Treating the Complex, the Undiagnosed, and the Misunderstood in PT

WEBVTT

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Sound effect-y.

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All right,

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this episode brought to you by Brooks IHL,

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elevating clinician education for the next

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generation of physical therapists,

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residencies,

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fellowships in whatever flavor of ice

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cream you prefer, pediatrics, geriatrics,

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orthopedics, pelvic floor, get your mix.

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Find them online at brooksihl.org.

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That is brooksihl.org.

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Elevate your career with Brooks.

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Our episode today,

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our guest was headed for a career.

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I am not making this up, probably.

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As a reptile surgeon, yes, crocodiles,

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venomous snakes, but a spinal cord injury?

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changed the course of everything.

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Now she's a clinician for humans,

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a coordinator,

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an educator who blends psychologically

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informed care and lifestyle medicine to

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treat some of the most complex cases in

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our profession.

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She's the mentor you wish you had, honest,

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empowering, radically human-centered,

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and she likes creepy crawly things.

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In her world,

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healing is more than symptom resolution.

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It's about showing up, slowing down,

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which I need to do,

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and seeing the patient as a whole.

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She might have black coffee in one hand

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and a tangled rope metaphor in another.

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She's here to remind us that doing the

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basics really well is elite level care.

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Let's welcome Faith Stokes to the show.

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Faith, how'd I do on the intro?

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You did great.

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So I can't,

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you can't have an introduction where I

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talk about crocodiles and snakes without

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being like backstory me.

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Absolutely.

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So I was actually interested in reptiles

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since I was a child,

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as in my mother said the first time

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I tried to catch a snake,

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I was still in a diaper.

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Yeah.

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All right.

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So she actually taught me how to read

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using snake books from the library because

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it was the only way she could get

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me to sit down long enough.

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Genius.

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So I was using their Latin names before

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I was ten.

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When I went to college,

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I was interested in veterinary medicine

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and everyone that knew me said, well,

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of course, she's going to become a vet.

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Of course,

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she's going to work with reptiles.

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She's going to go to zoos.

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I was already working at a zoo.

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In the reptile department.

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Where were you geographically?

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I was a volunteer for the Chattanooga Zoo

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in Chattanooga, Tennessee.

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So I was there first and to my

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knowledge, only reptile volunteer.

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I emailed them and said,

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I want to work in that department.

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And they said,

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people don't usually want to do that.

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Especially, yeah.

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Yeah.

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And I said,

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I will only work in that department.

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That's what I want to do.

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So they brought me in.

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I worked with the big pythons and the

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big boas.

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I got to hang out with the Komodo

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dragons and the alligators.

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My son loved coming to see me there.

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So this was just a normal pace of

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life.

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My research in undergrad was on creating

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or finding antibiotic type proteins in

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snake venom.

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So using it to treat antibiotic resistant

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bacterial strains.

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So I was playing with that research wise,

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got to compete at several conferences with

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it.

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But my husband in two thousand eleven had

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a spinal cord injury and I was going

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to have to leave,

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obviously for specialized training to go

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and finish that career path.

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And I remember keenly.

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He was in inpatient rehab at the time

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at Siskin in Chattanooga.

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They were wonderful.

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And I was like,

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I don't think I'm going to be able

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to go.

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I can't leave you guys.

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And he was like,

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I think you should try PT.

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They have a doctorate program here in

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Chattanooga.

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You could stay at home with us.

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You could still be Dr. Stokes.

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It's a super stable career.

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They have good insurance.

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He'd obviously been looking into this.

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And he said the phrase,

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I see you in them.

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Wow.

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And I was like,

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I'm standing there in jeans, Jimmy.

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And I had been in a stream that

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morning chasing hellbenders,

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which is a salamander.

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I don't know what that is.

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Okay, good.

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Yeah.

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Thank you.

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What's their Latin name?

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I don't know.

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I don't remember anymore.

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Faith,

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you could have literally said gibberish.

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I would be like, God, I am not.

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No, no, I am not going to,

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I'm not going to mess that up.

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I've been out of it long enough.

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I was in a stream.

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I was in a stream.

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I had mud up like mid femur and

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I looked at him and I was like,

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they sit in a business office in business

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professional clothes.

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I have nothing in common with these

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people.

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And he's like, I don't know.

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I see you in them.

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Just think about it.

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So when I started my PT program,

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I was accepted.

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I lied on my application and told them

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I always wanted to be a PT and

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I related to the field.

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You know,

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anything that you think you have to do

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to get into a graduate program.

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You wanted to be like a Python trainer.

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So that's PT, right?

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Same thing.

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Yeah.

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No, it was a lie.

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My first day of school,

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I just remember sitting in there thinking,

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I don't want to be here.

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I don't want to be.

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You very rarely get bitten.

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It's never zero.

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It's probably a higher impedance,

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but you rarely get bitten.

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People who do herpetology do really well

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with TBI patients.

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Why is that?

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Just because the TBI patients are super

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impulsive and aggressive.

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It's the same as a crocodile.

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That was not on my bingo card,

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but I bet you a bunch of TV,

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I bet you a bunch of neuro-PTs,

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I can hear them right now going, yeah,

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that tracks, that tracks.

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I could totally tackle someone and wrestle

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them down and talk to them calmly the

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whole time and keep your blood pressure

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down and they're going to stop struggling

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eventually.

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But anyway, long story, very short.

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I was probably in my second year.

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I went on a residency call with the

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APTA to just look at residencies because I

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was like, if I'm going to do this,

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I need to do this.

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I need to like it is what it

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is.

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I'm here.

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This is not going to change.

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So who do I want to be?

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And maybe I just haven't found that

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version of myself yet.

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So that's what launched me into my

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training pathway from that world into this

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one.

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But I will say that even just the

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work that I did with reptiles,

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kind of along the lines of the

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conversation with the patient population I

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work with,

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With a reptile,

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they have no attachment to you.

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They don't have mammalian brains.

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So they could kill me.

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I could die.

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They're not going to miss me.

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They don't care that I exist.

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You take care of them because it's a

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living creature and it deserves patience,

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love, kindness,

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whether it can reciprocate or not.

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And so that was what I really pulled

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from my reptile training into patient

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cares.

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There's sometimes there are patients who

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seem,

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and I'm gonna highlight that they seem

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unlovable.

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And I just remind myself,

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if you can care for a boa constrictor

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that really just wanted you to die,

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but you did everything you could to take

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care of that animal because it was alive

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and it deserved to be taken care of,

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you can take care of this person and

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they don't have to love you back.

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And carrying that into care,

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humans respond completely differently to

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that approach than reptiles.

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I know that shocks you.

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This is my shocked face.

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I know, right?

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Humans respond differently to that

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approach when you walk into the room and

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you say,

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regardless of what I get out of this

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relationship,

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I'm going to meet their needs.

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That's powerful.

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Did you ever ask your, I mean,

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you must've asked your husband, like,

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but what did you see in me?

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Like,

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I see them and I see you in

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them.

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I see them in you.

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Did you ever ask him, like,

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what's that mean?

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Like what, like, you know,

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he could probably word it a little bit

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better,

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but Joey has had several TBIs and words

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are not his strength,

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which was why in that moment,

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that was all he could give me.

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Um, but I will be honest,

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like the people,

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this is something I tell my mentees,

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the people that know you,

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and love you for who you are will

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see potential in you that you don't see.

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And sometimes you just have to trust them.

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So now like looking at what I do

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and my identity and like,

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I hope I'm in my nineties treating

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patients.

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Like I don't, I love what I do.

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And so I don't know what he saw,

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but he was right.

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So I think that's,

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that was what I took away from it.

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Even now making career decisions,

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like I'll think, oh my gosh,

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I don't know that that's the best fit

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for me.

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Or I don't know that I should do

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that.

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And the people that love me are in

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my ear saying, no, that's you go.

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So that was my first introduction to just

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jumping blindly off a cliff when someone

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told me to jump.

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And it's been a bit of a pattern

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for me lately.

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I love that.

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Um,

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I love the fact that like we've got,

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you know, what,

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three hundred thousand PTs in the country

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or whatever.

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And there's like stories like that.

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But you'd never know.

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Right.

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We just assume.

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Right.

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I tore my ACL as a soccer player

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in high school and my grandmother.

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Those are the two cliches.

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Right.

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That's a cool story, though.

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Thank you for telling me that.

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Mm hmm.

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Yeah.

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We apparently met.

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We're going to talk about what you're

00:09:49.990 --> 00:09:50.971
talking about, CSM.

00:09:51.111 --> 00:09:52.494
The prompt I put on LinkedIn was like,

00:09:52.514 --> 00:09:53.634
let's put some butts in seats.

00:09:53.674 --> 00:09:55.937
A lot of people,

00:09:55.976 --> 00:09:58.418
APTA has a monumentally large job.

00:09:58.519 --> 00:09:58.919
Yes.

00:09:58.960 --> 00:10:00.900
Which essentially is like communicate,

00:10:02.071 --> 00:10:03.831
all of the four hundred i don't even

00:10:03.851 --> 00:10:05.933
know bajillion sessions at this one

00:10:07.215 --> 00:10:08.735
conference we're talking about csm which

00:10:08.755 --> 00:10:10.456
is in a couple of months i remember

00:10:10.537 --> 00:10:12.298
my first csm which was la and there's

00:10:12.317 --> 00:10:14.240
a story there which i don't remember and

00:10:14.259 --> 00:10:15.701
i remember my professor had asked me like

00:10:15.740 --> 00:10:17.162
what'd you think of csm and i was

00:10:17.182 --> 00:10:18.903
like it was a circus and she goes

00:10:18.942 --> 00:10:20.364
it was and i go with a bunch

00:10:20.403 --> 00:10:23.927
of circuses in it like like twenty

00:10:23.947 --> 00:10:25.707
different circuses in the big top and i

00:10:25.727 --> 00:10:27.408
remember just being like for someone like

00:10:27.469 --> 00:10:27.568
me

00:10:28.570 --> 00:10:30.071
overstimulated but i like that sort of

00:10:30.110 --> 00:10:32.393
thing but you leave like just spent so

00:10:32.472 --> 00:10:37.596
we met at csm in twenty fifteen sixteen

00:10:37.635 --> 00:10:39.336
whenever that was when it was la it's

00:10:39.376 --> 00:10:40.957
gonna be in la so faith and jimmy

00:10:40.998 --> 00:10:44.140
are going full circle um what are you

00:10:44.301 --> 00:10:45.841
you said you remember we met i don't

00:10:45.861 --> 00:10:48.023
remember this help me out what did i

00:10:48.123 --> 00:10:49.604
did i do something bad no you didn't

00:10:51.918 --> 00:10:55.121
You had won an award for this podcast

00:10:55.201 --> 00:10:56.443
idea.

00:10:57.183 --> 00:10:59.027
My program had won an award for a

00:10:59.106 --> 00:11:00.408
fundraiser.

00:11:00.567 --> 00:11:03.572
All of the students that had won awards

00:11:03.611 --> 00:11:04.332
for something,

00:11:05.100 --> 00:11:08.001
were all pulled together to prepare us for

00:11:08.042 --> 00:11:10.043
the ceremony so that we knew how to

00:11:10.083 --> 00:11:11.845
behave and what to say and what not

00:11:11.884 --> 00:11:13.605
to say and where to walk you know

00:11:14.025 --> 00:11:16.587
yeah they were they were corralling the

00:11:16.628 --> 00:11:20.431
toddlers um so we were we were all

00:11:20.510 --> 00:11:22.432
like grouped together at the bottom of the

00:11:22.471 --> 00:11:26.154
stairs talking and you started talking

00:11:26.195 --> 00:11:28.376
about this podcast that i remember you

00:11:28.417 --> 00:11:30.197
describing it with such excitement

00:11:30.977 --> 00:11:33.400
And you were, I don't know if you,

00:11:33.461 --> 00:11:35.822
I think at that moment you were saying,

00:11:35.982 --> 00:11:37.104
I don't know if this is something I'm

00:11:37.124 --> 00:11:38.125
going to keep doing,

00:11:38.784 --> 00:11:40.407
but it was just something you were super

00:11:40.466 --> 00:11:41.246
excited about.

00:11:41.287 --> 00:11:42.948
And then, like I said earlier,

00:11:43.048 --> 00:11:44.870
a few years later, I was like,

00:11:45.291 --> 00:11:45.770
he did it.

00:11:45.811 --> 00:11:48.153
It's still going because I saw it pop

00:11:48.293 --> 00:11:50.895
up and I thought he will never remember

00:11:50.916 --> 00:11:52.517
me, but that's completely fine.

00:11:52.716 --> 00:11:54.159
That was a decade ago.

00:11:54.179 --> 00:11:54.419
That was.

00:11:54.660 --> 00:11:55.501
I know.

00:11:55.883 --> 00:11:56.464
I mean, that was.

00:11:58.467 --> 00:11:59.168
I know.

00:11:59.789 --> 00:12:00.471
It's wild.

00:12:00.552 --> 00:12:01.614
And like, when you turn back.

00:12:02.923 --> 00:12:03.163
You know,

00:12:03.183 --> 00:12:05.365
the stupid cliche is cliche for a reason.

00:12:05.385 --> 00:12:07.067
It's like, where did a decade go?

00:12:07.226 --> 00:12:09.208
Like, it's crazy.

00:12:10.409 --> 00:12:11.650
And then I do the math on like

00:12:11.730 --> 00:12:13.192
number of episodes, number of,

00:12:13.211 --> 00:12:14.293
I don't really care about episodes,

00:12:14.312 --> 00:12:15.634
like number of conversations,

00:12:16.014 --> 00:12:17.075
number of people you met,

00:12:17.294 --> 00:12:18.895
number of stories you've heard and shared.

00:12:18.916 --> 00:12:21.217
And you're like something like sixteen

00:12:21.258 --> 00:12:23.058
hundred episodes in ten years,

00:12:23.099 --> 00:12:24.139
which I'm not a mathematician,

00:12:24.200 --> 00:12:24.921
but I'm glad it's ten.

00:12:24.961 --> 00:12:25.280
It's round.

00:12:25.520 --> 00:12:27.221
It's one hundred and sixty episodes about

00:12:27.562 --> 00:12:28.222
per year,

00:12:28.503 --> 00:12:30.544
which means almost every other day.

00:12:32.125 --> 00:12:33.105
That's intense.

00:12:33.125 --> 00:12:35.307
I need to get out more.

00:12:35.408 --> 00:12:35.988
I know I do.

00:12:36.427 --> 00:12:38.230
All right.

00:12:38.250 --> 00:12:39.009
So you're going to CSM.

00:12:39.070 --> 00:12:39.431
I am.

00:12:39.990 --> 00:12:41.572
You're going to be on the big stage.

00:12:41.631 --> 00:12:42.432
Congratulations.

00:12:42.572 --> 00:12:44.293
Although just because your your thing

00:12:44.354 --> 00:12:46.495
wasn't picked doesn't mean it wasn't a

00:12:46.515 --> 00:12:48.236
good submission.

00:12:48.337 --> 00:12:49.477
Absolutely correct.

00:12:49.558 --> 00:12:50.818
And I will interview anybody who had a

00:12:50.860 --> 00:12:52.181
great submission but didn't get picked.

00:12:52.900 --> 00:12:54.501
There's only so many things that they can

00:12:54.562 --> 00:12:55.383
put on the stage.

00:12:55.403 --> 00:12:56.283
They try to mix it up.

00:12:56.303 --> 00:12:57.524
So it's not the same things or same

00:12:57.565 --> 00:12:58.245
people over again.

00:12:59.426 --> 00:13:00.508
wanted to throw that psa in there a

00:13:00.528 --> 00:13:02.590
little little shot for apta to be like

00:13:02.629 --> 00:13:03.751
we i see what you're trying to do

00:13:03.812 --> 00:13:06.235
it's not easy so what what what is

00:13:06.394 --> 00:13:07.677
what how do we put butts in seats

00:13:07.736 --> 00:13:09.399
what's on the marquee what do you want

00:13:09.458 --> 00:13:11.500
who do you want in the seat who

00:13:11.620 --> 00:13:12.883
who should be there what are they going

00:13:12.903 --> 00:13:14.865
to get when they come see faith is

00:13:14.905 --> 00:13:16.167
it just you or do you have co-speakers

00:13:16.768 --> 00:13:18.169
i do i have a co-speaker

00:13:19.542 --> 00:13:25.304
So Mika and I are presenting.

00:13:25.524 --> 00:13:27.385
Oh, now you've got different Mika.

00:13:27.765 --> 00:13:29.326
Now I've got the last names mixed up.

00:13:29.606 --> 00:13:30.947
Well, I'm going to meet this Mika.

00:13:31.006 --> 00:13:31.548
I'm going to know too.

00:13:31.567 --> 00:13:32.748
You are going to meet Mika.

00:13:32.788 --> 00:13:33.607
She's wonderful.

00:13:34.229 --> 00:13:34.369
Um,

00:13:34.408 --> 00:13:37.070
she works in the residency with me and

00:13:38.051 --> 00:13:39.270
Mika and I are presenting.

00:13:39.311 --> 00:13:39.630
So we're,

00:13:39.931 --> 00:13:42.972
we are both pelvic health specialists and

00:13:43.052 --> 00:13:45.533
we're presenting on a syndrome.

00:13:46.447 --> 00:13:49.211
That the story behind this syndrome,

00:13:49.230 --> 00:13:50.231
which I think is what makes it

00:13:50.312 --> 00:13:50.831
interesting,

00:13:51.011 --> 00:13:53.534
is males were getting on discussion boards

00:13:53.575 --> 00:13:56.517
for years talking about this topic.

00:13:57.577 --> 00:14:02.081
And what we found was that in about

00:14:02.142 --> 00:14:02.903
twenty twenty,

00:14:02.962 --> 00:14:04.764
the medical community finally said we

00:14:04.804 --> 00:14:05.885
should take this seriously.

00:14:05.905 --> 00:14:06.626
This is a thing.

00:14:07.047 --> 00:14:07.847
Only took two decades.

00:14:08.390 --> 00:14:09.672
Yeah, it only took a while.

00:14:10.251 --> 00:14:11.613
So but in twenty twenty,

00:14:11.893 --> 00:14:14.033
the medical community said pelvic health

00:14:14.073 --> 00:14:15.815
therapists are the therapist,

00:14:15.934 --> 00:14:17.755
are the provider of choice to send these

00:14:17.796 --> 00:14:18.417
patients to.

00:14:19.037 --> 00:14:20.937
Guess what we knew about this population?

00:14:20.957 --> 00:14:24.679
Nothing, nothing.

00:14:24.700 --> 00:14:25.780
This was the first thing that was

00:14:25.821 --> 00:14:26.240
published.

00:14:26.860 --> 00:14:29.123
So these patients is called hard flaccid

00:14:29.182 --> 00:14:32.424
syndrome and it is a syndrome,

00:14:32.485 --> 00:14:34.806
meaning that it is not one thing.

00:14:35.336 --> 00:14:36.197
cluster.

00:14:36.317 --> 00:14:37.878
It is a cluster of things.

00:14:38.118 --> 00:14:39.057
Absolutely.

00:14:39.619 --> 00:14:43.380
And so what we started working on together

00:14:44.501 --> 00:14:47.724
was these patients were coming in and they

00:14:47.744 --> 00:14:49.024
were telling us it was just a,

00:14:49.065 --> 00:14:50.565
like a, just a few patients,

00:14:50.645 --> 00:14:52.846
but those of us that started seeing them

00:14:53.466 --> 00:14:57.509
started to see more and more and more.

00:14:58.831 --> 00:14:59.230
And I

00:15:00.972 --> 00:15:03.134
What I think has been interesting for me

00:15:03.174 --> 00:15:03.895
as a clinician,

00:15:03.936 --> 00:15:05.096
now I'm going to have to look up

00:15:05.136 --> 00:15:05.898
her name because y'all,

00:15:05.918 --> 00:15:08.360
it is literally bugging me because it's

00:15:08.500 --> 00:15:09.721
Mitchell is stuck in my head.

00:15:09.761 --> 00:15:10.523
I think it's Bryant.

00:15:10.582 --> 00:15:11.243
It is Bryant.

00:15:11.683 --> 00:15:11.943
Okay.

00:15:12.605 --> 00:15:13.225
Now I feel better.

00:15:13.625 --> 00:15:14.547
Mika Bryant and I,

00:15:14.586 --> 00:15:16.128
she practices in North Carolina.

00:15:17.109 --> 00:15:18.730
We started actually doing teams

00:15:18.791 --> 00:15:22.715
conferencing on these patients because

00:15:23.095 --> 00:15:24.937
there was nothing in the evidence that

00:15:25.984 --> 00:15:27.583
The only thing that we were finding for

00:15:27.624 --> 00:15:28.865
a while were case studies.

00:15:29.565 --> 00:15:31.485
And they were looking at one component of

00:15:31.524 --> 00:15:32.164
the condition,

00:15:32.225 --> 00:15:34.206
the pelvic floor component or the direct

00:15:34.326 --> 00:15:35.245
genital approach.

00:15:36.105 --> 00:15:39.067
And what Mika and I both found was

00:15:39.126 --> 00:15:41.648
that you had to treat the whole person.

00:15:42.827 --> 00:15:46.168
And so per my general population,

00:15:47.048 --> 00:15:50.070
pelvic health therapists who work with

00:15:50.110 --> 00:15:51.490
patients who have syndromes,

00:15:52.280 --> 00:15:54.081
who work with patients who have

00:15:54.142 --> 00:15:56.804
complicating autoimmune, orthopedic,

00:15:56.985 --> 00:15:59.125
yellow flag, lifestyle issues,

00:15:59.787 --> 00:16:01.187
pelvic floor dysfunction,

00:16:01.248 --> 00:16:02.448
sexual dysfunction.

00:16:03.450 --> 00:16:05.650
This is a patient population where all of

00:16:05.691 --> 00:16:07.091
those things merge together.

00:16:07.173 --> 00:16:08.734
And if you aren't addressing each

00:16:08.813 --> 00:16:10.274
component in some way,

00:16:11.296 --> 00:16:13.778
they do not respond well to conservative

00:16:13.817 --> 00:16:14.038
care.

00:16:15.618 --> 00:16:18.599
So what we're doing is this is our

00:16:18.658 --> 00:16:20.580
title is a little bit tongue in cheek.

00:16:21.019 --> 00:16:27.042
So it's called the syndrome itself is a

00:16:27.162 --> 00:16:30.703
partially erect penis and it stays that

00:16:30.724 --> 00:16:30.984
way.

00:16:31.183 --> 00:16:32.604
It never fully relaxes.

00:16:32.924 --> 00:16:34.384
They never get a full erection.

00:16:35.325 --> 00:16:37.306
So we called the presentation.

00:16:37.346 --> 00:16:40.246
It's not that hard clinical reasoning in

00:16:40.267 --> 00:16:41.827
the presentation of hard flaccid.

00:16:44.461 --> 00:16:46.568
No notes.

00:16:46.609 --> 00:16:48.355
Well done.

00:16:48.375 --> 00:16:48.875
Slow clap.

00:16:50.326 --> 00:16:51.587
Because that's the point, right?

00:16:51.628 --> 00:16:53.109
You got to get attention.

00:16:53.448 --> 00:16:55.370
I try to tell people the headline is

00:16:55.389 --> 00:16:56.071
to get attention.

00:16:56.331 --> 00:17:00.134
The sub headline is to explain the

00:17:00.193 --> 00:17:01.855
context, not the other way around.

00:17:02.034 --> 00:17:02.575
So keep going.

00:17:02.875 --> 00:17:03.176
Well done.

00:17:04.375 --> 00:17:06.298
So we came up with the title and

00:17:06.617 --> 00:17:09.259
we present one of my patients that I

00:17:09.299 --> 00:17:11.020
treated for this who got better.

00:17:11.300 --> 00:17:15.584
And we track how he did through treatment.

00:17:15.983 --> 00:17:18.965
But we talk through how do you evaluate

00:17:19.046 --> 00:17:20.007
each of these areas?

00:17:20.747 --> 00:17:23.089
How do you prioritize one area over the

00:17:23.170 --> 00:17:23.410
other?

00:17:23.450 --> 00:17:24.711
And that's where the clinical reasoning

00:17:24.750 --> 00:17:25.531
component comes in.

00:17:25.971 --> 00:17:28.755
So while it is very specifically the

00:17:28.875 --> 00:17:30.977
entire, I want to be very clear,

00:17:31.217 --> 00:17:33.179
I would welcome any specialty,

00:17:33.700 --> 00:17:35.681
but our entire presentation is about

00:17:35.721 --> 00:17:36.041
penises.

00:17:36.061 --> 00:17:36.241
Got it.

00:17:39.377 --> 00:17:41.579
What we talk through specifically is how

00:17:41.599 --> 00:17:43.182
do you clinically reason through a

00:17:43.281 --> 00:17:43.781
syndrome?

00:17:44.522 --> 00:17:46.884
How do you make the decision to prioritize

00:17:46.904 --> 00:17:48.326
the orthopedic dysfunction?

00:17:48.787 --> 00:17:51.789
How do you prioritize the psychosocial?

00:17:52.250 --> 00:17:53.991
How do you get these patients in

00:17:54.051 --> 00:17:54.771
counseling?

00:17:56.294 --> 00:17:58.654
and help them find a counselor who can

00:17:58.714 --> 00:18:00.777
have a conversation about sexual

00:18:00.817 --> 00:18:04.038
dysfunction with compassion and recognize

00:18:04.058 --> 00:18:06.020
there's even an addiction component to

00:18:06.060 --> 00:18:06.260
this.

00:18:06.280 --> 00:18:08.342
So that's where Mika's specialty is.

00:18:08.701 --> 00:18:11.785
Her background prior to being a PT was

00:18:11.845 --> 00:18:15.267
working in the counseling arena with

00:18:15.287 --> 00:18:15.807
addiction.

00:18:16.188 --> 00:18:17.328
What kind of addiction?

00:18:17.568 --> 00:18:20.810
So there's a substance issue?

00:18:20.871 --> 00:18:23.252
It can be substance.

00:18:23.333 --> 00:18:24.854
It can even be masturbation.

00:18:26.604 --> 00:18:28.084
So they, yes,

00:18:28.684 --> 00:18:30.746
this is very much a pelvic health topic,

00:18:31.205 --> 00:18:33.386
but I think it represents well,

00:18:34.027 --> 00:18:36.028
even across orthopedics,

00:18:36.828 --> 00:18:38.609
when we are talking about the fact that

00:18:38.650 --> 00:18:40.151
these patients have to be managed

00:18:40.191 --> 00:18:40.971
holistically.

00:18:41.530 --> 00:18:43.092
And as you evaluate each of these

00:18:43.112 --> 00:18:43.813
components,

00:18:44.492 --> 00:18:47.473
what Mika and I both have found is

00:18:47.554 --> 00:18:47.974
that the

00:18:48.933 --> 00:18:51.075
these patients often have some type of

00:18:51.134 --> 00:18:52.595
past medical history of trauma.

00:18:53.736 --> 00:18:55.936
And so when you are approaching the

00:18:56.017 --> 00:18:56.596
addiction,

00:18:56.656 --> 00:18:59.397
when you are approaching the issues that

00:18:59.438 --> 00:19:00.678
these patients face,

00:19:02.199 --> 00:19:04.180
the compassion has to be completely

00:19:04.220 --> 00:19:06.921
different and they may not tell you.

00:19:07.060 --> 00:19:10.662
So my patient didn't tell me his trauma

00:19:10.781 --> 00:19:13.282
till nine months into treatment.

00:19:13.442 --> 00:19:15.344
Mika's patient, it was over a

00:19:19.500 --> 00:19:23.682
Those are things that if you aren't aware

00:19:23.721 --> 00:19:24.902
that it might be there,

00:19:25.462 --> 00:19:26.982
or you're just assuming they'll tell you

00:19:27.042 --> 00:19:27.683
if it is,

00:19:28.384 --> 00:19:30.464
especially given that it is individuals

00:19:30.505 --> 00:19:32.185
likely to identify as male,

00:19:33.046 --> 00:19:34.507
they just might not talk about it.

00:19:35.968 --> 00:19:36.489
Um,

00:19:36.568 --> 00:19:38.150
I've never talked about this in the show,

00:19:38.329 --> 00:19:39.611
but I, I have a penis.

00:19:39.871 --> 00:19:41.491
And if I had this, like,

00:19:41.612 --> 00:19:42.272
I'm just trying to picture,

00:19:42.292 --> 00:19:43.192
cause that's what we do, right?

00:19:43.232 --> 00:19:45.494
We try to empathy, not sympathy, empathy,

00:19:45.515 --> 00:19:45.835
empathy.

00:19:46.154 --> 00:19:48.916
So I'm just like, gosh, that would be,

00:19:50.117 --> 00:19:50.979
that would be devastating.

00:19:51.118 --> 00:19:51.358
Right?

00:19:51.398 --> 00:19:53.661
Like, and what you said,

00:19:53.780 --> 00:19:54.701
then of course I go to what you

00:19:54.721 --> 00:19:55.541
said before, which is like,

00:19:55.582 --> 00:19:56.122
what do we do?

00:19:56.843 --> 00:19:57.923
We ask for advice.

00:19:58.443 --> 00:20:00.025
You can't ask one of your buddies, right?

00:20:00.045 --> 00:20:01.105
You're probably not going to, you could,

00:20:01.165 --> 00:20:02.906
but hopefully you're probably not going

00:20:02.946 --> 00:20:04.268
to, you're going to do this,

00:20:04.627 --> 00:20:04.949
go to the,

00:20:05.729 --> 00:20:06.028
Reddit,

00:20:06.048 --> 00:20:07.431
you're going to log in with your burner

00:20:07.451 --> 00:20:08.152
account, right?

00:20:08.271 --> 00:20:09.472
The account no one can track you with.

00:20:10.134 --> 00:20:11.755
And you're going to find nothing.

00:20:12.276 --> 00:20:13.057
And then you're going to go,

00:20:13.457 --> 00:20:15.659
I'm the only person who's dealing with

00:20:15.679 --> 00:20:15.920
this.

00:20:16.480 --> 00:20:16.961
Absolutely.

00:20:17.101 --> 00:20:18.162
And then you're not going to go anywhere

00:20:18.201 --> 00:20:21.285
else because no one ever put down an

00:20:21.365 --> 00:20:22.707
exit sign that said, actually,

00:20:22.787 --> 00:20:23.928
if you have this, go this way.

00:20:24.248 --> 00:20:26.049
So for a long time, this was happening.

00:20:27.131 --> 00:20:28.873
That sounds awful.

00:20:30.050 --> 00:20:32.031
It was definitely for these patients.

00:20:32.152 --> 00:20:34.272
They were having to self-support one

00:20:34.292 --> 00:20:35.933
another when they did find each other.

00:20:36.233 --> 00:20:36.673
Yeah.

00:20:36.753 --> 00:20:37.734
Even if you did find each other.

00:20:37.795 --> 00:20:39.394
So like that is sort of how the

00:20:39.414 --> 00:20:40.115
internet, right?

00:20:40.556 --> 00:20:41.615
Cause even in the,

00:20:41.816 --> 00:20:44.178
in the medical community for a long time,

00:20:44.377 --> 00:20:46.157
this was discredited and they've even

00:20:46.218 --> 00:20:47.898
started doing studies now and they're

00:20:47.939 --> 00:20:49.759
still providers who don't believe this is

00:20:49.839 --> 00:20:51.361
a syndrome or an issue.

00:20:51.441 --> 00:20:51.580
Yeah.

00:20:52.031 --> 00:20:55.633
And it is devastating.

00:20:55.673 --> 00:20:56.334
Quite literally,

00:20:56.413 --> 00:20:58.054
there's visible proof of this.

00:20:58.134 --> 00:20:58.775
There is.

00:21:00.154 --> 00:21:02.175
You're talking about what you're talking

00:21:02.195 --> 00:21:02.296
about.

00:21:02.316 --> 00:21:02.715
You're seeing.

00:21:02.756 --> 00:21:03.236
You can see it.

00:21:03.756 --> 00:21:04.196
You can see it.

00:21:04.217 --> 00:21:04.957
It's difficult to fake.

00:21:05.217 --> 00:21:06.057
I mean, I have one of these.

00:21:06.076 --> 00:21:08.178
That'd be difficult to fake.

00:21:08.218 --> 00:21:08.738
Correct.

00:21:09.377 --> 00:21:09.739
No, that's...

00:21:11.521 --> 00:21:12.583
I think in medicine,

00:21:12.603 --> 00:21:14.644
and this is a faith soapbox,

00:21:14.784 --> 00:21:16.404
and it's something I had to get over

00:21:16.444 --> 00:21:19.586
with as someone who practices in complex

00:21:19.626 --> 00:21:20.166
cases,

00:21:20.946 --> 00:21:23.048
we get really comfortable being the expert

00:21:23.068 --> 00:21:23.608
in the room.

00:21:24.568 --> 00:21:26.911
And anytime we are not the expert in

00:21:26.971 --> 00:21:28.832
something, it makes us uncomfortable.

00:21:29.776 --> 00:21:32.416
And our discomfort as a human is going

00:21:32.457 --> 00:21:34.278
to cause us to respond in a certain

00:21:34.317 --> 00:21:34.538
way.

00:21:34.637 --> 00:21:36.919
So each individual is going to have a

00:21:36.959 --> 00:21:38.000
different response to that.

00:21:38.039 --> 00:21:39.921
And I find that in the medical community,

00:21:40.381 --> 00:21:42.261
especially with sexual dysfunction,

00:21:42.281 --> 00:21:44.103
and that's why Mika and I were so

00:21:44.182 --> 00:21:45.844
excited to present this together,

00:21:46.463 --> 00:21:48.265
is she messaged me and said,

00:21:49.105 --> 00:21:49.404
Faith,

00:21:49.484 --> 00:21:51.326
no one is presenting on male sexual

00:21:51.365 --> 00:21:51.685
function.

00:21:51.705 --> 00:21:53.106
There's a lot of stuff on females.

00:21:53.146 --> 00:21:54.587
Last year, they only had,

00:21:54.847 --> 00:21:56.308
I forget how many male talks.

00:21:56.328 --> 00:21:58.230
And she's like, this is an issue.

00:21:58.250 --> 00:21:59.089
This is a problem.

00:21:59.109 --> 00:22:00.471
We've both struggled with this.

00:22:00.550 --> 00:22:01.852
We need to present on this.

00:22:02.551 --> 00:22:04.153
And so we we put in to do

00:22:04.192 --> 00:22:04.953
it together.

00:22:05.034 --> 00:22:07.954
But just the medical providers I speak to

00:22:07.994 --> 00:22:08.295
now,

00:22:08.335 --> 00:22:10.135
when they say I'm not comfortable talking

00:22:10.175 --> 00:22:10.676
about that.

00:22:11.616 --> 00:22:13.118
Mika and I will tell them, that's fine.

00:22:14.119 --> 00:22:14.539
That's fine.

00:22:14.579 --> 00:22:16.182
If they start talking to you and you're

00:22:16.201 --> 00:22:17.762
uncomfortable, send them to me.

00:22:18.163 --> 00:22:19.085
I will screen them.

00:22:19.224 --> 00:22:20.986
If they are not appropriate for my office,

00:22:21.126 --> 00:22:22.448
I will let you know where they need

00:22:22.468 --> 00:22:22.887
to go.

00:22:23.388 --> 00:22:25.550
But if this is not a conversation you're

00:22:25.611 --> 00:22:26.932
comfortable having, that is,

00:22:27.653 --> 00:22:29.595
I don't know where that provider is coming

00:22:29.654 --> 00:22:29.894
from,

00:22:29.994 --> 00:22:31.557
either from past experiences

00:22:32.076 --> 00:22:34.157
experiences or training.

00:22:34.798 --> 00:22:36.558
I am trained to talk about this.

00:22:36.659 --> 00:22:38.299
I am comfortable talking about this.

00:22:38.339 --> 00:22:39.759
So just send them to me.

00:22:39.839 --> 00:22:41.101
Please do not send them back to the

00:22:41.141 --> 00:22:41.580
internet.

00:22:41.921 --> 00:22:42.580
Yeah.

00:22:42.601 --> 00:22:44.362
So this is a talk that's going to

00:22:44.402 --> 00:22:45.502
be about a case study.

00:22:46.462 --> 00:22:47.383
This is a talk that's going to be

00:22:47.423 --> 00:22:49.124
about a syndrome that like maybe a lot

00:22:49.163 --> 00:22:49.604
of people, I mean,

00:22:49.844 --> 00:22:50.704
maybe a lot of people in the room

00:22:50.765 --> 00:22:51.204
won't know.

00:22:52.133 --> 00:22:53.453
But this is also gonna be a talk

00:22:53.493 --> 00:22:55.295
about how you reasoned your way through

00:22:55.315 --> 00:22:55.434
this.

00:22:55.474 --> 00:22:56.155
So even if you're like,

00:22:56.215 --> 00:22:57.115
I don't treat pelvic,

00:22:57.395 --> 00:23:00.798
I might never see a patient like this,

00:23:01.038 --> 00:23:02.358
there's still gonna be a component where

00:23:02.378 --> 00:23:03.000
you're like, hey,

00:23:03.039 --> 00:23:04.401
here's this thing that no one knew

00:23:04.421 --> 00:23:07.423
anything about, and here was what we saw,

00:23:07.522 --> 00:23:08.262
and then here's what we did,

00:23:08.282 --> 00:23:09.284
and here's what happened.

00:23:09.903 --> 00:23:11.384
And PTs, I mean, from what I know,

00:23:11.424 --> 00:23:12.605
PTs love stuff like that.

00:23:12.625 --> 00:23:13.184
So even if you're like,

00:23:13.305 --> 00:23:14.546
this doesn't make any sense.

00:23:15.105 --> 00:23:16.526
I love things that don't make any sense

00:23:16.546 --> 00:23:17.205
looking forward,

00:23:17.365 --> 00:23:18.586
like someone who's going to work with

00:23:18.626 --> 00:23:20.047
reptiles, but now as a PT.

00:23:20.406 --> 00:23:21.567
And then you look backwards and you're

00:23:21.587 --> 00:23:24.009
like, oh, all the dots line up.

00:23:24.048 --> 00:23:25.048
That makes perfect sense.

00:23:25.068 --> 00:23:27.029
So even if you're like, ah, male pelvic,

00:23:27.089 --> 00:23:27.690
no thanks.

00:23:28.910 --> 00:23:30.351
Feels like there's still some gems.

00:23:31.611 --> 00:23:32.090
There is,

00:23:32.171 --> 00:23:34.051
especially for the orthopedic component.

00:23:34.071 --> 00:23:35.071
That's something I've...

00:23:35.673 --> 00:23:36.712
Which section is this in?

00:23:37.711 --> 00:23:39.071
This is in pelvic health.

00:23:39.112 --> 00:23:39.372
Got it.

00:23:39.451 --> 00:23:39.932
Okay.

00:23:39.951 --> 00:23:40.692
But it's sneaky.

00:23:40.791 --> 00:23:43.173
Cause it's like it's in pelvic health,

00:23:43.212 --> 00:23:43.953
but you're like, Hey,

00:23:44.814 --> 00:23:45.834
just don't overlook it.

00:23:45.854 --> 00:23:46.335
That's the,

00:23:46.355 --> 00:23:48.115
that's the cool part about CSM is like

00:23:48.615 --> 00:23:49.036
it got,

00:23:49.096 --> 00:23:51.436
and for people don't know each section

00:23:52.217 --> 00:23:52.916
puts forth,

00:23:52.936 --> 00:23:54.758
there is allowed X number of talks per

00:23:54.798 --> 00:23:55.337
day, whatever,

00:23:55.377 --> 00:23:57.298
because capacity and money and that's how

00:23:57.318 --> 00:23:57.578
it works.

00:23:58.298 --> 00:23:59.619
And, um,

00:24:00.996 --> 00:24:02.738
Even if you're like, I'm an ortho PT,

00:24:03.259 --> 00:24:05.441
I would say you're doing yourself and your

00:24:05.480 --> 00:24:08.565
patients a disservice if you stay only on

00:24:08.605 --> 00:24:09.705
the ortho track.

00:24:10.105 --> 00:24:10.426
Right.

00:24:10.606 --> 00:24:12.429
Like, hey, man, you bro out on that.

00:24:13.529 --> 00:24:15.392
Three hundred and sixty two days a year,

00:24:16.192 --> 00:24:18.855
maybe it's called combined sections,

00:24:18.915 --> 00:24:20.157
meaning they're all there.

00:24:21.003 --> 00:24:23.224
dip man like touch a little like you

00:24:23.244 --> 00:24:24.766
know remember remember trivial pursuit

00:24:25.086 --> 00:24:27.086
don't just get green wedges like get a

00:24:27.126 --> 00:24:29.407
blue get a yellow get a pink so

00:24:29.428 --> 00:24:32.449
when you leave your pie is full so

00:24:32.489 --> 00:24:34.529
if you were considering taking jimmy's

00:24:34.549 --> 00:24:36.530
approach which i do i do agree with

00:24:37.392 --> 00:24:39.333
the reason why a talk like this can

00:24:39.373 --> 00:24:43.115
be so important is specifically as as

00:24:43.194 --> 00:24:46.715
someone who identifies as female this can

00:24:46.756 --> 00:24:48.957
be incredibly hard for male patients to

00:24:48.997 --> 00:24:49.798
speak with me about

00:24:50.669 --> 00:24:53.711
And they may talk to someone who appears

00:24:53.750 --> 00:24:54.750
to identify as male.

00:24:55.471 --> 00:24:57.393
This is a conversation these patients

00:24:57.432 --> 00:24:57.853
bring up.

00:24:57.893 --> 00:25:00.454
And Mika and I both had the experience

00:25:00.515 --> 00:25:02.655
where we were learning how to navigate

00:25:02.675 --> 00:25:06.597
these conversations to ask appropriate

00:25:06.637 --> 00:25:06.998
questions.

00:25:07.018 --> 00:25:09.078
Like these are challenging conversations

00:25:09.118 --> 00:25:10.460
to have with patients.

00:25:11.039 --> 00:25:12.922
And if you've ever had the experience

00:25:12.942 --> 00:25:14.162
where a patient has brought up an

00:25:14.201 --> 00:25:15.303
uncomfortable topic,

00:25:16.300 --> 00:25:18.823
and you didn't know how to respond in

00:25:18.863 --> 00:25:20.084
a way that was going to be the

00:25:20.124 --> 00:25:21.305
most supportive of them,

00:25:22.365 --> 00:25:24.548
that is what we go through in this

00:25:24.607 --> 00:25:28.171
talk is how did we learn to communicate

00:25:28.191 --> 00:25:30.092
to these patients to normalize what

00:25:30.132 --> 00:25:32.693
they're feeling, to reassure them,

00:25:33.234 --> 00:25:34.976
to talk them through the process,

00:25:35.236 --> 00:25:37.218
to get them to the right specialist,

00:25:37.698 --> 00:25:40.320
but recognizing that in syndromes,

00:25:40.361 --> 00:25:42.082
a lot of times the PT is

00:25:42.951 --> 00:25:44.174
becomes the PCP.

00:25:44.655 --> 00:25:47.423
We are the provider in the middle that

00:25:47.462 --> 00:25:49.468
is comfortable talking about everything,

00:25:49.688 --> 00:25:50.671
but knows, okay,

00:25:50.711 --> 00:25:52.255
it's time to send you to this person.

00:25:53.001 --> 00:25:53.162
Okay,

00:25:53.201 --> 00:25:55.022
it's time to loop this person into the

00:25:55.083 --> 00:25:57.042
equation.

00:25:57.083 --> 00:26:00.743
So I'm excited because I enjoy talking

00:26:00.784 --> 00:26:01.825
through clinical reasoning.

00:26:01.884 --> 00:26:03.865
I think that's one of those topics that

00:26:04.265 --> 00:26:05.405
we need a class on,

00:26:05.425 --> 00:26:07.165
but a class on clinical reasoning doesn't

00:26:07.246 --> 00:26:07.905
usually sell.

00:26:08.705 --> 00:26:11.707
And it's usually hard to frame into a

00:26:11.767 --> 00:26:14.488
curriculum because it's best done when

00:26:14.528 --> 00:26:16.528
we're doing it on live patients or on

00:26:16.588 --> 00:26:17.848
real patient case studies.

00:26:18.808 --> 00:26:19.670
So for me,

00:26:19.730 --> 00:26:21.351
I think the thing that's exciting about

00:26:21.391 --> 00:26:24.814
this is to take the patient case all

00:26:24.854 --> 00:26:27.915
the way through to recognize that the

00:26:27.996 --> 00:26:30.377
standard clinical presentation now has

00:26:30.417 --> 00:26:31.439
some variation.

00:26:32.839 --> 00:26:35.701
And to be able to reason through,

00:26:35.902 --> 00:26:37.403
is this condition present?

00:26:38.203 --> 00:26:40.484
Recognize medical providers in your area

00:26:40.525 --> 00:26:41.987
may tell you it's not even a real

00:26:42.027 --> 00:26:43.567
thing and not want to treat it.

00:26:44.707 --> 00:26:46.147
How do you help them find the right

00:26:46.188 --> 00:26:46.728
provider?

00:26:46.867 --> 00:26:48.450
But then for me,

00:26:48.849 --> 00:26:51.050
as I was in my fellowship specifically,

00:26:52.231 --> 00:26:55.534
I was exposed to some training.

00:26:55.594 --> 00:26:57.836
I believe her name was Hughes in twenty

00:26:57.875 --> 00:26:58.115
twenty.

00:26:58.155 --> 00:26:58.875
Christina Hughes.

00:26:59.376 --> 00:27:02.798
She did a paper on patients who had

00:27:02.838 --> 00:27:05.141
been in pelvic health and failed pelvic

00:27:05.181 --> 00:27:07.201
health like they did not recover.

00:27:07.362 --> 00:27:08.982
Sexual function, prolapse,

00:27:09.063 --> 00:27:10.183
urinary incontinence, et cetera.

00:27:10.644 --> 00:27:12.506
She took an exhaustive approach to the

00:27:12.546 --> 00:27:12.905
spine.

00:27:14.798 --> 00:27:18.040
and all of them got better.

00:27:18.121 --> 00:27:20.082
And it really challenged me to say,

00:27:20.241 --> 00:27:21.682
how good is my spine exam?

00:27:22.624 --> 00:27:24.365
And when we look at this syndrome,

00:27:25.474 --> 00:27:28.116
there are two places the spine can really

00:27:28.136 --> 00:27:29.979
begin to play into their presentation.

00:27:30.038 --> 00:27:31.680
And that's something that Mika and I both

00:27:31.700 --> 00:27:35.983
have found clinically is that we have to

00:27:36.044 --> 00:27:37.424
be exhaustive.

00:27:37.525 --> 00:27:39.686
We have to progress through full range of

00:27:39.767 --> 00:27:43.190
motion with overpressure and make sure

00:27:43.230 --> 00:27:45.971
we're addressing any type of source of

00:27:46.011 --> 00:27:48.193
those symptoms just because of where it

00:27:48.213 --> 00:27:49.015
can get disrupted.

00:27:49.035 --> 00:27:49.434
And again,

00:27:49.474 --> 00:27:51.196
there's a lot of wonderful researchers

00:27:51.237 --> 00:27:53.338
that specialize in sexual medicine only

00:27:54.019 --> 00:27:56.221
doing research in this population now

00:27:56.281 --> 00:27:58.123
trying to understand those mechanisms.

00:27:59.125 --> 00:28:00.306
I love theory.

00:28:01.152 --> 00:28:02.673
but i want to know what i need

00:28:02.712 --> 00:28:05.115
to do monday because they're going to be

00:28:05.154 --> 00:28:07.156
here on monday so there's a lot of

00:28:07.257 --> 00:28:10.180
theory going around right now um we will

00:28:10.220 --> 00:28:12.981
briefly touch on that in our talk but

00:28:13.061 --> 00:28:15.703
we are mostly talking boots on the ground

00:28:15.845 --> 00:28:17.625
what do you need to do on monday

00:28:17.705 --> 00:28:20.008
what do you need to hand them when

00:28:20.028 --> 00:28:22.410
they come in the door what message do

00:28:22.450 --> 00:28:25.152
they need to hear what's their prognosis

00:28:26.012 --> 00:28:27.634
How long is it going to take to

00:28:27.673 --> 00:28:29.795
do an evaluation on this person?

00:28:30.715 --> 00:28:34.679
What should you allocate for time-wise if

00:28:34.719 --> 00:28:36.460
they are uncomfortable with a certain type

00:28:36.500 --> 00:28:37.140
of provider?

00:28:37.180 --> 00:28:39.541
How can you supplement care in that area

00:28:39.582 --> 00:28:40.903
to keep them moving forward?

00:28:41.383 --> 00:28:42.723
So our hope is to make it a

00:28:42.743 --> 00:28:44.984
really practical approach to a challenging

00:28:45.025 --> 00:28:48.086
case, pulling all of those components in.

00:28:48.106 --> 00:28:49.268
Do you know when it is?

00:28:49.587 --> 00:28:50.189
When's your talk?

00:28:50.209 --> 00:28:52.470
It's on Thursday.

00:28:52.509 --> 00:28:53.931
I don't remember the date yet.

00:28:54.278 --> 00:28:54.678
Thursday.

00:28:55.198 --> 00:28:57.398
I think Valentine's Day is Saturday.

00:28:57.419 --> 00:28:59.279
So, fourteen, thirteen, twelfth.

00:28:59.299 --> 00:29:00.441
The twelfth at two.

00:29:00.941 --> 00:29:01.260
At two.

00:29:01.441 --> 00:29:02.422
And say the name again,

00:29:02.501 --> 00:29:03.761
just so people will mark it down.

00:29:03.842 --> 00:29:04.863
I'll put it in the show notes, too.

00:29:05.423 --> 00:29:06.483
It's not that hard.

00:29:06.663 --> 00:29:08.845
Clinical reasoning in the management of

00:29:08.865 --> 00:29:09.625
hard flaccid.

00:29:09.704 --> 00:29:11.905
You got to earn their attention to get

00:29:11.925 --> 00:29:13.047
them get butts in seats.

00:29:13.487 --> 00:29:14.346
I'm not going to lie.

00:29:14.406 --> 00:29:15.968
I was a little disappointed not to get

00:29:16.008 --> 00:29:17.949
Valentine's Day because I thought like a

00:29:17.989 --> 00:29:19.890
penis talk on Valentine's Day was actually

00:29:19.910 --> 00:29:20.730
going to be pretty fun.

00:29:20.769 --> 00:29:21.851
But I'll take Thursday.

00:29:22.474 --> 00:29:24.195
It's pre-Valentine's Day, little surprise.

00:29:24.636 --> 00:29:25.317
Yes, it is.

00:29:26.337 --> 00:29:27.117
We got to pay some bills.

00:29:27.137 --> 00:29:30.500
Hang tight one second.

00:29:30.540 --> 00:29:33.002
Episode is sponsored by Empower EMR.

00:29:33.303 --> 00:29:36.644
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00:29:36.944 --> 00:29:39.027
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00:29:39.067 --> 00:29:39.446
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lightning fast documentation and

00:29:40.847 --> 00:29:43.230
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00:29:43.250 --> 00:29:43.769
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Learn more, take a test drive,

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kick the tires, light the fires.

00:29:50.035 --> 00:29:51.215
Empower EMR.

00:29:52.797 --> 00:29:54.298
And we want to make sure you know

00:29:54.318 --> 00:29:55.740
about this organization.

00:29:56.020 --> 00:29:56.922
If you haven't heard about them,

00:29:57.323 --> 00:29:59.526
my first exposure was at an APTA national

00:29:59.566 --> 00:30:00.026
conference.

00:30:00.046 --> 00:30:01.367
It was called Go Baby Go,

00:30:01.847 --> 00:30:03.691
supporting pediatric mobility and play for

00:30:03.730 --> 00:30:06.094
children of all abilities through those

00:30:06.114 --> 00:30:07.335
little modified, you know,

00:30:07.355 --> 00:30:08.537
the battery powered cars.

00:30:08.817 --> 00:30:10.199
You modify them and make it's like a

00:30:10.259 --> 00:30:10.719
hackathon.

00:30:11.460 --> 00:30:11.779
And this way,

00:30:11.819 --> 00:30:13.481
kids have mobility devices and they don't

00:30:13.501 --> 00:30:13.842
have to, like,

00:30:14.142 --> 00:30:16.002
pay for wheelchairs that cost thousands

00:30:16.022 --> 00:30:16.784
and thousands of dollars.

00:30:17.023 --> 00:30:17.565
And they're awesome.

00:30:17.845 --> 00:30:19.385
And then you can help build them.

00:30:19.465 --> 00:30:20.406
It's all open sourced.

00:30:20.606 --> 00:30:21.446
Let kids be kids,

00:30:21.528 --> 00:30:23.169
even if they roll a little different.

00:30:23.528 --> 00:30:25.410
Learn how to donate or get involved at

00:30:25.450 --> 00:30:26.911
GoBabyGo.org.

00:30:26.991 --> 00:30:28.712
That was Cole Galloway who kicked off that

00:30:28.732 --> 00:30:29.133
initiative.

00:30:29.153 --> 00:30:30.574
And I saw him in an APTA event.

00:30:30.634 --> 00:30:31.515
That was the first time I ever heard

00:30:31.535 --> 00:30:31.934
him speak.

00:30:32.375 --> 00:30:32.615
All right.

00:30:32.736 --> 00:30:33.797
So you have a meeting.

00:30:34.557 --> 00:30:36.098
But I want to make sure that we

00:30:36.118 --> 00:30:36.740
get to this.

00:30:37.339 --> 00:30:38.260
I post on LinkedIn.

00:30:38.401 --> 00:30:40.403
I now treat LinkedIn like Twitter.

00:30:41.084 --> 00:30:41.845
I posted something.

00:30:42.165 --> 00:30:43.446
You didn't disagree with me,

00:30:43.606 --> 00:30:44.448
but you were like, hey,

00:30:45.088 --> 00:30:47.270
and I think we probably most likely agree

00:30:47.551 --> 00:30:48.432
on what I said,

00:30:48.512 --> 00:30:49.753
but we'll bring it on.

00:30:49.773 --> 00:30:50.114
We'll learn.

00:30:50.394 --> 00:30:51.855
So I will read the post.

00:30:52.136 --> 00:30:53.498
I said, hey, unpopular opinion.

00:30:54.038 --> 00:30:55.380
Nobody cares about what you did.

00:30:56.080 --> 00:30:57.362
Not on LinkedIn, not on Instagram,

00:30:57.382 --> 00:30:58.362
not on Facebook, nowhere.

00:30:58.782 --> 00:30:59.403
I wrote a book.

00:30:59.923 --> 00:31:00.963
I launched a podcast.

00:31:01.023 --> 00:31:01.864
I posted a video.

00:31:01.943 --> 00:31:03.065
Cool, great, fantastic.

00:31:03.424 --> 00:31:05.465
But what does it have to do for

00:31:05.726 --> 00:31:06.906
me?

00:31:06.926 --> 00:31:08.188
This is the lesson that I'm trying to

00:31:08.228 --> 00:31:08.788
show people.

00:31:08.807 --> 00:31:11.170
I'm trying to grab their attention, faith,

00:31:11.410 --> 00:31:12.470
and then teach them the lesson.

00:31:12.490 --> 00:31:13.510
I got to get their attention first.

00:31:14.090 --> 00:31:15.751
I continue to say social media isn't your

00:31:15.791 --> 00:31:16.393
trophy shelf.

00:31:16.413 --> 00:31:17.313
It's a value exchange.

00:31:17.633 --> 00:31:19.334
People care about four main things.

00:31:19.933 --> 00:31:21.355
Does this save me time, make me money,

00:31:21.375 --> 00:31:22.036
make me better?

00:31:22.435 --> 00:31:23.757
Does this make me laugh for a second?

00:31:24.501 --> 00:31:25.182
If the answer's no,

00:31:25.201 --> 00:31:26.623
then your post is just a digital pat

00:31:26.643 --> 00:31:27.022
on the back.

00:31:27.343 --> 00:31:28.163
And congratulations,

00:31:28.182 --> 00:31:29.443
you're seconds away from dislocating your

00:31:29.463 --> 00:31:29.763
shoulder.

00:31:30.023 --> 00:31:31.544
Don't dislocate your shoulder patting your

00:31:31.585 --> 00:31:31.845
back.

00:31:32.625 --> 00:31:33.444
Want people to listen?

00:31:33.924 --> 00:31:35.306
Want your stuff to sound like it matters?

00:31:35.405 --> 00:31:37.145
Stop announcing your accomplishments and

00:31:37.165 --> 00:31:38.646
start explaining how what you do lifts

00:31:38.686 --> 00:31:39.247
other people up.

00:31:39.666 --> 00:31:40.708
When you help someone rise,

00:31:40.867 --> 00:31:42.327
suddenly everyone starts paying attention.

00:31:42.448 --> 00:31:44.068
And then you said counterargument.

00:31:44.128 --> 00:31:44.808
And I love counterarguments.

00:31:44.828 --> 00:31:45.890
Do you want to read your counterargument

00:31:46.089 --> 00:31:48.790
in your voice?

00:31:48.871 --> 00:31:49.851
Expand it for me.

00:31:50.211 --> 00:31:50.730
All right.

00:31:51.131 --> 00:31:52.311
So my counterargument...

00:31:53.193 --> 00:31:54.234
was to ask,

00:31:54.855 --> 00:31:56.596
what if this individual is a minority,

00:31:57.155 --> 00:31:59.797
marginalized, or atypical in their field?

00:32:00.438 --> 00:32:02.818
So these individuals inspire others who

00:32:02.898 --> 00:32:04.619
identify with them to see these

00:32:04.660 --> 00:32:06.381
accomplishments as achievable.

00:32:07.805 --> 00:32:09.247
I often work with students who are

00:32:09.287 --> 00:32:11.269
first-generation college graduates.

00:32:11.608 --> 00:32:13.631
Posting means that our community,

00:32:13.671 --> 00:32:15.752
so our PT community,

00:32:16.173 --> 00:32:17.634
can support and cheer for them in a

00:32:17.694 --> 00:32:21.137
way that their environment can't because

00:32:21.159 --> 00:32:23.540
they don't understand their experience.

00:32:23.701 --> 00:32:25.202
And for me,

00:32:25.282 --> 00:32:26.824
this could certainly fall under how does

00:32:26.844 --> 00:32:27.684
this make me better?

00:32:27.704 --> 00:32:27.785
Yeah.

00:32:28.826 --> 00:32:31.268
But I want to see their accomplishments.

00:32:31.567 --> 00:32:32.528
I want to promote them.

00:32:32.588 --> 00:32:33.609
I want to cheer for them,

00:32:34.009 --> 00:32:35.490
especially in these cases.

00:32:36.372 --> 00:32:38.073
But then the flip side of that argument

00:32:38.113 --> 00:32:39.534
is when we're trying to fight for

00:32:39.614 --> 00:32:40.214
equality.

00:32:41.294 --> 00:32:43.454
we can't decide who that goes to.

00:32:43.494 --> 00:32:44.596
It has to be for everyone.

00:32:45.317 --> 00:32:48.179
So I'm okay with posting accomplishments

00:32:48.459 --> 00:32:50.460
and maybe that's my unpopular opinion,

00:32:50.539 --> 00:32:50.960
but if I,

00:32:51.421 --> 00:32:53.301
I don't know if someone is a minority,

00:32:53.461 --> 00:32:54.442
if they're atypical,

00:32:54.583 --> 00:32:56.183
if they're marginalized in some way.

00:32:57.045 --> 00:32:57.805
Um, so it's,

00:32:57.964 --> 00:32:59.486
it is easier for me to say,

00:32:59.526 --> 00:33:01.366
you know what you post it,

00:33:01.667 --> 00:33:02.667
what you do is on you.

00:33:02.708 --> 00:33:04.409
What I do is on me and I'd

00:33:04.449 --> 00:33:05.009
rather clap.

00:33:05.458 --> 00:33:06.077
Yeah, yeah.

00:33:06.378 --> 00:33:07.078
I don't disagree.

00:33:07.179 --> 00:33:08.279
I think we probably are more...

00:33:09.401 --> 00:33:10.902
So thank you for challenging me because

00:33:11.122 --> 00:33:13.463
I'm not here to just post stuff and

00:33:13.483 --> 00:33:14.324
have everybody agree with me.

00:33:15.305 --> 00:33:16.125
I agree, a hundred percent.

00:33:19.367 --> 00:33:20.107
I'm struggling with like,

00:33:20.388 --> 00:33:21.249
that's what I meant,

00:33:21.709 --> 00:33:22.750
but it isn't what I said.

00:33:23.211 --> 00:33:24.330
But I don't disagree with you.

00:33:24.431 --> 00:33:25.071
So I'm just like, where...

00:33:25.432 --> 00:33:27.192
So maybe if I had added like to

00:33:27.252 --> 00:33:28.253
motivate others,

00:33:28.874 --> 00:33:31.195
because like I did something amazing.

00:33:31.415 --> 00:33:32.596
I'm here for it.

00:33:33.698 --> 00:33:34.999
I guess my problem is...

00:33:36.650 --> 00:33:37.490
Especially PTs.

00:33:39.373 --> 00:33:40.493
When they wrote a book,

00:33:41.755 --> 00:33:43.296
it takes them months or years.

00:33:44.037 --> 00:33:45.637
Faith, I'm excited when I read a book.

00:33:46.398 --> 00:33:47.539
I pat myself on the back when I

00:33:47.599 --> 00:33:48.540
finish reading a book.

00:33:48.840 --> 00:33:52.545
I cannot imagine or fathom writing a book.

00:33:52.865 --> 00:33:53.566
My problem,

00:33:53.586 --> 00:33:55.067
what I'm trying to get people to see

00:33:55.768 --> 00:33:56.608
is, I agree with you,

00:33:57.884 --> 00:33:59.605
You took nine months to write a book

00:34:00.045 --> 00:34:02.086
and fourteen seconds to post about it.

00:34:02.487 --> 00:34:03.846
You said, I wrote a book.

00:34:04.228 --> 00:34:05.587
What I want you to say is,

00:34:06.249 --> 00:34:07.788
look what I'm able to help you unlock.

00:34:09.030 --> 00:34:10.311
Because that will get people to go,

00:34:10.451 --> 00:34:12.172
hang on a second, what does that mean?

00:34:12.672 --> 00:34:14.452
So you're right.

00:34:15.052 --> 00:34:17.295
Your critique of what I said was right.

00:34:18.041 --> 00:34:18.922
What I'm trying to figure out is how

00:34:18.942 --> 00:34:19.541
do I say it better?

00:34:19.563 --> 00:34:22.465
Because what I meant is if someone did

00:34:22.525 --> 00:34:24.887
something from a minority,

00:34:25.307 --> 00:34:28.570
how do we make sure everybody recognizes,

00:34:28.710 --> 00:34:31.172
lifts that person up so that what you're

00:34:31.193 --> 00:34:32.675
saying is more people see it?

00:34:33.255 --> 00:34:34.617
I was doing it more of a reframe,

00:34:34.657 --> 00:34:35.097
which is like,

00:34:35.237 --> 00:34:36.438
I see what a lot of you are

00:34:36.458 --> 00:34:36.719
doing.

00:34:37.179 --> 00:34:37.820
I wrote a paper.

00:34:38.726 --> 00:34:40.148
Tell me what I'm going to get if

00:34:40.228 --> 00:34:41.829
I give you eleven minutes to read the

00:34:41.889 --> 00:34:43.692
paper, if I could even access the paper.

00:34:45.514 --> 00:34:46.615
Please give me free access to.

00:34:46.635 --> 00:34:51.322
I got to see so much greatness going

00:34:51.362 --> 00:34:51.922
around.

00:34:51.983 --> 00:34:52.784
Like I launched,

00:34:53.063 --> 00:34:54.826
I published another podcast episode.

00:34:55.778 --> 00:34:56.798
Cool story, Jimmy.

00:34:56.858 --> 00:34:57.679
That's about you.

00:34:57.880 --> 00:34:59.639
What I want to say is we're going

00:34:59.659 --> 00:35:02.621
to make sense of lizards and clinical

00:35:02.661 --> 00:35:06.061
reasoning with mildly flaccid penises,

00:35:06.422 --> 00:35:07.862
and you're going to walk out not feeling

00:35:07.922 --> 00:35:10.242
uncomfortable if this ever comes to you.

00:35:10.382 --> 00:35:12.123
You know what I mean?

00:35:12.362 --> 00:35:13.842
I recorded a podcast episode,

00:35:14.182 --> 00:35:15.744
as the kids would say, cool story, bro.

00:35:15.804 --> 00:35:16.423
Tell it again.

00:35:16.864 --> 00:35:17.923
So I don't disagree with you.

00:35:17.943 --> 00:35:20.324
I have two thoughts for you.

00:35:20.364 --> 00:35:20.605
Okay, go.

00:35:22.532 --> 00:35:22.632
Okay.

00:35:22.672 --> 00:35:22.831
One,

00:35:23.592 --> 00:35:25.552
you're coming at this perspective as a

00:35:25.632 --> 00:35:26.132
mentor.

00:35:26.853 --> 00:35:28.074
You do this for a living.

00:35:28.094 --> 00:35:28.353
Okay.

00:35:28.994 --> 00:35:31.755
So you in that post were mentoring us,

00:35:32.496 --> 00:35:35.237
mentoring potentially people who do not

00:35:35.297 --> 00:35:36.818
know how this currency works.

00:35:36.838 --> 00:35:36.958
Got it.

00:35:36.978 --> 00:35:39.298
So I didn't understand the audience

00:35:39.338 --> 00:35:39.659
enough.

00:35:40.260 --> 00:35:42.840
You were mentoring to say, Hey y'all,

00:35:43.847 --> 00:35:44.967
You're coming into your own.

00:35:45.007 --> 00:35:46.088
You're doing great things.

00:35:46.128 --> 00:35:46.909
Fantastic.

00:35:47.309 --> 00:35:49.630
This is how you leverage that because deep

00:35:49.670 --> 00:35:50.592
down inside,

00:35:51.472 --> 00:35:53.034
I don't know anybody that didn't become a

00:35:53.094 --> 00:35:55.235
PT to be really good at what they

00:35:55.295 --> 00:35:57.476
do in whatever avenue they do it to

00:35:57.577 --> 00:35:58.297
help people.

00:35:58.878 --> 00:36:00.639
Like it was too much work to not

00:36:00.659 --> 00:36:01.539
come in to help people.

00:36:02.079 --> 00:36:03.842
So I think you were coming to it

00:36:03.882 --> 00:36:05.583
from a mentoring perspective.

00:36:06.072 --> 00:36:08.172
what I've had to learn from a mentoring

00:36:08.213 --> 00:36:10.434
perspective is that if someone has never

00:36:10.494 --> 00:36:11.795
had this modeled for them,

00:36:12.315 --> 00:36:14.416
so say they have never been in an

00:36:14.476 --> 00:36:16.717
environment where they've had a platform,

00:36:17.277 --> 00:36:19.217
this is the first time they've been given

00:36:19.398 --> 00:36:20.458
one and they get up there with a

00:36:20.518 --> 00:36:23.280
microphone and they're just sweating and

00:36:23.340 --> 00:36:25.380
like, they don't know what to do.

00:36:25.460 --> 00:36:25.760
And like,

00:36:25.780 --> 00:36:27.440
you're up there trying to help them and

00:36:27.561 --> 00:36:29.081
ask them questions like you're doing now

00:36:29.101 --> 00:36:29.521
with me.

00:36:30.463 --> 00:36:31.963
I've learned that when they post those

00:36:31.983 --> 00:36:34.503
things and it's really comes across as

00:36:34.543 --> 00:36:35.184
bragging,

00:36:36.445 --> 00:36:38.905
I can either walk away from it or

00:36:38.985 --> 00:36:39.646
I can say, no,

00:36:39.666 --> 00:36:41.766
this is another mentoring opportunity for

00:36:41.806 --> 00:36:44.768
me where I can get in the comments

00:36:44.907 --> 00:36:45.648
and say, wow,

00:36:45.927 --> 00:36:47.349
I can tell why you're so proud of

00:36:47.389 --> 00:36:48.389
this accomplishment.

00:36:48.989 --> 00:36:50.989
What was the biggest barrier you hit and

00:36:51.050 --> 00:36:52.150
how did you solve that problem?

00:36:52.190 --> 00:36:54.090
Help me understand how you did.

00:36:54.130 --> 00:36:54.911
Yeah.

00:36:54.952 --> 00:36:56.052
What is the biggest lesson?

00:36:56.592 --> 00:36:57.612
But I was trying to be funny and

00:36:57.632 --> 00:36:58.213
sarcastic.

00:37:01.929 --> 00:37:03.851
So now what I'm going to wait,

00:37:03.871 --> 00:37:04.771
what you said, you had two things.

00:37:04.791 --> 00:37:05.831
Was that two things or one thing?

00:37:05.851 --> 00:37:06.771
Those were the two things.

00:37:06.811 --> 00:37:07.193
So you,

00:37:07.492 --> 00:37:08.713
that was the perspective was the

00:37:08.753 --> 00:37:09.273
mentoring.

00:37:09.393 --> 00:37:11.574
And then as we try to elevate our

00:37:11.614 --> 00:37:12.215
mentoring,

00:37:12.934 --> 00:37:14.376
we can either walk away and say,

00:37:14.416 --> 00:37:15.876
I'm not mentoring this person.

00:37:16.077 --> 00:37:17.097
They're not a nice person.

00:37:17.157 --> 00:37:18.177
Or I could say, you know what?

00:37:18.217 --> 00:37:19.378
I'm going to assume.

00:37:20.179 --> 00:37:21.418
That they just don't have the knowledge of

00:37:21.478 --> 00:37:21.818
a skill.

00:37:22.280 --> 00:37:23.780
Well, I say that all the time.

00:37:23.880 --> 00:37:24.661
I used to say.

00:37:25.731 --> 00:37:27.152
When I got into this profession,

00:37:27.432 --> 00:37:28.675
I looked around and PTs were bad at

00:37:28.695 --> 00:37:29.235
communicating.

00:37:29.677 --> 00:37:31.298
And then I was like, I amended that.

00:37:31.318 --> 00:37:32.860
I was like, oh no, you know what?

00:37:32.880 --> 00:37:33.242
That's not it.

00:37:35.242 --> 00:37:35.563
Um,

00:37:35.643 --> 00:37:36.903
I think you're trained to communicate

00:37:36.963 --> 00:37:39.005
certain ways and you do those things and

00:37:39.025 --> 00:37:39.125
you,

00:37:39.244 --> 00:37:40.885
and surprisingly the things you're trained

00:37:40.925 --> 00:37:42.005
in and you do a lot, you're good.

00:37:42.025 --> 00:37:42.945
You're better at, right?

00:37:43.706 --> 00:37:44.907
And then when you look at mass

00:37:44.947 --> 00:37:46.268
communication, faith,

00:37:46.307 --> 00:37:47.887
it's almost as if it's an entire degree

00:37:47.927 --> 00:37:48.407
in college.

00:37:48.507 --> 00:37:49.728
And I have one of those mass

00:37:49.748 --> 00:37:53.030
communication, but not the same.

00:37:53.309 --> 00:37:54.030
It's not.

00:37:54.090 --> 00:37:55.550
And then I come to the defense again

00:37:55.590 --> 00:37:55.871
and say,

00:37:55.931 --> 00:37:57.532
PTs aren't bad or healthcare providers

00:37:57.572 --> 00:37:58.632
aren't bad at communicating.

00:37:58.652 --> 00:38:00.432
I'm using air quotes on a podcast.

00:38:01.273 --> 00:38:03.114
You lack the T's and P's.

00:38:03.134 --> 00:38:04.054
Did I ever talk to you about the

00:38:04.094 --> 00:38:04.574
T's and P's?

00:38:05.842 --> 00:38:06.902
I think you talked about it on your

00:38:06.922 --> 00:38:08.204
last episode.

00:38:08.583 --> 00:38:11.925
Tools, training, time, people,

00:38:12.445 --> 00:38:15.748
process to then generate the product,

00:38:16.268 --> 00:38:17.128
which is the thing.

00:38:17.588 --> 00:38:18.389
That's work.

00:38:19.490 --> 00:38:20.050
That's work.

00:38:20.090 --> 00:38:20.590
Yes, it is.

00:38:21.072 --> 00:38:23.632
And I, I recognize that like, Hey man,

00:38:23.873 --> 00:38:25.414
I'm sharing this thing and I'm doing it

00:38:25.474 --> 00:38:27.635
while I'm on the bus or just between

00:38:27.675 --> 00:38:28.155
whatever's.

00:38:29.197 --> 00:38:29.476
And yeah,

00:38:31.067 --> 00:38:32.728
I what I hope to do is not

00:38:32.748 --> 00:38:33.528
give a lecture.

00:38:33.588 --> 00:38:34.690
I want to give a bunch of little

00:38:34.730 --> 00:38:35.110
digest.

00:38:35.170 --> 00:38:36.090
I'm just going to be the guy who's

00:38:36.110 --> 00:38:36.271
like,

00:38:36.472 --> 00:38:38.072
let's make you one tenth of one percent

00:38:38.092 --> 00:38:38.653
better today.

00:38:39.434 --> 00:38:40.835
But I see where my sarcasm might have

00:38:40.914 --> 00:38:41.695
missed it a little bit.

00:38:41.735 --> 00:38:42.836
I was close.

00:38:43.056 --> 00:38:43.737
Here's the best part.

00:38:44.018 --> 00:38:45.199
Got a degree in communications in two

00:38:45.219 --> 00:38:45.699
thousand one.

00:38:45.920 --> 00:38:47.340
Been doing it a lot.

00:38:48.581 --> 00:38:50.603
Still a process to get better at it.

00:38:50.643 --> 00:38:51.905
You could still miss the mark.

00:38:52.525 --> 00:38:55.148
You always have to be evaluating that

00:38:55.548 --> 00:38:56.329
because, because you,

00:38:56.530 --> 00:38:58.170
even if you know the audience, well,

00:38:58.811 --> 00:39:00.632
the audience is so vast and so wide,

00:39:00.733 --> 00:39:01.994
like you're, it's not going to land.

00:39:02.014 --> 00:39:02.894
It's a bell curve again.

00:39:03.215 --> 00:39:04.797
It's going to land with a lot,

00:39:04.836 --> 00:39:05.818
but then also there's going to be, well,

00:39:05.858 --> 00:39:06.978
what F and what actually,

00:39:06.998 --> 00:39:08.199
and then faith comes in the comments.

00:39:08.219 --> 00:39:09.420
Like what I'm like, Oh, you know what?

00:39:09.501 --> 00:39:09.701
Yeah.

00:39:09.820 --> 00:39:10.101
Okay.

00:39:10.161 --> 00:39:10.722
No, she has a point.

00:39:11.163 --> 00:39:11.983
So here's what I'm going to do.

00:39:12.923 --> 00:39:14.744
I'm going to take this lesson.

00:39:14.844 --> 00:39:16.664
I'm going to go back to that post

00:39:16.864 --> 00:39:20.186
and I'm going to remix it as the

00:39:20.206 --> 00:39:21.585
kids would say and see if I can

00:39:21.606 --> 00:39:23.365
make it better because that's all we do.

00:39:24.306 --> 00:39:25.606
Were you great with your first?

00:39:25.806 --> 00:39:28.807
Do you remember your first patient?

00:39:28.907 --> 00:39:30.648
No, I really don't.

00:39:30.887 --> 00:39:31.467
I don't remember mine,

00:39:31.487 --> 00:39:32.628
but I remember just like being like,

00:39:32.728 --> 00:39:34.489
I would probably apologize to my first one

00:39:34.528 --> 00:39:34.809
hundred.

00:39:35.737 --> 00:39:35.916
Right.

00:39:35.936 --> 00:39:37.177
Wouldn't we all?

00:39:37.237 --> 00:39:38.177
No, I'll tell you this.

00:39:38.277 --> 00:39:39.518
I can tell you one of my first

00:39:39.617 --> 00:39:39.757
ones.

00:39:39.777 --> 00:39:41.759
And it's probably one of the reasons why

00:39:41.898 --> 00:39:43.699
I don't remember like the initial

00:39:43.739 --> 00:39:44.340
patients.

00:39:45.619 --> 00:39:47.621
He was a stroke patient and he came

00:39:47.701 --> 00:39:49.920
in and man,

00:39:49.960 --> 00:39:51.802
he was having a hard time like through

00:39:51.842 --> 00:39:52.581
his paperwork.

00:39:53.161 --> 00:39:55.143
When he left, I was like,

00:39:55.182 --> 00:39:56.242
he's not coming back.

00:39:57.364 --> 00:39:57.643
You know,

00:39:57.684 --> 00:39:59.623
we're almost nine years later and we still

00:39:59.664 --> 00:40:00.764
have lunch every month.

00:40:01.204 --> 00:40:01.864
Really?

00:40:03.072 --> 00:40:04.574
So hold on a second.

00:40:04.614 --> 00:40:05.534
You had to have asked, like,

00:40:05.594 --> 00:40:06.856
what was it to go from throwing your

00:40:06.896 --> 00:40:09.057
papers to nine years?

00:40:09.659 --> 00:40:09.759
Like,

00:40:09.778 --> 00:40:11.081
did you just give him enough compassion?

00:40:11.121 --> 00:40:11.721
Like, what was it?

00:40:13.163 --> 00:40:14.403
I didn't get upset at him.

00:40:14.724 --> 00:40:15.965
He said he was going to come back

00:40:16.085 --> 00:40:16.246
in.

00:40:16.385 --> 00:40:17.827
He was someone who kept his word.

00:40:18.608 --> 00:40:20.391
And I just kept trying.

00:40:21.231 --> 00:40:22.492
I kept trying to work with him.

00:40:22.512 --> 00:40:24.193
We ended up working together for two

00:40:24.233 --> 00:40:24.673
years.

00:40:25.675 --> 00:40:27.715
He had a stroke on his dominant side.

00:40:27.815 --> 00:40:29.637
I literally helped him handwrite and fill

00:40:29.697 --> 00:40:31.257
out his disability paperwork.

00:40:33.139 --> 00:40:34.860
Again, I worked with reptiles.

00:40:35.340 --> 00:40:37.442
I was used to things wanting to bite

00:40:37.481 --> 00:40:39.182
me when I was trying to help it.

00:40:39.722 --> 00:40:43.365
So it didn't upset me that he was

00:40:43.405 --> 00:40:45.947
upset at me.

00:40:46.447 --> 00:40:48.528
I was like, okay, he needs help.

00:40:48.688 --> 00:40:49.570
He's scared.

00:40:50.369 --> 00:40:51.831
How do I calm him down?

00:40:51.911 --> 00:40:53.431
What does this patient need from me?

00:40:53.472 --> 00:40:54.913
And he needed help with disability

00:40:54.932 --> 00:40:55.413
paperwork.

00:40:56.233 --> 00:40:58.054
That's not in the playbook,

00:40:58.094 --> 00:40:59.916
but you recognized it was necessary.

00:41:00.777 --> 00:41:03.398
Because I walked in the room and said,

00:41:03.579 --> 00:41:04.559
this organism,

00:41:04.599 --> 00:41:06.780
this living thing needs this.

00:41:06.840 --> 00:41:08.302
This is not personal.

00:41:08.422 --> 00:41:10.063
It is a response to something in the

00:41:10.483 --> 00:41:10.963
environment.

00:41:11.824 --> 00:41:13.565
And so we worked together on and off

00:41:13.585 --> 00:41:15.304
for two years and he is still one

00:41:15.344 --> 00:41:16.865
of my dearest and closest friends.

00:41:17.365 --> 00:41:19.306
So I love to tell that story to

00:41:19.346 --> 00:41:22.246
new grads because they think that when you

00:41:22.286 --> 00:41:23.387
come out of school,

00:41:23.487 --> 00:41:25.088
like you don't know anything and you've

00:41:25.128 --> 00:41:26.807
got to hide the fact that you're a

00:41:26.867 --> 00:41:28.289
new grad and you've got to wait till

00:41:28.329 --> 00:41:29.509
you get all the letters.

00:41:30.028 --> 00:41:30.730
And I'm like, no,

00:41:30.809 --> 00:41:33.550
my biggest cheerleaders to this day are

00:41:33.610 --> 00:41:35.690
patients that I treated in that first six

00:41:35.791 --> 00:41:36.090
months.

00:41:36.110 --> 00:41:37.612
There are four of them that I still

00:41:37.652 --> 00:41:38.431
stay in touch with.

00:41:39.536 --> 00:41:41.039
And like I said,

00:41:41.079 --> 00:41:43.342
they're my biggest cheerleaders and I have

00:41:43.402 --> 00:41:46.164
told them I had no idea what I

00:41:46.204 --> 00:41:46.846
was doing.

00:41:47.327 --> 00:41:48.909
And they said, we knew,

00:41:49.028 --> 00:41:50.269
but you figured it out.

00:41:51.126 --> 00:41:52.827
So figure it out.

00:41:53.668 --> 00:41:55.248
It is okay to not know what you're

00:41:55.268 --> 00:41:55.548
doing.

00:41:55.969 --> 00:41:56.668
Yeah.

00:41:56.728 --> 00:41:57.389
Ryan Clark,

00:41:57.429 --> 00:41:58.269
before we do your parting shot,

00:41:58.289 --> 00:41:59.050
because I know you've got a meeting.

00:41:59.070 --> 00:42:00.489
I don't want to be the reason for

00:42:00.510 --> 00:42:00.710
a meeting.

00:42:01.050 --> 00:42:03.650
Ryan Clark was a former NFL pro bowler.

00:42:04.032 --> 00:42:04.331
Awesome.

00:42:04.351 --> 00:42:05.711
Played for the Steelers and the Giants.

00:42:05.751 --> 00:42:08.793
I saw him at a healthcare medical

00:42:08.833 --> 00:42:10.114
conference in D.C.,

00:42:11.034 --> 00:42:12.295
he had this i forget what the condition

00:42:12.335 --> 00:42:13.596
was i think it might have been sickle

00:42:13.615 --> 00:42:15.036
cell anemia he had some condition where it

00:42:15.056 --> 00:42:17.297
was not every test he was being given

00:42:17.798 --> 00:42:19.420
you're fine man and he's like i am

00:42:19.519 --> 00:42:21.501
losing weight i can't get out of bed

00:42:21.701 --> 00:42:23.302
it's like i'm a defensive back in the

00:42:23.641 --> 00:42:28.304
nfl i can't get out of bed so

00:42:28.344 --> 00:42:29.846
this was the team dot also you're an

00:42:29.905 --> 00:42:32.108
nfl defensive back you have the best

00:42:32.148 --> 00:42:34.329
doctors in the world and this one doctor

00:42:34.509 --> 00:42:35.170
might have been great

00:42:36.101 --> 00:42:37.202
But he was like, no, you're good.

00:42:37.342 --> 00:42:37.623
Go ahead.

00:42:37.663 --> 00:42:38.043
Get out of here.

00:42:38.063 --> 00:42:38.403
And he's like,

00:42:38.744 --> 00:42:39.965
I'm wasting away to nothing.

00:42:41.788 --> 00:42:43.510
I think he said go out of pocket

00:42:43.530 --> 00:42:45.030
and go to a new doctor.

00:42:45.090 --> 00:42:46.552
And the doctors did all the same tests

00:42:46.612 --> 00:42:48.695
and said everything came back negative.

00:42:49.215 --> 00:42:50.117
And then Ryan Clark was like,

00:42:51.177 --> 00:42:51.478
and he goes,

00:42:51.498 --> 00:42:52.500
I don't know what's going on,

00:42:52.519 --> 00:42:53.460
but we're just going to keep doing stuff

00:42:53.481 --> 00:42:54.101
till we figure it out.

00:42:54.181 --> 00:42:55.443
And Ryan Clark goes, that's all I wanted.

00:42:55.963 --> 00:42:56.543
That's all they want.

00:42:56.563 --> 00:42:59.606
Just tell me that you believe me.

00:42:59.626 --> 00:43:00.065
Look at me.

00:43:00.206 --> 00:43:01.706
I'm a defensive back.

00:43:01.806 --> 00:43:03.027
I'm dripping weight.

00:43:03.108 --> 00:43:04.088
I'm dropping weight like Creed.

00:43:04.168 --> 00:43:04.648
Not normal.

00:43:05.128 --> 00:43:05.628
Everything's normal.

00:43:05.648 --> 00:43:05.849
He goes,

00:43:05.869 --> 00:43:07.030
I don't know what's going to happen,

00:43:07.050 --> 00:43:08.010
but we're going to keep doing it to

00:43:08.050 --> 00:43:09.170
figure it out.

00:43:09.471 --> 00:43:11.411
Someone just wants a wingman.

00:43:13.012 --> 00:43:14.032
It's not an assembly line.

00:43:14.052 --> 00:43:16.273
There's going to be a lot of typical

00:43:16.293 --> 00:43:18.574
things in your career.

00:43:18.655 --> 00:43:23.338
Read and recognize when it's inaudible.

00:43:23.717 --> 00:43:24.418
See, I could do this all day.

00:43:24.438 --> 00:43:25.559
Yes, you can.

00:43:26.876 --> 00:43:28.117
Are you ready to do the parting shot?

00:43:28.157 --> 00:43:28.856
Your parting shot?

00:43:29.297 --> 00:43:35.059
Sure.

00:43:35.079 --> 00:43:36.460
Our parting shot brought to you by Get

00:43:36.480 --> 00:43:37.300
the Message Out,

00:43:37.500 --> 00:43:39.420
a full service storytelling shop.

00:43:39.920 --> 00:43:41.561
It's a small creative agency with a big

00:43:41.621 --> 00:43:41.961
mouth.

00:43:42.541 --> 00:43:43.822
We help healthcare professionals turn

00:43:43.842 --> 00:43:44.422
their ideas.

00:43:45.235 --> 00:43:47.097
into impact for podcast launches,

00:43:47.137 --> 00:43:48.117
social media strategy.

00:43:48.878 --> 00:43:50.579
They help you speak your truth and connect

00:43:50.599 --> 00:43:51.039
with your audience.

00:43:51.079 --> 00:43:51.960
And by they, I mean me.

00:43:52.001 --> 00:43:52.621
It's my company.

00:43:52.760 --> 00:43:53.101
I do this.

00:43:53.121 --> 00:43:53.481
This is me.

00:43:54.521 --> 00:43:55.422
Just drop me an email,

00:43:55.463 --> 00:43:56.864
jimmy at ptpinecast.com.

00:43:56.903 --> 00:43:58.784
I help APTA sections and academies do

00:43:58.804 --> 00:43:59.005
this.

00:43:59.065 --> 00:44:00.286
I help private practices do this.

00:44:00.666 --> 00:44:02.248
We just help you make your good work

00:44:02.628 --> 00:44:03.007
well known.

00:44:03.909 --> 00:44:06.090
So your parting shot, last chance,

00:44:06.369 --> 00:44:08.030
mic drop moment, soapbox statement.

00:44:08.791 --> 00:44:10.132
What do you want your parting shot to

00:44:10.152 --> 00:44:10.233
be?

00:44:11.027 --> 00:44:12.369
I want to loop back to something you

00:44:12.389 --> 00:44:13.831
said at the start of the podcast when

00:44:13.851 --> 00:44:15.634
you were talking about the tangled rope.

00:44:15.653 --> 00:44:17.275
Oh, yeah.

00:44:27.429 --> 00:44:28.911
is what moves patients forward.

00:44:29.251 --> 00:44:30.690
And so if we're looking at a tangled

00:44:30.751 --> 00:44:32.871
rope and it's a small, simple knot,

00:44:33.431 --> 00:44:35.472
many of us feel really comfortable using

00:44:35.512 --> 00:44:37.833
our basic skills to tease that apart and

00:44:37.914 --> 00:44:38.713
untangle the rope.

00:44:39.393 --> 00:44:41.074
And a complex patient is not any

00:44:41.114 --> 00:44:41.695
different.

00:44:41.914 --> 00:44:43.335
It is a larger knot.

00:44:44.416 --> 00:44:46.137
It is the same basic approaches.

00:44:46.197 --> 00:44:47.777
It's the same humanity.

00:44:48.358 --> 00:44:50.657
It's the same skills that we have been

00:44:50.717 --> 00:44:53.139
taught since we were in PT school.

00:44:53.820 --> 00:44:54.800
It takes longer.

00:44:56.141 --> 00:44:57.302
which is what makes us nervous.

00:44:57.342 --> 00:44:59.242
And sometimes we have to have people help

00:44:59.322 --> 00:45:01.844
us hold the rope up while we're teasing

00:45:01.884 --> 00:45:02.384
it apart.

00:45:02.445 --> 00:45:04.346
But we do it the same way.

00:45:05.146 --> 00:45:09.268
So try not to make really complex things

00:45:09.467 --> 00:45:10.168
complex.

00:45:10.208 --> 00:45:11.670
Find the simplicity in them.

00:45:12.650 --> 00:45:14.550
Use your training and what you've learned

00:45:14.590 --> 00:45:15.110
to do.

00:45:15.672 --> 00:45:19.594
It just may take longer.

00:45:19.634 --> 00:45:20.313
Mike drop.

00:45:20.795 --> 00:45:21.875
Boom.

00:45:21.934 --> 00:45:23.376
Faith Stokes, we'll see at CSM.

00:45:23.416 --> 00:45:24.416
I'm going to be there.

00:45:25.358 --> 00:45:26.519
I'm going to be doing something ridiculous

00:45:26.559 --> 00:45:26.960
probably,

00:45:27.019 --> 00:45:29.161
but maybe we'll recreate like where we met

00:45:29.222 --> 00:45:30.521
because it'll be the same venue.

00:45:30.541 --> 00:45:31.302
We'll try to figure it out.

00:45:31.322 --> 00:45:32.063
That's exciting.

00:45:32.503 --> 00:45:36.445
And we'll take a selfie for ten years

00:45:36.585 --> 00:45:37.266
under the influence.

00:45:37.286 --> 00:45:39.228
That's a decade under the influence is

00:45:39.248 --> 00:45:39.827
what the podcast is.

00:45:39.847 --> 00:45:41.088
That sounds fantastic.

00:45:41.108 --> 00:45:42.969
Let's do that.

00:45:42.989 --> 00:45:43.951
FaceDokes, appreciate the time.

00:45:43.971 --> 00:45:44.510
Thanks for doing this.

00:45:45.231 --> 00:45:45.771
Absolutely.

00:45:45.811 --> 00:45:46.391
Have a great day.