Saving Lives: An ER Doctor’s Journey From Acute to Chronic Care

So welcome everybody. This is our first episode inaugural. We're going to be talking with our very own Dr. Christian Jensky. You for years, met you initially in the clinic and now we're just doing really cool things together. Every functional person has their own journey. I feel like the people that are really good at their art start practicing on themselves, the family members, their spouses. So I want to talk a little bit about your journey. What takes a board certified emergency room doctor working in the yards in Chicago and you know, all that kind of stuff. How do you get to functional medicine from the acute of acute care to now the chronic of chronic care and preventative?

Yeah, so it's quite the polar opposite. So yeah, I am conventionally trained in emergency medicine and I practiced emergency medicine for 19 years before I officially retired. And the reason I put that in quotes is because once you're an ER doc, you're always an ER doc and who knows what the future holds. But emergency medicine was what I felt like to be my calling for a long period of time. But the reality of burnout is true and real and I experienced it firsthand and you know, I felt like I had made a lot of difference in people's lives and patients lives, but I was suffering along the way. And as you give of yourself, you start to lose as well in some way, shape or form if you don't establish boundaries and have a lot of self care built in. And I didn't even understand what those terms meant. And so as I was practicing emergency medicine, I was failing myself and I became ill and, and as that illness got worse and progressed and I was kind of seeking answers that weren't being answered and I was being met with the frustration of finding ways to determine essentially how I can get better and what I can do about it. I stumbled across functional medicine as a concept and started to do what we lovingly refer to as biohacking, where I was kind of doing some self testing, listening to podcasts and trying to absor whatever information I could without any really reliable compass to guide me. And really the reality is that the few things that I did made a huge difference. And so to me it felt powerful even before I knew the true power of functional medicine. And then I stumbled across you and we started working together as a doctor patient relationship and you immediately seemed to kind of understand what was going on. And it clicked and we started to implement some treatment strategies and again I started to get better and better and for me that was the definitive light bulb moment where it was just like how do I not just do this for the rest of my career? I was already frustrated and kind of looking for an out. And so at that point in time, it was, how do I not only continue my own personal health journey and affect change in those that I love, but also how do I make this my lateral movement? And I subsequently undertook a fellowship in integrative medicine per your guidance, and did a certificate program in functional medicine through ifm. And then more recently, I did a fellowship in anti aging and metabolic medicine through a 4M and in the interim have been practicing all the while. And so it was a logical transition, but started and sparked by my own personal health journey and building upon that, getting me to the point where I was able to leave emergency medicine and practice functional medicine.

So you did four years of medical school, four years of ER training.

Three.

Three years of our training.

Some are four, but I did three.

Okay. The three at the Miracle College of Virginia used to like to call it back in the day. Then you did two year certification through IFM, then another two year fellowship through a 4M on top of your two.

Year fellowship in integrated medicine. It was AIHM, AIM, and I did the AIHM and IFM. So I did a two year fellowship in Integrated medicine and the certificate program in Functional Medicine concurrently. So I was doing those at the same time while working in the er, doing locum tenens, which for those of you that don't know, is like traveling ER work. And so I would go and do a clip of like five shifts in a row somewhere else, so Delaware, Norfolk, wherever. And then I would come home and I would do two weeks of academics and try to be a dad and a husband and a friend and whatever else. And then I would go and travel again and do ER work. And oh, by the way, all the while I was treating myself for all these conditions that I had that we'll talk about. But I look back on that and it's just kind of insane that I was able to even do that. But yeah, that was all the education.

Yeah. So one of the things that kind of impressed me with you as a patient, early colleague was just you were going through it. You're going through it faster than I did, which I was like, I thought I did it pretty fast. Yeah. And you were just kind of burning to both ends. Yeah, obviously going from emergency medicine to functional medicine. What were some of the big roadblocks? Whether they're like just maybe your own personal issues with that transition, because there's a lot of, you know, being a professional and having academic and going to this thing, it's like, is this really real medicine? You know, what were some of your stumbling blocks? Roadblocks, maybe some of your struggling points, maybe during that transition?

Sure. So there's doubt, obviously, because, I mean, it's. Gosh, it's such a drastic lifestyle change. So not just lifestyle change for your own health, but the lifestyle change from being an ER doc to being a functional medicine provider, where I was essentially a shift worker when I was in the er. And that's part of the problem is, like, that's what contributes to the deterioration of your own health is all that shift work. And there are studies that show that flipping from day to evening to night shifts and back, and the rigors of the ER shift, just in general, even if you had the same hour block per shift, I mean, it's just there's so much unpredictability and understaffing, and you're just overwhelmed all the time, and everyone's really, really sick. And so it's quite complicated. And then you go to the polar opposite end of the spectrum, where it's dealing with prevention and root causality and personalized, individualized medicine. So it was a complete shift in my thought process, which is not easy to do, because part of the reason, when you're trained in medicine and you kind of hone your craft, like, it's built in to be almost rote in your memory, because especially in emergency medicine, because you don't have time to sit and wax philosophical about a case, you have to act immediately. And so I went from this very ingrained, reflexive, reactive way of treating patients to sitting down and cerebrally thinking about a case and thinking more and asking why? And asking why and going deeper and expanding. And so that was interesting. And try to kind of changing my mindset. That was a little bit of a roadblock in the beginning, but I slowly realized that that actually came more natural to. More naturally to me than the previous way, because I've always been curious. I've always had that intellectual curiosity, and I think, in general, childlike curiosity. And I think we both have that, and I think we feed off of each other in that way that when one of us learns something, the other one's like, oh, I want to go learn that. I mean, that was me with you. Like, in the beginning, you knew everything and I knew nothing. And it was like, I need to catch up to this guy. And so I wanted to learn this and that. And the next thing, then you come back from a conference and you're talking about hyperbaric oxygen. I got to go learn that. And it was just one thing after the other. And I think that we motivate each other in that way. But I think innately we're both. Yeah, at our core kind of that way. The obstacles that I met were really the logistical stuff, the time that I would need to do all the academic work. I mean, I literally went back to medical school again in the middle of my career, right. So I'm 20 years in, or at that point, 15 years in, and I'm still practicing because I have a family to support, but at the same time, I'm going full time to school. Right. And granted it's online and you can kind of do it on your own time, there's still a lot and the density of that material and what you're doing about it. And so that was a bit of a roadblock. And then just the understanding of if this could be my career, if this could be my life, if this is something that I can do for the rest of my life, would there be a market for it where we were? Would I have consistent patient volume? Doubting yourself when you're not really sure of what you're doing and if you're able to kind of change patients outcomes and affect change in their health. And so as you start to see more patients and really you have to practice, and that's truly the art of medicine is just building on that and building on your knowledge base and gaining in your confidence. And for every moment of frustration, there might be two of reward and or vice versa, but you have to hold on to those and you have to use that positive energy and that positivity to build and say, hey, it's going to be okay. And so that was really what I was kind of learning along the way. And then last but not least, the stuff that's obvious, like the lack of mainstream acceptance and like being seen as like, quack who is practicing voodoo or witchcraft, when the reality is, like, you and I both know as conventionally trained physicians who have MDs and have gone through that and practiced that for a long time, that it's not the case. And that if anything, this is so much more marred in biochemistry and science and physiology, and it's so cutting edge and so tip of the spear that it's not that. And so having to convince your colleagues when you need their help for a patient or convince family members of patients, I found that to be slightly frustrating in the beginning, but now it's just kind of old Hat. And it's the norm. And if you fight for what's right with regards to your patients and you do what's right by them and you do what you know to be true, and you practice evidence base, I don't see anything wrong with any of that. And I feel like then you're really, truly practicing your calling in that way.

And one of the things was interesting. I'll Romecha. You know, we wear unicorns. It's like how often you see they're magical creatures. They only exist in fairy tales. And magical exist. And then I met you. I'm like this guy. I see unicorn too. And then it was one. Because my wife and I talk about a lot of stuff about. I'm sure you and your wife do as well.

Yeah.

And the thing is, like, you've always been close to my heels, man. You've been just there pushing me. We've been pushing things like we push each other.

Yeah.

It's like, how did he learn that? That's no fair. I need to learn that too. Right. And so the same way that you kind of alluded, you pushed me. I pushed you. You also pushed me because. Wow. It's like having someone who's got the same level, the same drive, who's learning different things because we're just in different, you know, looking at the exact same stuff and then being like, wait a second, he's reading this. I gotta read that too. And then that's kind of cool. Yeah, I think we kind of. There's a saying, iron sharpens iron. Right. I feel like we kind of sharpen each other a little bit. But on a side note, off of that a little bit, I remember when you were in the, er, what we'll call the pandemic in this environment, and how crazy that was going from having multiple people being intubated or not intubated, because you actually figured that out pretty early on. But even, like, not working for two months. Share with us about, like, in my mind, I never imagined any not being.

Able to be at work. Yeah, yeah, yeah. That was something that we've talked about quite a bit. So during the pandemic, I decided to stay in the emergency department and continue to work. And I felt like that was the right thing for me to do. And so although I technically put myself in harm's way, it just didn't feel right to cut and leave during something that we may never, ever see again in our lifetime. And was pretty unique in its own way. And although I was there part time, I was still working. And I was still on the front lines and I was still seeing really sick patients. And in hindsight, we were probably identifying cases before it was officially declared a pandemic. And you go back and you have all these aha moments and these hindsight realizations, but it was at a point where we were inundated and busy all the time to it was like crickets. And volume was down, everyone was on lockdown. People were afraid to go to the emergency department because of fear of exposure. So the volume for typical emergencies that we would see, like strokes and acute heart attacks and sepsis, basically disappeared. And people were staying at home and just being sick. And that's kind of crazy to me, but it was because they were more afraid of what would happen if they came out. And I wasn't able to get shifts. And it was just like. You know, you always joke when you're an ER doc. First of all, if you work in the er, whether you're a doc or a nurse or tech or whatever, we all have a little bit of a sick sense of humor and that's kind of what gets you through in certain ways. But we would always joke that the world will never cease to have emergencies because people are often doing things that they probably shouldn't be doing. And so there's job security and being an emergency medicine physician or nurse or whatever. And then all of a sudden I'm met with this situation where it was like, I can't get work. And that was a little bit eye opening and almost paralyzing. And thankfully I was also concurrently working here at rifm. And so I was able to still generate revenue for my family and also see patients and still affect change and help people get healthy, but in a different way and in a prevention way. And at that point in time, we were doing so much education, you and I, and a lot of alleviating of concerns and fear for patients. But yeah, that was just kind of crazy that I couldn't get shifts. And it was probably at least three months, if not longer.

So you're a doctor without work for three months. We had an Airstream at that point in time and we actually were in the process of I'm selling and someone looking at it. It was a neurosurgeon from Washington state who didn't have a job anymore. And so they were basically like just going to do go hospital, hospital east coast and they need a travel thing. So they basically just moved here for six months because they had no work in Washington state. It's like when in Your life. Would someone that high level who literally, like, can hospitals work without neurosurgeons? Like, is it impossible? They could. They had to work. And it was just kind of like this crazy, like, wow. At the same time we were staying busy doing what we're doing. So. A couple questions, changing direction a little bit. I know personally, I have inflection points in my career. I say it's like the ancient Cape Canaveral, that's a mile at the moon. Like the small little change in your life, whether it's your health, your wife, your kid, a patient you see. Why don't you tell us a couple examples, a couple of inflection points along your journey where something happened. In hindsight, it's like, that's the little thing that changed everything for you.

There are many, and really most of them are personal, as you would expect. And the reality is a lot of what I do now is because of my own personal health and like, where I was and how the trajectory that I was on compared to my current state of health, and then how I affected change in my family's health, in particular my daughters. And I'll talk about that a little bit as well. But, you know, when I met you, initially I was sick. I was 40 years old. So this was what, nine years ago? And I was sick and a new parent and a couple years newly married. And I didn't have all the classic genetic predispositions. I didn't have the parents with heart disease and diabetes. And I wasn't raised in a house where people were smoking cigarettes. My parents never drank, and we ate very healthy and we were fairly healthy and we were active. And so it just didn't make a whole lot of sense. And. And I think that's part of the reason why people couldn't really pin it down when I was seeing some of my conventional colleagues. And it wound up being things like mold illness and Sibo and heavy metals and sibo's small intestinal bacterial overgrowth and heavy metals and a lot of other esoteric things that are now gaining more mainstream notoriety. And as I started to get treated for these things and could feel the impact of my brain switching back on and weight falling off and my energy coming back, it was so powerful for me to understand that the recognition of these disease states and the treatment that didn't require a whole lot, but just some change or addition by subtraction, a couple supplements here, medications there, a remediation of a home that allowed me to regain my health and be the husband I'M going to cry. Like the husband and the father that I wanted to be. That was huge. That was huge for me. And that was part of the reason why I sought you out was essentially that I felt like I couldn't be that for my family. And so the ability to gain that back was enormous. And then along the way, it was just like, it just becomes part of who you are. And, you know, my daughter was three and she was bloated all the time. And whenever she would have a bowel movement, it would be hard and it would float. And I knew in my training that meant fat malabsorption. And I knew that her gut wasn't working right. And so I did a stool analysis on her, and it showed fat malabsorption. It showed that she had significant inflammation. And we're taught that you have to identify what the source of that inflammation is. So I pivoted to some food sensitivity testing, and gluten and dairy were very high. And so I then pivoted to a celiac panel with no inclination whatsoever that this was going to be positive. And the entire thing came back lit up like a Christmas tree. And I was just baffled. And the sad part of that story is that I was away on Locum's work and I had to Zoom or FaceTime my wife and tell her that our daughter had celiac. And she cried and we cried together, and she was confused. And within a day, she had literally cleaned everything out of our kitchen, everything out of the pantry, everything out of the refrigerator that had gluten in it, threw it out, and had literally gone to the supermarket and replaced everything that was there with gluten free options. Like, owned it immediately and was like, if our daughter can't eat it, none of us are going to eat it. And so we went gluten free as a family, and that was huge. But also, I mean, in theory, kind of change the trajectory of my daughter's life. I mean, that's enormous. Those are just two examples of many that just along the way have affected change in such a positive way. But, like, those are the ones that really hit home. Right. Because they're. They're personal.

Just to clarify. So your daughter's three?

Yeah.

And typically, a kid with bloating and gut issues would just kind of linger for years and years and years. You had a positive antibody testing for celiac.

Yeah.

Change things. And what was repeat testing? Three.

Yeah. So, you know, which is kind of cool.

This is kind of cool.

It is. And the conventional way of diagnosing celiac is eat gluten so that it disrupts your gut. And then we'll take you to GI and they'll scope you and they'll find a patch that's red and they'll biopsy it and they'll say, yeah, this is celiac. And my personal opinion is that the lab testing is so sensitive now that if the shoe fits, wear it. And she had the genetics unbeknownst to us. We subsequently tested and we saw that we were also genetically susceptible. I have a gene, my wife has a gene, my daughter has both, my son has both as well. He did not develop celiac. I don't have it, my wife doesn't have it, but my daughter did. So there was some environmental trigger. And, and so ultimately having that knowledge, I just said, we're just going to treat it. So we went gluten free. I put her on a gut protocol and within six months her gut was healed and her celiac antibodies were negative. Completely normal. So remission. And she's been gluten free since she's going to be 10 in May. She owns it. She knows what she can and can't eat. She double checks everything. She'll call adults out if they give her the wrong food. I mean, it's hilarious. It's awesome. Like she used to be skittish about it all and confused and now she just totally owns it and like literally will affect change in her friends. Like, you shouldn't eat that. That has gluten in it. It's just awesome to see. It's really kind of cool. But yeah, it's powerful. I mean, literally it's. You remove the thing that was contributing to the problem and then you can give a little bit of healing, whatever that looks like. And a lot of things will autocorrect. I mean, the body's pretty infinitely wise in that way where if you nudge it along or get out of its way, it's going to move towards homeostasis, which is balance. And that's ultimately what it does or what it did for her at least.

One of the things I tell people is our body was designed or made to self heal and self repair. Just remove the things that are blocking that process, give it what's lacking and it'll do what it's made to do. And in that way this is like crazy simple. But then it's like, okay, what are those things? What's the nutrient? What's the food? What's the environmental thing? And then it's like, okay, what do you remove first? Second or third. And the people I see that have the most profound responses clinically, and I'm sure the same thing with you is the people who just own it change everything. They come back three months later and you're like, I guess we're kind of, what do we do next? Because those people push me to be better at my heart.

Yeah, now everything's normal. Let's optimize. Right, Exactly. I always say you've changed everything from abnormal to normal. Now we work on my optimization and what else do you want to look at? And then you start diving deeper if they're so inclined to do so. But yeah, I agree with that. You can juggle all the balls at the same time. You can move things along a little bit more easily. I mean, none of this is quick. It's all slow medicine, but it's effective as hell. And the reality is that because you don't operate in a vacuum, the body that is, that if there is a significant degree of pathology in one organ system, then clearly you have to prioritize that. But you're not going to get those systems back to homeostasis or across the finish line, as I say, until you've balanced other aspects of the physiology that may be off. Like a good example would be the gut brain axis. And if someone has gut dysfunction, if you're not addressing the brain component, if you're not addressing the chronic stress component or limbic dysfunction, you're going to get their gut mostly better, but it's not going to get all the way where it needs to be. And so those that really commit and do the lifestyle stuff and the supplementation and, or medicine and everything else that they need to do will move that needle more quickly. But then it's about maintenance and sustaining that and consistency. And that's not easy either. So, you know, oftentimes people can commit to hardcore three months, but then holidays come around or a massive life stressor, and there's a little bit of a backslide. But you have to reassure them, because this is my own personal experience, is that that's life, that's who you are. That's the reality of our human existence, is that there's going to be ups and downs. There's always going to be stressors, there's always going to be a curveball. But as you build upon these resilience stores in your body and physiological stores, and you continue to move and move and move in a positive direction, you're better equipped to handle those inevitable curve balls. And it's a hiccup versus a landslide in the past. And then you just build on that and you build on that and you build on that and now you own it and it takes less to maintain. So you expand and contract and expand and contract until you're at a point where contraction is where you need to be. And it's the lifestyle that has taken over and it's a handful of other things that you might need because lifestyle can't support that. That's really when you see the true power of what it is that we do. And I think that you would agree with that.

Yes, I know in my field, I'm not sure how it works with ER keeping your board license, but all my other licenses, they all hang on my family practice license, which is the same thing where you have to maintain your ER kind of thing. But in my world, literally, I get a journal sent to me every month. If I read three articles, take a quiz, that's really all I need to do to stay board certified in family medicine. Yeah. Now, people that are good at. They do, they do way more, of course, but like the bare minimum, you know, know, board certification in my world is like, it's not the goal, it's like the ticket for entrance.

Yeah.

It's like, congratulations, you're board certified. So insurance pays for your bills. Like, you're at the party now. Where are you going to be in 20 or some years? But that's like a segue to what does it look like to stay with functional medicine versus ER or family medicine? Because I know the keeping up and learning new things between the two of them, it's like night and day. It's like elementary school and grad school. It's like, totally. So why don't you tell us a little bit about.

Yeah, yeah, I would agree. I think whether it's primary care, family practice, emergency medicine, ob, gyn. I mean, like, I feel like the way that conventional medicine is set up is you train, so you go to medical school, you figure out what you want to do, you hopefully get accepted into a residency, you do your residency, however many years that is, it's usually at least three. And then if you're surgical, five, if you're neurosurgical, seven. And then if you want to subspecialize, you do a fellowship and you add on, you tack it on. And so that's one way to get extra training and extra academia. But then you go practice and that's it. And you keep up on board certification, which is you have to take this big test every so Often. And in between, you get what's called CME or continuing Medical education. And most people try to find the easiest way to get CME right. What's the least amount that I can do to get the most CME? Category 1 credits so that I meet my state's suggested recommendations to maintain board certification. And it doesn't really change or shape your practice a whole hell of a lot. So by the time you're halfway through your career, if you're not keeping up on your own or the system in which you're working isn't shaping and affecting change, you're practicing antiquated medicine. In my opinion, the flip side of that is, and there's a little disclaimer, there's a little bit of difference in emergency medicine, which is to say that I think it's a little bit better than most because you have to keep up with advances on how you're managing emergent care. And whether that's the introduction of ultrasonography for guiding intubation in central line placement, or the changing of sepsis protocols or stroke protocols or STEMI protocols. And these things that we would do to get patients, prevent them from end organ damage and get them to the cath lab or to the CT scanner or to thrombolytics or to the ICU quicker, that's pretty great. But when it comes to other fields, I go back to my previous statement with regards to functional and integrated medicine. There's no end point. Like, it's infinite. It's quite literally like, you're never gonna stop. And like, I used to joke with my family that if I can get paid to be a professional student, like, sign me up, like, that's the job I want to do. What do you want to do? I want to be a professional student. Somebody just pays me to just learn stuff for the rest of my life. This is easily the closest thing to that, in my opinion. It is. It's never going to end. We're never going to know enough. We're going to continue to learn and continue to advance. And there's always stuff coming out. We're constantly reading, we're constantly learning. There's always a textbook here or an article here. But then, like, all these different conferences that you and I go to and all these different fellowships that we decide to do or different certifications, we're peptide certified and we're SIRS certified and all these other things. Like, the next thing that comes out, if you're seeing patients that have this condition, whether it be POTS and dysautonomia, or hypermobility. You got to learn about it. Where do you go to do that? You got to go and learn it somewhere. So it's through a 4M or IFM or wherever, but it is infinite and it is constant. And you and I are always trying to kind of advance that. And I feel like that goes back to the whole unicorn conversation. I don't know many people that are so profoundly curious about just gaining knowledge on top of knowledge on top of knowledge, and then also revisiting what they've already learned to go back and hone those skills that they thought they once had that could be even sharper. Like, you learn GI right off the bat. Functional medicine, the mantra is, when in doubt, heal the gut. Right? So you do the GI module and you feel like you can conquer the world, and then you learn everything else and you're like, oh, crap. And the reality is that if you go after someone's gut, you're going to make change, you're going to affect change in their health. But that's not going to necessarily be all in all in everybody's case. But like, I've treated so many different guts and seen so many different GI results, but I still go back and look and try to revisit what am I doing? What can I do differently? Because you're going to have a patient that's not getting better, and you have to be the person that gives a shit enough to care to try to figure out if maybe you're missing something or something new has come out that you can now use to help that patient or some new data or some new study or some new evidence about a probiotic that can affect change, that individual. And if you're just sitting on your hands and practicing what you learned and not what you're learning, then you're not going to win in that way. You're not going to get that patient better.

Yeah, I know we have a similar experience where I'll be reading things in the morning and someone's picture pops in my head. I'm like, what if this will work with them?

Yeah.

Or like you're just sitting here on the couch, just sometimes I daydream. And all of a sudden this pet thing pops in your head because you connect some dots and you're like, what if that help her? And that's just like life on a daily basis, you know?

All right, 100%.

So we'll come to close this section, talk about you people getting to know you a little bit next. I think we're talking about your family a little bit and how for both of us, our family is a cry fest. Yeah, it's okay, man.

Yeah.

But I mean, it's a gas in my fire.

Yeah.

It's what makes me, like, what takes me next level is my kids, my family. So don't make me cry. So we're going to do that one next, man. And to everybody listening to us, thanks for coming out and we'll talk some more stuff later.

Thank you.