What You Don't Learn in Medical School

We learned nothing about addiction. Not taught this at all. Here's what we were taught about addiction.

Hi, everybody, and welcome to the podcast. This is Generations md. My name is Stephanie, and I'm joined by my colleague Sarah Davis, also my mother. We're in a new studio today.

If you guys will look on TikTok.

You'Ll see some different clips. Clips. It's really high quality. The exam room here.

Yeah, we decided to come into the exam room. We'd done the office, we did the waiting room. Now we're in the exam room. We're seeing every bit of this enormous office.

Yeah. We're currently using our EKG machine as a tripod, so. So it's been a minute. We took a little break. Sorry, guys. Sorry to the viewers. I know a lot of people were asking about it.

Yeah, everybody was having, you know, they couldn't enjoy their Christmas because they were like, where's the next episode of the podcast?

Exactly. I know it hindered your Christmas vacation and the holidays a lot, but we just had to take a little, you know, a little break.

A little break. But we're back now better than ever. Okay, well, we're gonna do a couple things today.

We have some viewer questions. So thank you guys to everyone who sent questions in. We're gonna kind of go through them and talk about a couple different things. So you ready to just dive on in?

Yeah. Do you want me to do that first question. So this comes from a viewer who chooses to stay anonymous, but the question is, what do you do if you have been applying to medical school this cycle and at this point you haven't gotten in anywhere? Not only have you not gotten in, but you haven't gotten in any interviews. And about half the schools you've applied to have told you no. And about half the schools you've applied to haven't sent you anything. No interview invite, just kind of radio silence?

Yeah, I mean, this happens to a lot of people. This is not rare occurrence at all. People apply and they don't get any interviews. Or maybe they get one and they don't get that acceptance. You gotta be rational. Like, it's good to be optimistic for a while. But, I mean, at this point, if you really don't have any interviews, like, I would probably start thinking about plan B. I remember when I first submitted my applications and I hadn't got any interviews yet, like, early August, I was like, I cannot imagine going through all of that again.

It is hard.

But now, at this point, after I've been removed from it for A little bit, and I've gotten in, so I don't have to think about this. But I was thinking, if I didn't, would I go through it all again after being a little bit removed, I feel like I could be motivated to do that. But at the time, right after I finished writing all those essays and, you know, I would not take the MCAT again. I was happy with my score. I could not do that. But why? Why didn't you get in? I feel like evaluating that.

I think that's a really important question, and I think it's important to look objectively at your application and maybe have somebody else look at your application to say, what do you know? Are there some certain holes in your application? And, you know, there's things that you can control and things that you can't control sometimes, you know, okay, you wanted to go to one particular school. Well, they already happen to have a lot of other people who maybe were very similar to you in whatever demographics or, you know, where you're from or scores or something like that. And so you just happened to not make that cut that time. But that was more just based on luck rather than something that you could really change. But there's probably something else that you can improve in your application. I think it's, you know, GPA is going to be pretty tough to change, but the things that you can and change are, you know, maybe you didn't have enough clinical hours, maybe you had some other really great things in your application, but you didn't really highlight those. And so sometimes just having some other eyes go back, look through your application and say, hey, you know, this was really interesting, but you didn't really say very much about it. Can you expand on that? Kind of maybe, you know, maybe you can improve some of those essays, but things like the mcat, that's going to be your biggest game changer, I think.

I think besides scores and stats, just talking in regards to the application, wording your application well and making it sound good maybe can get you some more interviews or maybe more acceptances. But I think at the end of the day, these people that are reading your application, it's not just about highlighting things and making your application so good. So many people have so many businesses tailored to trying to make your application sound good to get in. And maybe that's a small aspect, but at the end of the day, it depends. They want to look at your application and be like, okay, they understand what they're getting into. When you're going to medical school, like, you Understand what being a doctor is like. You have had all of these other experiences that prove that you are capable of being a good physician. So I think it's just like, if you. I think it's about. More about getting that experience rather than just, like, making it sound good on application.

I agree. That's, you know, I would just try to think of, like, people that maybe kind of shot themselves in the foot by not, you know, one of those ads. Kind of some time for reflection and looking back and, you know, do, you know, do you really want to be a doctor?

I think anybody that has the qualities and the characteristics to get into medical school and, like, just, you know, being smart can be really successful in a lot of other things. So I feel like looking back, if I was in that situation, and I never encourage taking time off because it just pushes your life back more. But I feel like I might take a step back and be like, okay, let me try some other career paths. And if there's still something, like, in the back of my head telling me like, I. I wish I would have reapplied. I wish I would have done that, then I would do it.

So, okay, so what are you. So boil down your recommendations. You didn't get in this cycle.

It depends on the person. It totally depends on the person. I would say don't just go get more degrees to get more degrees.

I agree with that.

Don't just apply to some grad school because you don't know what you're doing. I feel like so many grad school programs are just because you don't really know what you're doing. Do stuff that. Go try to do something that you're interested in. Unless that grad program is something that you're super interested in, and that's something that you want to do. Don't try to focus so much on what's gonna make my application look good. Yeah, don't waste your life trying to impress these application reader people.

Yeah. And don't waste your life. Somebody was telling me about somebody who had. Was saying, oh, this was so fantastic. She finally got into medical school after 10 years of trying. And. And they were saying, like, yay, never give up on your dreams. I'm like, yeah, give up on your dreams. I mean, you could have done so much more in 10 years. And, like, I don't know. I just can't imagine, like, doing that every year. Oh, okay. Well, it's year seven this time. It's really gonna work.

Like, yeah, definitely don't waste 10 years of your Life trying to make your application look good and trying to impress these other people, that's just like. I mean, that's need for validation, right?

Like, I guess. I don't know. I mean, you. Some people would say, oh, no, you know, she just really wanted to be a doctor and for whatever reason wasn't able to do it until. Until that 10th try. I would say your chances of getting in are. Are not going to go up with.

Some schools have limits. Like, I think, like, I applied to Harvard. Not that I, you know, whatever, but. But they said you can't apply more than twice. They put it on there.

Oh, man. Because I was gonna apply.

Oh. But that I even, like, when I'm talking to. I was like a part of the medical fraternity. And when I'm talking. When I was talking to, like, freshmen that were talking about joining the med fraternity and talking about doing pre med, I was just like, they're like, what do I need to do? What's the checklist?

What do I.

And I'm like, do stuff that you're interested in, and if that leads you to. Down this path, then great. But if not, then don't just try to check everything off the box. And I think that's the same advice I would give to somebody who didn't get in. I'm like, okay, go do something more clinical. If you find that as some sort of aspect of that really interesting, then go, like, follow that a little bit more and like, continue doing those sort of things and following what you're interested in. And again, if that is leading you to medicine, then great. But.

But if it leads you somewhere else.

It leads you somewhere else. Yeah, exactly.

Well, you know, we talked most recently about how you've been doing this job as my medical assistant for about six months. If you didn't listen to that episode, go back and listen. Because we do grade Stephanie on her performance. But, you know, doing this clinical experience as an ma, I feel like you've kind of learned about as much as you could learn in an MA. Do you think that's true?

Yeah, yeah, 100%.

You kind of max out with some of these different jobs. You know, you learn a little bit about by watching stuff, but when you don't have all of that knowledge from medical school and residency, I just don't think you're. You're not really seeing the picture the same way. And I think the same thing is true. Like, you do shadowing and stuff. I remember shadowing in the emergency room when I was in college, and I saw some Stuff. But I even, like, think back now about the way I viewed it then and what I was actually seeing. And you're not. You don't see it through the same lens when you don't have all of the knowledge. So again, I'm just kind of saying that all of those things, like, they're good and you see them, but you're not. It's not going to make it so, like, oh, yeah, now being a doctor is going to be so much easier because you saw all this stuff.

Well, that's a good segue into what are things that you wish you knew or maybe thought you knew before starting medical school that you wish you knew?

There's a lot of different things.

This was a question from a viewer. Anonymous.

Oh, another anonymous. Boy, people are very.

It was Thomas, my boyfriend.

Okay, okay. Wow, you really outed him fast. May. I don't know. Do you really want to know how bad things are or not? Like, you could kind of say the same thing with, like, parenting. Not that parenting is bad, but, you know, if you would. Some things in life are just hard. I mean, some of the stuff in medical school that I just thought was, you know, just really hard as far as, like, how poorly you are treated sometimes by everybody in the hospital you're paying to be there. And then you've got, like, nurse scrub techs acting like you're just like the gum on the bottom of their shoe, and you're like, huh, this just seems kind of messed up. But I don't know that knowing about that beforehand would have helped me in any way.

Okay, so what are things that you wish you'd learned in med school? Another anonymous question.

Okay, so I do have sort of a list of some of those things that I really had to kind of teach myself about in practice that, for whatever reason, we did not learn in med school or residency, which is honestly crazy. I think that maybe it's. I think that a lot of this stuff is better now. Like, one of the things that comes to mind is addiction. We learned nothing about addiction, even though. I mean, even when I was in med school and residency, there was a lot of science out there. There's a lot more now. But we did know things about it. Not taught this at all. Here's what we were taught about addiction. How to spot a drug seeker in the emergency room. Like, there were some people that would come in because they were addicted to opioids, and they would come in and say that they had a headache or something. And I remember there was a thing where we would make this a red piece of paper in their chart because they had had a history of being drug seeker. And so you knew you would, like, okay, they're just trying to fake this thing and trying to get a shot at Demerol, so don't give it to them.

So essentially it was like, just don't give them drugs because they're trying to get something from you rather than this person has a mental disorder. And, like, let's try to get therapy.

For or let's try to help them. It's a health disorder. Right.

They're coming in. Maybe they're coming in because they want drugs, but it's because they have a health disorder that needs to be treated.

Yeah. Hey, preaching to the choir here. I know. I mean, it's really. It's really true. But the. But that was not acknowledged. No drug treatment. You know, we never offered them drug treatment. We never even thought about why they were coming in for that. Like, it was just like, oh, no, they're trying to get Demerol from us. No, you're not gonna have it. Get them out of.

Did they have drug treatment? Like, did they have buprenorphine?

They did not have that as well. Or. I didn't know about it. I don't know exactly how long that's been around. It's probably been around for a long time, but I don't think there was as much science about that. But that was not something that we even had heard of or knew anything about. But there certainly were drug treatment centers, and certainly, like Narcotics Anonymous and AA have been around forever and ever. I mean, why. We couldn't have at least said, you know, I see you've been in here multiple times. It seems like you are wanting narcotics. Let's talk about it. Let's see, you know, let's. Let's have a conversation about it. But we, you know, we didn't. And we were certainly not taught to do that. And even things like we were taught to screen for alcohol. What we called alcoholism now we call it alcohol use disorder. But there was a question, this CAGE questionnaire. I don't know, do they still use that? You ever heard of that?

Maybe I will say about it, because I had to screen for AUD a lot.

Oh, yeah. So the four. So it's just the acronym cage, C, A, G, E. But the four questions were, are you concerned about your drinking? Do you get angry when people talk about your drinking? Do you feel guilty about your drinking? And then E, which I always thought really, like, totally jumped over Was, do you ever have a morning eye opener? And like, I just always thought, like, the first three are kind of, you know, a little subjective. Nebula is okay. You know, am I concerned about my drinking? Blah, blah. But, like, eye opener. I mean, that one is like, if you are drinking first thing in the morning, you have a drinking. Yeah, I think that is just very. There's just really not a lot of circumstances where you could justify that in order your first thing out of bed was that you have to, like, take a shot of vodka. I think, you know, there's something going on, you got a problem. But even then, like, you know, it would say. And we learned that in residency and stuff, okay, you know, you gotta screen for this. But then what do I do? If it's positive, then I'd be like, Then you just say, okay, well, you should go to get some treatment. Well, where, where should they go? What. What does that treatment look like? You know, we. Like, I never worked or rotated through any alcohol treatment centers. You know, like, you're kind of to say, like, oh, yeah, well, you should go get this. Bye. Bye. I mean, I don't do that. If I'm referring somebody to a cardiologist. I don't just say like, oh, you got a heart problem? Okay, go to the cardiologist. I tell them, you know, oh, this is what the cardiologist is going to do. These are the tests to prepare to go to the cardiologist. You know, I hand them off to the cardiologist. But here's something as difficult as drug treatment, which, of course, you know, there's lots of denial associated with that. I mean, there's a whole host of problems. But if you don't even really know what drug treatment is all about, I don't know how you're supposed to refer somebody to drug treatment.

Yeah.

So I think that that is just an area where, you know, we need to. And now there are, like, tons of medicines that, you know, that primary care physicians can prescribe for alcohol use disorder, for opioid use disorder. And there's a lot of things that can be helpful. And hopefully, hopefully they teach all of that stuff in residency. Although I kind of doubt it.

An MMI question I would have is, a patient comes in, what, wanting opioids, like, what do you do?

And stop make them go away? Like, that's what.

That's the wrong answer now. So even like, like, I get. Because they. I mean, that's. That's so frustrating. I mean, that's just like proof that the healthcare system is A reason for so much stigmatization of, like, these mental health disorders and addiction in general. Like, that is. That's. That's really makes me upset. Like, that's really. And that's why all these doctors who are. Are your age are still treat these people like they don't have a health disorder. It's so gross.

Honestly, I'd be interested to see. I mean, there's lots of this talking about all of it, but I'd be interested to see what it's really like when you do these rotations and how people really handle it. I bet there's still a whole lot of that old thing.

I think so too. Cause I think a lot of people are hesitant to change. And I look at the school med school curriculum just learning like cell bio and like, all those stuff, not how to deal with patients with addiction. I mean, I don't know. I haven't. Obviously I haven't done it and I haven't seen it, but I think, like, even. I think so many people still don't really understand that. I worked with opioid use disorder patients, so I feel like. And I worked in multiple addiction labs, so I feel like I have more of a open mind to that thing. But I think so many people don't. And if they're not taught, then they don't know what to do.

Yeah, it's. And, you know, a lot of people just. I find addiction is very interesting because you. If you. If you don't learn about it and you don't know to look for it, you don't see it. But when you actually have, like, open your mind and kind of learn to see it, you see it everywhere. Yeah, I didn't. I didn't see it for a long time. Then my eyes were really open to it. And now I look for it all the time. I ask about it. And you know, and people are. You. You have this impression that people are just gonna deny everything. And that's not really true. If you ask the right questions, people will tell you what's going on. And it's, you know, it's. It is. It's just a huge problem in this country. But you're not gonna see it if you just bury your head in the sand and say, oh, no, I don't. I don't see patients. I don't see drug addicts.

Yeah, it's gross.

Okay. Anyway, similar thing is eating disorders.

Yes. So big. We could go off on this.

We learned nothing about this in medical school. Not one thing. You know, I don't even ever remember anybody talking about was just completely glossed over. It was thought then that it was, you know, yeah, it's out there, but it's just. It's teenage girls, you know, those are the only people. It's just a real small percentage of the population.

And you have to be under BMI weight.

Yeah, yeah. You know, you can spot them because they're, you know, they're emaciated. And then you might be like, oh, hey, this person has an eating disorder. About eating disorders. A person can have an eating disorder, have their labs be perfectly normal, have their BMI be perfectly normal. So same thing. If you don't ask about it, you're not gonna find it. Now, if somebody comes to you and tells you they have an eating disorder, that's fine. But just like most things in medicine, people don't walk in the door and tell you this is the problem, even though sometimes they want you to ask these questions. But if you don't know the questions to ask, you'll miss it every time.

And I think it's the same thing with the addiction is when you don't know about it, then you don't see it. And then when you know about it, then you see it everywhere.

You see it everywhere. Yeah, yeah. And. But I think that, you know, I thought, oh, if somebody has an eating disorder, they're going to have, you know, their labs, I'll just check their labs, and then those will be abnormal. And that will guide me to it. There'll be lots of other things that will show up and that will tell me. And that's just not true. And, you know, it's not like you don't have to do a huge long rotation in order to learn some of this stuff. You really just need a few lectures so that you know how to spend and what to look for.

Yeah. And I think that that's also kind of an issue with just such segregation of medicine is people are just like, oh, that's a mental health disorder, like psychiatrist. But like, it's literally affects your mind and your body. So that is one thing. Also your mind is your body. So I think, especially if you're going into primary care, like, you need to be able to know all the mental.

Health disorders as well in primary care. One of the messaging that they got right during my time was that, you know, family physicians need to know how to treat anxiety and depression. We really, we actually did get kind of a lot of training in my residency program on those issues, especially depression. And that's really true. I mean, most cases of depression do not need to be followed by a psychiatrist, but you need to know how to treat it. You need to know how to spot it. You know, they taught us that pretty well. So I feel very comfortable with. With anxiety and depression, but some of these other things, you know, the addiction, the eating disorders, it really would not be very difficult to incorporate that into the curriculum. And again, maybe they do more now, but that stuff, I would doubt it.

Even in psychiatry rotations, they don't even talk about ED a lot.

Wow.

So it's just like. But even other. Like, with. But with everything in primary care, you're supposed to know a little bit about everything, right? You're supposed to be able to spot something, something, or know something that is abnormal, and then you can send them to a specialist.

And. And we did, like, in medical school, we did, you know, two months of rotation on psychiatry. Like, one of them was at the VA hospital. And ptsd. Ptsd. It's all ptsd. And, you know, the rotation was. I mean, it was interesting, but they had this whole program when the per. When the people. I wonder if they still do any of this. You. Yeah, I can't wait to find out about all this stuff. Like, so the. The patients would come to the inpatient ward at the VA because a lot of times they were struggling with ptsd, sometimes even schizophrenia, and like. Like super bad depression and anxiety, and they get admitted. And the first thing was that they had to stay in their pajamas the whole time they got their VA pajamas and they had to wear those. And then they could kind of earn their way up. They, you know, because they would stay there for, like, weeks. What? Yeah, you had to earn your way.

Like a prison.

Kind of like a prison. Oh, my goodness. And so there was like, group therapy and, you know, and some individual therapy, and I don't know what else was really going on there. I mean, I think about what we were kind of. We would do intake history and physical exams on the. You know, on the patients. And a lot of them had been in and out of the hospital like, for years. And so you kind of look through their whole chart and, you know, kind of kind of see what had happened. I mean, a lot of times what happens is people just had stopped taking their meds, but they had these meetings with all the other patients. And so there's like a room full of, like, 30 of them. And then they would come in, then they would say they had, like, talk in their own, on their own behalf to kind of get promoted to the next level. So I remember them saying, well, so I've been here and I feel like I've been going to group therapy and doing the stuff, and I feel like I deserve the chance to come out of my pajamas and wear real clothes. And then, then the other patients voted on whether the person. What? I know, even as I'm saying this, I can't believe I'm saying this. The pajamas, the pajamas. And then they both, they're like, oh, yeah, yeah, I think he can come out of his pajamas now. Oh, my goodness. And then they could be in clothes. Oh, and then, like more privileges, you know, the more you progressed on and did all the stuff you were supposed to do and you were compliant with your medicines and everything, and then you had more privileges. And when you got more privileges, then you could go out on pass so you could, like, leave for the weekend, go do whatever you wanted to do and then come back for more. For more inpatient therapy on Monday. That's. We did. Oh, I also did a child psych rotation. Oh, that was rough, man.

Wasn't it? It wasn't just all adhd.

Oh, my gosh, no. Every single patient who got admitted there had first killed the family pet, had then set lots of things on fire, sometimes their own home. I mean, it was like real heavy, heavy pathology.

I am. That makes me scared to have kids. Like, oh, my goodness.

Yeah. I mean, you're talking to this kid and you, you know, and they just kind of seem like a normal kid and you're just, you know, chit chatting and then you read their file and you're like, oh, my God, what do you do? There's just lots of therapy going on. There's group, lots of groups. And I don't, you know, I don't know. As a med student, like, like I was kind of talking about before, you don't really know what you don't know. So I was rotating there through, like seeing it through my own eyes at the time. Probably if I rotated through now, I would see a different story. But, yeah, I mean, just lots of really intensive therapy. I mean, a lot of times these parents were just at their wit's end and they're like, I just need to drop off this kid. You need to do something with them. But those were conditions also that are just really, really difficult to treat. So I don't know. I don't know what happened to a lot of those kids, but. Right. I mean, I needed to be seeing, like, adhd, you know, anxiety, huge, huge issue in kids and learning Behavioral therapy techniques, all of that kind of stuff would have been so much, so much more helpful. And I mean, I would say that this. So this problem kind of relates to medical education overall, and that's that you are, you were in a tertiary care hospital during your rotation, so you are seeing like, kind of the worst of whatever problem it is, people at their very sickest. There's sort of a theory that, like, oh, okay, well, you need to see all the really, really bad pathology and that that will help you to recognize it in your practice. But while there's a little bit of truth to that, it's. It's also, I mean, sometimes just kind of, it's not the best use of your time to just see again, like, the most severe cases when, unless you're in that specialty, you're not ever going to see those cases. But that's kind of the way medical education is set up because it's at tertiary care hospitals for the most part.

What else?

What else? Okay, so on a little more mundane level is I have never gotten really, really great at doing a musculoskeletal exam on people in family medicine. People come in lots of times with different aches and pains, knee pain, back pain, and I can do it reasonably well. Part of the reason that I'm not quite as good as I could be is because my husband, Dr. Matthew Davis, is a sports medicine doctor and he sees my patients for their musculoskeletal injuries. And so I just, a lot of times say, oh, yeah, you need to see Dr. Matt Davis, Dermatology. Yes.

Speaking of that, my foot issue has not improved.

Oh, you're kidding.

It has not gotten worse, but it has not improved.

Oh, well. Well, we're gonna have to refer you to a dermatologist. Here we go. Dermatology is. So it's everywhere in primary care. You need to know, like, what are the, what are the common things? What are the common treatments? And I do know a lot of dermatology because I do see a lot of these things, but I would still like to know better. And I would say just with. Go back to what I was saying before. I mean, same thing. So when you are rotating, if you do a dermatology rotation during medical school, which is just an elective, it's not required. But you're at this academic institution where you're not seeing anybody first coming in for this rash, you're seeing somebody who is now on their, like, fifth doctor for this rash. And it looks, the rash looks completely different than it did when it first popped up. And so, like, it's. It's hard to kind of relate that back to the way patients are gonna present when you're the first one to see them. Yeah.

So learn dermatology. Okay, that was a good list. So I asked some of my friends some questions, and we got a mixed bag here.

Okay.

So I'm gonna do some rapid fire.

Well, somebody asked, why don't we get.

Yearly PET scans to catch early cancer?

That is a very good question. There's a couple of different reasons. If you got a PET scan every year, it would probably actually end up increasing your risk for cancer because of the radiation exposure. So some of these tests, they might seem like, oh, well, what's the harm? Let me just get a CT scan or PET scan or whatever else, and then I'll know if I have cancer. But there is some risk to doing some of those screening procedures. The other reason is cost. I mean, it's. It is expensive to do these things. You can't really do that on a broad scale. But the third reason, and probably really the most important is those tests are not designed to be screening tests. They're really designed more for if you're actually having a problem, you can go and take a look at what's there and the chances of you. If you do some tests like that, probably something might light up or you see some abnormality on a CT scan. And now you're like, okay, is this dangerous? Is it not? Not dangerous? We end up going in there, doing a biopsy of that thing, which ends up being a whole nothing. And so now you had an invasive procedure for something that was never going to bother you at all. So screen. There's. I mean, when we do these screening tests, we do a huge study on all of these different tests to see what makes a good screening test and that there's a bunch of different features of a screening test to make it important to do on a population level. But some of those things are. It has to be something that then you can follow it up with another test that isn't gonna be super high risk. There are a few things that are out there, though. There is this one blood test that has become available that it's just a simple blood test. So it's non invasive, pretty much. And it does check for a bunch of different markers of tumors. And right now it's not covered by insurance. It costs about $1,000. And so, you know, obviously that's not accessible for most people, but for somebody that wanted to do that, that's not an unreasonable test to do if somebody is really paranoid and wanting to know about screening tests or cancer. The downside of that, though, is the same thing is that if something comes back positive, now you're sort of on a wild goose chase trying to figure out what to do to follow up that abnormal test.

Good answer. How gross is it to kiss my cat.

First? I thought they were asking if I was kissing the cat. I don't want to kiss your cat.

I can speak on behalf of this. I'm pretty sure that, like, bacterially, like, there's more bacteria in the human.

That's true.

Human mouth, mouth than in the cat. But you have. But, like, human to human contact, you have the same bacteria in another person rather than me to a cat, which they have a different microbiome in there. So there could be stuff that's invasive.

Yeah, I mean, the. You know, the. It is important to know that, like, if you get bitten by a human versus a cat versus a dog, a human bite, the worst. That's much more likely to get infected than a cat.

We're talking mouth to mouth, though.

Yeah, we're just. We're not biting. No. You know, it's.

Will it get you sick?

I mean, probably not. You do.

But what if the cat eats something like, and then it has some sort of disease and then you kiss it?

That could be. And, you know, and then, of course, you do have the toxoplasmosis with.

Oh, yeah, yeah.

And so, you know, I mean, they're probably not that far away from their mouth is not that far away from the poop. There's probably worse things you could do than kiss your cat, but is it really necessary?

How do I cure my bunions?

Oh, bunions. You want to see a bunion? I can show you my foot if you want to take a look at that. It ain't pretty, man.

The viewer says that she can't wear high heels because of them.

Yeah, been there, sister. I would say at this point, the only real treatment for bunions is surgery. And it is a big, painful surgery. My mom had to have it. But I would say get yourself some flax.

Okay. I think that's about it.

All right. Well, anyway, thank you guys for listening.

We have some exciting guests coming up, so make sure you follow us on Spotify, subscribe to us on Apple, follow Park cities, personal physicians on Instagram, follow us on Tik Tok at Generations md and we will talk to you guys next week. Bye.

Right, bye.