Stories That Move
We've been dreaming about this for a long time... and now it's finally here!
Get a first look at DreamOn Studio's brand new podcast, Stories That Move!
When we create videos for our clients, there's often incredibly rich narrative that we can't include in the final cut. Being behind the scenes, we're fortunate to hear the depth and full context behind each story.
So in this podcast, we want to pull back the curtain and allow you to experience the extraordinary stories of extraordinary people we've been honored to connect with.
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Stories That Move
Dr. Michael Tsangaris | The Healing Power of Listening
Join us for an insightful conversation with Dr. Michael Tsangaris, a leading pediatric pulmonologist from Riley Hospital for Children, who opens up about his remarkable journey from facing medical school rejection to becoming a specialist in pediatric lung diseases. Dr. Tsangaris shares how his initial interest in orthopedic surgery evolved into a passion for pediatric pulmonology, sparked by his experiences in the emergency room. His story is one of resilience and dedication, offering a unique perspective on overcoming setbacks and the power of persistence.
We delve into the art and science of listening in medicine, a skill he has mastered to improve both patient care and personal fulfillment. Discover how investing time to truly understand a patient's story results in more effective treatment plans, especially in complex cases involving anxiety. The conversation sheds light on the systemic constraints healthcare providers face and the importance of empathy, highlighting the invaluable role of mental health resources for the next generation of medical professionals.
Finally, explore the profound impact of anxiety on physical health, illustrated by poignant stories from Dr. Tsangaris' practice. As mental health demands soar, particularly for children, we examine the link between anxiety and physical symptoms. Dr. Tsangaris shares practical advice for managing anxiety and fostering empathy, emphasizing the importance of listening in a noisy world. This episode is a powerful reminder that attentive listening and empathy are crucial in navigating today's medical and emotional challenges.
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I'm hopeful that the stigma attached to mental health issues goes away and the realization of the link between those mental health issues and physical health. Because the physical health, you know, it's the physical symptoms that keep people in the revolving door of the medical system. I think if we could identify really some root, some significant contributors, perhaps even a root cause of those physical symptoms and address that, I mean quality of life for the patient becomes significantly better.
Speaker 2:Hey everyone, welcome to Stories that Move. I'm your host, matt Duhl, alongside my co-host, mason Geiger, here at Dreamont Studios.
Speaker 3:Today we are so excited to welcome Dr Michael Sangeris, a dedicated pediatric pulmonologist from Riley Hospital for Children and a professor at Indiana University School of Medicine.
Speaker 2:Dr Sangaris has a profound impact on young lives, dealing with complex breathing issues. Today he'll share his journey with us, from his early days to his influential role in pediatric health care and breakthroughs he has made with patients by developing a skill that has been a game changer in his practice.
Speaker 3:An accomplished and well-loved figure in his field. Dr Sangaris' standout trait among his patients and their parents is his exceptional ability to listen. Today, he humbly connects his medical expertise with his passion for helping children, and this episode is filled with heartfelt stories and valuable lessons.
Speaker 2:So, without further ado, let's welcome Dr Michael Sangueras to Stories that Move. Welcome back to Stories that Move, brought to you by DreamOn Studios. I'm your host, matt Duhl, with me, as always, my co-host, mason Geiger. How are we doing this morning? Doing pretty good.
Speaker 3:How are you? I'm doing pretty good.
Speaker 2:Good.
Speaker 3:Coming off a little stomach bug, but I'm excited for today's conversation. Well, hopefully today makes you feel better.
Speaker 2:Yes, and we have the right person in the house to help us feel better at least. So we have with us today a really special guest. So excited to talk to him, Dr Michael Sangaris. Dr Sangaris, thank you so much for being here with us today.
Speaker 1:Thank you, guys. I appreciate very much the invitation.
Speaker 2:Yeah, much for being here with us today. Thank you, guys. I appreciate very much the invitation. Yeah, so we got to meet Dr Sangaris a couple months ago and hear a little bit of his story, what he does. He's a pediatric pulmonologist Did I say that right, correct, Okay At Riley Hospital for Children, and he's also a professor of clinical pediatrics with Indiana University School of Medicine. Yeah, so just excited to dive in today. So with that intro, tell everybody a little bit about yourself, who you are, what you do, what that pediatric pulmonologist means.
Speaker 1:Thank you. I was school at IU in Gary and then it was at that point in my life that I became interested in medicine and finished my undergraduate degree at IU and then applied to the IU School of Medicine where, unfortunately, I was rejected the first time I applied. And so now I had a year to think about what I wanted to do. I clearly wanted to reapply and in the meantime I worked as an orderly in an emergency room in downtown Gary, indiana, just really to sort of be in the medical environment, and it was a very rewarding experience. And I applied again to the School of Medicine and so the second time I actually got accepted as an alternate, so sort of by the skin of my teeth, and then I was assigned to go to the Evansville Center of Medical Education for the School of Medicine. So I lived in Gary, I was assigned to Evansville about as far away from home as you can get from Gary and I did my first year of medical school in Evansville and then finished my medical degree in Indianapolis IU School of Medicine at the main campus, my medical degree in Indianapolis IU School of Medicine at the main campus, and did a residency in pediatrics. And actually when I went into medical school I wanted to be an orthopedic surgeon. My experience in the emergency room we got hung around a lot of orthopedic surgeons and trauma I thought this was pretty cool. And then when it came time as a student to do orthopedic clerkships, uh I thought you know, the surgery is fascinating. But uh, it just for some reason it just didn't click with me.
Speaker 1:And then I started doing my rotations at the children's hospital at Riley and that that definitely clicked. Um, and so I clicked and the kids with lung diseases tended to. I really sort of tended to really enjoy taking care of them. And so when I finished my general pediatric residency I stayed on for another three years to do a fellowship to specialize as a pulmonologist in pediatric pulmonology, and that finished in 1989, and I've been on the faculty of the School of Medicine since 1989. And I do 100% service, if you will patient care, we do teaching. We seem to almost always have a learner of some sort, whether a junior medical student, fourth-year medical student, sometimes a resident with us in the office. And so here we are. Here we are.
Speaker 2:Yeah, okay. So for those of us in the room who are a little bit slower me, pulmonologist, what is that?
Speaker 1:I'm assuming practice of you said lungs, lung diseases, lung diseases in children and the most common thing we see by far is asthma. We also will see a lot of cystic fibrosis patients and newborn graduates NICU graduates, as we call it. These are babies that were born prematurely and with underdeveloped lungs and once they graduate, if you will, in our discharge from the newborn ICU, they tend to have varying degrees of lung problems for several years of their you know the next few years, so we end up taking care of them in the office and the lung disease of prematurity. So those are the between the asthma my practice is by far asthma and the newborn graduates, the NICU graduates, yeah.
Speaker 3:Yeah, how have you seen so in the years of practice, like asthma, has it gone up, come down, like with technology, like what? What are some of the things you've seen change over the last couple of decades?
Speaker 1:Well, what we've seen change for the negative, I think is air quality. Environmental air quality issues tend to be a problem for a lot of kids with asthma, particularly in urban areas. On the other side of the ledger, the medications work. If you take them, they will work, and so one of our biggest challenges is really keeping kids and their parents in tune with preventative care rather than crisis management. I mean, we're always trying to emphasize the need to take your medicine on a daily basis, even though you feel great, because it keeps you from getting sick, and so the concept of preventative care sometimes doesn't click. The medications are wonderful I mean that would probably be the biggest advance and getting kids to take them is another thing and a lot of, basically, things that we've become much more mindful of over the years are what are called social determinants of health, and we as physicians can only control really what happens in our exam room. Once that patient and family leave the exam room back into their life, then sometimes life takes over and taking their medication is not the top priority. Things like food insecurity and housing insecurity and you know we're becoming much more mindful of that and trying to address that, those issues, trying to first identify those issues. Sometimes that's a challenge too. A physician frequently is not aware of those until you start asking some questions. And once you ask the questions, it's amazing what you hear. And that's sort of what catalyzed my interest in listening to stories, because patients have stories to tell. Everybody has a story to tell, and one of the things I always emphasize.
Speaker 1:To the medical students that are with me I say look, if you forget everything else you saw today and everything that we talked about today, remember this. If you let the patient talk long enough, they'll tell you exactly what the diagnosis is. So you have to let them talk. And because every patient and the kids that we see most of the time come in with the moms. So and the mom is the only person on the planet that knows this kid and she's got all the hundred pieces of the kid's jigsaw puzzle in her head and her job is really not to put the picture together. That's our job, but the only way we can get that picture is to get the pieces. Well, how do you do that? You ask questions and then you listen, because every answer is pieces, and the more pieces you get of that hundred piece puzzle, the more clearer, the picture becomes um, so, and you don't even need all hundred pieces. You know you can get most of those pieces and you start to get the picture. But you have to ask the question and then listen.
Speaker 1:I don't see how anybody makes a diagnosis on anything without the story. The history is crucial and what I find amazing really is how often we hear, at the end of an initial visit, the mom will say stuff like thank you for listening. Nobody's ever listened to me before and I'm thinking thank you for your kind words. Then, on the other hand, it aggravates me. I say well, if nobody's listening, what are they doing? You know what are they doing if they're not listening. And to me, one of the other things back to your question, mason, was you know the changes over time, over the years. And one thing that has just hit me every day and I'm not exaggerating when I say this is that there's not a day that goes by that we don't see a kid that comes in with some sort of breathing issue that is anxiety-related.
Speaker 2:Not a day.
Speaker 1:And sometimes these kids have underlying asthma. There are some physical issues with their lungs that are being aggravated by anxiety, or their lungs are totally healthy but they can't breathe and they have chronic cough and chest pain and difficulty catching their breath because of straight-up anxiety. When you hear their history, it's evident fairly early on in the history that their lungs are healthy. Evident fairly soon, fairly early on in the history, that their lungs are healthy. Which then prompts me to ask a little bit different line of questioning, and I preface my line of questioning as follows. I say look, I'm going to ask you some questions that probably nobody's asked you before. And here's why Because there's not a day that goes by that we don't see a kid that comes in with anxiety-related symptoms. And that's when it becomes very interesting, because a lot of times, even when I say that, the kid and the parent will look at each other and go, you know, like, okay, we've hit on something here, and so then I go through, then I tell the parent.
Speaker 1:I said, look, this has been going on for about four or five years now. The pandemic had a lot to do with it in terms of bringing the anxiety piece to the surface. But I said, when we ask the kids what are the things in their life that stresses them out, we tend to hear the same things over and over again, to the point where I've learned to lump them into a couple of buckets stuff at home and stuff at school. So I said I want to go through each things in each bucket and tell me if anything pertains to your particular story. So under the stuff at home we talk about, you know, the child's perception of ill health in a loved one, somebody close to them parent, grandparent, sibling maybe a minor medical issue, but it's something that's talked about around the house and the kid hears the conversation and starts to run with it in their mind that something really bad is going on Loss of a loved one, loss of a pet, or having to relocate a pet, a peer, a friend, somebody the kid hangs out with that's dealing with their own significant medical or social issues, normal family day-to-day stuff, kid-kid conflict, parent-kid conflict, parent-parent conflict, job-related issues, financial issues, relationship-related issues that's the stuff at home and then the stuff at school top on the list these days.
Speaker 1:Back to your question is the kid with the breathing issues being victimized, teased or bullied in school, either face-to-face or social media, or both. To face or social media, or both. The kid perceives an unfair or mean teacher or can't stand math or hate science or something in their schoolwork. That's frustrating. The student athletes are a totally separate group. I mean the performance anxiety that they put so much pressure on themselves to perform perfectly on the athletic field and if they do something wrong, that's it. Perfectly on the athletic field, and if they do something wrong, that's it. The wheels fall off and it can affect them in very interesting ways.
Speaker 1:I mean, in our world it's breathing, and so the point I want to make is those are frequently it's rare that when I go through the bucket stuff that the family will say no, we're cool, everything's good. I mean, nothing really resonates. That's unusual. It's almost always that something. And again you can tell as you go down the list they'll look at each other and then the mom will look at the kid. Well, you want to tell them and the kid will no, why don't you tell them? And so then we hear the stories you hear you can't make up, I mean in terms of what's going on in the lives of these kids that clearly is affecting the way they breathe.
Speaker 2:Yeah, no, you unpacked a lot there and I want to get into some of the anxiety parts and hear some of the stories and pieces, but I want to, yeah, dive into just the listening piece just a little bit, because I think just that was one of the things when we first met you that just drew us to you of not to throw all your colleagues under the bus and medical industry but it's not an industry known for listening right, and, like you said, as people are coming out of your office they're saying thank you for listening.
Speaker 2:And I would say, by and large, in my own medical experiences, you know, and with my kids, with myself, with family it's and again I have, I have several family members who are in medical profession, so huge respect for it, but it doesn't feel like the system is built around just that bedside manner and care and connecting with humans and having the time and the margin to listen.
Speaker 2:It feels like it's a very systematic of we got to get in, we got to get out. There's all of these regulations and things, so what was it for you that had you lean in and say hold on a second. We need to ask some questions, we need to sit and listen.
Speaker 1:Well, great question, your comment about not wanting to throw colleagues under the bus. I appreciate that and it's absolutely not my intention. In fact, frequently when I am thanked for listening.
Speaker 1:I'll usually reply by saying you know, your primary care doctor knows all the stuff we just talked about, but they, on a typical day, will see two to three times as many patients in a day as I do. So do the math for them to have the kind of conversation we just had. Okay, which, if I'm in their shoes as a primary care doctor, I would be very frustrated because I know there's a root cause for what brings this kid to my office, but I can't take a dive into it. I just don't have the time. You're right, the system is not set up. It's not conducive to listening to stories and so now, so I have a little bit of an advantage as a specialist. I have more time with each patient. I also a huge advantage that I have as a specialist is, by the time a kid gets to me, I've got records I can review, so I sort of know the journey they took before they got to me They've had a few steps before.
Speaker 1:Exactly. So I know what's been done, I know what's not been done, I know what's been tried and what's worked and what's not worked. So it's not like we have to rehash all that stuff and we can sort of get a running start into. You know the crux of the matter here, this which typically leads to the discussions about the anxiety, but your point is well taken. I mean, it's not a system that's conducive to listening and it's very frustrating for the provider as well as for the patient, because it's all about listening and that's the most rewarding thing, I mean when you. It's honestly, it's very rewarding when somebody says thank you for listening. Nobody's ever listened.
Speaker 3:I really appreciate the time you know, and we hear this every day.
Speaker 1:I mean every day. We heard it yesterday a couple of times, you know. So it's, this is not. Uh, this is a daily thing and um, and it's top of mind for parents. I mean you, you'd like to think, oh no, you know, maybe you just had a bad day or whatever, didn't feel like no, you hear this over and over again.
Speaker 2:I mean this this lack of listening is a thing. Okay, it's, it's. It's not something that you know, it's not a one-off, it's, we hear it all the time. Yeah, so for you, as you are also, um, you know, a professor through IU and you're working with, you know, students who are coming up, how are you imparting some of that to the next generation?
Speaker 1:Well, when they're with me, basically they'll shadow me during the day and I'll always tell them. At some point during the day I mentioned a few minutes ago, I said look, the most important thing I want you to take out of this day is the value of listening. Okay.
Speaker 1:And usually by the end of the day, because not a day goes by. They've heard one or two pretty compelling stories, okay, from patients that are coming in for the first time with chronic respiratory problems. And the student is hearing the approach I take with look, I'm going to ask you a little different set of questions, and I think that. So that's what I tell the student. Just, this is the one thing you want to take away. If you let the patient talk long enough, they'll tell you what the diagnosis is, and I said I don't know.
Speaker 1:I tell them, I don't know what field you want to go into, but I can't imagine, whatever you do with your career, you have to listen, okay, because it's not only you're really getting to the crux of the matter and helping that patient in a very real way, but it's physician satisfaction as well, it's rewarding for you, for you, and it sort of you know, it sort of negates a lot of the burnout issues and the spinning your wheels issue, which is a big deal in medicine these days. And then you have a situation where you really think you made a difference in somebody's life and that sort of wipes out all the negative stuff that happened that day. You know, as if you can come away with one or two positive things. So it's a physician satisfaction. It's clearly a patient satisfaction issue.
Speaker 3:So I thought I'd love to dive back in a little bit into your history of like. When did you know? Kind of like growing up, like we're going to rewind all the way back.
Speaker 1:Yeah.
Speaker 3:That it was like healthcare, like you wanted to be a doctor.
Speaker 1:Probably not until late high school, undergraduate, college, for sure. Some of the courses I took were just in physiology, in particular the way the body works. It's fascinating the way the body defends itself against germs and the way it accommodates stressful situations. I mean, it's just the way the body works is pretty amazing. It's sort of miraculous really. Yeah, it really is. And so I'm thinking well, this is pretty cool stuff, and so that was really sort of the spark, the first step.
Speaker 3:So whenever before you knew you wanted to be a doctor, then what was kind of your career track before that?
Speaker 1:Honestly, you know I and this is going to sound corny but I don't remember ever wanting to be anything other than a doctor, even as a little kid. I mean, as you know you're, you know grade school and middle school and you got to study hard. You kind of think, you know, if I want to be a doctor, I got to get good grades and so you're pounding away, grinding away, grinding away. So that was sort of me, you know is. And then you get to medical school and you have their colleagues, your other classmates. You know they're getting A's on every test and they go oh man, that was the hardest test ever, and of course they get an A. You know they're getting A's on every test and they go oh man, that was the hardest test ever, and of course they get an A.
Speaker 1:You know I'm sitting there staying up all night studying and come back, you know, with, you know, with a much lower grade than an A. So I always, in fact I'll tell the students sometimes that are they tend to be driven, I mean, they didn't get to where they're at by being, by being lazy, and said look, p equals MD. Okay, you don't have to knock it out of the park every day. It may be different in law school, I don't know, but in medical school, well, and I think I turned out okay and I was rejected once and got in as an alternate, literally by the skin of my teeth, and I got in because somebody that was accepted dropped out. So they come back to the alternate list and pull you off that list and now you have a spot. And so you know, and I understand that the selection process is very it's difficult. I mean, I don't know how you gauge somebody's ability to do medicine in a 15-minute interview, but so you know, I guess I turned out all right.
Speaker 2:So so, with that first rejection, where, where did you go mentally and emotionally with it of like, well, now, what am I?
Speaker 1:going to do? Yeah, well, exactly because I had I had an undergraduate degree in biology, it's not particularly marketable and I'm thinking, I mean, I still find medicine fascinating. This is what I want to do with my life, and so I guess that the next logical thing was to try to get a job in a hospital someplace, to be around medicine and get a chance to talk to some doctors about my experience getting rejected, and some of them they could relate to that, you know, and they were very encouraging and supportive and that helped. I mean, that helped. I wasn't hearing stuff like you know, what are you doing or are you crazy? I mean, no, they were. You know, keep at it, keep at it, you know you'll get it, and so that helped.
Speaker 3:That was very helpful as well. That's great. So, through through that journey, where did like the idea of like listening and identifying the story like really come from? Yeah, it.
Speaker 1:It really. It comes from the fundamental desire to get the right diagnosis. Okay, I mean, these, these patients are coming to you because something's wrong, all right, and your job is to first identify what the problem is, which is really the diagnosis, and then create some sort of solution to the problem, a treatment plan. So if you don't have the right diagnosis, whatever treatment plan you think you're creating is not going to work because you're aiming at the wrong target. So you're trying to figure out exactly what the target is here, which is the diagnosis. And so one way I look at it is that I could sort of knee-jerk this and say oh, you know what it kind of sounds like. You have asthma, they tried this medicine, didn't work. Let's try this medicine and I'll see you in a couple of months. It's not going to work. And so now you have a dissatisfied patient who's going to come. If they come back in a couple of months, will be mad because what I did didn't work. And so now they're frustrated, they're not happy with me. Now I have to pull another rabbit out of my hat plan B, plan C and so you keep sort of churning this, and this is where it becomes frustrating and the patient gets mad. The physician is mad. So that's the one scenario.
Speaker 1:The other is to take the time up front, devote the time up front to hit the, to determine what the target is. Because you're going to spend this time either now up front or on the back end. It's your choice, okay. And it's going to be a lot more frustrating use of your time on the back end. If you don't do it right on the front end, so spend the time now. Frustrating use of your time on the back end. If you don't do it right on the front end, so spend the time now. And it becomes.
Speaker 1:All these follow-up visits become way easier if you invest the time at the first visit rather than you know, shortchange the first visit and shortchange the second visit and third visit, and eventually they're lost to your follow-up. They don't come back and then so what have you done? Now? You've still got this kid out there that something's wrong and they're floating around out there and they're not coming back to you, and you know, and they leave with a bad experience and this is the. You know that nobody ever listened, and so it's an investment really for me. I mean, I'm going to spend the time. One way or the other, spend it up front. Okay, it pays off in the end big time.
Speaker 2:I know a big part of your practice and you alluded to it earlier is, you know, in some of the patients that you see is unpacking more of what's going on in life because you have found anxiety to be, a big part of that. When did that start for you? When did that sort of aha moment click in? When did that start for you? When did that sort of aha moment click?
Speaker 1:in. You know the pandemic really. So you're talking about 2020, when people were scared you know everybody's masked up People were scared to go out of their house, people were scared to come to the doctor's office, so these kids would come in and everybody on the planet had been affected literally by this germ, and the kids were. Interestingly enough, the experience in, generally speaking, in the pediatric world with COVID was a very, very different, much milder sort of experience than in the adults. Okay, what we were all seeing on TV every night, um, was not the rule in the pediatric world. It was, uh, uh, for reasons. It's interesting there my kids clearly got sick, but not on the scale like you were seeing with the adults. But these kids, every kid, knew of a family member, a friend, somebody who was affected by COVID and that person may have had a very bad outcome. That person may have died, and so the kid knows this and they're very aware. So if they start getting even a simple cold the bucket thing now they run with it in their head that something bad is really going to happen. I'm going to die, okay, because I saw that person who I know got COVID and they died. So this was really the beginning of it became very evident the role that anxiety was playing because of COVID. And so you can assure the child who's otherwise healthy kid, who really has tested positive for COVID but really never had any symptoms.
Speaker 1:A lot of these kids get tested and come up positive because another family member, an adult, felt got a cold or something. They got tested, they came up positive. So the whole family gets tested and so some of the kids will come up positive even though they had no symptoms. They only got tested because there was a family member. They got positive, but it was top-of-mind source of anxiety that something bad was going to happen. So reassuring them that you know what, you're good, okay, you're good, okay, you're good. I know there are bad stories out there. Clearly you're not in that boat, all right, and explain why. I mean, if you were in that boat we'd be seeing this, this and this. We're not seeing these things. So I get it that you're positive. I get it that you're worried about it, but it's, you're going to be okay, all right.
Speaker 1:And then, as time went on, I think in fact my bucket stuff, stuff at home, stuff at school, the pandemic was a bucket unto itself. Covid was a third bucket, all right, because everybody was worried about it and for a variety of different ways it impacted these kids with anxiety so they felt like they couldn't breathe. I mean, this is really, and when I tell them, I said, look, when you tell me you can't breathe, I believe you, I'm not telling you that you're you know. You don't know what you're talking about. I believe you. The question is, why? Okay, why do you feel like you can't breathe?
Speaker 1:And, and a lot of times there was no physical, you know they were healthy but they couldn't breathe because they were worried, you know. And breathing, in fact, the treatment really a lot of times for the anxiety-related breathing issues is relaxed breathing techniques. I mean sort of changing the way you breathe, some of the skills that you would learn in martial arts. Actually, you know you have to in order to do martial arts correctly. You have to learn how to breathe certain ways at certain times. Well, if you can learn how to control your breathing when you're getting anxious, that can really take the edge off of the anxiety significantly. And so that's really where the link between anxiety and physical symptoms for me, anyway in my office, became very evident is that the kids were super worried about their experience with COVID or a loved one's experience with COVID, and it affected them. Even though they really had no physical issues, they felt like they were sick.
Speaker 3:Wow For some of those kids who are coming in with those anxiety-driven symptoms. What are the next steps for them?
Speaker 1:One is recognizing the link between anxiety and those symptoms and in my world, again, as a lung doctor, it's going to be either shortness of breath or chest pain or coughing. In other specialties it might be palpitations in the cardiac specialty or headaches in the neurology specialty or headaches in the neurology special. So, identifying, making it clear the link between anxiety and the symptoms and reassuring them that they're not alone, and back to what I said a few minutes ago, there's not a day that goes by and I'll say stuff like and this is true, like you're the first kid I've seen today here we are talking about anxiety. I'm pretty sure that before the day's over we're going to hear another story like this. So you're not alone, you're in a boat with a bazillion kids. Okay, and I think that that just reassurance that they're not alone is very helpful for them. And then really the next step would be connecting them with a mental health professional, somebody, a talk therapist, to somebody who's trained to sort of probe and ask questions in a non-threatening way and get these kids to open up about some of the stuff that might be going on in their life that is causing their breathing symptoms and then not to eliminate the stress I mean, I don't know anybody that lives a stress-free life but to teach them ways to cope with it. Okay, and in fact I encourage the kids that if you can learn these techniques now, at your young age, you're like way ahead of the pack when you get older, because these exact same techniques will be useful to you in school, in college, in a job, in relationships, whatever you know part of your life that you know you pursue. You can learn how to sort of identify when you're going into this rabbit hole and learn and get good at the techniques of taking the edge off. You're miles ahead and this is the stuff that you can be taught. You know. This is what.
Speaker 1:And now the problem that we face is that the demand for this service is off the rails. There's not nearly enough people out there with the skill set the mental health professionals to service this population. So the wait time is forever to get in to see a therapist. The families are more than willing. They're thankful. Oh, great, I'm so glad my kid doesn't have asthma. Yeah, I'll be glad to see a therapist. Great, good luck, okay. So be patient, get yourself on some waiting list someplace and be prepared to wait. Okay, because the demand for the service and it's just indicative of how pervasive this problem is the mental health professionals are booked up for months.
Speaker 2:The first time we met, I remember you told us a story and we can cut this if you can't tell it. I know you've got to remove names and those sorts of things, keep it general. But I remember a story about a mom and a child who had been down a long road of trying to figure things out and she even, just on the way to your office, was pulling the car over on the side of the road several times out of fear that her child wasn't breathing. Can you share that with us?
Speaker 1:Absolutely Sure. Now, this actually was back, I think, in 2009,. This goes back a ways. This was the swine flu epidemic, Okay, when, again, the whole world was on edge because of swine flu and no vaccine, and so there was a child that I wasn't involved with their care. They were at the downtown, the main campus of Riley, in the intensive care unit and actually passed away because of swine flu. And this, as you might imagine, I mean that news went through this kid's school like wildfire. Imagine, I mean the that news went through this kid's school like wildfire.
Speaker 1:So a couple of months later, uh, I see a young, uh, young boy who comes in with a cough, a chronic cough of a couple of months duration and vigorous cough. I mean cough till he's throwing up and is debilitating him. He couldn't go to school and stuff. In fact, to your point, the mom said on the way just today, on the way to the office from my house, I had to pull over three times because he's coughing his head off in the back seat and I stopped the car to attend to him. And so that's the kind of thing we've been dealing with for the last three months, thing we've been dealing with for the last three months, and it became evident that this little guy was in the same school as this other kid who passed away, and so he was clearly very aware of what happened to his classmate. And so this kid gets a cold. You know this just starts out with a simple cold, starts coughing like I just described. That's going on for now two to three months, and so when it comes to the office, we go through the questions. We don't want to miss an underlying problem with asthma, pneumonia, bronchitis, so you know. So we ask the appropriate questions to sort of screen them for those problems. When those questions don't pan out, there's no asthma, bronchitis, pneumonia there. Then we start asking about anxiety. It became evident that this kid was worried that because he developed a cold soon after that other kid passed away, so he thought he was going to die. Okay, because that's what happened to that other little kid. And so we reassured him that he was healthy, that he is very unfortunate. What happened? Very sad, what happened to his classmate. He has a different story. Okay, you're not that kid, Um.
Speaker 1:And so we, we finished the visit and, and it was about lunchtime, so I finished the visit, I go down, get a little lunch I come back up to the office and this was in the day before we had electronic records, everything was still pen on paper. And I'm walking back to my office and my nurse hands me this kid's folder with a little sticky note. It says mom just called, he stopped coughing. And so I actually get choked up even I've told this story a thousand times and I always get choked up every time. And I stand in the hallway there with this kid's record and I go whoa, you know. So I put this, the chart, on my desk and a couple of days later I called the mom. I said I heard he stopped coughing. She goes yeah, he didn't cough once from on the way back to the house, from the office.
Speaker 1:On the way to the house I had to stop three times. This first time that I can remember that we could go someplace in the car and I didn't have to pull over because he's coughing his head off. I mean literally, if you can identify the anxiety, the link between anxiety and the symptoms, reassurance, literally. I mean the problem went away immediately. I mean immediately. So I'll never forget that story. But it's just, this is a very powerful force. But it's just, this is a very powerful force. You know what's going on up here has a huge influence on what happens everywhere else in your body. So, yeah, he stopped coughing. Didn't cough once the entire ride home, wow, yeah.
Speaker 2:That's amazing. So for you, as these last number of years, the mental health aspect, the anxiety aspect of what's going on with kids has just become more and more to the forefront. Yes, um, how do you carry that? Because you, you trained in a certain set of medicine a certain practice, and now you're connecting with kind of an entirely different field right yeah, no, I feel I've told parents because I I qualify.
Speaker 1:I said, look, I'm not a mental health professional, but I, I said the. I feel like I've been grandfathered into that field over the last two or three years because of how frequently we have encounters like what we're having today. The anxiety piece, and it's a thing I mean, and there actually is a growing body of evidence that is documenting the link between anxiety and inflammation in the body. Okay, and asthma can be thought of as just simply inflammation of a very specific part of the body your breathing, your bronchial tubes. But the point about anxiety being a trigger for inflammation, so you can have asthma which is inflamed bronchial tubes. You can be taking all your medicine perfectly, never miss a dose. You're into preventative care. You take your medicine by the book. If there's an anxiety trigger that's not been identified and managed, it's going to keep the asthma out of control. It's no different than allergy. Everybody intuitively knows well allergies, tobacco, smoke, viruses, I mean, these are sort of the classic triggers for asthma. Well, add on to that list anxiety, because the anxiety can trigger inflammation which, in a respiratory system, triggers the asthma. So I feel like, oh, and this just came to my mind to answer your question. Every now and then there'll be a kid that comes in with a chronic respiratory issue of some sort.
Speaker 1:I'll go through the discussion that I just outlined for you. You know the bucket stuff. Sure, At the. This has happened, I think, three times over the years, where at the end of the discussion, the parent will tell me that they themselves, when I do a social history and you know what do you do Tell me about your household. The parent is a clinical psychologist, and so they'll say that.
Speaker 1:And I go whoa? I said when were you going to tell me that? I said so, it's okay. So you've just heard my whole spiel here. All right, and you're a professional, this is your area. I said am I talking out of my head or what? They go no, absolutely not. In fact, they say this is the kind of thing we see in our practice all the time. This is my kid. I didn't want to sort of try to therapize my own kid. So here we are, I said, but in terms of but they say you're absolutely spot on. So I feel like I've been affirmed in a way, you know, sort of an honorary degree in mental health by mental health professionals, because this is what they see every day and it's just they didn't want to deal with it with their own kid, but so those were like whoa, and so that sort of gives me the affirmation that I think I'm on the right track here when I'm asking these kinds of questions.
Speaker 2:Yeah, yeah, received that validation for that. Yeah, that's amazing. So, as you think about your practice and your field, what are you hopeful for when you look towards the future?
Speaker 1:And the realization of the link between those mental health issues and physical health. Because the physical health.
Speaker 1:You know it's the physical symptoms that keep people in the revolving door of the medical system over and over and over again. Identify really some root, some significant contributors, perhaps even a root cause of those medical, of those physical symptoms, and address that. I mean quality of life for the patient becomes significantly better. They're very grateful. They quit accessing the medical system uselessly. The medical system is sort of unburdened. Okay, because it's no fun for the providers as well. Okay to be seeing the revolving door patient. So that's what I hope and really I think to achieve. That is, I guess, the realization that it's a problem. We're not making this up. The mental health issue is for real. It can affect the body in a variety of different ways and there's no stigma to it. Okay, in fact, the reassurance you're not alone. That's the point. You're not alone. All right, you're not alone.
Speaker 2:We hear stuff like this all the time. How are you seeing the next generation of students coming up, because, I mean again, there's generational differences in terms of just passion, areas, focuses, some of those things. Are you seeing hopeful things in terms of better listeners, some of those types of things?
Speaker 1:Yes, and actually along those lines, short answer to your question is yes, Think about this. So the students that we have, the medical students, it's very stressful being a medical student?
Speaker 2:Yeah sure.
Speaker 1:They're under a lot of pressure and they are, you know, they're not that much older than the kids we see in the office these days who we have these anxiety discussions with, okay, and they're in a very high pressure situation, okay, and a lot of pressure they put on themselves. It's not easy. The School of Medicine actually has done a very good job providing mental health services for the students free of charge, anonymous, and so I'll ask the students, because they hear these stories, so I'll you know during the day, and so I'll sort of relate it back to their own experience. I said so. You know, I understand the school has some pretty good mental health resources. They all agree.
Speaker 1:Yes, some of them have actually even told me that they've accessed those services themselves. So I sort of congratulate them. Good job, keep doing that, okay. So my point is, I think, in terms of empathy you know, now you're, there's a generation of students coming through the system, now that they themselves are mindful of the anxiety piece, they themselves have accessed resources to help them manage it I can't help but believe that's going to help them when they're they're now they're, you know, in charge of their patient's care and they can empathize, which I think is huge. It's huge if you can just empathize and walk in their shoes for a day or two, and they've done that. I think they're learning how to do that, so that's very, very good.
Speaker 3:It's really encouraging. You talked a little bit earlier on about some of the tangible like. Here are some easy things you can be doing to kind of help with some anxiety pieces. Could you share for our listeners out there what are some of those? Maybe, while they're say waiting to get in with a mental health provider, some things they can be doing to help manage some of these anxieties?
Speaker 1:Yeah, well, I talk about the benefit of relaxed breathing techniques. There are many books written about relaxed breathing techniques. A lot of this is based in yoga, and so books written by yogis can sometimes be very helpful in terms of teaching people the people, the kids how to do these relaxed breathing techniques there. Actually, there's a website that I have found very useful. I was told this by one of the clinical psychologist's parents that came in, because I will tell them look, you know your waiting list, I'm sure is a mile long. They agree. I said how can I find, how can I find therapists? So it's psychologytodaycom, it's all one word, psychologytodaycom, and you put in your zip code and what pops up is all of the mental health professionals in your zip code and their biographies and pictures and what their specialty is and do they take insurance and what they charge, and so that can be a quite helpful resource for people looking for counselors.
Speaker 1:The other thing I sometimes mention the kids that are going to public school. Particularly big public school systems may have a little bit of an advantage, because a lot of those systems have counselors in the schools and many times those counselors are licensed clinical social workers who are licensed to provide mental health therapy this is the group there in private practice. So many of these therapists are licensed clinical social workers in private practice. Well, the school systems employ them as well as counselors, and so I'll encourage the kids who are going to the you know, the public school systems to access that counselor and assure them that I'm pretty sure that that counselor you're not the only kid that that counselor is seeing for these types of issues. And so please, you know, take advantage of that. So I'll sort of try to steer them into what resources are available in their school system.
Speaker 2:Yeah, yeah, that's great. Now, I love what you're doing, so grateful for you and the work that you're doing, and I think that the things that you're talking about are just very human things and you know, I think we all could, yeah, just take a beat and a pause and just evaluate how are we, as listeners, in our day-to-day life and in the very noisy world that we live in, the very polarizing world that we live in, how much could we gain in just pausing to listen and to hear each other's?
Speaker 3:stories.
Speaker 2:And the realization that there's more going on behind the scenes than what we're seeing face-to-face. And so just taking that time of when we're interacting with our kids in the morning, when we are at work and we're having maybe a tense conversation, whatever the case may be, I think it's just if we could take on some of this mindset. I feel like we'd be a better place for it. So, yeah, I really, really appreciate that perspective a lot. As we wrap up here today, any parting words, any thoughts.
Speaker 1:Yeah, you know something I read recently that I wish I had come up with. But, as a lung doctor, we use stethoscopes a lot, right? And something I read is that you don't need a stethoscope to listen to the heart. Okay, and I thought, whoa, I wish I'd have thought of that. You don't need a stethoscope to listen to the heart. So everything we're talking about here is really listening to the heart, and so, literally, you know you're listening to the heart, but figuratively, you don't need the stethoscope to listen to the heart. You just need, you just need your ears and listen.
Speaker 2:So that's worth the price of admission right there, that's good stuff. Well, thank you so much for your time. Thank you for what you do, um, for you know people out there who are maybe jaded and cynical about medical community. You shine a very bright ray of hope into that. So thank you for the way that you do what you do and we appreciate your time here today.
Speaker 1:Thank you very much. It was a pleasure being here. Thank you.
Speaker 2:Awesome. Well, thank you everybody for listening and watching along to Stories that Move and we look forward to seeing you next time. Thanks so much. Thank you for joining us for this episode of Stories that Move brought to you by Dream On Studios.
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Speaker 3:Yeah, we believe every story has the potential to inspire, to move and to make a difference.
Speaker 2:Let's make yours heard Until next time keep moving forward and keep telling those stories that matter.
Speaker 3:Take care, everyone. We'll see you next time on Stories that Move.