  And my favorite thing is vegetable medley.
• 44:52
  I go over, I've got Trader Joe's across the street.
• 44:54
  I go over there, I pick out random vegetables-
• 44:57
  Mm-hmm
• 44:57
  ... throw them in a pot, put some of the protein beef broth on there in a bullet,
• 45:01
  and there are my meals for the week.
• 45:03
  Does it feel like it tastes good? You feel good?
• 45:05
  It tastes good. Yeah, absolutely.
• 45:07
  Yeah.
• 45:07
  Yeah. So I feel good. It's ready. It's cheap.
• 45:12
  Yeah.
• 45:12
  Yeah. Seriously, and it's good for you.
• 45:14
  Yeah.
• 45:14
  And then I still want to go out or go out to dinner, I'll have a steak or whatever.
• 45:18
  Yeah.
• 45:18
  I just not-
• 45:19
  Do it like sometimes, not always.
• 45:20
  Exactly.
• 45:21
  Yeah.
• 45:21
  Because my old way was, I have to have meat with every dinner.
• 45:24
  Hypercholesterolemia was your life
• 45:26
  Yes, it was. And I said, "You know it.
• 45:28
  You've seen my labs." So it was like triglycerides were up, cholesterol was up.
• 45:32
  Yeah.
• 45:32
  And even though, no matter how healthy I thought I was living, I was still just
• 45:35
  intaking-
• 45:36
  Yeah
• 45:37
  ... cholesterol. So if you can just base it that way, there's tons of
• 45:41
  things, lentils, soy, any of these beans, they've
• 45:45
  got protein.
• 45:45
  Yeah.
• 45:46
  You can still be fine.
• 45:47
  Meet your quota.
• 45:49
  Yes.
• 45:49
  Yeah. You haven't lost muscle mass, so I think-
• 45:53
  A little bit. But I've-
• 45:55
  Have you?
• 45:55
  Yeah.
• 45:56
  I haven't seen you for maybe two months.
• 45:58
  Yeah. I haven't been hit that hard.
• 46:00
  I've been sitting at a computer with my face in it writing-
• 46:03
  Document
• 46:03
  ... scholarly papers.
• 46:05
  Oh, I loved it.
• 46:06
  But certainly you could do it. There's a good video out there if you ever watch
• 46:10
  it called "Game Changers." It's about these pro athletes and the
• 46:14
  strongest man in the world who are on plant-based diets.
• 46:16
  Yeah.
• 46:17
  And so there's things to do with that.
• 46:19
  So you're hitting your sleep, you're hitting this.
• 46:21
  But one of my favorite, and I know we're running short on time, is I just
• 46:25
  want to touch on this connectivity.
• 46:27
  Okay.
• 46:27
  Social connection. That is-
• 46:29
  Ew, who would've thought?
• 46:29
  ... so important. Yes, because in this stressful environment-
• 46:33
  Yeah
• 46:34
  ... you're not sleeping good, you don't feel good, a lot of people just
• 46:37
  isolate.
• 46:38
  Yeah.
• 46:38
  They go through a breakup or stress at work, they just want to isolate-
• 46:41
  Yeah
• 46:41
  ... and just shut down, right?
• 46:43
  Yeah.
• 46:44
  But social connection is so important, too.
• 46:46
  And as we were talking about with your animals increasing that
• 46:49
  oxytocin, you get that by having good-
• 46:51
  Yeah
• 46:51
  ... connection. Not just being around random people.
• 46:54
  Maybe it is that for you, but actually connecting with the people.
• 46:57
  And a lot of people have the social anxiety or have
• 47:01
  problems making friends and connections. There is an effort to it.
• 47:05
  It's a challenging-
• 47:07
  Oh, I like to use that
• 47:08
  ... pillar.
• 47:08
  Yeah.
• 47:08
  And sometimes people have isolated
• 47:12
  themselves
• 47:14
  over time.
• 47:14
  Like wave at your neighbor.
• 47:16
  Right.
• 47:16
  Say hello-
• 47:17
  Small-
• 47:17
  ... to people walking by
• 47:19
  ... small moves, right.
• 47:20
  Yeah.
• 47:20
  Yeah. And if you're in California, they probably won't say hey back and just look
• 47:23
  at you weird. But that's
• 47:25
  okay.
• 47:27
  You just get used to that-
• 47:28
  It's just like New York
• 47:28
  ... here, right? Yeah.
• 47:29
  Yeah.
• 47:29
  It used to be so strange coming from the Southeast.
• 47:31
  I was like, "Why do these people don't say hey back when I pass them?" But -
• 47:34
  That's why people probably think we're so nice-
• 47:37
  Exactly
• 47:37
  ... because that's just how people do it in Florida.
• 47:40
  Yeah.
• 47:40
  "Hey, how are you?" Don't actually tell me.
• 47:43
  Yeah. Don't tell me.
• 47:45
  Yeah.
• 47:45
  We're just trying to be polite, right?
• 47:48
  Yeah.
• 47:48
  But I tell people, if you want to get that connection, try to find what you're
• 47:52
  interested in. It doesn't matter what it is.
• 47:54
  Find what you're interested in, find other people that are interested in
• 47:58
  that. We have such an advantage. Now, the internet and social media can be
• 48:02
  such a disadvantage because you can get lost and go down this rabbit hole of
• 48:05
  whatever your algorithm takes you to.
• 48:07
  Yeah.
• 48:07
  But you do have groups like Meetup or whatever,
• 48:11
  that it's other people out there who feel equally like they want to
• 48:15
  connect-
• 48:15
  Awkward
• 48:16
  ... with other people, but it's awkward-
• 48:17
  And isolated
• 48:18
  ... and they're just like, there's Bumble BFF where you go meet
• 48:21
  friends.
• 48:22
  Stop.
• 48:22
  Yes. Yeah. Where you're just like, "I just want to meet a friend." And
• 48:26
  as a medical traveler, I get it. Sometimes you're in a city, you know zero people.
• 48:30
  I'm just like, "I just want to hang out with somebody," or, "I want to go
• 48:33
  play tennis or go snowboarding. I wish I had somebody to go with."
• 48:37
  And so you can get on these groups and-
• 48:39
  Yeah
• 48:39
  ... actually meet people that are interested in doing the same things you can.
• 48:43
  So there's options. But you got to take it in baby steps because
• 48:47
  it's not that easy. There's a lot of mental block-
• 48:50
  Yeah
• 48:50
  ... behind it, right?
• 48:51
  Okay. So to lifestyle, you have to make small changes in your
• 48:55
  overall lifestyle. Thank you so much for those tips.
• 48:58
  I look forward to hearing more.
• 49:00
  Yeah.
• 49:00
  I love experiencing your journey with you as you are on this
• 49:04
  path. It is so, ugh, I want to go into that
• 49:08
  doctor too.
• 49:10
  You'll be getting the monthly updates, for sure.
• 49:12
  Okay. Done.
• 49:13
  Yeah. You'll get the newsletter.
• 49:15
  All right. Tim Pace, thank you so much.
• 49:17
  Yeah. Thank you for having me. Great to talk with you guys.
• 49:19
  Pace of Life.
• 49:19
  Absolutely.
• 49:20
  We'll talk again soon.
• 49:21
  Absolutely.
• 49:22
  Thank you.
• 49:23
  Yes.
• 49:23
  All right.
• 49:24
  Appreciate it.
• 49:24
  And that is all.
• 49:25
  Thanks, guys.
• 49:25
  Until next time.