Dr. John Geiser (MD/PhD) on Harvard, leaving academia, and changing paths

Had a reason why I did it, and I could articulate it. Well, not that I'm smart or anything.

I just Harvard and taught at Harvard.

No, I'm just.

I'm like, you know, I respect these people's opinion.

Hello, everybody, and welcome to our podcast. This is Generations md. My name is Stephanie Davis, and I'm joined here by my colleague Sarah Davis, also my mother, Dr. Sarah Davis. How you doing?

I'm doing fantastic. How about you?

I'm doing good. We just finished our interview with Dr. Geiser.

Dr. John Geiser, anesthesiologist. And it was.

His story is just incredible. Like, this is definitely worth a listen. Everybody, stay tuned for this.

I mean, the guy should write a book.

Yeah, like, this was quite something else. We got a lot of content, so. So Dr. John Geiser got his MD, PhD from the University of Illinois College of Medicine. He then trained at residency at Harvard, then got a fellowship in Sydney. Then he also was an assistant professor at Harvard, Southern Illinois and UT Southwestern.

He is also the golfing buddy of my husband and Stephanie's dad. He mentions him several times throughout the interview and as Matthew and their additional golfing buddy, another anesthesiologist named Todd. So when he hears talking about Todd and Matthew, that's the golfing gang.

Yeah, this was an incredible interview. So please welcome Dr. John Geyser.

Yay.

Yeah, I just edited through and I try to edit out the ums and stuff.

The best was what Magic showed me. It's like, so, mom, do you sore was on the mcat? Do you know what your grade point average is? Like, whoa, is she gonna get after my.

Yeah, I have a file.

How did you get that from University of Illinois. Wow, that's impressive.

Yeah, that would be kind of brutal. If we did that to all of our guys, we'd ask you something and you're like, well, let me fact check that.

You've got your mom on the phone, or I call your school, I call your college.

How good of a student was he?

Yeah, it's funny, like, when I was in college, there were so many things that I not privy to or just I didn't experience or even understand or know because I just was. I was playing sports, I was playing football, and then I was trying to, you know, get good grades.

I wanted to go to professional school.

And I initially, my dad was a dentist, so I wish I was just going to go to dental school. And then the summer after my freshman year in college, I worked as a pathology assistant. Like, one of my dad's good Friends was an ENT surgeon, and he was good friends with a pathologist. And it was, you know, good for me to work. Like, basically, I did autopsies with this guy who's kind of a famous pathologist. I didn't know at the time. Anyway, my point is, I, you know, was like, just worked a lot, you know.

Yeah.

So I got to med school, and.

These people were talking about gunners and all this stuff. I don't know what. They use that term.

Yeah, yeah, yeah. Did they use that term now? I didn't know what that term was, though, until I got to med school, because they did not use that term in college.

Yeah, these group of guys that were really super competitive, like, they all want to go into orthopedics or some high, like, dermatology. You got to be like, top your class. And I was like, I just want.

To graduate anesthesia, though. Wait, how did you. That's really competitive.

Oh, my God. It was so brain. So my. My dad's another one. So my dad was a dentist, but, like, his, you know, one of his good friends was an obstetrician. One of his good friends was ENT surgeon. One of the guys was the obigani. He had three boys, and none of them wanted to go into medicine. So he's like, if you go into ob, you can have my practice. I'll just give it to you. Like, they're my dad and his. They're good friends. Like, I'll just give you a practice, my practice. So you can just come in, work with me a couple years, whatever. So I'm thinking I'll do that.

Sounds good. Yeah, sounds like done.

You know, and so I started out and I finished college a semester early. So I. I was working in this lab, and I thought, man, I think I'm going to get my PhD too. And, like, reproductive physiology. And then. Then I'll be perfectly. I can do infertility. You know, back then, there was no infertility, like, reproductive.

End quality.

Yeah. You could do both, right. You could be an obstetrician and do your fertility stuff.

Yeah, right.

So anyway, I did my rotation ob.

I'm like, I don't want to do this. I'm screwed now.

And I'm like, you know, PhD and all this stuff.

So you had gotten a PhD?

Yeah.

Yeah.

Oh, wait.

Wow.

Okay, Wait, wait. Yeah, we got back. We need to hear kind of your journey a little bit.

So anyway, I applied to the MD PhD program to this end, Right. So I'm in med school in Illinois. There's Like California. There's three different branches of it. You can go to Chicago, you can go to Rockford. Actually three, four, Peoria or Champaign Urbana, which is where I started out and where the main campus is. And then I started doing this research. And this guy's like, really? He was my PhD mentor, and he was like, you know, I think you'd be great at this. I love the research. I really like the science. You know, physiology was cool and endocrinology was cool, you know, and it kind of has some meaning later on. But anyway. And he's like, why don't you do the combined program? Because if you want to be a physician, you can do a lot more as an MD, PhD, than you can do as a PhD as far as research and grant money. And so I'm like, shit, yeah.

I remember telling my dad that.

He's like, you're gonna be a doctor. What are you doing? PhD. It's just a waste of time.

See, that's what I've always thought about MD, PhD. That's what I've always said. Oh, and no shade on anybody who's in a PhD program. But I've always thought, like, if you want to do research, you can do that with an MD or PhD. If you just want to do research, you can be a PhD. But if you want to practice and be an MD. And to me, it just seems like the PhD, like, what good does it do?

Yeah, it's worthless now. That's how I got down that path. Funny too, because I transferred because I wanted to do my clinical medicine in Chicago. So I was in Urbana for, like, basically six years, Champaign, Urbana. And I'm like, I want to do. And there was a portal for me to do that. And I'd finished all my research and I'd already set for my fiverr. So I didn't. I didn't really have to be there. So I transferred. And then I remember getting there, and my advisor in med school was a trauma surgeon, and he did tremendous amount of research. And they were all MDs. And they're like, would you help us in our lab? I said, yeah, because you have research experience. I can set up some research. I can do some statistics. I know, like, what to apply for this, you know, these variables and whatnot. And so I ended up starting working there.

And thank God, because, you know, like.

In my third year, I started doing my rotations and I did OB quickly because I wanted to, you know, see it. I did a research. I mean, a month of reproductive physiology, and I was like, holy shit, now I'm lost. And my advisor, who is the trauma surgeon, said, well, you know, what about trauma surgery? Do you got to do a general surgery and do trauma? I was like, I did my general surgery rotation. I was like, this is so. So, like, I had so much time in the hospital. Like, I didn't want. I want to have some life. And I was running competitively at this point. I'm like. I'm really like, my life. So I don't know. And then so I did a rotation ent Urology. And like, just. It's boring. Like, it's not stimulating me. And so my advisor said, try anesthesia. There's a famous anesthesiologist here, you guys would know, who's like a pioneer in regional anesthesia and local anesthetics. And so I did a rotation and I loved it. I thought the guys were cool. They were super smart. They used chemistry and physics and biochemistry and all pharmacology and physiology. And I just thought. And they were really super smart, but they were very like, not arrogant assholes. Like, so anyway, and then they're done.

With work by like 4:30 or something, right?

Yeah, exactly. And this guy was so. He's like, I always pick one student a year and I kind of. There's an award you got this Raymond Zick award. It's like for the best student in anesthesia. And then. And then he wrote letters for me. And these letters were unbelievable. Like, I got residency. I mean, you know, acceptances for every place I applied. And they're like, so we got the.

Star student in here?

No, no, he's like. He got a letter from Milan Winney. Like, you know, Alon, Winnie. I'm like, yeah, he's my. He's my mentor. They're like, oh, my shit. Like, it was awesome.

That's awesome.

The chairman at Harvard was like, best friends with him.

Wait, so that's where you went in Boston?

Oh, you went to Harvard for your residency? Okay. Wow.

Nice.

That's sick.

Wait, so did. So you got your PhD all before you started the MD?

It was kind of. Yeah, pretty much.

Okay, pretty much. But it's.

It was in your. Like, My first year of MD. PhD. You're taking. It's the same. Kind of, the same crossover because, you know, I'm taking more MD stuff. I'm still doing research. But in order to get your PhD, you have to. You submit your research proposal to a committee, and then they. They approve it, and that's to get your master's degree and Then they take that information and then you have to postulate what you want to do with that. And then you have to get in front of a. Like a. It's like a panel, a trial, and they just hammer you. I mean, just. It's brutal.

How long. So how long did the whole thing take you?

So for everything was seven years.

The I worked with an MD PhD last summer in a lab, and he just seemed like he was working all the time. Like, I would leave the lab at 5pm and I would get there the next day at like 8am and he was there. And he had been there all night working. Yeah, like, he was just. It was a different level of intensity that I was so unfamiliar with.

Well, it kind of happened to me when I finished my residency. So I did a fellowship in critical care, cardiac thoracic anesthesia in Australia. I came back and I was on staff at Harvard. I was one of the hospitals and I was doing research, writing grants. And it was like consuming. Like, it was so consuming. And I remember it was like a Wednesday night. It's like midnight. I hadn't seen my friends in a month or two. And I was just like trying to get this grant, trying to get this money. I'm trying to get tenure. And it's really hard to move the academic ladder at Harvard. So I was like, I had guys that I knew that were instructors in anesthesia and they'd been there for 20 years. I mean, they didn't got to an associate professor yet. And so I'm like, do I really want to do this crime?

You thought so. You thought you were going to go down more of the research path.

I was literally thinking I was going to be an academic guy. I was going to lecture. And I loved teaching students, residents and medical students. Not the Harvard medical students very much, but they were very arrogant. But the residents, I liked it and I liked the research. I like to feel like you have your finger on the pulse of medicine because you're there. I remember I was a third year.

Medical student in Chicago and I was doing a rotation at one of the community hospitals, Weiss Hospital, which is a very nice hospital. It's folks affiliated with University of Chicago. And these two guys were talking and.

They'Re like, man, there's these drugs out and they're like some new drugs and they help with blood pressure. They're. They call it ACE inhibitor or something like that. And I'm like, I don't want to be that guy. Like, I want to know what's going on. So I got To.

I want to know what ACE inhibitor is. I want to know what an ACE.

Inhibitor is before it's like, you know.

Been out for 10 years. And I was thinking, like, these guys are very up to date and other things like that, I think. And I felt like if I was in academics and obviously, you know, Harvard's got a reputation that, you know, kind of is pretty decent, so.

Pretty decent.

If I'm there, I can be, you know, and, you know, I got a faculty position, and. And it was just. It was just.

It was pretty decent.

It was interesting.

It was interesting. Then I was thinking, like, what am I gonna do now that I was lost? And I remember I came home for Christmas to my family in Illinois, and my dad, one of his friends was.

A cardiologist, was in academics at University of Virginia for, like, 15 years, and then left and went into academic. I mean, into private practice. And he's like. I talked to him.

Literally, this is the randomest thing I've ever had. A cocktail party.

Oh, wow.

Christmas vacation.

And he's like, you're just. You're young. It's time, you know, just. You're gonna waste your time. You're gonna be. So. I've written three books and published all these articles, and I'm having so much fun now. I'm practicing medicine, making a ton of money. I have time for myself and my family. It's just awesome. So just give your.

Do yourself a favor and leave academics. Enjoy private practice.

Yeah.

How old were you at this point?

I was 35. I think about that now. Like, I would work all day and night, and then, like, I was training for. I ran, like, a bunch of marathons and a lot of road races. I ran for Nike for just a little bit as a masters runner. And so I was traveling. And I just remember, like, I don't remember sleeping very much.

Do you feel like you were just. Like, you were just trying to keep going to the next thing? You were always on that high.

I think if someone met me at the time and it was more popular.

Than it is now, like, they probably.

Thought I was, like, frenetic or bipolar or something, or manic. I was busy. But I think one of my things that helped me, like, I really have no problems going to sleep, so I can literally sleep standing up or in a chair. And when I lay in bed at night, I go to sleep, like, in 20 seconds. I think that there's no tossing and turning and stress.

I just fell asleep.

But I think that, well, you were a bit exhausted.

I remember like, literally coming home from being, like, doing a heart transplant, my, like, junior year, I mean, third year.

Of meds of residency. And I'm thinking, I got 18. I gotta run 18 miles today, the marathon coming up.

And just being like, oh, my God.

My big question is just like, why, like, why did you end up doing the. The MD, PhD, and why, like, you, like, why were you training for the marathon? And, like, why did you.

I don't know.

I just, like, you felt like you, like, needed to do these things or do you. Or were you, like, I want to like, everyone else. I'm at Harvard, Everyone else around me is, like, doing all these amazing things.

Yeah.

And like, was it like, keeping up with that or was it really just like, like intrinsic motivation that, like, you always want?

This is a therapy session.

No, I think. I think, you know, I think one of the big things is I went from, you know, I was very competitive, like, athletic competitive. And growing up, you know, I. I just was very active kid, and I was. I liked that competition, and I wasn't great at all that stuff, but I was pretty good at a couple of them. Then, you know, I played high school football, college football, and I was super competitive. And then that went away. It's like, I. I just remember I'm. I'm kind of a little lost. Like, I need something to do. And my cousin who's, say, played college football in different college, he gave me some running shoes. Like, let's just go running. And I lived in a. Like, in a park, kind of like by White Rock, but a smaller scale. And so I started and I worked two jobs because I was paying my way through school, for school, and I was trying to save money. I worked during the day at the hospital, and then I was a janitor at the. At the state capitol in Illinois. And then I came home and I ran. I remember I'd go for runs and I just. Just got like, this is something I can. You know, like, this is my competition now. This is my athletic endeavor. So, yeah, I ended a 5k, then 10k, then half marathon and a marathon. And then. Then I started literally reading, you know, Runner's World, like, how do we train? Like, I don't know what I'm doing. You know, I remember my first marathon.

I was.

I was running.

It was back in Illinois, and I.

Was like, I just ran, like a long distance and thought that's what you should do.

And then I remember running my first marathon, and I was sucking wind, and I did okay.

I'm like, I think I maybe should think about, like, how do you train for this?

Look at a plan.

Maybe the furthest I'd ever run was, like, 15 miles. And, you know, I'm thinking, there's gotta be some science around. Anyway, and then that just sort of.

Yeah.

Started the file. And I think everything else, like, the PhD thing, it's like, wow, this is interesting stuff. Like, I want to be stimulated. I want to be interested. And I wasn't, like, you know, top of my class by any means, but I was competitive, you know, I. Obviously, I got into medical school, but it wasn't like, the number one choice or, you know.

And I remember applied to two schools in Illinois that were the state schools because I could afford them.

Yeah.

Back then it was University of Illinois or Southern Illinois University, and that was it.

Well, I don't know. That anesthesiologist did seem to say that you were the best kid.

Yeah, well, I mean, that's. Because that's the other thing, too. Like, I tell my nieces and nephews all this all the time. Like, show up. Like, I just showed up. Like, I. People. I don't know if you saw this. When I was in med school, antisure rotation was like a joke. Like, they'd leave at noon or, you know, like, you go to a little lecture in the morning, and then they start cases and they just disappear, Right?

Oh, yeah, Yeah.

I just showed up. I stayed there every. I got there every day. I stayed there every day, you know, And I think he saw that I had passion for just learning. Like, I want to know. And, you know, one thing, too. Like, I remember one of my attendings used to say, like, in med school, he's like, listen, you're a doctor first, and you're a specialist second. Like, don't forget that you're a doctor like, a lot of people. My orthopedic surgeon friends.

Right, right.

You can say something like, I don't.

Know what you're talking about.

I literally just kind of realized, like.

Two minutes ago, like, we're probably. You're probably recording this.

She would say, like, F word or she edits stuff.

I edit.

Yeah. Because actually, we're not. You might have to rate it as explicit. We're clean right now.

I was just gonna go back to just the PhD thing. I remember. So I did a summer in doing research in Charleston at musc. And going into the summer and a lot of the other people who were with me when we went into the summer, we were like, oh, maybe we'll think about doing Ph.D. or maybe we'll think about going down that path or maybe MD, PhD. And then after doing it, we all realized we're like, we're not gonna do PhD. We were just like, that wasn't for us. And various reasons for that, I guess. And also like, you were talking about the people who are in academics just saying, do Maryland. Don't go down the academic path. That is what I experienced 100%. There was like, there was a guy in who worked in our lab and he was still under, like the guy who actually owned the lab. And he had been there for 25, 30 years and he still didn't have his own lab. And he. That's what he was trying to work for. And he was like, I. This is like, don't do this. Like, do. If I were to go back, I would have just done an MD and not done that. I guess if you want to talk about, I mean, do you. You use your PhD now? Like, are you still interested in that world?

Yeah. You know, it's funny, I still, I mean, I still, I don't like, do a tremendous amount of reproductive physiology kind of research, but there's an article that piques my interest. I'm still like one of the nerdy guys that still gets the New England Journal of Medicine and, and I still read, you know, science sometimes or something article come across. And I think too, this is not important to most people, but I feel like I have a different lens when I see research. Like, I really look at statistics and I look at their null hypothesis, I look at how they analyze their data. And most physicians, researchers do not do a good job of that. They don't have a good statistician or someone who's kind of overseeing because they'll. What they're analyzing their data with is just. It's not really what I would use and it's really not a good barometer or they'll make a statement at the end of their conclusion, these research articles. And I'm like, I don't know if you can make that conclusion after, you know, you have 14 patients or, you know, and there's been literally landmark medical research based on horrible, horrible data collection and horrible statistics. Like, kind of lecture I would give the medical students that there's lots of things in medicine that there's right answer for both sides, but you really want to do is get on. If you're on one side versus the other, just know your argument, why you believe that, you know, and there's people that can argue on both sides, like why you should or shouldn't do these things. And I'm like, you're both right. Just depends on how strong your argument is on either side of that fence. And you, like, I believe what I believe based on my understanding of the science. And I could be wrong, but I'm gonna go all into this side and I don't know what I'm talking about.

I think that the types of people that go into medicine and go into STEM in general are very. The types of people who are black and white thinkers too. Like, you like to Say X equals 6, right? Like, you like to have the answer. And like, I think making sure that people understand there's so much gray in this world in general. Like, I mean, I don't know about. Yeah, I don't, I don't know as much about dopamine as you do, obviously. But, like, that was part of my study was like, looking at actually, like, adverse effects of drug withdrawal and how, like, that affects dopamine neurons. So, like. And like, that actually, you just think dopamine equal. Good. Like, that's what I learned in college. But, like, really, like, there's so much nuance and stuff that you don't understand. And I think, I guess, like, going back to how you got a PhD and like, doing that research helps you understand all the nuances and understand so much gray. That is science. Really?

Really. And I, I, you know, I, I used to. I guess my, My point is, like, I had a reason why I did it and I could articulate it. Well, not that I'm smarter or anything.

I just went to Harvard and taught at Harvard.

No, I'm like, you know, whatever. No, I respected people's opinion because it, I respect your opinion, but this is why I do it. If you want to know why I came off on this drug, that's why I do it. Because I think it's beneficial for the patient. And I have data that shows it's productive.

I mean, you could argue that that is what intelligence is. Being able to understand why you're doing what you're doing and what the purpose is. Right. I don't know. I think that's a difference.

And I think it's. I mean, I think all that stuff is super important. I mean, for me, I'm talking to patients all the time. I'm trying to. And when they. And my patients are very intellig, educated people. And, you know, it's really important for their confidence in me that I can say, you know, okay, I want to do this. And if they have more Questions, I can explain why. And then a lot of them do read this or that. And sometimes they say, well, you know, I read this thing and it said that this is bad. And I'm like, yeah, you're always going to find some naysayer of something. But I'm like, yes. And that what they're saying is not completely untrue. But in your case, this is why I do believe this is going to be beneficial. And, you know, but yeah, you have to be able to kind of like, explain to them why you're doing what you're doing. It doesn't go very far in my practice to be like, well, I'll do it, because I said so.

You know, that's your mom. It's a way harder job than difficult than a job because I don't have to explain to the patient while they're sleeping, while I'm doing this or the surgery, because he's kind of like, whatever.

What I found, really found, this is probably one of the biggest learning points that I had, is like, anesthesia is.

The most misunderstood specialty of all of medicine. People do not know literally what you do. They're like, oh, you just put this medicine in the IV and turn this dial. Then you read the paper. There's no idea what we're doing. And if you literally put someone in a chair and said do this, they would be lost because it's just kind of this enigma. And I think you as a physician, when you see patients, especially because you don't get the end result that I get very quickly, right, you might have someone on an ACE inhibitor or calcium channel blocker or whatever, and you might not see what you want for months. And you have them come back and they're, I've got a headache and I got to change this drug or I got my throat swollen up, whatever, right?

We get to sort of see literally.

How what we decision we made works or doesn't work and, you know, sometimes change gears and sometimes we make the wrong decision. You know, I might.

Well, so tell me, like, are you. So now you've been in private practice for how long?

1997.

Okay. So that's been a long time.

97. 98. Yeah.

And I mean, do you like what you do now?

You know, it's changed a lot. And it's funny now, like, looking back and what I can say to you, someone who's going to medical school, looking back just like from that 30,000ft view, I don't know if the juice is worth the squeeze. It's a Huge commitment. If you're really all in, and that's to your specialty, to your profession, to your community, your practice partners and everything else suffers somewhat. And I think about all the nights and weekends and holidays and stuff that I miss with my family. My parents are both deceased now. They, you know, come to Christmas, come do this, come, come there, you know, and I feel like. And now on top of that, which, that never really bothered me until like the last few years I practiced, patients are so disrespectful and unappreciative and talk to you like you're the help. And medicine is becoming. Used to be this noble profession is now just, you know, you're a provider. Like people call me a provider. It's the most insulting. Like, you think about your work ethic and your commitment to what you do. And if I went into venture capitalism or, you know, mergers and acquisitions or something, I would have so much better life because I would have weekends and nights free. Now I'd be probably retired with a second house somewhere else. And I mean. And I'm just like, medicine for me is like a horse race. The gate opens, you run as fast as you can, and then it's over. And that's the way our practice is. I mean, you know, when I slow down, the money slows down or the production. You work with people you don't really work with. You gotta get. You get kind of in the glue factory lane. And it's just, I think back, I'm like, God, I mean, I never would have thought like my father. I saw my father practice for 40 years and I see people like, you're John Geisler. Your dad's Bill Geyser. And he's such a great guy. He really fixes me up. Like, you know, I had all these problems with my teeth and what a good, good guy, blah, blah. And I thought that's be a good profession to go into. Like, your patients appreciate you and your, you know, your commitment is helping people. And you get paid for it. You get paid okay. You know, my parents weren't rich or anything, but we had a nice life. And I thought, well, if I do something like that, I can use my information science brain and help people and get paid. And. And now I think back and think, man, I don't know, was the juice worth the squeeze? And it's hard, you know, in this.

Environment, like, especially working with surgeons.

Yeah, you're just, you're like the lamprey that's on bottom of the shark. You're just parasite to Them because you're just getting money from them. They are hard work because you gotta.

Put them to sleep just keeping their patients alive.

Yeah. You're not a colleague or you're not a consultant, which that's what I consider myself. Just like the cardiologist or the internist is, you know, getting cleared for surgery or whatever they want to say about it.

Yeah. Well, it is a little tough in your. Because you don't have any control over the patients that you see. I mean, you don't have any screening or anything. You just got to see them. I mean, for me, if somebody acts like that, I mean, I just say, bye, bye.

Yeah, yeah, yeah.

You just gonna put them to sleep and say goodbye. Yeah.

I think it's also too over time affecting me. Like I was telling Todd, I feel like sometimes I just. Like I'm. Maybe I'm doing a disservice because I'm just so irritated with this person or so irritated that I have to be there and do this case. And this is such a. This is a financial emergency. It's not a medical emergency. The surgeon wants to do it now because it's convenient for him.

Yeah, yeah. He's got a boat payment due.

Yeah. Or whatever.

Yeah, whatever. So that's hard.

Well, so. But just along those lines. Okay, but let's say. Let's say you've already made the choice to go to medical school like some people. But in your picking your specialties, I mean, do you. I mean, obviously you really enjoyed anesthesia more than anything else. But if you. Knowing everything that you know now, would you still make that choice to be.

An anesthesiologist once again, probably not. I mean, I probably would do more of a lifestyle choice. But this is all retroceptoscope.

Everything's 2020 through the retrospective.

Plus you're a different person now. Yeah, yeah, yeah.

And I was, you know, I've. I mean, I'm 62, not, you know, 22 or 28 or whatever, Med school and. And I think too, like, you don't think of those things. I literally remember I'm a third year resident. I'm on call. I finished some big heart case and I was working with this older attending who mostly did, like ambulatory anesthesia stuff. And we were talking and he's like, I told him about this case. It was really fascinating. He goes, yeah, I used to be on the heart team. I used to do anesthesia for open hearts. And he was probably 60 plus at the time, so probably my age now. Nice guy. And I'm like, you don't do hearts anymore. And I just thought, how lame. Like, I'm always.

What a loser.

I'm always. I didn't say that, but I felt like it was kind of like. Like weak. Like it was weak or something, you know? And I look back now and I think, like, he. He was. I respect him so much.

I wish he's probably passed away. Ed Ruff was his name. Dr. Ruff. He was a really nice guy.

Can we back up a little bit and talk about Australia and Hawaii? So when were you in Australia and in Hawaii?

So.

So it's kind of a long story, and I'll try to make it short.

But, you know, I went to college in med school. Like, I was, like, in love with.

My high school sweetheart. I was gonna be an obstetrician, move back to my hometown and take over this job.

Right, that was your plan?

That was my plan.

You know, it's like 18 year old. I got it all worked out. I was a pretty intense kid then. So, like, I'm gonna do this.

And so I think, you know, that all sort of fell apart.

You know, my high school girlfriend dumped me for some other guy.

And so I was like, you know, I don't know. And these opportunities kind of came of this kind of came of ale to me. So when I was doing. Working in this lab as a medical student in Chicago, one of the residents, you know, the general surgery residents, always rotated through and did research for two years at most big academic centers. So he was telling me about. He did this, like, rotation in Thailand, and it was like a missionary work. It was really cool. And he saw this different part of the world. And I'm thinking, wow, that's really neat. I never thought about going to something like that. So I remember I was at the. I was at med school and got accepted this program, this honors program. It's called the James Scholars. They had their own, like, little office and whatever part of the school.

Star student and a James scholar.

So anyway, I was talking to, like, our. My faculty. She was like a vice chancellor. And I was talking about this guy Matt. He was really cool.

He did this thing.

She goes, like, we have this program in your last year. You can do it for as long as you want. You can do it for one month, three months, six months, eight months. You can apply for it, and we'll pay for you to go, and you can go and work in Thailand. And so I spent, like the last part of my senior year in Thailand as a missionary. So it Was great. Learned so much. I lost a lot of weight, but I learned so much. And so that kind of sparked this, like, wow. And so my sister was living in California, and I'm thinking, wow, I'm gonna maybe go there and do some rotations. So I end up doing a rotation at Stanford and UCLA and UC San Diego. And I'm thinking maybe I might do my internship in Hawaii. They have a program there, and it's super competitive, but I'm like, I'm gonna give it a shot. And so sort of matched to that program. And then the Harvard program. And when I was at Harvard and.

In my second year, I started working.

With all these foreign attendings from Australia. I'm like, you guys are wankers. You're so colloquial. You just do everything here. You gotta see the world, man.

Yeah, those are the Aussies.

You need to come to Australia and do your fellowship.

We'll show how to do it.

We have some famous guys there. And I'm like, They're like, you know.

Basically threw it down for me because I became really good friends with a couple of them.

And I'm like, if you set up a fellowship for me, I will come, like, a month later. They had it all laid out, all organized, and they're like, and we're gonna throw whipped cream on top with a cherry. You can work as a National Rescue Lifesaver helicopter doc on our National Helicopter Rescue Service while you're doing it.

I'm like, oh, that is so badass.

Wow.

So I signed up, and I called my friend Jonathan Mark at Duke, and.

I said, hey, I'm gonna do it. And he's like, that's great. I know those guys. You're gonna have a great time. That's awesome.

Wow.

And it just sort of like, you know, fell in my lap. And, you know, and my family were kind of joking around like, I have a job. It's not like, I'm going there, and, like, I want to move to Australia, and I don't know what I'm gonna do. Someone says, I'm gonna give you a.

Job, and you're gonna move there. It's easy. It's not really hard. And once again, I was single, and.

I was like, yeah, what the hell?

Yeah.

I feel like you should write a book.

Yeah.

Like, there's so much stuff with your life. I mean, I feel like it's like multiple lives, you know?

I talked to Sus, and she's like, we had a first date, and we.

Started talking, and she's like, What?

Yeah.

And he's giving her like one little bit. Then we had another date.

She's like, wait, what? And she's like, after like the fourth date, she's like, I've never met anyone like you. It's bizarre because she's a one town girl.

She's like, you know, I grew up in Arlington. I went to TCU, went to law school, and then went to the DA's office. And now I'm in Brexit in Dallas.

Been all over the world. Hey, congratulations, by the way.

Thank you. I appreciate it. So do you have any advice for going down this path?

Other than don't do it?

Yeah, other than don't do it.

I don't know. I think. Be honest with yourself. I think too. I think, you know, I said this to Matthew, I said, you know, your mom to him, your wife, you know, Sarah's got a great job. I think she, you know, has a practice that she kind of can control a little bit. You have some more control of your life. You have some great clients, I mean clients, great patients that you get to know sort of intimately, you know, personally and then, and you can build that, which is just something that I think is great. Man or woman, what you really, really love might not be what's the best for you, personality wise. Yeah, I think sometimes, like, God, I went into a specialty that like as overnight call and does all these, you know, I do, you know, little kids and old people and women labor and, you know, there's all these things that can go wrong in every avenue that you pick, as well as, you know, being overworked and underpaid. But there's other things like dermatology and radiation oncology. One of my best friends from internship as a radiation oncologist. And he's got a great life and, you know, he makes a lot of money and he, he, he. There's no emergency, right. Radiation oncology.

Yeah.

So when he takes call, you know, they might get a consult about something he's got to see the next day. But.

Yeah, and I mean, that's kind of like why we're, we're doing this little series of talking to people in different specialties. Because like, as my mom said, when you're going through it, when you're doing rotations, like, you're just seeing, like you're just seeing the pathology, you're just seeing the doctor there. You're not seeing them for all day and what their actual life is like. So. And that is important. That's something that I do think about especially just being a woman. Like, I like, do like that, having a lifestyle and like, I want to have kids and do that. So, like, I do want to make that a priority and just remember that and not kind of get stuck in it and just be like, this is so exciting.

Like, yeah, getting kind of sucked into something. I mean, obviously you gotta have something, something that you enjoy, but you can get too into it. Yes. My suggestion was that people should. It should be 24 hour shadowing, you know, it should let go and follow a person home.

I remember, I think I was telling you earlier about this wife's hospital. I'm doing this rotation and you know, the obstetrician is 40 year old guy with. He had three or four kids and he's like, it's Saturday and he's with me in the call room talking about. He goes, this is not like delivering babies. It's happy. Everything's great, you know, thank you, doctor. Blah, blah, blah, blah. This is. I'm here with you instead of my family at the beach in Chicago, in my son's birthday. Like, this is life. Like, this is your life. Like, you are on the hook and it's, you know, on the hook all the time. So think about that. And I was like, man, I never thought about that. Because the reality of life, like your mom said it best, like you're in the hospital and you're seeing this stuff and it's cool. And go to the operating room and take somebody's gallbladder out, whatever. It's really cool. That's not real. It's more than that. It's way more than that.

Yeah, yeah. It's not that cool when you're missing out on stuff. Missing out on your life.

Yeah, yeah, exactly, exactly.

This has been just. Yeah.

I feel like we didn't even like, scratch the surface of your life.

I know.

Mikaela is so much more interesting than I am.

We're gonna have to. I mean, I mean, we're gonna have to have like you back. Have Todd on.

No, Matthew, you're not gonna.

Oh, yeah, no, we'll have him eventually. We'll see.

He's an interesting guy.

I like Dordale.

He doesn't seem that interesting to us.

I know, but he's a pleasure and.

I. Yeah, thank you so much for having.

Interesting.

I didn't really. When I came here, I had no.

Idea what I was gonna say.

I was like, I'm not that interested.

Oh, my God, this is different. This is like.

I don't know what to say.

And y' all know where to find us. Follow Generations MD on TikTok. Follow Park City's personal physicians on Instagram. Thank you guys so much for listening, and we'll see you next week. Bye, guys.