Stepping Outside Your Lane | Shantanu Rai

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The creative side of us, the human side of us, the humane side of us, that's what's going to actually distinguish us more and more.

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Because, you know, the thinking, the differential, the whatever is increasingly going to be something else.

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So it's an interesting moment for us to think about storytelling.

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Welcome to A Heart for Space.

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I am your host, Dr. Emojahungar.

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Join me as we uncover what it takes to reach beyond the limits of what we think is possible and turn the biggest dreams into tangible reality.

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Thank you.

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So I'm excited today.

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We have a rare occurrence.

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I get to interview my first doctor.

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We have a few more coming up on this podcast, including Dr. Astronauts.

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I have doctors who started programs.

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Like we're going to have a doctor who does the preventative, start preventative cardiology, which is kind of pretty cool.

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But I don't have...

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Any doctors who are authors, at least not in the sense of like an actual fictional suspense author, like creative writer, which is pretty cool in my opinion.

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So I guess I start this out for everyone like this.

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For someone who's never heard of you and you meet them at a dinner party, how would you describe yourself?

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Yeah, well, first of all, so grateful to have this chance and also to connect with you and get to know you better.

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Yeah, I mean, look, I'm a doctor in the safety net, meaning, you know, I worked in a low-income community, low-income clinic.

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And I've also been doing some writing to kind of show people what's behind the exam room curtain.

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And it ended up being my first book, which is a novel.

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Yeah.

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Um, it's on its surface, a medical thriller, medical mystery, but really it's about what's happening in medicine today and kind of, um, engaging people on what we need to do to make the system better.

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Yeah, I mean, we'll get into it, but there was a lot of points that got me.

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And I liked, I mean, without ruining the book, I liked the very end of it where you had the list of, you know, recommendations.

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I won't call them demands that the doctors made.

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And...

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We'll talk about it.

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I went to Boston Medical Center, which you actually did call out specifically.

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That's where I did residency.

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So I was like, oh, Boston Medical Center gets a shout out, which is pretty cool.

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It does.

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But that's where I did residency.

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So I was excited to see that institution.

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We could talk about that, too, in the future.

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But you write under a pin name, right?

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Yes.

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And before we go any further, what does that mean to you?

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Why did you make that choice?

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Because it is interesting.

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It's a to-do.

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Yeah, you know, I put a lot of thought into it.

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I mean, I think, look, at the most basic level, you know, I think I am talking about, even though it's fiction, a lot of it's based on my actual experience as a doc.

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And so you see a lot of doctor, you know, novelists like,

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Michael Crichton, you know, he initially wrote under a pen name when he was in medical school, Bruce Landon, the bestselling medical book of all time.

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Right.

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House of God, which was like, you know, I think must reading for a lot of us coming up through training at least 10, 15 years ago.

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He also wrote under a pen name, Samuel Sham, real name, Steve Bergman.

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So on one level, it was sort of there was there was that literary tradition.

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Yeah.

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But on the other level, straight up, this is a takedown of the modern health care system.

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It is a full takedown.

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And, you know, especially when I started writing it five years ago, I was very much ahead of where the health care discourse is.

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I think now because of the pit, which I'm sure we'll talk about because of maybe even the Luigi Mangione case.

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Yeah, I think I'm I'm definitely kind of, you know, a slightly ahead of the curve, but not so far ahead of the curve.

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And so there are some risk.

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to me.

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Doctors that speak out, during the pandemic, we had doctors get fired, nurses get fired for saying, hey, there's a patient safety issue, or hey, there's not enough masks in this hospital.

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And so I did it to protect my patients, but then also to protect myself.

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I mean, it's interesting because your book covers kind of all the aspects.

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There's the

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both physicians and the public have a specific view of.

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I feel like a lot of people look down on it, but I think we also understand that there's a lot of burnout in medicine.

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And you can't, like, you and I can't practice medicine necessarily the way we want in a system, but we might be able to do that in concierge medicine.

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You also have the safety net hospital, which is

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You know, I went to Boston Medical Center.

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Before that, I did med school in Memphis.

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When I was at Vanderbilt, I worked at Meharry Medical Center and Nashville General Hospital, which is a safety net hospital here.

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It's a part that I think a lot of us enjoy and have a love for, but it's not sustainable in other ways.

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So it's like, yeah, we were all talking about this, but you're right.

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It's come to a head over the last five years.

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So it's interesting that you saw it before.

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Yeah, you know, so much of medicine is a complete mystery to people, right?

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I mean, first of all, people don't like to think about health care or medicine until they need it, right?

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But even when they do, they see such a small slice of it.

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And I think so much of this, like I said, it was about pulling back the exam room curtain, right?

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And really because I think until you have deep empathy for the people working in the system, like that to me is a source of change.

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Right.

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And let's be honest, like doctors, you know, I think the perception for most people are not doctors, including me, because I grew up the first kid in my family to be a doctor is like, look,

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aren't their lives great?

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Yeah.

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I mean, they get paid pretty well, right?

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They're respected.

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You know, in my family, we used to stand up when the doctor uncles used to come into the dinner party.

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You know, they seem to drive nice cars.

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And some of them, at least to patients, they might think, well, hey, this guy is, they're not even listening to me.

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They're looking at their computer.

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And so I think what I understood was if we want to change the system, we got to get people to care.

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And so for me, the moment was I had this idea of, you know, again, I grew up a lot on Bollywood movies.

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I used to watch it with my mom and Bollywood movies for folks that don't watch or they're like these like sort of out of this world, like these houses and like the dances.

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It's all, you know, it's all escapism.

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So I was I was on a trip with my mom and I was like, man, like, what if there was this doctor?

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that made like a million dollars a year per patient and had his, had his own private jet.

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He would make house called by private jet and he's taking care of supermodels on mega yachts.

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He's taking care of like these.

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So I had this like flash of inspiration, but then to your point, I had this moment where I was like, okay, but why is he doing that?

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Yeah.

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And that's when I sort of tapped into exactly what you're describing.

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I think every doctor goes through this moment in their life where they're like, hey, I can work in the system, but then like I can't do what I want to do or should I just leave the system?

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Now, for some doctors, leaving the system means maybe they go work at the VA or something.

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Maybe some of them quit medicine, right?

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And go into tech startups.

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Maybe some of them, you know, start concierge practice.

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Some of them commit suicide.

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Yeah, it's true.

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I mean, we don't even talk about that.

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Yeah, we should talk about that.

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Every doctor goes through this moment, and so what I wanted to do was capture this moment and this dilemma that we all face.

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And of course, this character took an extreme view.

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He became a doctor to bazillionaires.

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But I also wanted to present the alternative, which is like, what else can we do?

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And that's really what the book's about.

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The book's about this guy who made one set of decisions and then ends up through a series of circumstances going down what I think is the third option that I really hope more of us take.

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Do you want to expand on what the third option is?

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Because you actually have, it's not just one main character, because you also have the administrative doctor, right?

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The doctor who goes that down that road.

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You have the doctor who is the old doctor that we all respect, but is not functioning in the system anymore because the system's moved on really and changed.

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You had, I mean, you had the research doctors and what that looks like.

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And I mean, we're dealing with this every day.

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I mean, I'm in academic medicine.

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I don't use a pin name.

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You can search where I go to work.

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But I see it.

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I see you have all these roads that you can take.

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So, yeah, what about the third road?

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And I'm not going to give away what your main character does in the book, which I think is an altruistic road, which I love.

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Yeah.

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We also, by the way, have the startup doctor.

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He's probably one of my favorite doctors who didn't even go to residency.

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Yeah, which we know lots of them.

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We know a lot of those people, right?

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No, the third path that I'm happy to talk about, the third path is really simple, is one word.

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It's fight.

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Fight.

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You know, one of the things I do in the book is, you know, what's really fun about medicine for those of us in it is, you know, all of us have our sayings.

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Right, so there's like a saying, you know, for those out there not in medicine, you just like, you know, in a medical emergency, the first pulse to take is your own.

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Yeah, true.

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Right?

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Space emergency too, probably.

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Yeah, and by the way, that's an interesting one because that actually came from a novel.

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Most people don't realize that came from House of God.

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Oh, nice.

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But we actually say it in medicine.

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In the vernacular and stuff, yeah.

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And so all throughout the book, I use a lot of these ones that most doctors would recognize.

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But then I was very intentional.

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I wanted to put one saying in the book that I wrote.

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Because I wanted to stand out.

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And it's exactly on this point, which is, you know, a good doctor treats the patient.

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A great doctor fights for all patients.

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And that's really the third way.

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The third way is this is our lane.

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Yeah.

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And what we have to do is fight because that's the only way the system is going to change from the inside out.

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That is a great line.

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A good doctor.

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Repeat it.

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We're going to put this out.

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A good doctor treats the patient.

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And a great doctor fights for all patients.

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All patients.

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I like it.

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A great doctor fights for all patients.

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And it's hard.

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I mean, it's hard as a clinician.

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I mean, I'm a full-time practicing physician.

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I do some administrative work.

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I'm at the VA and I'm at an academic center too.

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It's hard to fight.

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I mean, we do it because...

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But it is a constant thing, and we all work in a system that probably wasn't designed for any of this, right?

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Because it's become a capitalistic system where there are insurance companies involved and pharmaceutical companies involved.

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And by the way, the other thing I should say is I don't mean to say that as –

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necessarily an additional burden on doctors, right?

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Like I'm married, I only work part-time, I'm married to a real doctor, right?

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Who's an oncologist who does this six days a week, doesn't get a break.

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And so I'm not saying it that way.

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What I'm saying is that I'm almost giving them permission that I think a lot of doctors feel like, hey, I have to kind of toe the line or, hey, I have to stay in my lane.

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And I'm not saying you have to take a second job, like, you know, picketing people.

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You know, outside the hospital, what I'm saying is like, yeah, that like, but by making noise by, you know, even saying, hey, like this patient needs to get seen or, hey, I don't agree with that policy or, hey, I'm going to have a sub stack or, hey, I'm going to like like any of those ways.

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I think what I'm trying to say is.

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That fight, I think, is going to change the system.

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But I also think it's going to sustain you.

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And I want to give people, not only saying permission, but you're welcome to do that.

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And really, you're doing something monumental by doing that.

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And so there's a lot of ways of fighting.

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And that gets to, I guess, another question I had, which is,

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By having a literary identity that's separate from your clinical one, so freeing the two pieces, does that allow you to say things that your physician self can't?

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And for those of you watching, this is just an audio-only podcast because we are choosing to protect the identity of our author and our physician, which I think is awesome.

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But, yeah, what does that allow, I guess, for you as an author?

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Yeah, it's incredibly freeing.

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Actually, it's something that I didn't see when I made this decision is how freeing it is.

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Because I can talk about what I'm seeing in clinic, you know, and not feel like it's going to come back to my patients or my staff, which I would hate to do.

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Of course.

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Right.

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It also allows me to...

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to kind of create even my own persona around how I communicate these things, right?

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Like so much of us, we have to kind of meet audience where they are, right?

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Obviously a lot of it's on Instagram and things like that.

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And so like, I'm able to sort of connect with people in a way that I think is harder to do.

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So it's been incredibly cathartic for me to have that that space.

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Like, I think, you know, I think even on the most basic level, imagine if you're at a dinner party and a doctor starts talking about some like horrible accident that happened in the hospital.

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Like, what would you do?

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You'd be like.

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Dude, like, like, isn't that patient private confidentiality?

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Isn't that like, that's also kind of like unprofessional.

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Yeah.

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And by the way, that's what makes it that's why doctors, I think, are so lonely is because interesting.

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We're kind of trained and told or expected to just hold all this in.

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Yeah.

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And then who are we supposed to tell this to?

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And so at least for me, you know, again, it's about protecting my patients and my teams, but also it's just a space where I can just talk about these things in a healthy way.

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I mean, right?

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Like we all do.

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We all complain.

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00:14:16.934 --> 00:14:21.918
I mean, most professionals, you know, have, you know, but in medicine, there's this extra like little...

217
00:14:22.638 --> 00:14:29.463
layer or three that says, like, no, like, keep it in because that's patient's information or because that's sensitive or something.

218
00:14:29.763 --> 00:14:31.984
Well, and I do think it's also public perception.

219
00:14:32.024 --> 00:14:39.530
Like, yes, there are times where the public doesn't seem like they're supportive, but I think still in this modern era, most people respect...

220
00:14:40.670 --> 00:14:43.192
the field of medicine, their physician.

221
00:14:43.772 --> 00:14:54.839
And so, I mean, I remember I was talking when I worked in Blue Origin, the space company, I would tell people stories, not about patients directly, but just like, you know, that doctors are normal people too.

222
00:14:54.879 --> 00:14:56.600
It's like, what is it that TMZ thing like?

223
00:14:57.000 --> 00:14:58.201
Celebrities are just like us.

224
00:14:58.241 --> 00:15:00.022
Look, they're getting their...

225
00:15:00.422 --> 00:15:01.523
Groceries.

226
00:15:01.623 --> 00:15:05.184
And some of these engineers would be like, are you kidding me?

227
00:15:05.485 --> 00:15:06.185
Like, what do you mean?

228
00:15:06.205 --> 00:15:09.126
And I'm like, look, man, like, you know, you're an engineer and you do this.

229
00:15:09.206 --> 00:15:16.250
But people, it's hard to share those stories because people do hold us to a higher expectation and understandably.

230
00:15:16.730 --> 00:15:16.910
Yeah.

231
00:15:17.010 --> 00:15:17.230
Yeah.

232
00:15:17.510 --> 00:15:17.690
Yeah.

233
00:15:17.730 --> 00:15:20.172
And I think, and I have to talk about the pit, right?

234
00:15:20.192 --> 00:15:20.972
We got to talk about the pit.

235
00:15:21.032 --> 00:15:21.152
Yeah.

236
00:15:21.172 --> 00:15:23.693
I mean, I think that's incredible, right?

237
00:15:23.713 --> 00:15:24.874
They've done a very good job.

238
00:15:24.954 --> 00:15:29.056
And like what, and what's amazing is they're, they're just showing, right?

239
00:15:29.676 --> 00:15:31.297
And there's actually moments where I'm watching it.

240
00:15:31.317 --> 00:15:32.777
I'm like, hey, can you turn the camera away?

241
00:15:32.797 --> 00:15:33.437
We kind of got it.

242
00:15:33.457 --> 00:15:35.558
You know, like the patient's throwing up and then throws up again.

243
00:15:35.638 --> 00:15:40.000
Or, you know, that young woman that was so horrible had the sexual trauma.

244
00:15:40.300 --> 00:15:47.082
And then they're watching the, you know, they're showing us doing the sort of the rape kit on her.

245
00:15:47.782 --> 00:15:50.783
And it's like in most shows would kind of like, okay, you get the point.

246
00:15:50.803 --> 00:15:51.524
Let's move on.

247
00:15:52.144 --> 00:15:53.644
And they're just staying on it.

248
00:15:54.505 --> 00:15:58.006
And I think there's, I've learned so much about just show people.

249
00:15:59.028 --> 00:16:01.991
Show people what is it like to be in that nurse's shoes?

250
00:16:02.091 --> 00:16:04.333
What is it like to be in that doctor's shoes?

251
00:16:05.153 --> 00:16:07.435
And I just think that's been incredible for our profession.

252
00:16:07.455 --> 00:16:10.278
In a way, it's showing kind of the dirty side of what we do, too.

253
00:16:10.978 --> 00:16:14.862
But I think it's mainly been good, and I think it's probably rebuilding trust.

254
00:16:15.402 --> 00:16:19.586
What the show doesn't do, and that's kind of why I wrote mine, was it doesn't talk about the why.

255
00:16:19.926 --> 00:16:21.948
But they do an incredible job with the what.

256
00:16:22.733 --> 00:16:25.417
Well, you wrote your book before the show, I would imagine.

257
00:16:25.557 --> 00:16:25.817
Yes.

258
00:16:26.238 --> 00:16:33.128
And I wonder how watching the show, if you choose to write another book, which I suspect once you've written one, you're going to write another one.

259
00:16:33.148 --> 00:16:38.816
But how does watching the show and seeing that type of storytelling change what you do in the next book?

260
00:16:40.758 --> 00:16:42.118
Yeah, that's a really good question.

261
00:16:42.138 --> 00:16:43.459
I haven't thought about that.

262
00:16:43.599 --> 00:16:47.240
I mean, A, I think on some level it's validating, right?

263
00:16:47.280 --> 00:16:56.102
That, like, I think if you were to do a show, you know, where all the – like, think of Grey's Anatomy as a counterpoint, which is a great show, too.

264
00:16:56.182 --> 00:16:56.682
I don't have any issues.

265
00:16:56.702 --> 00:16:57.682
I mean, it's been on for 20 years.

266
00:16:57.702 --> 00:17:01.103
But Grey's Anatomy shows sort of the perfect, right?

267
00:17:01.183 --> 00:17:02.223
All the doctors are handsome.

268
00:17:02.243 --> 00:17:03.403
They're all getting a lot of sex.

269
00:17:03.723 --> 00:17:10.045
And they're, you know, and, you know, but I think actually today audiences would reject that.

270
00:17:10.865 --> 00:17:16.048
Because most people's lived experiences, hey, I keep getting these like bills from the doctor.

271
00:17:16.068 --> 00:17:17.629
I can't find a doctor.

272
00:17:17.969 --> 00:17:23.192
And like, so I think that, you know, it's kind of like how people went from Superman to Batman.

273
00:17:23.312 --> 00:17:26.554
We're in the Batman phase where we want real.

274
00:17:26.594 --> 00:17:27.474
We want dark.

275
00:17:27.614 --> 00:17:28.315
We want.

276
00:17:28.695 --> 00:17:29.956
So I think on one level is validating.

277
00:17:30.016 --> 00:17:31.437
I think maybe lessons learned.

278
00:17:31.857 --> 00:17:36.820
I think it's, you know, I in the book do and you'll you'll appreciate this, do a lot of stylized medicine.

279
00:17:36.840 --> 00:17:36.940
Yeah.

280
00:17:37.765 --> 00:17:39.727
And I did that because I was like, oh, it's got to be entertaining.

281
00:17:39.767 --> 00:17:41.088
It's got to be sort of comedic.

282
00:17:41.468 --> 00:17:50.475
But maybe if I did another one, I would stick a little closer to the reality and kind of that concept of keep the camera on what's happening.

283
00:17:51.176 --> 00:17:52.817
Because there's something so powerful about that.

284
00:17:53.238 --> 00:17:54.579
The stylized piece, you know.

285
00:17:55.019 --> 00:18:02.045
I was just waiting for Tom Cruise, like in Mission Impossible, where he shocked himself with the, I don't know if you remember that scene from one of the, but it didn't happen.

286
00:18:02.085 --> 00:18:02.605
But you're right.

287
00:18:02.625 --> 00:18:03.806
I mean, it is different.

288
00:18:03.826 --> 00:18:05.107
You have to choose as an author.

289
00:18:05.127 --> 00:18:05.228
Yeah.

290
00:18:05.828 --> 00:18:09.672
Do you present it more the way you did or more like real?

291
00:18:11.353 --> 00:18:14.116
And that's definitely a literary choice, I guess.

292
00:18:15.497 --> 00:18:24.825
Yeah, there's a great— You know, the author who wrote Life of Pi, Jan Martel, he has a great line in the book.

293
00:18:24.845 --> 00:18:30.290
He says, Fiction is the selective twisting of reality to bring out its essence.

294
00:18:30.951 --> 00:18:31.191
Huh.

295
00:18:32.150 --> 00:18:32.310
Right.

296
00:18:32.350 --> 00:18:33.411
You don't want to just.

297
00:18:33.691 --> 00:18:33.832
Yeah.

298
00:18:33.852 --> 00:18:37.395
You just want you don't want to show it as it is because you don't get its essence.

299
00:18:37.475 --> 00:18:39.377
You have to selectively twist.

300
00:18:39.417 --> 00:18:41.979
So the question that becomes, what do you twist and what don't you twist?

301
00:18:41.999 --> 00:18:43.180
And what's the selective part?

302
00:18:43.901 --> 00:18:44.041
Right.

303
00:18:44.061 --> 00:18:48.565
Like I twisted the fact that, of course, no doctor makes a million dollars per patient per year.

304
00:18:48.966 --> 00:18:49.126
Right.

305
00:18:49.166 --> 00:18:50.587
But I did that for a reason.

306
00:18:51.428 --> 00:18:51.688
Right.

307
00:18:51.708 --> 00:18:56.730
And and hospitals are bad, but they don't like kill people not to give away what happens in the book.

308
00:18:56.790 --> 00:18:56.950
Right.

309
00:18:56.970 --> 00:18:58.191
They don't murder people.

310
00:18:58.211 --> 00:18:58.371
Yeah.

311
00:18:58.391 --> 00:18:58.731
Yeah.

312
00:18:58.931 --> 00:19:00.292
So that's the selective twisting.

313
00:19:00.452 --> 00:19:00.692
Right.

314
00:19:00.832 --> 00:19:02.193
But it's to make a point.

315
00:19:02.513 --> 00:19:02.733
Right.

316
00:19:02.813 --> 00:19:04.114
It's to show the reality.

317
00:19:04.174 --> 00:19:06.114
And so I know it was a guidepost for me.

318
00:19:06.615 --> 00:19:07.395
No, that was clever.

319
00:19:07.435 --> 00:19:09.536
I mean, it was it was fun book to read.

320
00:19:10.796 --> 00:19:12.517
Now you've served in free clinics.

321
00:19:12.577 --> 00:19:13.578
I mean, is that right?

322
00:19:14.476 --> 00:19:15.336
You practice, okay.

323
00:19:16.136 --> 00:19:17.237
And underserved communities.

324
00:19:17.257 --> 00:19:21.258
So what does that choice say about how you believe medicine's supposed to be?

325
00:19:21.278 --> 00:19:22.438
Because you're choosing to do that.

326
00:19:22.538 --> 00:19:27.099
No one's making a million dollars a patient working in an underserved clinic or a free clinic.

327
00:19:27.119 --> 00:19:31.201
And I often tell people, you know, when I get frustrated, they're like, well, what would you do?

328
00:19:31.221 --> 00:19:32.121
Would you give up medicine?

329
00:19:32.141 --> 00:19:35.442
And I briefly gave it up when I went, worked for Blue Origin, I missed it.

330
00:19:35.462 --> 00:19:39.383
And I say, no, I would work in a free clinic maybe once a week or twice a week.

331
00:19:39.943 --> 00:19:41.484
Because I think there's something to it.

332
00:19:41.985 --> 00:19:44.387
So if I was a lottery winner, that's where you'd find me.

333
00:19:46.268 --> 00:19:51.753
Yeah, I mean, yeah, look, I think everyone has to make life make sense for them, right?

334
00:19:51.893 --> 00:19:56.657
Like, and I think it's really important to say just out loud, I don't do that work full time.

335
00:19:56.737 --> 00:19:59.399
Like, that's not my only source of income and livelihood.

336
00:19:59.519 --> 00:20:03.482
And A, because of the livelihood part, but B, because that's a tough job.

337
00:20:04.263 --> 00:20:05.244
to do five days or so.

338
00:20:05.304 --> 00:20:14.930
I don't want to pretend to be something I'm not like I'm not, I'm not fully not a saint and I have my own needs and I, I respect massively people's need to sort of put their oxygen mask on first.

339
00:20:14.950 --> 00:20:16.371
So I just, I just have to say that.

340
00:20:17.692 --> 00:20:21.815
I think after that though, I do think that, look, we all have choices to make.

341
00:20:22.395 --> 00:20:25.857
And I think that, you know, choices have trade-offs.

342
00:20:25.917 --> 00:20:28.739
We can't, I think, get everything we want.

343
00:20:28.980 --> 00:20:29.120
Right.

344
00:20:29.140 --> 00:20:31.681
So for example, I work a day a week in clinic or two,

345
00:20:32.922 --> 00:20:41.064
I could choose to do that at a concierge practice, or I could choose to do it even in a normal hospital setting as an outpatient doctor and get paid a lot more.

346
00:20:41.824 --> 00:20:46.185
So I'm actively trading off that with this.

347
00:20:46.785 --> 00:20:53.987
And I think that, like, sometimes doctors, and I love doctors, you know, get into a little bit more of a victimhood mentality than they need to.

348
00:20:54.027 --> 00:20:57.888
And it's sort of like, look, if this isn't working for you, you do have choices.

349
00:20:57.928 --> 00:20:59.669
Now, those choices come with tradeoffs.

350
00:21:00.309 --> 00:21:01.309
And they're real tradeoffs.

351
00:21:01.629 --> 00:21:02.211
Right?

352
00:21:02.553 --> 00:21:06.989
But you can make them, and we're so blessed that you're still gonna probably be okay.

353
00:21:07.650 --> 00:21:07.910
Yeah.

354
00:21:08.230 --> 00:21:08.510
Right.

355
00:21:08.990 --> 00:21:15.872
And I think that like in the end of the day, I think that's so important is reconnecting to purpose and reconnecting to why you went.

356
00:21:15.892 --> 00:21:21.714
And, you know, sometimes I read my old medical school personal statement and it's not about accountability per se.

357
00:21:21.774 --> 00:21:25.615
It's about really being in touch with who I am and what I need.

358
00:21:25.835 --> 00:21:27.196
Like, what does my soul need?

359
00:21:28.116 --> 00:21:34.418
And that's kind of how I found myself into it is really just being clear.

360
00:21:35.438 --> 00:21:48.685
about what I need so that so I can continue to live a joyous life and be a great parent to be a great everything and I think that if you're at if you're in a system that's eating away at you you have choices those choices come with trade-offs but don't make that other choice

361
00:21:49.698 --> 00:21:55.142
Well, I do say it's interesting because we all go into medical school and we can't wait to see the patients, right?

362
00:21:55.923 --> 00:21:56.904
And then we become attendings.

363
00:21:56.924 --> 00:21:58.184
We're like, wait, I got to go to clinic.

364
00:21:58.245 --> 00:21:59.626
Can't I read another echo?

365
00:21:59.686 --> 00:22:02.708
And I remind the young people who are training.

366
00:22:02.728 --> 00:22:07.612
I'm like, we have to recall that we went in it for the patients, not for the echoes, not for the cats.

367
00:22:07.812 --> 00:22:08.612
Yes.

368
00:22:09.413 --> 00:22:10.434
So it is interesting.

369
00:22:11.254 --> 00:22:16.799
Now, what would you say keeps you up at night about modern medicine since you did such a nice job?

370
00:22:17.599 --> 00:22:28.505
job writing about, like what is the one thing that you're like, this is what people need to understand about the system, good or bad, I guess, keep you up at night makes you think bad, but I guess you could tell us the good thing too.

371
00:22:28.985 --> 00:22:32.207
Well, I do want to say a good and a bad, so let me start with the bad.

372
00:22:32.587 --> 00:22:33.548
I think that

373
00:22:35.528 --> 00:22:48.415
So I think that on net, medicine has gotten worse and it will continue to get worse until we deal with the fundamental structure of health care.

374
00:22:48.955 --> 00:22:53.577
And the whole reason I wrote the book is that can't be solved by the people in medicine.

375
00:22:54.118 --> 00:22:54.438
Okay.

376
00:22:54.798 --> 00:22:56.339
It has to be solved outside.

377
00:22:56.380 --> 00:22:58.782
So how do I get people on the outside to care and change it?

378
00:22:59.702 --> 00:23:07.029
The example I always think about is in Brazil today, and it has been for 30, 40 years now, all HIV medicines are completely free.

379
00:23:07.569 --> 00:23:08.010
It's incredible.

380
00:23:08.030 --> 00:23:16.857
And the reason that happened is not because the patients stood up, not because the doctors stood up, not because the government stood up or the hospital stood up.

381
00:23:16.937 --> 00:23:18.198
It was because people.

382
00:23:19.199 --> 00:23:26.686
In Brazil, there's a movement, a civil, not a civil rights, a human rights movement to say that we are going to cover this for everybody forever.

383
00:23:26.766 --> 00:23:27.546
And they did.

384
00:23:28.167 --> 00:23:43.280
And that's what we need in this country, in my opinion, because we've and I think the danger right now is that a lot of us in medicine are very big proponents of things that are great additions to the cake, layers of the cake, but not the foundation.

385
00:23:43.640 --> 00:23:44.740
We're excited about AI.

386
00:23:44.941 --> 00:23:45.601
Yay.

387
00:23:45.701 --> 00:23:47.962
We're excited about, you know, accountable care.

388
00:23:47.982 --> 00:23:49.563
We're excited about prevention.

389
00:23:50.123 --> 00:24:01.008
But the problem is the more that we say that and we in the same sentence don't say that everybody in this country needs basic access to high quality health care is another moment where someone says, oh, yeah.

390
00:24:01.748 --> 00:24:02.588
This is working.

391
00:24:02.849 --> 00:24:08.231
There's this innovation approach, this, you know, profit-driven approach to getting where we need to go.

392
00:24:08.251 --> 00:24:09.711
Because this doctor's not mentioning the other thing.

393
00:24:09.751 --> 00:24:13.313
He or she's only talking about AI, only talking about value-based care.

394
00:24:13.773 --> 00:24:22.377
And every time we do that, we actually make it harder for our colleagues who are trying to advocate for, you know, fundamental change that has to happen to our system.

395
00:24:23.537 --> 00:24:27.819
So that's sort of, you know, my really sobering take.

396
00:24:27.879 --> 00:24:34.683
I mean, to me, the travesty is, you know, growing up in Tennessee and seeing rural hospitals close, just shut down.

397
00:24:34.743 --> 00:24:35.243
It's crazy.

398
00:24:35.263 --> 00:24:38.224
And you're like, wait, how far do you have to drive to get care in this country?

399
00:24:38.244 --> 00:24:39.045
Yeah.

400
00:24:39.085 --> 00:24:39.225
Yeah.

401
00:24:39.765 --> 00:24:40.305
Yeah.

402
00:24:40.345 --> 00:24:41.305
Okay, so that's the economics.

403
00:24:41.325 --> 00:24:42.606
That's what you remember, the fundamentals.

404
00:24:42.626 --> 00:24:43.166
The same thing.

405
00:24:43.186 --> 00:24:45.466
Like you saw all these primary care companies, startups.

406
00:24:45.646 --> 00:24:47.466
Some of them are kind of whack, but a lot of them are good.

407
00:24:47.706 --> 00:24:48.326
They folded.

408
00:24:48.387 --> 00:24:52.727
It's because the fundamental economics, the fundamentals of the structure.

409
00:24:52.847 --> 00:24:54.728
Like I read something interesting the other day.

410
00:24:54.748 --> 00:24:59.068
They were saying that, you know, if we keep training more doctors, we won't solve the problem.

411
00:24:59.088 --> 00:24:59.168
Why?

412
00:24:59.528 --> 00:25:08.470
Because they said something like 50% of, and I'm going to get the numbers wrong, but 50% of doctors that graduate are choosing to go to the same 10% of geographies.

413
00:25:08.830 --> 00:25:10.151
Something insane like that, right?

414
00:25:10.171 --> 00:25:13.932
So the more you create, the more you're just going to siphon them off to this place.

415
00:25:13.972 --> 00:25:17.093
And so again, fundamental structure changes have to happen.

416
00:25:17.473 --> 00:25:17.794
Yeah.

417
00:25:19.094 --> 00:25:19.234
Hmm.

418
00:25:19.834 --> 00:25:20.295
Interesting.

419
00:25:21.115 --> 00:25:21.375
Okay.

420
00:25:23.647 --> 00:25:51.447
tough man it's tough that does but it is possible though i i think that's the thing that i really do believe you know and and someone has done policy at different points in my life too it's possible we can do it but it has it has to and i'm actually in a weird way again thanks to the pit and honestly storytelling i think there's more opportunity today uh and mangi and so many things where people are just standing up and saying people are standing up and saying this isn't working

421
00:25:52.307 --> 00:25:56.648
And for those of you who don't know Mangione, is it Luigi Mangione?

422
00:25:56.668 --> 00:25:57.929
It is Luigi, yeah.

423
00:25:58.149 --> 00:26:03.990
Was the person who allegedly shot and murdered a healthcare executive of an insurance company.

424
00:26:04.411 --> 00:26:12.573
So, yeah, so that is a pretty dramatic way for a citizen to take action.

425
00:26:13.513 --> 00:26:14.254
take a stance.

426
00:26:14.334 --> 00:26:16.237
And so we're not advocating for that.

427
00:26:16.257 --> 00:26:25.349
But I do think you're right that I remember I took care of a patient in a regional community hospital who had a pulmonary embolism and she didn't have health insurance.

428
00:26:25.369 --> 00:26:26.631
And I said, why don't you have health insurance?

429
00:26:26.651 --> 00:26:27.733
She's like, well, I could afford it.

430
00:26:27.773 --> 00:26:28.113
I just...

431
00:26:29.074 --> 00:26:29.935
don't think I need it.

432
00:26:30.075 --> 00:26:37.762
And that's, these people, all the people who are out there need to take a stance and say, how do we make this better?

433
00:26:37.822 --> 00:26:39.584
Because you're right, it's hard as a physician.

434
00:26:39.904 --> 00:26:41.706
We're not going to be the only ones that can improve it.

435
00:26:41.786 --> 00:26:43.727
We're part of that, but not the only piece.

436
00:26:44.088 --> 00:26:45.669
100%.

437
00:26:46.149 --> 00:26:46.430
Now,

438
00:26:47.964 --> 00:26:49.765
Why did you choose a thriller form?

439
00:26:49.785 --> 00:26:54.626
We kind of talked about the Bollywood and the fantasy piece of it, which I loved.

440
00:26:54.906 --> 00:27:01.648
But obviously you mentioned John Grisham, which is thriller, you know, human condition, mining town.

441
00:27:02.168 --> 00:27:07.110
What did you think you needed a thriller form to kind of like express what you were thinking in your story?

442
00:27:07.783 --> 00:27:11.645
Yeah, I mean, I think, look, at the most basic level, you've got to meet people where they are.

443
00:27:12.145 --> 00:27:26.791
You know, like if you think about the TAM, right, like the total market of books, right, like most people, even very well-read or professionals, let's not call it well-read, like professionals will maybe read five books a year, right?

444
00:27:26.892 --> 00:27:34.055
And, you know, I go, you know, on spring break or something, you walk back to swimming pool and, you know, some people have their books open and that's what you have to work with.

445
00:27:34.870 --> 00:27:35.010
Right.

446
00:27:35.030 --> 00:27:37.453
So the question is, how do you become that fourth or fifth book?

447
00:27:37.614 --> 00:27:40.577
Because look, at the end of the day, I didn't want to just preach to the choir.

448
00:27:40.978 --> 00:27:46.766
I wanted like everyday people to read this who are not in medicine, because again, that was my whole change hypothesis.

449
00:27:47.830 --> 00:27:49.171
And so I knew I needed something.

450
00:27:50.872 --> 00:28:02.479
And that was really the impetus was like, you know, I can read another I can write another book that my mom and a couple of my friends I twist around to read or I can write something that potentially hundreds of thousands of people get the story.

451
00:28:02.920 --> 00:28:06.802
And I was super lucky, you know, it was super hard and we could talk about that.

452
00:28:06.822 --> 00:28:10.004
But there was a moment when I was actually trying to sell the book the first time.

453
00:28:10.024 --> 00:28:11.745
There's been multiple.

454
00:28:12.526 --> 00:28:15.348
But the first time what happened was I didn't even know this was a thing.

455
00:28:15.868 --> 00:28:23.213
My my my agent went out with the book to, you know, big publishing houses who, by the way, none of them wanted to publish the book.

456
00:28:23.714 --> 00:28:28.437
But a couple of the junior people, at least we think, allegedly leaked the book.

457
00:28:28.457 --> 00:28:29.378
Oh, interesting.

458
00:28:29.398 --> 00:28:31.879
And next thing I know, we have on the Internet.

459
00:28:32.420 --> 00:28:34.882
No, leaked it to sorry, to movie studios.

460
00:28:35.562 --> 00:28:36.322
Very cool.

461
00:28:36.502 --> 00:28:43.285
And ended up being this actually competitive process where multiple studios came in and said, we want to buy the rights to your book.

462
00:28:43.345 --> 00:28:47.146
So it got picked up for film before it did for that.

463
00:28:47.186 --> 00:28:47.346
Correct.

464
00:28:47.366 --> 00:28:47.946
It's amazing.

465
00:28:48.006 --> 00:28:49.107
I don't think I've ever heard of that.

466
00:28:49.187 --> 00:28:54.028
That's like Andy Ware almost where no one would want to publish his book and then he put it out on the Kindle.

467
00:28:54.068 --> 00:28:55.229
And that's incredible.

468
00:28:55.469 --> 00:28:55.829
Yeah.

469
00:28:56.349 --> 00:28:58.370
Yeah, and that's what fueled the sale ultimately.

470
00:28:58.390 --> 00:28:58.710
That's awesome.

471
00:28:58.750 --> 00:29:01.111
And by the way, even then I had to rewrite it a couple more times.

472
00:29:01.171 --> 00:29:13.378
But again, it's like if you get a story that's compelling, right, that is visual and that, again, meets the moment and meets people where they are, that was really what I wanted to solve for.

473
00:29:13.418 --> 00:29:18.220
And I think that the success of it in that film world is certainly proof.

474
00:29:18.240 --> 00:29:18.961
That is super cool.

475
00:29:19.121 --> 00:29:19.541
Yeah.

476
00:29:20.061 --> 00:29:23.083
I mean, I think people say it's pretty darn hard to get a film film.

477
00:29:23.903 --> 00:29:24.403
picked up.

478
00:29:24.523 --> 00:29:26.665
So to do it without trying.

479
00:29:28.046 --> 00:29:28.466
Totally.

480
00:29:28.866 --> 00:29:29.707
Amazing.

481
00:29:30.347 --> 00:29:33.449
When was it that you knew you were going to go from like thought to action?

482
00:29:33.489 --> 00:29:36.511
Because a lot of us have ideas, things we want to do.

483
00:29:38.192 --> 00:29:43.836
But few of us actually, especially if you're working full time, whatever your career, take that step to make it happen.

484
00:29:43.876 --> 00:29:45.136
So when was that moment for you?

485
00:29:45.156 --> 00:29:47.338
When were you like, I knew I had to put it on paper?

486
00:29:48.247 --> 00:29:50.650
Yeah, so I was very much tiptoed.

487
00:29:50.730 --> 00:29:54.053
I mean, I'm the guy who went to a science and math high school even.

488
00:29:54.334 --> 00:29:58.118
Okay, so I don't think I'd written even a lick of fiction since middle school.

489
00:29:58.999 --> 00:30:00.180
And I don't want to tell you how old I am.

490
00:30:00.200 --> 00:30:02.263
But let's just say that was more than a couple years ago, okay?

491
00:30:02.343 --> 00:30:02.603
Yeah.

492
00:30:02.723 --> 00:30:08.069
And so for me, the way I did it, actually, I'll start by saying it was a lot like how I did my medical training.

493
00:30:08.129 --> 00:30:08.309
Yeah.

494
00:30:09.010 --> 00:30:12.132
When I got through medical school, like people was like, oh yeah, medicine takes forever.

495
00:30:12.152 --> 00:30:13.072
That's why I didn't become a doctor.

496
00:30:13.092 --> 00:30:15.634
For me, I was like, look, medical school sounds great.

497
00:30:15.674 --> 00:30:16.654
I get to like learn all this stuff.

498
00:30:16.674 --> 00:30:17.735
So then I got my four years.

499
00:30:17.855 --> 00:30:22.097
Then it was like, hey, residency, if you do your first year, you can get licensed.

500
00:30:22.117 --> 00:30:24.378
And under good Samaritan laws, you can work at a free clinic.

501
00:30:24.578 --> 00:30:25.739
And that was my plan, by the way.

502
00:30:25.779 --> 00:30:26.579
So I did a year.

503
00:30:26.599 --> 00:30:28.841
And then two thirds into the year, I said, you know what?

504
00:30:29.061 --> 00:30:30.481
I'm really enjoying the outpatient side.

505
00:30:30.501 --> 00:30:31.202
I have a lot more to learn.

506
00:30:31.222 --> 00:30:32.122
I'm going to do a second year.

507
00:30:32.142 --> 00:30:32.903
And I did a second year.

508
00:30:33.583 --> 00:30:38.004
And then I was like, okay, I did a second year, let me do my third year because I actually want to work and be a hospitalist.

509
00:30:38.024 --> 00:30:38.384
Wow.

510
00:30:38.484 --> 00:30:42.525
So you never went into like a categorical mindset initially.

511
00:30:42.545 --> 00:30:42.945
No, I did.

512
00:30:42.985 --> 00:30:43.305
Yeah.

513
00:30:43.365 --> 00:30:48.286
I mean, effectively, if you zoom out, it's like, okay, this guy went straight through college, straight through medical, straight through residency.

514
00:30:48.346 --> 00:30:51.767
But for me, it was very empowering to think of it stepwise.

515
00:30:51.787 --> 00:30:52.607
That's amazing.

516
00:30:52.627 --> 00:30:54.788
Again, it's the whole, I don't need to do this.

517
00:30:54.888 --> 00:30:55.608
I get to do this.

518
00:30:55.628 --> 00:30:55.728
Yeah.

519
00:30:56.168 --> 00:30:58.409
It's not I have to do this, I get to do this.

520
00:30:58.509 --> 00:30:59.830
And so I approached the book the same way.

521
00:30:59.850 --> 00:31:09.935
What I did was, because I had no idea what I was doing, is I actually took a bunch of master classes and one of them by James Patterson literally was like, oh, you should do an outline.

522
00:31:09.955 --> 00:31:10.696
And I was like, yeah, no shit.

523
00:31:10.716 --> 00:31:16.799
But what was really cool is he actually included the outline in the class for his first book, Along Came a Spider.

524
00:31:17.359 --> 00:31:21.461
And so I'm flipping through, and he gave the original, by the way, outline, not the final.

525
00:31:21.481 --> 00:31:22.742
So I'm going through this and I'm like,

526
00:31:23.887 --> 00:31:24.567
I can do this.

527
00:31:25.088 --> 00:31:25.348
Yeah.

528
00:31:25.508 --> 00:31:27.348
Because every chapter had like two sentences.

529
00:31:27.368 --> 00:31:29.089
I was like, I can, so I was like, let me start with that.

530
00:31:29.109 --> 00:31:33.531
So I wrote an outline, you know, and then I shared it to a couple of people that said like, this is kind of interesting.

531
00:31:33.891 --> 00:31:36.072
So I was like, okay, let me write the first two chapters.

532
00:31:36.352 --> 00:31:36.612
Yeah.

533
00:31:36.832 --> 00:31:37.513
And then I did that.

534
00:31:37.593 --> 00:31:42.355
And then I actually went to a writer conference, a writer event in New York.

535
00:31:42.375 --> 00:31:43.395
This was like hilarious.

536
00:31:43.415 --> 00:31:44.956
So this thing's called thriller fest.

537
00:31:45.656 --> 00:31:48.999
And so literally I'm a full time doctor or like whatever stuff I go to New York.

538
00:31:49.019 --> 00:31:50.460
My wife's like, what are you doing?

539
00:31:50.820 --> 00:31:51.241
I love it.

540
00:31:51.661 --> 00:31:52.021
I love it.

541
00:31:52.221 --> 00:31:55.144
Can't you just buy a motorcycle like the rest of you middle aged men?

542
00:31:55.204 --> 00:31:55.584
That's right.

543
00:31:56.064 --> 00:31:59.747
So I go to New York and I'm literally standing in line between two behind two vampires.

544
00:32:00.988 --> 00:32:04.951
Two people dress up as vampires with their book samples.

545
00:32:05.712 --> 00:32:08.394
And then I had a couple people read and they said, this is really good.

546
00:32:08.414 --> 00:32:10.475
So then that's how I went about it.

547
00:32:10.716 --> 00:32:11.837
A little affirmation.

548
00:32:12.317 --> 00:32:13.738
Yeah, at some point you got to jump in.

549
00:32:13.758 --> 00:32:17.381
And so I did that, but I definitely took my time.

550
00:32:18.361 --> 00:32:19.863
Well, how did you find time?

551
00:32:20.043 --> 00:32:23.565
I mean, if you're working, you said you do part-time medicine, part-time something else.

552
00:32:23.685 --> 00:32:29.390
And then you're married, so it's not like you're 20 years old, single and sitting in an apartment.

553
00:32:29.410 --> 00:32:29.550
Yeah.

554
00:32:31.083 --> 00:32:36.225
smoking a cigar and thinking about the world.

555
00:32:36.686 --> 00:32:41.408
Yeah, look, I think like all of us, I think if we find something, we just motivate ourselves.

556
00:32:41.428 --> 00:32:46.790
So what I ended up doing was, I ended up getting up, whenever I would do writing cycles, there's a lot of cycles.

557
00:32:47.130 --> 00:32:56.894
So it's not continuous, it took five years, but there's a lot of downtime because someone's reviewing it, then you go to agents, but anytime I had a cycle, I would get up at like four, 4.15.

558
00:32:58.315 --> 00:33:02.499
And so between 4, 4.15 and when I would normally get up at 7.15, because my wife's like, hey, this is great.

559
00:33:03.099 --> 00:33:03.339
Yeah.

560
00:33:03.520 --> 00:33:08.424
But like, you're not trading off like, you know, time with the family and your responsibilities.

561
00:33:08.444 --> 00:33:09.825
So like, do what you want to do.

562
00:33:10.586 --> 00:33:11.487
And I'm just joking.

563
00:33:11.507 --> 00:33:12.107
She didn't say that.

564
00:33:12.127 --> 00:33:14.709
But that's I wanted to hold up my end of the bargain.

565
00:33:14.729 --> 00:33:15.890
Yeah.

566
00:33:15.990 --> 00:33:17.071
But, you know, I'll tell you the truth.

567
00:33:17.151 --> 00:33:18.493
I never set an alarm one time.

568
00:33:19.475 --> 00:33:20.596
Wow, you just wake up.

569
00:33:20.796 --> 00:33:21.557
I would just wake up.

570
00:33:21.597 --> 00:33:22.457
I was on a mission.

571
00:33:23.498 --> 00:33:25.900
And it was some of the greatest moments of my life, honestly.

572
00:33:25.940 --> 00:33:29.843
Just, you know, me, a really tall French press of coffee.

573
00:33:29.863 --> 00:33:31.144
Yeah.

574
00:33:31.364 --> 00:33:35.768
Quietly, you know, working away on something I believed in.

575
00:33:35.788 --> 00:33:36.949
That's awesome.

576
00:33:37.069 --> 00:33:37.869
I did the opposite.

577
00:33:37.909 --> 00:33:38.990
It was at the end of the day.

578
00:33:39.150 --> 00:33:40.031
Everyone would go to bed.

579
00:33:40.051 --> 00:33:43.354
And I'd be like, okay, every week I need to do this.

580
00:33:45.275 --> 00:33:45.635
All right.

581
00:33:45.916 --> 00:33:48.378
If you were going to describe, we'll talk about the book.

582
00:33:48.980 --> 00:33:58.512
If you're going to describe your book about what it really is at the core, and you've kind of said this, but not the back cover version, but like, what would you say?

583
00:34:00.174 --> 00:34:03.858
What's your elevator pitch to sell this as a movie, which you've already done, but...

584
00:34:04.879 --> 00:34:08.483
Well, you know, honestly, for the movie, it's a lot like the back cover, you know.

585
00:34:08.583 --> 00:34:08.823
Really?

586
00:34:09.063 --> 00:34:10.505
But so you're asking two different things.

587
00:34:10.565 --> 00:34:10.985
It is.

588
00:34:11.025 --> 00:34:14.669
Because, you know, movies are very visceral and visual.

589
00:34:14.689 --> 00:34:22.476
I mean, for me, it's really all of us live in a world that is somewhat unjust or not right.

590
00:34:23.037 --> 00:34:26.600
And the book at its heart is about the choices we can make.

591
00:34:27.961 --> 00:34:37.904
It's about the dilemma we face when we say, hey, I'm a teacher and I can see kids in my classroom who are not serving well.

592
00:34:39.424 --> 00:34:46.446
I'm a soldier and I can see that some of the wars that we go to aren't the things that we want them to be.

593
00:34:47.106 --> 00:34:50.247
I'm a whatever it is.

594
00:34:50.527 --> 00:34:54.488
I think all of us face this dilemma and this question

595
00:34:55.368 --> 00:34:58.229
And that's really, you know, what the story is at its heart.

596
00:34:58.289 --> 00:34:59.170
And it's a change story.

597
00:34:59.190 --> 00:35:00.330
It's a redemption story, right?

598
00:35:00.350 --> 00:35:05.512
It's a guy who in the beginning, you know, he's, you know, yeah, he looks like he's doing great.

599
00:35:05.592 --> 00:35:09.414
He's flying around in this private plane, but he's estranged from his family.

600
00:35:09.494 --> 00:35:10.914
He's estranged from his mentors.

601
00:35:10.954 --> 00:35:15.076
He's far from his mission, right, in life, which was to serve the underserved.

602
00:35:15.816 --> 00:35:21.277
And it's a redemption story because he comes back to where it all started for him.

603
00:35:22.158 --> 00:35:26.019
And he redeems himself, but he also changes the system and finds another way forward.

604
00:35:26.059 --> 00:35:30.480
So that's really, you know, at the heart of what it's about.

605
00:35:31.340 --> 00:35:38.021
Well, and I won't give away too much, but it's interesting that he gets called back by someone he was estranged from.

606
00:35:38.321 --> 00:35:41.382
You know, it's kind of like that's how the redemption story starts.

607
00:35:41.402 --> 00:35:41.782
Yeah.

608
00:35:45.058 --> 00:35:46.659
He probably would have kept doing what he was doing.

609
00:35:46.859 --> 00:35:49.141
And he was doing good things, you know, but yeah.

610
00:35:49.161 --> 00:35:49.401
Correct.

611
00:35:49.461 --> 00:35:50.562
The track wouldn't have changed.

612
00:35:50.602 --> 00:35:50.782
Correct.

613
00:35:50.802 --> 00:35:57.286
And that's one of the things I really loved about the writing was, you know, and I think about my inspiration, you know, some people love it, some people hate it.

614
00:35:57.306 --> 00:36:00.208
But, you know, like Dan Brown to The Da Vinci Code, right?

615
00:36:00.228 --> 00:36:01.129
The Lincoln Lawyer.

616
00:36:01.309 --> 00:36:02.490
Or, of course, Grisham is...

617
00:36:03.370 --> 00:36:09.717
What I find about this genre that's really hard is there's too much grotesque bodies and sexual violence.

618
00:36:09.998 --> 00:36:13.121
Especially, honestly, medical thrillers tend to be some of the darkest.

619
00:36:14.182 --> 00:36:17.726
And I think what I took away from them is the puzzle.

620
00:36:17.786 --> 00:36:20.289
People love a puzzle in a puzzle in a puzzle.

621
00:36:20.409 --> 00:36:22.552
So the first puzzle of the book isn't actually...

622
00:36:22.992 --> 00:36:24.513
this murder mystery that it turns out to be.

623
00:36:24.533 --> 00:36:35.261
The first puzzle is, yeah, why did this guy who the last time I saw him, we had a massive fight and he like disowned me, why did he page me at moments as he was dying?

624
00:36:36.162 --> 00:36:41.806
And it's actually interesting, it's actually a mystery that they don't really, really solve till like the end of the book, arguably.

625
00:36:41.846 --> 00:36:42.767
The very end, yeah.

626
00:36:42.787 --> 00:36:44.989
So it's sort of like the mystery and the mystery and the mystery.

627
00:36:45.569 --> 00:36:50.613
And then the other thing that the movie, the film people picked up on is, this was really cool because I never thought of this framing.

628
00:36:50.633 --> 00:36:51.254
They said, oh,

629
00:36:51.974 --> 00:36:56.716
This is a murder mystery where the patients are the clues.

630
00:36:57.897 --> 00:36:58.717
Interesting, yeah.

631
00:36:58.737 --> 00:36:58.957
Right?

632
00:36:59.077 --> 00:37:02.599
Each patient puzzle in there is actually a clue to the broader.

633
00:37:02.819 --> 00:37:03.279
The broader.

634
00:37:03.299 --> 00:37:04.380
So the patient's the clue.

635
00:37:04.840 --> 00:37:08.982
And I like that you had the graph where he's writing like, you know.

636
00:37:10.237 --> 00:37:11.258
I don't know, I thought it was cool.

637
00:37:11.338 --> 00:37:11.998
No, thank you.

638
00:37:12.018 --> 00:37:13.519
I don't know how you'll do that in the movie.

639
00:37:13.599 --> 00:37:16.520
I'm laughing about that one because I'll tell you something really interesting.

640
00:37:16.540 --> 00:37:32.789
So this is what's so fascinating about creating stuff is so maybe year three of the Book of Five, you know, on a whim, my agent was like, oh, you know, I'm reading this for the 17th time, I'm losing track of what's happening, can you do something visual?

641
00:37:33.429 --> 00:37:34.510
And I was like, okay.

642
00:37:34.550 --> 00:37:35.210
And I try to do it.

643
00:37:35.230 --> 00:37:36.191
I'm like, oh, I can't do it.

644
00:37:36.351 --> 00:37:37.431
And she's like, okay, that's fine.

645
00:37:37.591 --> 00:37:38.252
Keep going.

646
00:37:38.852 --> 00:37:44.295
And then we're literally looking at what's called the, I'm sure you know this, the first past pages, right?

647
00:37:44.355 --> 00:37:46.736
So like at this point, you're like, pencils down.

648
00:37:47.257 --> 00:37:48.517
We're literally going to print.

649
00:37:48.617 --> 00:37:49.678
Do not mess with this.

650
00:37:49.838 --> 00:37:52.900
And I go, holy, I know exactly how to do this.

651
00:37:52.920 --> 00:37:53.160
You had it.

652
00:37:53.400 --> 00:37:54.020
That was great.

653
00:37:54.301 --> 00:37:55.381
And then we had that.

654
00:37:55.682 --> 00:37:56.502
I hand drew them.

655
00:37:56.622 --> 00:38:00.625
And then I had to add a couple things about how him and his mentor used to write things down.

656
00:38:00.645 --> 00:38:01.666
I didn't have that either.

657
00:38:01.686 --> 00:38:03.107
So this is kind of fun.

658
00:38:03.147 --> 00:38:06.990
Like, I've had a lot of people tell me they love that part or it helped them.

659
00:38:07.370 --> 00:38:13.174
And I'm like, wow, that was like, even my publisher was like, are you serious right now?

660
00:38:13.334 --> 00:38:15.356
We're going to make these changes at this point.

661
00:38:15.376 --> 00:38:16.597
And I was like, yes.

662
00:38:17.720 --> 00:38:18.800
Tell them it was worth it.

663
00:38:19.541 --> 00:38:20.341
Tell them it was worth it.

664
00:38:21.201 --> 00:38:23.823
I'll tell them an astronaut doctor told me that it was a good idea.

665
00:38:23.843 --> 00:38:24.243
That's right.

666
00:38:24.283 --> 00:38:25.083
Tell them someone, you know.

667
00:38:25.103 --> 00:38:26.624
That's like instant credibility.

668
00:38:28.244 --> 00:38:30.865
Maybe not deserve, but I'll take it.

669
00:38:31.426 --> 00:38:34.767
So most physicians talking about identity, that's a good lead in.

670
00:38:35.087 --> 00:38:36.888
We have very defined identities.

671
00:38:36.908 --> 00:38:39.769
A lot of us define ourselves as being a doctor.

672
00:38:39.809 --> 00:38:41.010
I'm an academic physician.

673
00:38:41.050 --> 00:38:42.530
I'm a cardiothoracic surgeon.

674
00:38:43.271 --> 00:38:46.192
And you've chosen to step outside of that.

675
00:38:47.467 --> 00:38:56.195
Was there resistance, you know, either within yourself or like externally with your family, your friends, your mentors, your colleagues?

676
00:38:58.637 --> 00:38:59.838
Yeah, you know, it's interesting.

677
00:39:00.318 --> 00:39:05.683
So first of all, you know, at least it was helped by the fact that I always think of myself as a human being first.

678
00:39:06.043 --> 00:39:13.229
Like, I don't know, there's some people, you know, like the whole like, call me Dr. Rye, you know, like I was never one of those guys and I sometimes hear that and I still laugh at myself.

679
00:39:13.250 --> 00:39:14.611
I'm like, oh wait, who is he talking about?

680
00:39:16.304 --> 00:39:24.248
But you're right that I was very quiet about, forget the pen name, I was very quiet about the book for probably four of the five years.

681
00:39:25.448 --> 00:39:33.192
And it's still sometimes in certain social situations, you know, like a friend of mine will be together with other friends, I'm like, yeah, and he wrote a book.

682
00:39:33.212 --> 00:39:34.213
And they're like, oh, what is it about?

683
00:39:35.133 --> 00:39:37.374
It's definitely, it felt awkward.

684
00:39:38.835 --> 00:39:40.075
And I thought about that a little bit.

685
00:39:40.095 --> 00:39:44.978
I think part of it is we're so used to having an identity that's actually instantly respected.

686
00:39:46.178 --> 00:39:51.542
that I think that, look, look, if someone said, hey, this is a New York Times bestselling novelist, I think people would respect you.

687
00:39:52.082 --> 00:39:58.106
But otherwise, if you're like, yeah, I'm just like writing something and they're like, oh, you're writing nonfiction, then maybe like, oh, that's really cool.

688
00:39:58.227 --> 00:39:59.087
What are you an expert in?

689
00:39:59.387 --> 00:40:06.092
If you say I'm writing fiction as like a hobby, unfortunately, our community will generally be like,

690
00:40:06.732 --> 00:40:07.633
Oh, yeah.

691
00:40:07.653 --> 00:40:08.413
What are you thinking?

692
00:40:08.654 --> 00:40:08.794
Yeah.

693
00:40:08.814 --> 00:40:09.614
What are you thinking?

694
00:40:09.674 --> 00:40:11.035
Or I thought you were serious.

695
00:40:11.055 --> 00:40:12.556
Like, you're just a storyteller.

696
00:40:13.297 --> 00:40:19.721
And what the reality is, is that stories are the most powerful things that human beings have.

697
00:40:20.101 --> 00:40:20.261
Right.

698
00:40:20.281 --> 00:40:22.803
I mean, we have religion because of storytelling.

699
00:40:22.843 --> 00:40:23.003
Right.

700
00:40:23.043 --> 00:40:27.666
We have our the way we walk into a room is because of storytelling.

701
00:40:27.706 --> 00:40:27.906
Right.

702
00:40:28.126 --> 00:40:34.591
Even in medicine, the reason why people with on dialysis are on receive Medicare is because of a story.

703
00:40:34.611 --> 00:40:34.791
Right.

704
00:40:35.151 --> 00:40:40.092
Because someone stood at the House of Congress while getting dialyzed and said, see, we can live full, productive lives.

705
00:40:40.132 --> 00:40:44.293
So stories are super powerful, but they don't get a lot of love.

706
00:40:45.193 --> 00:40:51.115
And so it has been an interesting sort of shoot aware to kind of be like, I'm a storyteller.

707
00:40:51.395 --> 00:40:52.795
I'm a medical storyteller.

708
00:40:53.075 --> 00:40:56.056
And to really lean into that and be like, and you should be, too.

709
00:40:57.976 --> 00:41:01.297
I think it's probably a skill that we all need.

710
00:41:01.997 --> 00:41:05.841
And some people say like things like improv comedy, but that's also a story in the moment.

711
00:41:06.141 --> 00:41:06.301
Yeah.

712
00:41:06.562 --> 00:41:07.943
So it's hard to do.

713
00:41:07.963 --> 00:41:08.884
Well, and here's the interesting thing.

714
00:41:08.904 --> 00:41:16.371
If you think about medicine, when I go to you and I say, you know, hey, I have a 74-year-old with, you know, three vessel coronary disease and blah, blah, blah, blah.

715
00:41:16.731 --> 00:41:17.212
What am I doing?

716
00:41:17.392 --> 00:41:20.155
When I call you as a consultant, what do you say to me on the phone?

717
00:41:20.175 --> 00:41:22.037
You go, Dr. Rye, tell me the story.

718
00:41:22.457 --> 00:41:22.837
That's right.

719
00:41:22.857 --> 00:41:25.138
So we are actually natural storytellers.

720
00:41:25.158 --> 00:41:26.719
We learn through vocation.

721
00:41:26.799 --> 00:41:29.140
We learn through these anecdotal stories.

722
00:41:29.160 --> 00:41:34.603
We learn, you know, we tell each other stories because those stories are a representation of reality.

723
00:41:34.663 --> 00:41:36.364
I can't tell you every single thing about a patient.

724
00:41:36.384 --> 00:41:39.866
So I synthesize it into, OK, three vessel disease, whatever.

725
00:41:40.606 --> 00:41:43.828
And yet we don't want to embrace it.

726
00:41:44.648 --> 00:41:53.150
You know, and honestly, as we think about AI, I think it's going to become more and more important for us to embrace that sort of humanitarian or humanity side of us.

727
00:41:53.810 --> 00:41:53.930
Yeah.

728
00:41:53.990 --> 00:41:54.130
Right.

729
00:41:54.150 --> 00:41:58.792
The creative side of us, the human side of us, the humane side of us.

730
00:41:58.952 --> 00:42:07.454
That's what's going to actually distinguish us more and more because, you know, the thinking, the differential, the whatever is increasingly going to be something else.

731
00:42:08.454 --> 00:42:11.635
So it's an interesting moment for us to think about storytelling.

732
00:42:11.655 --> 00:42:11.855
Yeah.

733
00:42:12.738 --> 00:42:21.866
I mean, it's I love that you say that because traditionally, if we think about medicine at all these academic institutions, I feel like there's like an art and medicine building like art and medicine.

734
00:42:21.906 --> 00:42:24.929
So we traditionally knew that these things were important.

735
00:42:25.089 --> 00:42:29.472
But I feel like in modern day health care, it is removed.

736
00:42:29.653 --> 00:42:31.754
Yeah, we don't we don't do it.

737
00:42:31.814 --> 00:42:32.555
We don't have it.

738
00:42:32.575 --> 00:42:33.556
Yeah.

739
00:42:35.058 --> 00:42:35.938
A hundred percent.

740
00:42:36.639 --> 00:42:37.080
I don't know.

741
00:42:37.100 --> 00:42:41.584
Ironically, it's the advancement of technology that's going to actually push us to go back the other way.

742
00:42:42.085 --> 00:42:46.770
I mean, I remember you could walk into like a hospital lobby and someone would be playing the piano.

743
00:42:46.790 --> 00:42:50.293
I don't know who would be playing it, but you don't have that anymore.

744
00:42:50.434 --> 00:42:51.074
There used to be...

745
00:42:51.935 --> 00:42:52.695
Things like that.

746
00:42:52.775 --> 00:42:53.576
And yeah, you're right.

747
00:42:53.636 --> 00:42:54.816
So we do need to go back to it.

748
00:42:54.836 --> 00:43:02.199
And people are going to get, I think people are already getting tired of technology in their every aspect of their lives and are pushing for more in-person things.

749
00:43:02.239 --> 00:43:06.440
I mean, there's a loneliness epidemic in this country that's been documented.

750
00:43:06.500 --> 00:43:11.502
And a lot of it is probably due to the lack of needing each other for people.

751
00:43:12.530 --> 00:43:12.950
for help.

752
00:43:13.170 --> 00:43:17.412
You know, we don't have to like, we can order everything on our phone and we don't have to go to theaters.

753
00:43:17.472 --> 00:43:20.053
So it'll be interesting to see, but I hope you're right.

754
00:43:20.073 --> 00:43:23.995
I would like to be practicing in that, that world.

755
00:43:25.056 --> 00:43:25.556
Yeah.

756
00:43:26.096 --> 00:43:26.436
Okay.

757
00:43:27.117 --> 00:43:27.437
So,

758
00:43:30.465 --> 00:43:33.847
I guess, how do you deal with that voice that says stay in your lane?

759
00:43:34.127 --> 00:43:36.388
As someone who, we all deal with this.

760
00:43:36.408 --> 00:43:40.010
You know, we all have imposter syndrome, which is maybe something else.

761
00:43:40.050 --> 00:43:44.392
But, like, I'm sure at some point, five years, it took you to get this thing out.

762
00:43:46.293 --> 00:43:47.574
That's a long time to pursue something.

763
00:43:47.594 --> 00:43:48.294
It's a really long time.

764
00:43:48.514 --> 00:43:52.316
It's something that's not going to, you know, theoretically, you're not going into it for the money.

765
00:43:52.456 --> 00:43:57.999
So, how did you know, like, okay, it's okay.

766
00:43:58.019 --> 00:43:58.740
I can keep going.

767
00:43:58.780 --> 00:43:59.060
I can...

768
00:44:02.024 --> 00:44:18.093
Yeah, I mean, oh, I mean, I think, look, I think, again, I think so much of this for people that are privileged enough to be probably listening to this, you know, is really being deeply in touch with what your needs and your purpose are.

769
00:44:19.094 --> 00:44:19.415
Right.

770
00:44:19.815 --> 00:44:21.297
And and it was hard.

771
00:44:21.458 --> 00:44:32.414
You know, I think that one of the things that's hard about being creative is and I know one of my cousins is is an actress and I think about her a lot is is a priori.

772
00:44:32.434 --> 00:44:33.475
There's no guarantee.

773
00:44:34.016 --> 00:44:36.639
I mean, you know, like nonfiction as an example, right?

774
00:44:36.679 --> 00:44:41.704
Based on your credibility, you're able to probably get a book contract even before you wrote a word, right?

775
00:44:41.744 --> 00:44:47.069
Or maybe you had to write a few paragraphs or not paragraphs, a few chapters or a table of contents or sort of a proposal.

776
00:44:47.950 --> 00:44:52.554
I mean, these people that write fiction, I mean, they might spend five, ten years, right?

777
00:44:52.574 --> 00:44:56.158
I mean, we know this when, you know, Harry Potter, you know, that story is very famous about...

778
00:44:57.985 --> 00:45:03.430
And so I think it's, you know, for those of us in medicine, I think that's unusual.

779
00:45:03.490 --> 00:45:04.711
Obviously, we take risk.

780
00:45:05.492 --> 00:45:10.616
But then it's like sort of like, okay, you do your first year, then a second year, third year, intern, resident, you know.

781
00:45:11.257 --> 00:45:11.557
Yeah.

782
00:45:12.278 --> 00:45:15.180
But I think at some point, you know, we want to do things.

783
00:45:15.240 --> 00:45:18.503
And medicine, of course, is very like, you know, you saw a patient, patient, patient, patient.

784
00:45:18.523 --> 00:45:20.065
It's like very quick hit of impact.

785
00:45:20.645 --> 00:45:24.709
But I think if we want to do big things, and that matters to you if it does, yeah.

786
00:45:25.369 --> 00:45:29.473
you know, these things take real, it takes real risk and real investment.

787
00:45:30.294 --> 00:45:36.740
And I think that's, I sort of learned a muscle, I guess, is what I'm trying to say through this, where it was super hard.

788
00:45:36.800 --> 00:45:40.984
It's part of the reason I didn't talk about it because I never thought maybe you'll never get published.

789
00:45:41.505 --> 00:45:43.987
And I had some friends that said, you know, it's so cool you're even doing this.

790
00:45:44.007 --> 00:45:47.410
And I was like, yeah, I don't know, like, unless this doesn't go anywhere, I'm not really sure.

791
00:45:47.450 --> 00:45:49.892
But at some moment, you have to kind of let go.

792
00:45:51.174 --> 00:45:59.081
of control and enjoy the reps. And that's why I'm saying I look back, those moments from 4 a.m. to 7.30 were some of the best moments I've had.

793
00:46:00.883 --> 00:46:05.368
Professional, I should say, in case anyone that I'm married to might listen to it professionally.

794
00:46:06.549 --> 00:46:09.651
If your wife's listening to this, you're doing better than I am.

795
00:46:10.491 --> 00:46:14.354
You know, and I just think that that's, yeah, that's all part of life.

796
00:46:14.374 --> 00:46:14.914
And I like it.

797
00:46:14.954 --> 00:46:15.734
Enjoy the ride.

798
00:46:15.914 --> 00:46:16.475
I mean, it's interesting.

799
00:46:16.495 --> 00:46:18.136
Yeah, enjoy the ride and find purpose.

800
00:46:18.196 --> 00:46:18.876
And really ask for that.

801
00:46:18.896 --> 00:46:22.118
If you're doing this whole thing to get a book contract, please don't do it.

802
00:46:22.399 --> 00:46:26.281
At least if you're as untalented as I am, please do not do this.

803
00:46:26.621 --> 00:46:31.945
But if you're doing it because you honestly have something that you want to say, and even saying it to yourself at four in the morning,

804
00:46:32.585 --> 00:46:38.652
has some value to you and it makes you a better dad and a better doctor and a better human or whatever, like you're winning.

805
00:46:39.032 --> 00:46:42.276
And then if somebody buys your book and somebody buys the movie, that's all upside.

806
00:46:42.296 --> 00:46:48.783
And that's kind of how, you know, I, I sort of molded myself into, you know, through this process.

807
00:46:49.364 --> 00:46:49.524
Yeah.

808
00:46:49.564 --> 00:46:51.326
I think you're a hundred percent correct.

809
00:46:51.346 --> 00:46:51.867
You just got to

810
00:46:53.093 --> 00:46:54.975
commit that it's going to be a long road.

811
00:46:54.995 --> 00:47:01.661
I think a lot of physicians don't because we're so burnt out after becoming, you know, we've committed to becoming doctors, which is not a short road.

812
00:47:01.741 --> 00:47:02.241
No, it's not.

813
00:47:02.742 --> 00:47:05.124
And then the day-to-day can be a grind.

814
00:47:05.324 --> 00:47:08.407
I mean, not that other jobs aren't a grind, but you're like, all right, I've done it.

815
00:47:08.447 --> 00:47:09.408
I've done my hard thing.

816
00:47:09.508 --> 00:47:09.929
Yes.

817
00:47:10.709 --> 00:47:10.909
Um...

818
00:47:11.630 --> 00:47:12.731
But the only one is longevity.

819
00:47:12.751 --> 00:47:14.693
I mean, dude, life is long, right?

820
00:47:14.733 --> 00:47:17.915
I mean, if we're lucky, we're going to live to our 80s or 100s.

821
00:47:18.376 --> 00:47:27.864
And so I think that what really gets me is people are like, oh, I don't do that or I do X or I don't whitewater or I don't go for walks or I don't know how to cook.

822
00:47:27.884 --> 00:47:29.085
And you're like, yeah, I don't know how to cook.

823
00:47:29.125 --> 00:47:31.366
And my kids school, they always add the word yet.

824
00:47:31.727 --> 00:47:32.487
I don't know how to cook yet.

825
00:47:32.507 --> 00:47:32.728
Yeah.

826
00:47:33.268 --> 00:47:40.870
And so part of this for me is I think, and again, I'm not going to say this is a solution to burnout because I'm not even going to pretend to talk about burnout and how complicated that is.

827
00:47:41.390 --> 00:47:47.852
But there is some element, again, going back to victim, there is a component of like maybe part of what you need is a new challenge.

828
00:47:48.532 --> 00:47:51.813
And yes, it's more time, but I always say it's about, it's not about managing.

829
00:47:51.833 --> 00:47:53.034
I mean, managing time is important.

830
00:47:53.414 --> 00:47:55.234
Managing energy is really important.

831
00:47:55.554 --> 00:47:57.795
So I guess what I tell people who are thinking about going outside their lane is.

832
00:47:58.415 --> 00:48:02.017
Take a toe dip outside of the lane, right?

833
00:48:02.037 --> 00:48:05.359
Cross your toe and ask yourself how your energy feels.

834
00:48:05.399 --> 00:48:06.760
Do you have a bounce in your step?

835
00:48:07.361 --> 00:48:09.622
Because when I wrote that outline, I had a bounce in my step.

836
00:48:09.662 --> 00:48:09.962
Yeah.

837
00:48:10.323 --> 00:48:15.626
When I went to that, when I stood behind those Draculas, you know, what I didn't tell you is I got to meet these incredible people.

838
00:48:15.646 --> 00:48:19.308
People were like, hey, I was a firefighter for 30 years, but my dream was always to write a book.

839
00:48:19.348 --> 00:48:20.749
And now I'm fulfilling my dream.

840
00:48:20.769 --> 00:48:22.170
I was like, this is inspiring.

841
00:48:22.250 --> 00:48:24.330
Yeah, that's amazing.

842
00:48:24.810 --> 00:48:30.352
So that's what I would say is, you know, you can't step out of your lane if it's not sustainable and if it's burning you out.

843
00:48:30.572 --> 00:48:39.813
But if you have a good sense of, if you have a good sort of feedback mechanism, you're in tune with your feelings, take a toe dip outside and see how that feels.

844
00:48:39.933 --> 00:48:43.674
Because even though it's more time, it might be more energy.

845
00:48:43.714 --> 00:48:44.734
Yeah, I love it.

846
00:48:45.254 --> 00:48:46.054
I've never heard of that.

847
00:48:46.134 --> 00:48:47.615
So we're going to quote you.

848
00:48:47.755 --> 00:48:48.855
Energy management is...

849
00:48:49.871 --> 00:48:51.913
It's absolutely correct, 100%.

850
00:48:51.953 --> 00:48:52.313
100%.

851
00:48:53.074 --> 00:48:55.075
Okay, we're going to finish up.

852
00:48:55.095 --> 00:49:00.800
I've got to ask one more question just to respect your time, though I could talk to you for another two hours, I think.

853
00:49:01.440 --> 00:49:04.442
So, you know, this podcast is called A Heart for Space.

854
00:49:05.183 --> 00:49:09.286
So what is the space inside yourself or out in the world that you're still reaching for?

855
00:49:10.167 --> 00:49:10.787
What's next?

856
00:49:12.188 --> 00:49:12.569
Whew.

857
00:49:15.050 --> 00:49:15.491
Wow.

858
00:49:17.092 --> 00:49:18.213
That's such a deep question.

859
00:49:19.676 --> 00:49:20.576
Just gave you four minutes.

860
00:49:20.596 --> 00:49:21.437
You know, you got a minute.

861
00:49:21.797 --> 00:49:22.517
Yeah.

862
00:49:22.797 --> 00:49:25.198
No, I mean, well, the easier one is inside myself.

863
00:49:25.278 --> 00:49:29.340
I think inside myself, I'm still trying to find that stillness.

864
00:49:29.920 --> 00:49:30.240
Okay.

865
00:49:30.480 --> 00:49:35.983
You know, that like, hey, I still want to do things, but like I'm good in this moment.

866
00:49:36.163 --> 00:49:37.623
I'm here in this moment.

867
00:49:38.324 --> 00:49:44.346
I think I'm still trying to find that space, that space that, you know, when you're having a bad day, you can come back to it and say, hey, I'm here.

868
00:49:44.766 --> 00:49:45.166
I'm home.

869
00:49:45.546 --> 00:49:45.927
It's good.

870
00:49:47.547 --> 00:49:53.731
Um, yeah, in the outside world, I mean, I just think there's so much I want to learn.

871
00:49:54.132 --> 00:49:59.715
Like right now, uh, I'm actually learning a lot about how to take my cooking to one more level.

872
00:49:59.935 --> 00:50:02.837
You know, it's a gift I want to, I want to feed my kids more, which is great.

873
00:50:02.857 --> 00:50:09.021
But I also want to give them the gift of, of, of, of themselves being curious and cookers and stuff.

874
00:50:09.041 --> 00:50:11.883
So, you know, I'm, I'm spending a lot of time there at the moment.

875
00:50:12.303 --> 00:50:12.784
I love that.

876
00:50:13.084 --> 00:50:13.464
Yeah.

877
00:50:14.064 --> 00:50:14.565
That's awesome.

878
00:50:14.585 --> 00:50:14.685
Yeah.

879
00:50:15.158 --> 00:50:15.418
All right.

880
00:50:15.438 --> 00:50:15.779
Well, great.

881
00:50:15.799 --> 00:50:17.480
Well, I really appreciate you being on today.

882
00:50:17.500 --> 00:50:18.041
Thank you.

883
00:50:18.181 --> 00:50:18.641
Thank you.

884
00:50:19.002 --> 00:50:21.064
Thank you for listening to A Heart for Space.

885
00:50:21.745 --> 00:50:29.532
If you enjoyed this conversation, be sure to follow the show so you never miss an episode and consider leaving us a review to let us know your thoughts.

886
00:50:30.233 --> 00:50:37.659
For more on my work in the pursuit of ambitious goals, visit aheartforspace.com and look out for my upcoming book, A Heart for Space.

887
00:50:37.899 --> 00:50:40.341
Until next time, I'm Dr. Iman Jahangir.

888
00:50:40.822 --> 00:50:46.106
And remember, sometimes the only obstacle to achieving an impossible dream is the courage to keep going.