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Hosted by Dr. Val Civelli, White Coat Black Sheep explores physiology, functional medicine, and the medical questions most people are told not to ask.
This is where evidence meets curiosity, where dogma gets uncomfortable, and where real world medicine takes priority over headlines.
From understanding your lab work to debunking hormone myths, medication misconceptions, and optimization strategies, this podcast helps you understand what is actually happening inside your body.
If you care about health and think there might be a better way to practice medicine, you’re in the right place.
Welcome to White Coat, Black Sheep, where science gets curious and dogma
gets uncomfortable.
I'm Dr. Civelli, and today I have Tim Pace with me.
We're going to talk about physiology, evidence, and real-world
medicine, plus all the questions you're not supposed to ask but
probably should.
Mm-hmm.
If you care about health and think there's a better way, welcome to our show.
Absolutely.
Thank you so much for coming on today.
No, thanks for having me. It's great to be here.
I am just so excited to have you because there's been so much time
that's passed since
we were working in Bakersfield, seeing our
elderly sweet patients.
They're lovely.
They're so lovely.
It's a joy.
And they think we're so young because they're just really much older.
They are. I feel so old, and they think I'm so young, and I'm just like, "Ugh."
We're young pups to them.
Sometimes I'm dying inside, but there's
a few lively ones out there. I got to say, I had a dancer this morning.
Did you?
Yeah, you don't see that very often. I think she was 96.
I know. That's my grandma.
Yeah. She was like cruising down the hallway, ready for dance class.
So-
I wonder what her lifestyle was.
It's got to be something amazing. She
probably has some secrets that she doesn't want to share.
Right?
I think it's movement. Movement is the key.
She's dancing. She's still dancing.
She's a mover and groover, yeah.
Man.
Absolutely.
I think that's definitely the answer.
It's got to be.
Well, okay. So you are a doctoral candidate for
2027.
Yes.
And you're almost through your first semester.
How's it going?
Oh.
Tell us, what is- ... a doctorate of lifestyle medicine?
So lifestyle medicine-
I love it
... is basically whenever you look at it, there's six
pillars. So you've got adequate nutrition, you've
got avoiding risky substances, restorative
sleep,
maintaining physical activity, and my two favorite ones are
stress management-
Oh
... and social connectedness.
Oh my gosh.
So those are the ones. And so when you look at this from the
outside, it's like
these are the things you're supposed to be doing that people-
Yeah
... already know about. They're like, "Well, why is that a field of medicine?" But
certainly-
Yeah
... it goes way deeper because-
Because we're not good at it, people. That's why.
Exactly. People don't do it.
Look at me.
And yeah.
I've been so stressed.
Yes.
I had to deep breathe-
Mm-hmm
... literally before we started this session.
You saw it, and you're like, "You're good." I feel stressed.
Yes. And you know, it's the hardest thing to
implement these things.
It is.
And so from a lifestyle medicine standpoint, you
interview people, you listen to them.
Yeah.
There's these long forms that you fill out that you don't see on a regular medical
intake, and you find out where people are on their human connection side.
Wow.
Where are they at physically, but also mentally?
What kind of barriers do they have in their life?
And then you start to address those.
You got to find out what stage people are at.
Do they want to change? Are they like, "Oh, no. I'm not changing.
I'm not here." Are they at this pre-contemplation stage-
Yeah
... or are they motivated-
Mm-hmm
... and they're at a further stage?
And so you actually give them, it's
non-medical prescriptions for activities to do.
They're called fit prescriptions.
I love it.
F-I-T-T. So frequency, intensity, time, and
these are the things to help people move through the stages
to ultimately make this a lifestyle, a habit.
And it's harder than you think. I mean, really.
No, it is so hard. And I don't know really what's more
challenging right now.
Because to be successful, to be fit,
to have the look that you want, to have-
Mm
... the life that you want, to,
I don't know, the family, the vacations,
I mean, come on.
Yes. So it's the small changes that you
make. You're not flooding somebody with-
Thank you
... you're not just, somebody's like, "I want to get into exercise," and you're
like, "I'm going to prescribe you a marathon a week," or whatever.
You got to examine what their lifestyle-
I would fail
... entails. And so, it's interesting, when you first
come in as a patient, you do this lifestyle medicine long form, and it's
asking you all these questions about how you perceive things.
And then you score it.
Wow.
And the biggest
surprise for me when I did it, and went back and reviewed it, is I found out
I had anxiety. I scored off the charts on anxiety and
stress.
You mentioned that.
Yes. I knew I was stressed. And you're like, "Oh, life is stressful.
It's this-"
It's so hard.
I never considered anxiety as a thing.
And those-
Because that's the diagnosis.
Absolutely.
That changes it.
Yeah. And it's just how you perceive a certain situation, how you feel about it,
and then it's-
You just gave me an anxiety breath. Did you see that?
I just got anxiety for you.
Yes.
Oh my gosh.
But I think the first step is recognizing it, right?
Yeah.
And then you can address the things, and-
I'm ignoring mine.
Oh, yes.
I'm not ready.
Well, it's really difficult because the stats are
astounding how many people are so stressed out-
Yeah
... over work, social media, life in general,
responsibilities, and it builds up.
And then-
Yeah
... as you know, there's these
detrimental effects-
Yeah
... physically-
Yeah
... chemically in your body from stress.
Predictably.
Right.
Predictable health problems.
Yeah. So you got to find some interventions there before it gets out of hand
and leads to
psychosis or depression or-
I don't want that.
Yes.
I don't want down there either.
Or total burnout.
I don't need that one.
Oh, yeah. Because we've experienced burnout before.
Oh my goodness.
There's nothing that is-Worse than
just sitting there thinking there's nothing I can do.
And then you just isolate, right?
Yeah.
You're just like, "I don't want to hear anybody.
I don't want to hear anything." And then you just crawl in a corner.
Yeah.
So, you-
And then nothing happens for you in that corner.
Exactly. Yeah.
You're just hiding from everything.
The thing in the corner-
Which taking your time can be great, but you want to do it in a
healthy way, right?
No change has happened while you're in your corner.
No. You just put off all your problems and let them build up.
So,
yeah. It's very interesting, and it's cool to see
little techniques that you can throw in here and there that can make a big
difference.
I love it. Well, I do hope that throughout our entire session, that
you do throw some of those little techniques.
I am going to teach you a very easy one.
Please.
And so, when you're ready, we can do it.
Mm-hmm.
Okay.
Okay. So, before we learn how to fix anything,
you acknowledge that I have anxiety, right?
Because you did,
I guess, a questionnaire.
Yes.
So, there's been a lot of different talks even especially about depression, about
how we poorly diagnose it, and how we are using these
old-school techniques to treat it with SSRIs or whatever.
But really, we don't have any other tools.
It is a subjective assessment, but look at what it did for
you, right?
Yes. Absolutely.
Questions that request you as the
person taking that to look inside, stop
what you're doing, and to just
read, "Do I actually have this?"
It's weird. It's a different experience.
It is. And that's one of the big rules of the American College of Lifestyle
Medicine. It's they really hold their providers to
living the lifestyle.
That's the phase I'm in, so I guess I'm-
Yes.
Yeah.
It's just like you go into your physician and them preaching to you about
losing weight if they're overweight, or them preaching to you about stress if
they're like a total stress ball. And so it's like,
you've got to live the life.
Yeah.
And for me, I think it's been a huge therapy session-
Yeah
... going through.
I love that for you.
Absolutely.
So it's fun?
I'm not going to say school's fun, because there's a significant amount of
writing.
Okay.
I think for people who love writing, that might be super
fun for them. I'm more of a talker, as you know.
Just
get it flowing, and we'll sit there and talk forever. I hate texting.
I hate-
Yeah
... any form of written communication.
Interesting.
And this is a lot of writing. And-
Are your thumbs slow? You think maybe that's part of it?
Or as a guy, maybe your thumbs are big?
Thumbs are slow.
Show me your thumbs.
I
think I have average thumbs, but
basically I get around
it.
Mm.
Like if I'm writing a paper, I have it on dictate mode.
Yeah.
And I'll just sit there and talk about the whole thing, and write the paper, and
then go back and fix all that.
It's like Microsoft Word?
Yes.
Okay.
Yeah.
Whenever I was in my paper-writing era, that feature didn't work.
And so it was like- ... your voice tech's gone really
wrong. It just is so bad. I'm just like, "You are a
useless feature."
It is. I think it's gotten better.
Good.
It does a decent job. And-
Okay
... yes.
Yeah.
There's room for improvement, though, because it'll still put some
weird things in there.
Still does.
You can't just let it fly without proofreading it, that's for sure.
You could definitely go down a little wrong road there. So.
Oh my gosh.
Well, okay. Are we any steps closer to the
farm? Because I know that's on the list of the future, like wellness ventures.
Yes. So, that's the mission.
As you well know, I've ventured out to
Idaho looking around for this perfect farm for the miniature donkeys and
alpacas, and all the fuzzy little things.
Which I love it.
Yeah.
It's such therapeutic intervention.
Exactly.
I think that would work for me.
Yeah. And it's much easier-
They're like fluffy, innocent, sweet, can't talk.
Absolutely. That's the key there, can't talk.
You just come home to your animals. They just love to see you.
They run to the fence. They're super happy.
Yeah.
Which interestingly enough, we talk about that,
biochemically for us, for humans, and for
dogs even. They did a study on the release of oxytocin by petting your
dog-
Oh
... and the release of oxytocin in the dog itself coming up- ...
and freaking out. Theirs is way higher.
They're way happier than we are.
Yes.
So they just get-
That's why we're so bonded.
Yeah. That's the thing.
It's amazing.
Little Jax comes in and just loses it.
I just made him high.
Yes, exactly.
So, it's really cool to learn. You think of it as just,
"Oh, it's an emotion, just being happy." But it's actually, you break it down, the
science, it's a chemical process-
Yeah
... that you're dealing with there.
Just gave him drugs.
All of these things are. No matter what the emotion you're feeling, there's a
process going on chemically in your brain that's doing it.
Do they talk about cats? Like why they just don't care?
Have they got to the cat part? I
would love to know
their level of-
They're like, "I could not."
Yes, exactly. Yeah. Or they just look at you in
disgust and walk right by. Maybe slap something off the counter.
But that's their way of showing you.
It's either a big F you or it's like-
That's just savage.
But you know how they'll just look at you sometimes, and they know-
Judgy eyes
... they want you to make eye contact, and then they just stare at you and slap
something off of the counter. I know Leo, our cat, was
like that, and she just knew she wouldn't do it, but she would
just-Boom, and just wait for you to react.
Oh my gosh. If we have any veterinarians or anybody in this industry of
science, if you happen to know the chemical differences, I would love to
know.
Yes.
Okay, so just fun fact. While I took Jax to his cardiologist, because I
think he was faking a heart issue just for attention, for more oxytocin
because he was fine. But I learned that dogs are
more parasympathetic, so their heart rates are
slower, and they have a natural
AFib.
Really?
Because I heard it, and I was like, "Oh my gosh.
The sounds are regular," but then technically you're not supposed to be able to
hear
atrial fib.
Mm-hmm. Yeah.
I'm like, "Okay." I just knew this is a murmur.
And then it was irregular. So, yeah.
And then cats, on the other hand, stay sympathetic.
Okay.
So, just in their heart rates are different.
A normal for cats is different than normal for dogs.
Yes.
Anyway.
I don't know.
Yeah.
Like we were talking about, there's all of these nervous actions.
Yeah.
The release of the chemicals, everything you do.
So when you're stressed out, you're stuck in this sympathetic-
Yeah
... pathway.
Yeah.
You're in fight or flight-
Yes
... essentially.
Yeah.
Even when you think of a scenario. So this is
things that we're running with. So
maybe, I'm not judging gender-wise, but I've heard many
times that people wake up mad out of dreams, and I've been the
recipient of somebody being mad at me because of a
dream.
I know.
And so
Holy crap. I
probably shouldn't say I never anything, but I don't think I've ever done that.
Yes. Well, it's fairly common. It's happened to me multiple times.
Okay.
And so these dreams, I obviously do something wrong.
Somebody wakes up and is very mad at me, and then I have to
suffer the consequences-
It's like a ghost
... and apologize for whatever Dream Tim
did. Yeah. So it's
Dream Tim.
Exactly. It's like
nightmare or however you want to put it, but the same is true.
So
when you're thinking of a scenario-
Mm-hmm
... in your head, and it may not be true at all.
Say you're running a scenario, you're going to confront somebody or say something.
That elicits that chemical
release of stress and sympathetic activity and-
Yeah
... oxidative stress in the body-
Yeah
... just thinking of the scenario. The scenario doesn't even have to happen.
Right. But it's like a neural link was formed, like there's
a circuit that was formed.
Yes.
Why do we have to remember it? That part makes it weird to me.
Mm-hmm.
But I guess it's also because it surged a catecholamine, or even
an anticholinergic surge.
Both of those, any of those, could cause a memory.
Absolutely. Yeah.
Which is crazy.
Yeah. And yeah, when people say, "It's all in your head,"
it's there.
It is.
It's there.
Physically.
There's so much control. You think about these Buddhist monks that sit there and
meditate, and people that are just-
Are they really happy?
So-
Have we asked them?
Well, I think it's about
being present, being in control.
So they don't even ask questions.
Controlling your memories, controlling your thoughts
to your advantage to
not being at the mercy
of the wild brain. The wild brain's out.
Somebody's got to tame it. Somebody get a whip.
I'm a straight victim.
Oh, right here too. This thing goes 90 miles an hour.
Wake up in the middle of the night, and it's like, "Beep, beep, beep." Starts
firing off all these stressful things.
Oh my gosh.
I'm like, "Ooh. Let me put on some 'Ancient Aliens' real quick and kind of distract
myself," so.
Okay. So on that note, so then you do
recognize it. You feel a little bit of a surge, a spiral in
a sense.
Absolutely.
Overwhelm, anxiety, and you know that you need to go back to sleep
health-wise.
Mm-hmm.
And that you can catch another window, so you put on something
to...
The higher center of you, your frontal lobe then chooses that.
Yes.
So that's the cool part.
Mm-hmm. So you've got to make these decisions, right?
Yeah.
Otherwise, you'll lay there inside your head and start going around in circles,
and you're-
Which is a loop
... it's a loop, and then you're laying there, and then you're starting to
fear-
Mm-hmm
... out of your, let's say, is it the prefrontal cortex or the
amygdala?
Amygdala.
The amygdala, your fear center. Yes. Yeah.
So
you start fearing that you're not going to go to sleep-
Mm-hmm
... and that you're going to be tired the next day.
Yeah.
And then
it elicits anger.
Sleep stress.
Yes.
Yeah.
You're angry because you can't go to sleep, and then your heart rate's up, and then
you're-
Yeah
... oh, man. So-
Yeah
... there's ways around that. Obviously, and probably you've heard of it,
like Calm app and things like that.
They've got-
Calm did not make me feel calm.
I've got a funny story about Calm. So I signed up,
and they have-
It made me mad that it made me feel un-calm.
Have you tried the bedtime stories?
No.
Wait, does it have a purple cover?
I don't know. It's on the app, but I
had never tried a bedtime story. So there was this one, I just picked a
random one, and it happened to be Harry Styles telling a bedtime
story.
He does that.
And he's like, "Imagine us cuddled underneath the
stars." So here I am cuddling with Harry Styles underneath the
stars.
Were you smiling?
I was like-
Did you sort of like that?
I laughed. I was like, "What?"
You laughed because you were like, "No."
No, it was just
so random. And I think Matthew McConaughey has one.
Oh, wow.
There's different
Hollywood stars that have started putting out-
Interesting
... these bedtime stories.
Huh.
Yeah.
Based on the voice that you want.
It's their voice, yeah.
Huh.
I think a good person that could do it would be Morgan Freeman.
He does a really good one. I could listen to him.
I think he reads the Bible or some book, or I could just listen to
him. He's got a very calming aspect.
I just think the bass in his voice.
Yeah, it must be.
He's got a very deep voice. I think most people would like that.
Yes.
Very manly.
Yeah. My favorite is David Attenborough.
I have to look up who he is.
He's a
British guy that narrates all these nature things, and
he'll tell you random facts about animals, just random.
I love random animal facts.
And the weirdest animals, and just the facts about them and what their behaviors
are.
Yeah.
And then it bounces to another animal, and so there's no storyline that you get
caught up in. You're just listening to his voice tell you facts about animals, and
that, for me-
I like that
... that's great.
Yeah.
And you don't have to worry about the TV, even though-
Yeah
... "Ancient Aliens" works good. I think the blue light from the TVs
disrupts your sleep patterns-
I know
... and your REM sleep, so
that's-
And I choose all... Okay, not me, but
Crystal choose all these murder-type shows.
Yeah.
And I'm like, "All the violence." Jack's my dog. He can't even handle it.
He hears a few-
Man
... one gunshot, he's out.
Oh, no.
He's like, "This is ruining my sleep score."
My mom does that. My mom listens to the ID channel and serial
killer type stuff to sleep. Yeah.
She's just a man.
I incorporate them out in my dreams, so it's a little weird.
I'd rather dream about random little animals doing their thing.
I love that.
Yeah.
Or even in real life, not sleep, or going to sleep to this stuff.
I like just random animal facts. I find it-
Yeah
... calming, interesting, always relevant to no matter what is
the situation.
Yes.
It's therapeutic.
Right.
So you guys, if you're around us, just, "Hey, did you know?"
Yeah.
Just
like random facts about the galaxy, space, anything like that.
Yeah.
And I think everybody has to find their calming thing, right?
Yeah.
I'm very interested in space and alien stuff.
I hope to get-
Yeah
... abducted one day. And that is, I listen to these
things that don't have a storyline, because you start listening to a storyline, if
I'm listening to an interesting book-
Yeah
... I'm just going to get into it. So there's little tricks to sleep, but there's
also-
Yeah
... breathing exercises that are really-
You need to breathe better. No, I agree with you.
It's just so effective, but it's easy to disconnect and
forget that part.
Absolutely. It is. And that's where you have to
integrate, see what people's situation's like.
Yeah.
If you've got a high-stress job, you're
already behind all the time. There's things coming up.
Oh, yeah.
You got to find quick little interventions.
I need quick interventions.
And so one of the easiest things-
Yes
... is called box breathing.
Okay.
Have you ever heard of that?
So when I did my first cold plunge, the guy was like, "You should box
breathe."
Yes.
And I was
just flooded because the cold plunge is just so cold.
Yeah.
So, no. I guess the answer's no.
Okay. All right. So easy thing. So what you do,
you don't have to close your eyes and do this. It helps me to do this.
Okay.
And so you visualize this box, okay?
And visualize something going around the box.
So you inhale for four seconds,
and then you hold it for four seconds.
Then you exhale for four seconds,
hold it for four seconds, and repeat. So it's a four, four, four, four.
Okay.
Right?
And you're drawing a box.
You're just drawing that box. You're just watching a little thing go around the
box.
Interesting.
And there's actually videos online doing that.
I might have to look that up.
So that's the easiest one. And then you can do that
less than a minute. You can do one round, you can do
10 rounds, however much you need to calm yourself down.
And so I've got a little list here of all the
benefits of box breathing.
Please tell.
What's going to happen?
Let's hear it.
So obviously you're doing this deep breathing, so you're going to increase your
oxygen level. You're going to decrease your blood pressure.
You're going to increase your parasympathetic, which is the relaxing.
You're going to decrease your fight or flight, because say you're stressed out,
you're getting to a point, somebody's made you mad, you're starting to do this.
So you got to shut that off, okay?
Like you feel the flood. You feel like a flood of... Oops.
You feel-
Yes. Mm-hmm
... all those feelings.
Yeah, you feel this going on. And so it increases your
GABA, which is your calming chemical.
Decreases your cortisol-
Okay
... which is that very detrimental stress chemical.
Yeah.
Right? And then decrease the
adrenaline and noradrenaline.
Okay.
So therefore,
from the adrenal. So you're decreasing your heart rate and your blood pressure.
You're activating your prefrontal cortex-
Okay
... which increases focus-
Right
... and helps with decision-making, clear decision-making.
Oh, thank God.
Okay?
Right.
And then lastly, you're calming down your amygdala, which we talked
about earlier is your fear center.
Which sucks. Just on that note, that your amygdala
is a lower function. It is a lower
level of function. When I learned that in neurology,
I was just like, "Oh my God." That's why they're like emotional
decisions, they are not wise decisions.
Exactly.
They're not.
Exactly.
They could not-
Yeah, because when you're stressed out, you're not going to make the most rational
decision.
Mm-hmm.
You're not going to think through it clearly, because here you are, this
adrenaline's flowing. All this is-
Mm-hmm
... you're going to be reactive.
Yeah.
Your blood pressure's up.
Yeah.
Calm, thinking, decisive, and so it's-
Prefrontal
... interesting that just doing this box breathing a
couple times around, less than a minute, and-
Mm-hmm
... you can feel the psychological high that you get from it.
You can-
Wow
... feel it, right?
Yeah.
And it will recenter you, and it's such an easy little thing.
There's tons of techniques, there's tons of breathing and breathwork out there,
but that is,
I found, the easiest one to explain.
That's awesome.
It's not complex, and people can implement that at a red light.
Oh my gosh
You're getting some road rage, do some box breathing for a second.
Totally.
I just did it on the way here, so
Oh my gosh.
So when it comes to if you
compare that to say, the
Mm-hmm
The out breath
Yes
Specifically will lower the heart rate.
Yes.
The difference with box breathing is
giving that a fair and equal square, right?
Yes.
So it's like you're giving energy to the parasympathetic to balance on the
seesaw with the sympathetic.
Right.
Because they're always in competition.
And a lot of the times, the tool that's in there is also the focus.
So we were talking about distracting ourselves to go to sleep, right?
Yes.
So you're not thinking about these things you got to do the next day
Yeah
... or what's stressing you out. So
by focusing, and the reason I said visualize this box-
Yeah
... in your head is-
So that helps me a lot
... there you go. Now your focus has changed-
Yeah
... totally off of the thing that was causing you to get all raged up.
Oh my gosh.
So, it's very-- And there's tons of techniques.
Yeah.
You could go into breathing exercises and breath work for a long time,
and it's great.
Yeah.
And once you put that into practice-
Mm-hmm
... and can implement that in your daily, that's just a little tool that you have
in your pocket.
I'll just stop talking to patients.
Like, I'll have a stressed patient, I'll just like, "Hold on."
Yeah.
"I am seeing a box at this moment."
Or let them keep talking, because they're probably not talking about anything
relevant to the visit.
I'll draw a box around their head.
We've talked about this before, how it's just like you're in a
visit with a patient, and the last thing they're talking about is the relevant
things. They're talking about their cousin or where they-
Why?
... lived 30 years ago. And you're like, "You're wasting both of our times
right now. Let's get this thing done."
You guys.
Nothing like chatting it up with somebody, but you have an appointment, you have a
certain length. Let's address the problem and work on it here-
Yeah
... not fly off the handle and talk about such irrelevant
things. Yeah.
Yeah. If I could give any piece of
advice to non-medical people-- No, I don't even
want to say that, because even outside of--
So
you're a physician assistant, you're going for your doctorate, clinical for
20 something years, right?
Right.
In orthopedic surgery. And then, MP,
MD, DO, doesn't matter, we have to document a
certain way. And there's no way that patients will--
You won't know how we have to
gather the information and put it in so that it's proper, but
we have to, at some point-
Yes
... gather specific details and put them in an
exact format that is medically proper, and legal, and
medical, and useful. And if we don't do that, then
it's like we just wasted... I don't know.
You're at risk of so many things.
Yeah.
Like medical legal.
Absolutely.
And so whenever you, as a
patient, don't give us anything that is
relevant to-- Like, this is your moment.
There's no other time. This is the time for you to
say exactly what you want, feel, how you are doing, how you're
not doing. The rest of it doesn't fit into our note.
It doesn't help us. Maybe I get to know you a little bit better, but you
are wasting your time.
Absolutely. Yeah.
It's just so-- I don't even know how else to say it.
Right. If you have extra time, you know me-
Come on, say it
... I'm a talker. I'll chat with anybody.
But when you're
on 20-minute time slots or 15-minute time slots-
That's not even real anymore
... Yeah, I know.
You know, I was trained-
You don't have that much of documentation, right?
So I don't know about yours, but we were trained to do a seven-minute
start to finish.
Oh, please.
Your note, everything.
Yes.
That means two to three minutes with the patient, and
then next orders, next
do your note, and then sign.
Yes.
Like, we're just real timed.
Mm-hmm.
And these are formal.
That's crazy.
That means, don't tell me 31 years ago when I
was
in Oklahoma and I,
my, you know, I-
Then you're distracted.
Woo
"My uncle, he lived there, and he did this."
I just-
It's like, that's fine.
I died.
Yeah.
I can't. It shuts all systems-
Catch me outside and conversate with me. Just don't do it here in the office.
Cut me
to the bottom.
Yeah, see me at the grocery store, then we can chat, but
yeah,
don't waste the office time doing that.
Yeah. And I don't know about how you handle these, but
whenever somebody tries to throw the ball back to me, because we
walk in, we're the provider, "Hey, how are you?"
"Great. How are you?" "I'm wonderful.
How can I help you?" "Oh, what's new with you?" "Nope."
Irrelevant.
Yes.
We are both here for you.
Yeah. This is my new... This is what we do right now.
This is what's new. So let's get back-
Yeah
... on it, right?
What's new with you? I'm going to always bounce it back and I just
wish that somebody had maybe a pre-visit video.
It's not a bad deal. Yeah. You just do that.
Or you have one of those big red buttons where you just hit it, and it's like,
"Focus."
So you don't feel like you're interrupting somebody,
but if you hit the button, I think they'll get the point.
Yeah. Would you guys think it's rude if we throw up flags or cut-- Like you are in
a yellow zone. You are in the irrelevant zone headed towards a
red zone where it's like, eh.
Yes. And we're doing that, it's not to be rude,
it's to get you the most out of your visit, right?
I can't help you-
Yes
... if you've just spent your entire time, and I've just given you the
best of my energy, and the last person gets scraps.
Yes.
Especially when you go home, that person really gets scraps.
Oh, exactly. Well, medical
professionals are-Burned out.
Mm-hmm.
Burning out is a huge thing. There's so many articles on it right now.
Yeah.
The percentage is going up, up, up, along with documentation and
EMRs and-
Ugh
... and social media, all of these things.
And people in general, in life, the anxiety, the
depression, the stress levels, they skyrocketed
after the internet, and especially if they were on a trajectory like this after the
internet, then after COVID, they were like this.
Oh, totally.
There was a grand change in society, and so it's a
huge medical problem.
Yeah.
It's a psychological and physically medical problem because, as we
talked about, the psychological effects affect your physical-
Ugh
... your cardiac, your metabolic-
It does. We can't separate it
... metabolic disease. And just the going back to
the basics-
Yeah
... with lifestyle-
Yeah
... and getting things in order can prevent up to
80% of chronic and metabolic
diseases.
Wow.
If you can just-
I believe it
... follow this.
Yeah.
And it's really interesting. Yeah.
In your doctorate, do they
focus on more of the provider
side to not burn out or the patient
side, or both?
It's-
Like bringing that together
... it's really focused on both. I've
never been in-- Throughout any of my medical
training, throughout whatever, it's all been about the patient.
Yeah.
And then you're automatically supposed to be okay as the provider.
We're the asset.
Right. Yeah, we are the tool.
Yeah.
You're just supposed to be okay. But then, as you know, I've seen it myself, but
we take-
Yeah
... the least care of ourselves. People around me, it's not just me, but
I've been like eating-
No, we've trashed ourselves
... chugging Mountain Dews and eating Snicker bars at 3:00 in the
morning trying to get to the next surgery.
And we laugh about it.
Yeah.
I used to smash Red Bulls, like three of them-
Yes.
... and be like, "I don't feel anything."
Yes, just pots of coffee. Just all the things that are horrible for you,
and then you're trying to give-
Disgusting
... your energy to other people. So you can't be your best as a provider if you're
not taking care of yourself. So
it's very unique that this program
focuses, and there's things, it's like here's a provider section.
You're taking a survey or you're taking the same thing a patient
is on the monthly to see where you're at.
Because if you're down here-
Yeah
... how are you going to get somebody up here? How are you going to lift them up?
Oh, I love that.
Yes, absolutely.
Ooh, that's really good.
Yeah.
It's almost like the other side to the
comment that we hear over and over, and over.
Maybe we've even said, who wants to see the doctor
that is
not the image of health and wealth, right?
Who wants to be the patient of somebody who's like, "You need
to exercise and work on your diet and stress," but then
they look very unwell. They look-
Yes
... very unhealthy. They look sloppy and not put together, and it's
like
they're giving too much to you.
Yes, yeah.
To somebody-
Mm-hmm
... they have given too much, and they need to look at themselves now.
Absolutely.
And so it's like on our side, obviously, we're in
this industry, so we're preventing from ever getting to that point.
But I could see how easily it could happen.
Oh, yeah. I was down that road.
Yeah, same.
I entered burnout.
I, same.
I just finally burnt out and just took off.
Yeah.
But luckily, I had that luxury to do that, and kind of squirreled away and
just took off for- ...
months at a time, isolated, random countries, and just walked around.
But you were also in the surgical-
Yes.
What's worse?
Lots of surgery.
What's a less kind, soft place than surgery?
Like a surgical OR.
Yeah.
Oh my God.
Yeah. But at least you don't have to worry about what you're wearing because you
have your surgical scrubs.
That's true.
And they may be wadded. They look very wrinkled,
like they were just wadded, and-
Yeah
... you just walk around looking like that all day.
Just-
Like a slob
... grumpy and just-
Because it's sterile
... there might be blood stains on your pants that you don't realize that are
there, and you're just walking around with a piece of somebody's knee stuck to
your pants.
That's just life, right?
Well, from a non-OR perspective, but family medicine, I remember my
first inpatient rotation. I saw my senior, and she was wearing
the surgical scrubs, and I was like, "Why are you in surgical scrubs?" And
she looked awful. I
don't know, like she just worked out or something.
Yeah.
And had that look is... And so she also had like this dry--
This is so bad. She had some dry stuff, it was kind of cracked on her
neck.
Yeah.
And I was like, "Where are you coming from?" And she's like,
"Oh, I just had to deliver a baby. And oh, God, that's amniotic
fluid."
Oh, yeah.
And I was like--
I knew the field of medicine had to do OBGYN,
but you get splattered by amniotic fluid, and
then you don't even shower, and then you're still wearing this.
There's just so much.
Yeah.
We can do better. But when? Because she didn't even eat.
She was exhausted.
You never know when this stuff is on you.
Sometimes-
She was out
... a pretty big surprise.
The shocking was if I'm wearing my glasses, right?
I don't know about-- You're wearing the whole outfit, but-
Yeah, in total joints. But-
Yeah
... trauma, you typically don't wear the space suits, but when you're in-
Yeah
... total joints, yeah.
It splatters-
There's a lot of power tools going on there.
Yeah.
So the high RPM power tools, there's stuff
everywhere, yeah.
Oh my.
Which is part, it's really the fun part of it.
Yeah.
When you break out these saws and the drills, that makes you feel
like you're doing something.
It really does.
It does.
I did one OR day for ortho.
Yeah.
And I was like, "Pass me the drill." So they let me do some hammering-
Yeah
... which I wasn't strong enough for any of that stuff, but-
Oh, it would come with time.
Yeah.
You can stick it out. I'm sure you can pick it up.
Oh, man.
Put the rage into it. It's very
therapeutic, right?
Oh, it really is. It is.
It's basically woodworking.
Yeah.
You are woodworking. You're using all the same tools and-
Yeah
Just making it happen.
So post hip replacements, arthroplasties, it's
like, "Oh, you're having pain? Well, honey, that's
normal." Have you seen what happens?
I'm surprised you're not in more pain, right?
Yes.
Drilled. Yeah.
Yeah.
Totally.
It's pretty amazing what the human body can endure.
A little achy?
Babe.
Yes, exactly. Exactly. So.
Normal.
People are resilient when they want to be.
But once again, it goes back to your mindset, and if you
know you're going to do well and you're motivated-
Yeah
... after surgery, you're going to do well.
Yeah.
You go into it like, "Oh, this is going to be horrible.
And no, I don't want to do therapy.
No, it's going to hurt," well, you're probably not going to do so well.
Yeah.
You're going to stiffen up.
Harvard has done a study that was actually pretty...
I don't know. It was a little much, even for the other Harvard professors.
They were judging the person that did it, like, "That's a little extreme." Because
these people were wearing whole body suits, so even if they passed gas, that would
be
equated for.
Yes.
So everything in and out was equated for.
And so anyway, that was-
Wow.
Actually, I'm going to find the name of that study.
Oh, that would be-
I want to just bring it to the table
... very interesting.
Yeah.
There's a study for almost everything out there.
There is.
And people are looking for reasons to do a study.
Well, okay, so they're looking for reasons to do studies, but also, we need the
information.
We need... Yes, absolutely.
And we need also people to better understand the studies.
So yesterday, for example, I had a study given to me, and I was
just talking about progesterone with somebody, and they screenshot
something from Mayo Clinic. Love it.
Mayo's a great source to cite. But the way that they put together the information
of what we were talking about,
not correct.
Ah, okay.
So people make leaps because we still speak in a different language
than what we did prior to all of this training.
Yes.
So being able to read all the studies, understand
them, and then apply them into useful ways that you can get a
medical relevant,
I don't know. You have to make it relevant.
You're deciphering it.
Yeah.
You've got to take this accurate information, and then you could take a study-
Turn it to action
... and you can turn it to bias.
Yeah.
So you have to be very careful.
Yes.
You may go in with a preconceived idea and look for things in there that-
Yeah
... are trying to prove your point.
Yes.
No, the study is not.
Yes.
And so that's one big thing when you're writing.
You got to-
Yeah
... decipher and write it correctly.
Yeah.
And so that's podcasting as we're doing-
Mm-hmm
... or YouTube or posts.
Yeah.
Those are ways that we can get this information out to the public.
Yeah.
But you can
see it a lot-
Yeah
... where people have taken these and kind of construed...
It's almost like the media, right?
Yeah.
They're just like, "I'm going to spin my own little storyline here.
I'm going to take a piece of this-"
Yeah
... "a piece of this, and I'm going to glue it together, and then this is going to
be the truth."
Yeah.
So that's really a risky thing when
you're listening to people who
may not
have the integrity to not be biased.
Right. I at least hope to always, always,
always... So yes, right now we control the message, right?
Right.
We're talking into this microphone, you guys are all watching,
and you are hearing what you hear, and we're controlling the
message. But I hope to always just give
exactly my interpretation of information.
Look it up yourself. I would love to just create conversation.
Absolutely.
And if I'm wrong, then I want to be corrected.
Yes.
So I'm not afraid of being wrong. I'm not afraid of saying, "Oh, you know what?
I did say that, and
oops, thank you for telling me."
Right. Yeah.
I want to be corrected. I want to do better.
And there's a lot of stuff that's available for access, too, for people who-
Yeah
... want to do their own research.
Yeah.
There are libraries out there that are free access. There's paid access.
Yeah.
There's research AI now that makes it so much easier,
right? So there they'll go... You can give it an idea, and it's going to bring up
all these articles that relate rather than having to go I
know my li-
That's old school.
Yeah. The library old school was like-
Oh, my gosh
... you better search exactly what's in the title
or-
Yeah
... or in the abstract, or it's not going to pop up.
So-
Man
... common sense is nice.
And as somebody who has written a lot of papers and published
several-
Yes
... you know your title is actually the most important.
And sometimes a title is very long-
It is
... with the intention to get snags like that.
Yes, exactly.
And the more specific, like a 14-year-old female with
coccydal meningitis to the brain stem, basal ganglia.
You can really just make it very, very specific.
Absolutely.
And that's how I would name my papers.
That's-
You're one of those writers, are you? You just love writing.
I don't love it, but it was a tool.
Oh, yes.
I think.
It's definitely worth the work. You do learn a lot by going through
this, even though it can be painful with the busy work on top of life.
Painful.
But-
Yeah
... that's what we grind for. If it was easy, everybody would have one.
That-
Everybody would do it.
Is true.
Okay, so for your lifestyle
tips, is there anything that you would recommend
that's... So we know our box breathing. We have that.
We know why it would be helpful.
Yes.
We're redirecting with when you're trying to fall asleep, or if you
are asleep, then you wake up, how do you bring yourself back into sleep?
Really, it's about recentering. I think
the breathing is there, but everybody's different, so you have to
find your avenue.
Mm-hmm.
If you can do it by meditation, that's the cleanest way, right?
Yeah.
Turning the TV on, which is what I've done all my life, and I'm trying to wean off
of it, but "Ancient Aliens" makes meAt peace.
It works but-
But do you listen to it?
I do. I listen to it. If I look at the screen, it doesn't work.
So I just listen to it. So listening to something, that's the
easiest thing. Just don't do anything with a storyline, I would say.
There's a reason they say
practice yoga and practice meditation, and if you've ever done
yoga, yoga's hard.
It's really hard.
That's why you practice. Has somebody mastered yoga?
There might be a yoga master out there, but you practice at yoga-
Mm-hmm
... because you can continue to get better. Meditation is even further.
Yeah.
These people that center on
meditation, monks or whoever-
Yeah
... they work at it all their life trying to reach the
pinnacle of their control.
You know what?
It exists.
I used to think that was so abstract.
I think the closest thing I can really
bring that into a more tangible form,
for board exams or tests or anything that you know you
have to get through,
it's hard to sit down and
an eight-hour test, or I had an eight-hour test for two days.
So to train yourself to, you're going to sit here, ignore the
world around you, and just focus on this one question,
next question.
Exactly. Living in the moment.
Yeah.
Without distractions.
But to go back to that way of thinking,
it's different.
It is. And it's hard.
It's hard.
And people are like, "Oh, meditation." I get people all the time, "Meditation.
Oh, do that."
It feels so intangible.
It's the worst.
It's like-
It's hard
... this thing.
It's not bad when you do it, but it is difficult
to shut down and just live in the present second, the
nanosecond, and-
Yeah
... entirely focus. So it's something you definitely have to practice with.
So, you got your sleep, nutrition,
all the evidence-
Oh, nutrition
... has just pointed to whole food
plant-based. And so before anybody loses it, it's
not vegetarian, it's not pescatarian.
People are like, "I'm not giving up my meat." I'm like, "Nobody said you had to."
I'm just saying plant-based, right?
Yeah.
And then all the bros that are like, "I'm getting my protein." I'm like, "Where do
you think that cow came from? You think it's out there eating steak?" No, it's
eating plants. There's tons of plants with-
That's true
... very high amount of protein in there.
And my favorite thing is vegetable medley.
I go over, I've got Trader Joe's across the street.
I go over there, I pick out random vegetables-
Mm-hmm
... throw them in a pot, put some of the protein beef broth on there in a bullet,
and there are my meals for the week.
Does it feel like it tastes good? You feel good?
It tastes good. Yeah, absolutely.
Yeah.
Yeah. So I feel good. It's ready. It's cheap.
Yeah.
Yeah. Seriously, and it's good for you.
Yeah.
And then I still want to go out or go out to dinner, I'll have a steak or whatever.
Yeah.
I just not-
Do it like sometimes, not always.
Exactly.
Yeah.
Because my old way was, I have to have meat with every dinner.
Hypercholesterolemia was your life
Yes, it was. And I said, "You know it.
You've seen my labs." So it was like triglycerides were up, cholesterol was up.
Yeah.
And even though, no matter how healthy I thought I was living, I was still just
intaking-
Yeah
... cholesterol. So if you can just base it that way, there's tons of
things, lentils, soy, any of these beans, they've
got protein.
Yeah.
You can still be fine.
Meet your quota.
Yes.
Yeah. You haven't lost muscle mass, so I think-
A little bit. But I've-
Have you?
Yeah.
I haven't seen you for maybe two months.
Yeah. I haven't been hit that hard.
I've been sitting at a computer with my face in it writing-
Document
... scholarly papers.
Oh, I loved it.
But certainly you could do it. There's a good video out there if you ever watch
it called "Game Changers." It's about these pro athletes and the
strongest man in the world who are on plant-based diets.
Yeah.
And so there's things to do with that.
So you're hitting your sleep, you're hitting this.
But one of my favorite, and I know we're running short on time, is I just
want to touch on this connectivity.
Okay.
Social connection. That is-
Ew, who would've thought?
... so important. Yes, because in this stressful environment-
Yeah
... you're not sleeping good, you don't feel good, a lot of people just
isolate.
Yeah.
They go through a breakup or stress at work, they just want to isolate-
Yeah
... and just shut down, right?
Yeah.
But social connection is so important, too.
And as we were talking about with your animals increasing that
oxytocin, you get that by having good-
Yeah
... connection. Not just being around random people.
Maybe it is that for you, but actually connecting with the people.
And a lot of people have the social anxiety or have
problems making friends and connections. There is an effort to it.
It's a challenging-
Oh, I like to use that
... pillar.
Yeah.
And sometimes people have isolated
themselves
over time.
Like wave at your neighbor.
Right.
Say hello-
Small-
... to people walking by
... small moves, right.
Yeah.
Yeah. And if you're in California, they probably won't say hey back and just look
at you weird. But that's
okay.
You just get used to that-
It's just like New York
... here, right? Yeah.
Yeah.
It used to be so strange coming from the Southeast.
I was like, "Why do these people don't say hey back when I pass them?" But -
That's why people probably think we're so nice-
Exactly
... because that's just how people do it in Florida.
Yeah.
"Hey, how are you?" Don't actually tell me.
Yeah. Don't tell me.
Yeah.
We're just trying to be polite, right?
Yeah.
But I tell people, if you want to get that connection, try to find what you're
interested in. It doesn't matter what it is.
Find what you're interested in, find other people that are interested in
that. We have such an advantage. Now, the internet and social media can be
such a disadvantage because you can get lost and go down this rabbit hole of
whatever your algorithm takes you to.
Yeah.
But you do have groups like Meetup or whatever,
that it's other people out there who feel equally like they want to
connect-
Awkward
... with other people, but it's awkward-
And isolated
... and they're just like, there's Bumble BFF where you go meet
friends.
Stop.
Yes. Yeah. Where you're just like, "I just want to meet a friend." And
as a medical traveler, I get it. Sometimes you're in a city, you know zero people.
I'm just like, "I just want to hang out with somebody," or, "I want to go
play tennis or go snowboarding. I wish I had somebody to go with."
And so you can get on these groups and-
Yeah
... actually meet people that are interested in doing the same things you can.
So there's options. But you got to take it in baby steps because
it's not that easy. There's a lot of mental block-
Yeah
... behind it, right?
Okay. So to lifestyle, you have to make small changes in your
overall lifestyle. Thank you so much for those tips.
I look forward to hearing more.
Yeah.
I love experiencing your journey with you as you are on this
path. It is so, ugh, I want to go into that
doctor too.
You'll be getting the monthly updates, for sure.
Okay. Done.
Yeah. You'll get the newsletter.
All right. Tim Pace, thank you so much.
Yeah. Thank you for having me. Great to talk with you guys.
Pace of Life.
Absolutely.
We'll talk again soon.
Absolutely.
Thank you.
Yes.
All right.
Appreciate it.
And that is all.
Thanks, guys.
Until next time.