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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. Sevelli, and today we talk physiology, evidence,
and real-world medicine, plus the questions you're not supposed to ask
but probably should. If you care about health and think there's a better way,
welcome to our show.
Thank you so much for joining me today.
I have the honor and pleasure of introducing Dr.
Sandhu, cardiologist. Tell us more about you.
Thank you. Thanks for having me. I'm an interventional cardiologist,
and I'm in private practice for a while with a heavy bent towards
wellness and all things health.
Which I love.
Exactly. So that's what brings me here. Let's talk.
Yes. Let's talk. What does your day look like, just out of
curiosity? What time did you start?
Typically, I'm an early starter, so the day I do procedures, I usually
start my day at 6:30.
Okay.
So some cases earlier in the day. And then the office time, typically 7:30 to
8:00. And that goes on till 3:00 if I'm in office
all day or if I'm doing procedures, oftentimes half-a-day procedures.
Then depends on what's going on for the rest of the day, whether it be
meetings or some admin work, and then back to home.
Love it. I didn't hear exercise. Do you typically exercise or-
I'm usually an evening person for that.
Oh, okay.
So could be 5:00, 6:00. So usually that's the
first thing I would do soon as I get home.
Mm-hmm.
Before I do anything, that's when I would try to hit gym.
Okay.
Do the training and-
Fasted?
Typically not.
Okay.
So I've had lunch most days.
Mm-hmm.
But it's about three hours apart-
Mm-hmm
... in any case, so usually I would try to hit around 4:30 or
5:00.
That's good.
And that's about an hour of weight training at that time.
Mm-hmm. Love it. Do you take any sort of pre-workout before you do that?
I don't know if you feel a crash at the end of the day or fatigue.
Some people do.
Mm-hmm. Typically not.
I usually would stick to EAs.
Mm-hmm.
So to me, that's good enough for a pre-workout.
Love it.
Sometimes I take some taurine.
Okay.
And that helps.
That's really good.
I feel like for me, the taurine, sometimes it can give you a little
too much-
Mm-hmm
... right, don't you think?
It can. I mean-
Yeah
... there's a reason they use it in energy drinks.
Yeah.
So it works.
Yeah. I'm not quite sure the mechanism, but I know I definitely can-- I notice it.
Yes. It does work. I mean, the brain does get a little sharper, and-
Yeah
... you feel a little more of a lift.
That's great. So in the morning when you wake up, do you
feel like, "Let's go. I'm ready to conquer the day"?
Do you feel bursting with energy, or are you kind of a slug?
Most days, yes. So my morning's usually like
wake up, get ready. I do meditation in the morning.
Oh, that's great.
So I learned Kriya Yoga, so I spend about good 20
minutes after my prayers and spend time doing
Kriya Yoga. And then depending on the day,
some days I will do red light therapy in the morning and-
Love that
... alternate with plunge some days, depending on what day of training I'm in.
Mm-hmm.
And then just grab my morning protein
shake with some creatine and-
Yes
... glutamine and-
... gotta go.
Yeah. It really makes a difference, all of those little steps that you just
described. You preload with your day with the
protein and just habits.
Mm-hmm.
All of that together.
A routine, I guess that helps-
Yeah. Yes
... most of all.
Yes.
With the red light therapy and the cold plunge, there's a reason to do it or
not do it. Do you apply-- or what reasoning do you apply
to each of those when you do them or not do them?
So typically, I mean, cold plunge, the reason I stack it in the morning on
some days,
evening workouts and, of course, cold plunge, it will reduce
your soreness, but it does also negate some of the muscle growth effect.
So
I'll have 12 hours in between at least maybe 14, 15, and in the morning-
Mm-hmm
... I can do my three minutes. And typically, I mean, the
science says about 11 minutes a week, and after that, it's diminishing returns for
cold plunge. So typically-
Mm
... when I get in, it's usually about three minutes or so.
So three or four days of that will do it.
Yeah.
So-
Feel charged.
Exactly.
Yeah.
I mean, going in is not fun, but coming out, you feel great.
That-
You feel amazing.
Exactly.
Like very euphoric in a sense.
Very.
Yeah.
And it sets you up for the day better than any cup of coffee.
It really does. You can't even be mad.
No.
There's nothing that would like shift you into that space where you're like,
"Okay." No. So that's awesome. Is there
anything that outside of that that you would recommend for
lymphatic drainage?
Haven't had a whole lot of issue with that.
I have used the Hyperice
boots.
Mm-hmm.
But usually that's after a leg day.
Mm-hmm.
I'd spend some time doing that.
Yep.
There are days I would do the morning would
include when I do yoga, there are some
Surya Namaskar, so sun salutation, that will get your muscles going
a little bit.
Oh, that's good to know.
Yes.
Those specific moves. I know the twist really is helpful.
Mm-hmm.
So, okay.
Yep. So I mean,
it's a series of moves, so part of it is stretches your
hamstrings-
Mm-hmm
... part of it is you're doing downward dog.
So it-
Yep
... a lot of it kind of adds up in a sequential fashion.
Yes. Yeah. Definitely highly recommend.
What initially brought you into cardiology?
I know it's a very long path.
Mm-hmm.
There's a lot of pre-med and aspiring doctors.
If you rewind to the thing that was really
your why-
Mm-hmm
... what does that look like?
So I mean- I grew up in India,
and
of course, it's a very different system.
So
you're 18 when you pretty much decide what you're going to do with the rest of your
life. So there is not a trend of undergrad, four years college or
whatnot. You just go, so from 12th grade you're in medical
school.
Mm-hmm.
And I don't think most of us are smart enough-
No
... to know at that time what the hell I want to do with my life.
So when I started med school,
I thought I wanted to do this, but then I really didn't like it for first year.
It was not fun.
And
it took me a while to, okay, I'm in it now,
so let's get in it to win it.
Yeah.
And then things got better. My heart was in it.
Finished my
medical training there and landed up in New York here.
And
residency was
a lot of fun, learning medicine the new way.
Do you mean fun?
It was actually. If I look back at it-
Okay
... it was a lot of fun. I mean, first month was like a little deer
in the headlights.
Yeah.
And then, as you start getting a hang of it,
oftentimes you make your best friends in that time.
Yeah.
Because it's like you're in the trenches together.
Yes.
You're learning-
Trauma bond.
Exactly. You're learning together, you're doing things together that sometimes are
comfortable, sometimes not.
Yeah.
Sometimes you're exhausted, you're covering for each other.
So I feel, yes, it can be tough, but
it builds character.
That means, woo, it had some rough moments.
Oh, yeah.
Those character building.
That is true.
Ugh, my mom and dad used to always tell me that.
Anything that was suffering-
Mm-hmm
... builds character.
That's one way to look at it, right? It keeps you going.
Yep.
I was drinking the Kool-Aid full time, right?
Yeah.
And then,
initially I was kind of torn between, we had a very strong transplant
hepatology program, so liver transplant and whatnot. Found it fascinating.
Mm-hmm.
Enjoyed it. But to me, the turning point was my
critical care CCU rotation. Really loved it.
Ooh, that sounds so good. I like how it lights you up a little bit whenever you
just talk about it.
Yeah. No, it was
that defining moment, and
that's when I really started working, and I was fortunate. I got great mentors.
They helped me, they guided me.
And
I had a fun time learning. And
now if I look back, I could say, you know what?
If I wasn't doing cardiology, I really can't see myself doing anything else in
medicine. I do enjoy it that much.
I have no idea what I would be if I'm not a doctor.
I-
Yes. It's fun to imagine-
Mm-hmm
... the what if.
True.
Yeah.
I don't think I want to know myself-
Well, it-
... like that.
I think the introspection helps. Like you and I both kind of had a...
You are into wellness, functional medicine now.
You had the courage to kind of take the plunge.
Which it does take-
Which I applaud
... thank you. It does take courage.
Exactly. It takes-
It's not mainstream.
It's not mainstream yet. I think it is, you wanted to do
this, and you
took that first step.
Mm-hmm.
You took the full length leap in.
Yes.
Which I applaud.
Thank you.
And
I have-
Like let them laugh.
Exactly. That's okay.
Yeah.
That's okay.
Totally fine.
I mean, at the end of the day, we are here to help people.
Exactly.
And we do it the way we best see fit with us, right?
Yes.
And
I enjoy wellness. I enjoy a
lot of
biohacking. I read about it a lot. I talk a lot about my patients.
So I live on that fringe. I still haven't taken the leap, as you
say.
So I flirt with that border quite a bit as I talk to them, but...
That's the cutest way to say it. I like that.
Yeah, I
still practice traditional medicine, especially
for the insurance based patients, right?
Mm-hmm.
Those we have to. We don't have a choice.
Mm-hmm.
But having additional tools in our chest to offer
people and to use the science that we do have
available at our fingertips, and then make those scientific
connections. Because I never want anything to be Valerie's
opinion.
Mm-hmm.
I want it to be based on the information that we have, and all of
these other things have failed.
There must be something that will work.
No, I agree. And I think so many times the frustrating part is we see
this
whole functional medicine versus mainstream medicine as
either/or.
I know.
I don't believe that's the case.
Me either at all.
I think the true care, the right way to care for people
exists in the middle, where there is good elements in both.
Mm-hmm.
And you could use both.
Yes. Oh, totally. And I really think back
to biochemistry days, right?
Mm-hmm.
Whenever you're learning the purine pathways.
Mm-hmm.
You're learning oxidative stress.
You're learning what the liver does and where it chops things up, and what is
released when glucose enters the bloodstream, and then the insulin
receptors. So all of those things at that
level of considering the mechanism is what I think about
when I'm talking to the person and I'm hearing their problem, and I'm
thinking chicken versus egg. Which one came first?
Because a lot of the things that patients are describing are the symptoms that are
downstream. But what was the original?
I think that
knowing those mechanisms is everything, and that's how I really approach
it.
I totally agree. For me, the light bulb moment was, it was a few
years ago as I got more and more into
Sort of wellness part of it-
Mm-hmm
... and
working on metabolic disease, thinking about it that way.
It was that light bulb moment, "Huh, that's why they taught us biochemistry."
I know. I had the same light bulb. Isn't that so funny?
Because it's like, "Why do I have to know stoichiometry?"
Exactly.
"What is the point of this?" It clicks way later.
Exactly. So that was that whole first year and a half when-
Mm-hmm
... biochemistry was torture.
I was like, "Okay, I guess that's why."
That's why. Exactly. You're so funny.
I had the same thought.
Ugh. Yeah, or the pH in the GI
tract, in your mouth.
Mm-hmm.
How important is the mechanical chewing of your food
to break it up, and how much we chew, and then
the process of it going all the way down, and then the peristalsis that
happens.
Mm-hmm.
And then the timing of your valve opening so it can go to your--
It's just crazy. It's so detailed and
intricate. So I just circle back to those,
the minutia.
Yeah.
Right? Because I feel like that's where the problem is.
It's going back to the basics or-
Yeah
... first principles approach. Let's go back to the-
Yeah, fundamentals.
Exactly.
Square one.
Yeah.
Yeah. So
I don't know. As you are right now, how do you think everything is going
in private practice and cardiology?
Because I know you've ventured-- Just in the time that I've known you-
Mm-hmm
... you've had different business ventures, right?
So are you at the place where you're like, "This is fun"?
Yeah, most days, I would say yes, this is fun.
And we all have those days when it's not so much fun.
This is work.
And that's life. But-
Yeah
... no, I
started my current group about three years ago,
with the intent we want to provide great care to people,
and get really, really good cardiologists here to do
that.
Mm-hmm.
And fortunately, I'm blessed, I have awesome
partners.
I love your team. I like every single person there.
Hand-selected, great people.
No, thank you. We take pride in providing good care, and
most days, I feel we are able to accomplish that, I hope for most people.
Yes.
And
we are expanding the team this year, getting
hopefully two new people. Both are very accomplished, good people, so-
Cardiology?
Cardiology.
Okay.
So that
should further help
us grow and do things better. We just brought in
PET/CT.
Yes.
So-
How's that going?
It is good. To me, that's
the best form of non-invasive assessment that I could get for a patient.
And not only am I able to see the regular what a stress test would
show in a more high-definition fashion, so to speak-
Oh, wow
... then calcium scoring at the same time, see if there is calcific build-up in
the arteries, correlate that, and then do myocardial blood flow, which
means if the arteries actually behave the way they should
behave when they get a stimulus, if the blood flow increases as it should.
So all those add up-
Mm-hmm
... to give you a lot of confidence.
If it's completely normal, okay, I know you don't have disease.
Chances are we didn't miss anything.
Or-
Mm-hmm
... if there is a problem, going in knowing-
Wow
... what we are going in for.
Absolutely. What age do you recommend people to
do that? When would I start to think-- And really in the
preventative-
Mm-hmm
... medicine outside of the algorithm that we're trained in.
So not for PET/CT so much, but for calcium scoring initially.
That's where I would start for most younger age group.
The disease is moving younger. We have seen that.
Mm-hmm.
Part of it is biologic, part of it is the environment that we live in-
Mm-hmm
... and the foods that we eat. So all-
Yes
... of that comes together, right?
Right.
And of course,
not to downplay the stressors of modern life-
Yes
... that we live in.
Yes.
So
for a lot of people, if there is no risk factors, whatnot, but
for most people around 40, I would say get some sort of assessment,
whether that be cholesterol check and then a calcium score.
Mm-hmm.
That's an easy two-minute scan. There is no IV or dye.
And to measure how much calcium is built up in the arteries.
We've known that for ages, like 30, 40 years, since
we started-
Wow
... doing CTs, that if you have calcium build-up in your heart arteries, it's not a
good thing. And-
Not a good thing
... it correlates directly, the very early data that showed that over
300, the event risk is over 12%. However, if you're zero,
then the chances of having anything significant is pretty close to zero.
It's not exactly-
Mm-hmm
... zero, but-
Yeah
... it is pretty close.
Wow.
That's helpful. Is there any signs that would be precursors
to
a high calcium load in the arteries of the heart?
Symptoms-wise, you may not feel anything at all.
A lot of-
What about in the legs?
The legs is different. So the physiology, you may have a little
calcium build-up. So how do you get calcium?
So if you go back to you have cholesterol build-up initially, the
arterials, inner coating, which is the endothelial cells.
That's like the inner insulation on the cell-
Mm-hmm
... blood vessels.
Yes.
As it gets a little rust, so to speak, in the commonest term, your kind of
cells are not healthy-
Mm-hmm
... comes off. You create a little area of injury or a little tear.
That's where the whole pro-inflammatory process starts.
And you'll form a little scar or a fibrous tissue or some cholesterol
plaque build-up there. And as it gets old, the healing
process, without going too much into technicalities, will have some calcium
deposition in it, and that's what you measure.
I think of it as like a custard or like a soufflé.
Mm-hmm.
It's like a shell on the top-
Exactly
... with some nasty-
You got your own crème brûlée?
Crème brûlée. Yeah, it kind of grosses me out to think of it that way, but is that
what it looks like when you're actually in there and you-
So calcium can be pretty hard, actually. It's literally like a rock.
Well, that's the top layer.
Yes. And sometimes it goes pretty deep.
And when you're opening up these arteries, sometimes that's your enemy in
delivering the equipment that you need to deliver.
So there are tools that you use, whether that be rotablator, where it's a
little diamond burr that shaves off the calcium.
So cool.
Or, yeah, some newer technologies like shockwave, where it's like you're putting a
balloon that does lithotripsy and breaks up the calcium on the inside-
Wow
... before you work. So there are some tools to work around it.
Man. When you do that, is it kind of like instant
gratification for you, in a sense?
Certainly, it is.
I could see how that would be.
Generally, if you do get it right, one and one add up to two generally.
I love when it works that way.
Exactly.
Yeah, like no complications, all goes well.
And sometimes things don't go well, and that's part of what we do.
Yeah.
But as long as I believe you've done it for the right reasons to help
that patient-
Yeah
... and whatever comes, you can deal with it.
These are not low-risk procedures to start with.
We've made it sound that way. But it's-
We do. Like it's putting on an outfit, but it's invasive.
It is invasive and...
Yeah.
I forgot the vagal nerve stimulator.
Mm-hmm.
I forgot it.
I forgot it, too, actually.
Oh my gosh.
We got to do it some other time.
Man.
Yeah.
Who's running this thing? Two doctors are not doing
what-
That'll be fun to do next time. Let's do it again.
Yeah. Okay, perfect. You got a deal.
No, it's funny to see doctors assist doctors. It's really bad.
Isn't it really bad?
We're not used to that.
We're not used to it. Yeah, we stand in the wrong place. I don't know.
It-
I agree.
Thank God for medical assistants.
Oh, gosh. Well, yeah, on the topic of the vagal nerve
stimulator, there's so many different versions of those
devices that have come out. Some of them are for just in general stress,
anxiety, some are for sleep, some are, I don't know, they're
like a full collar-
Mm
... or some just sit right over the baroreceptors. What are your thoughts on it?
So, I
feel we are going to know more in time to come as to how the vagus nerve
stimulation works.
Mm-hmm.
We know what vagus nerve does. We know it traverses the whole
pathway up and down, and we know a healthy vagal response
is perhaps a good thing if you're living a stressful life.
Mm-hmm.
Now, when you start hacking this, how does that work?
Yes.
Okay. So that,
I would say,
to an extent it may be helpful.
Mm-hmm.
And there are different kinds of devices you can use.
Okay, what's the
easiest one that you can do? Just your breathwork. Okay.
Yeah. That's true.
Okay. Lower lobes in the lungs expanding with deeper breaths,
double the inspiration, and slow down your expiration like eight seconds.
That will actually slow down your heart rate, right?
Yes.
So that is vagus nerve stimulation in its most rudimentary form.
Then there are devices which work directly, like what we
were talking about.
You can have a device on your neck.
Mm-hmm.
Pulsetto, that can kind of give microcurrents and training the
vagus nerve that way. And then there are vibration-based devices, like
Sensate. So it's like a pendant.
Oh.
You can wear it and
when you're going to lay down for 10, 15 minutes, you can wear it with the
headphones on. And the principle there is,
you have air conduction with how you hear, and you have bone conduction.
All your bones absorb the vibrations also.
Yes.
So it creates those music and sound-based vibrations
that will actually hopefully put you in a little bit-
Interesting
... easier state and relax you, so to speak.
Okay.
So that is relaxation in another way.
Then there are other vagus nerve stimulators like Nereupod and whatnot, which are
a little more fancier, and
depending on
who you read, they do work.
Yeah.
I've used a few of these.
I like Sensate. I use it time to time.
I've seen, at times, for my sleep, it does affect my heart rate
variability in a good way.
Mine is low.
How low?
I don't want to say.
Okay. We're not going to put it out there then.
No, I need to fix it.
Sometimes in the 20s and 10s.
I didn't even know you could go as low as mine.
Well, you can, but you shouldn't, right?
And this is-
Why is that? Why do you think is that?
Well, I just started a business. So I think that is a
major
factor,
but the fact that it's showing on my data, which
is objective-
Mm-hmm
... means that I must be breathing differently-
Mm-hmm
... and I must be sleeping differently.
Right.
My exercise hasn't changed. My food hasn't changed.
Everything else is exactly the same.
You do travel a lot.
I do. Altitude maybe?
No. I feel it's
your social jet lag that affects it to an extent.
And your travel, you have actually jet lag. You go between East and West Coast.
Yeah.
Three hours.
Yeah.
And affecting the sleep time, of course, any time you switch, it takes a little
bit of time for the body to adapt to it and get in a good sleep rhythm.
There is actually,
I'm blocking on the exact reference, but there is a
thought that when there is some basic science data on this, that if you
actually sleep in a hotel room or a place you're not familiar, your body does not
feel familiar. For the first night or two, actually, there's more micro-awakenings,
and your heart rate does stay-
Wow
... a little bit higher-
Wow
... because you-
Even though you don't perceive it, your body perceives it as an unfamiliar.
So if I'm traveling in a new hotel or whatnot, first night
or two nights, you can measure it, your sleep will be a little bit
off.
I'm seeing this in my data.
Yep, and then it starts settling in.
Oh, no.
I'm just taking that in.
Because it matters. It's a vital sign.
Mm-hmm.
Absolutely. And then, how you structure your wind-down routine, I feel we are
really good at warming up.
Yeah.
We are really terrible at winding down.
I'm really bad at winding down.
Exactly.
I need to be told to wind down.
Do you look at your phone when you're ready to sleep before that?
I try so hard not to.
But you do.
I do.
If you spend 30 minutes on that... So there was
a very interesting experiment out of Australia, I think it was over 10 years ago.
And,
what they saw was
you could do the same book on iPad reading versus actual book.
And in the iPad reading group, the sleep was terrible
that night.
So you could expect that, okay, but what-
Right, with the light to the eye
... Right, the blue light, predominantly blue light wavelength.
Okay. Mm-hmm.
But
what you won't expect it, that effect lasted several days after.
So it was like a drug-
Several days, it's toxic
... It was like a drug that hung out for a while.
That is horrible. That is horrible, but so insightful.
And how many of us do that, right?
Oh.
Yeah, and then I even try to justify it in myself as it's work,
because I know my partner, if the nurses don't reach me, they're reaching
him, and I know they reach me first
just by the order of... I'm sure how they typically
default.
Mm-hmm.
So, I feel guilt-
Mm-hmm
... and like a bad partner if I don't catch it
first. So I'm like, "Oh, no, it's going to affect this person." But then that
person's also a team player and worst case scenario, they're going to the ER.
True, and you don't want that. No one wants that.
No.
But-
Yeah
... at the same time, responsibility, yes, that's part of we
learn to live with that because-
Yeah
... we are there to help people. But,
at the same time, I always give this analogy to my partners
who also feel the same way about we want to help
everyone all the time.
Mm-hmm.
And
we have to learn to balance.
Yeah.
All of us are guilty of that because even in the plane, they tell you to wear
your mask first before putting on the person next to you.
So if I am
awake, alive, and healthy, I'll be able to help that many more people.
It is so true. I need to always circle back to that.
Right.
Yeah. So with the travel back and forth, and
if I remained in a state of low
HRV, which is not good-
Mm-hmm
... that means higher body stress, that means higher heart rates-
Mm-hmm
... and probably higher diastolic.
Mm-hmm.
So long term, what would that look like? High blood pressure.
That would have impact.
Yeah, the direct correlation data,
I don't think there is a ton of it, but it does tell
you that your sleep is not very restful.
Mm-hmm.
It does tell you you're not getting into deeper sleep.
How much deep sleep do you get?
Okay. So right now it's not good. Probably two hours.
Two hours is not bad, but two hours of deep sleep and give or take two hours of
REM.
Yes, and then the rest is light sleep.
Yeah, that's reasonable. That's kind of within ballpark if you sleep seven hours-
Yeah
... you're going to get about 20% and then another 20% of REM, 20,
25% of REM on a good day.
Okay.
So that's good. Four hours of restorative sleep is actually not
bad. Then in that phase, so this is
like we figured out, okay, how long-
Mm-hmm
... but how deep do you go on that?
Yes.
So that's what HRV and resting heart rate will tell you how well you
recover on that.
Okay.
When you go deep sleep, how
good of a rest you're getting.
Yes.
So-
On average
... HRV is not a comparison between you and I.
HRV is a comparison between you and you. You will see your trend.
Oh, my worst enemy and opponent.
Exactly. So you want to better yourself-
Yeah
... not someone else.
Yes.
So a lot of times people ask me, "What's a good HRV?"
Mm-hmm.
Okay, I can give you a statistical ballpark number that doesn't make
a difference to you today because-
Right
... we are on a path here.
Yes.
So
now you're here. Let's see how we can make it better.
Yes. And I know for a fact, my HRV is typically much higher.
Mm-hmm.
So this is
not my norm.
In short periods, we can all take them, right?
Yeah.
We burn a little brighter that day, and that's it.
But if nothing changed, it's not good.
Yes. So if nothing changed, mean you will need to prioritize your health, right?
Yes.
And will that be-
Yeah
... whichever way we do it with a wind-down routine, and a lot of it is simple
fixes, actually.
Yeah.
I agree.
Well,
I would like to pull from the bowl of random questions-
Let's do it
... if you're okay with it.
Okay. This is just more of a social
thing, a social text style.
Mm-hmm.
If somebody texts you, "Hey"-
Mm-hmm
... or, "How are you?"
Mm-hmm.
Nothing else. What do you think?
It's weird.
Right?
I am very used to the point text.
Yes.
Say, "Okay, tell me what you
need." If someone haven't spoken to you in ages, okay, and someone
texts me, yeah, I get that. We haven't spoken-
Do you say, "Hey," back?
I will just say, "I'm good. How are you?" And I would want to know, okay,
is it just casual or are we want... And it depends.
If someone is your friend, yes, that's different.
Or if it's a person you don't talk to often, of
course, it comes different.
For me, this falls in the pet peeve category. It's probably why I wrote it.
I get it.
Yeah. I think, at least in my experience, it's followed by the
ask.
Yes.
It's like, "What do you want? Give me a bottom line."
Exactly. Tell me, and again, it's contextual.
It's who is texting is the key also, right?
Yeah. What if it's your mom?
Well,
then I think it means a little different.
She might actually just be wanting to know if I'm okay, right?
Yeah. That's fair. You're just, "I'm fine, Mom.
What about you?"
Yes.
Okay.
Does it affect you
if you are going to sleep and the
pillowcase and the
sheets are not completely fresh and ready and tucked from a made
bed?
I think I'm 50-50 on that.
Does it bother you?
I like it, I prefer it-
Yeah
... but I'll just make do and fix it the best I can, then do
it.
Some people spiral with that.
Yeah, I guess my OCD is just not at that level yet.
It's getting there.
I love it.
Let's see.
Are you the personality type to talk about it if
something is upsetting you, or just let it go and start fresh the next
day?
Whether or not it happens again, what is your style?
I generally prefer to talk-
Yeah
... about it. And so there is a very interesting
TED Talk that I heard a while ago,
and primarily what he divided into is every
conversation
has a primary
sort of flavor to it, so to speak. Okay.
You want to be heard,
in which case you can converse that way.
When two people are not on the same wavelength, that's when you don't understand
each other, and that's when conversations spiral, right?
Yeah.
So
when I'm conversing with you,
I come to you with a problem, and that I try to apply in my work also.
If someone comes to me with a problem, okay, you want to be heard, which means
you're just frustrated, and it'll be good if I hear it out and see if
I can do something about it.
Mm-hmm.
You want to be helped. If it's a problem-specific thing,
okay, give me your problem, and I'll do my best to solve it.
Like they're actually looking for a response, like weigh in.
Problem, solution.
Yeah.
Or I'm just telling you this, I know it may not be solved, but I'm telling you
this. Or number three, you want to be hugged.
If it's just an emotional conversation with someone you like-
Oh, that's true
... and a friend. And that's where I think
it goes sideways. Someone could be just coming, it could be a friend or a family
member coming for just a conversation of hugging,
basically. They just want-
Yeah, like, "Hold me. Life was hard."
Exactly. And then if I approach it in a helped
way, it doesn't go very well.
So sometimes I'm like, you know what?
Why can't we just
put a header on every conversation? This is a heard conversation.
This is a helped conversation.
That's so funny. I know if we could just start there, that would also help
me.
Exactly.
Like you don't need anything from me. You just want me to listen.
You're going to talk at me.
Just tell me.
I'm fine with that.
Exactly. Give me the header in the beginning, and I'll comply.
Gosh, that would help in relationships, too.
Yeah.
That really would... That wavelength, it's like this.
Exactly. Sometimes you're just two trains crossing each other because you're both
on different tracks.
Yeah. Are you married?
I am.
Yeah.
Three kids.
I forgot you had three kids.
Yeah.
Wow. How old are they?
So the boys are going to be in eighth grade now.
Okay.
So.
Man.
And my daughter, she is going to be a senior.
Okay. Wow. Anything fun with the
talks and being a parent and a cardiologist,
essentially you do it all. Anything fun come
up?
So,
like you learn to be a cardiologist.
Mm-hmm.
I think there is a learning to be a parent as well.
And there is no manual on that.
Yeah.
Okay.
I can see that. It looks hard.
Looks hard, right?
Yeah. It's wild.
So to me, that's like the hardest job.
Kids don't come with instruction manuals.
It'd be nice if they also came with headers and manuals.
And they are all different, right?
Oh my gosh.
And it's a lot of fun. But
I realize in my early career, of course, there is cardiology, which
is a busy trade to begin with. Then business.
Putting it all together,
the thing that initially takes the short shift for most of us, I would feel,
in medicine, is the family.
And
that's the part that
is like, okay, initially you do it.
Mm-hmm.
And
if you have a supportive partner, that works, right?
Yes.
On the same wavelength.
Exactly,
and fortunate to have that. But then-
Lovely
... as I learned more over time, the balancing, you
learn a little more balancing.
And
then, I'm in my 40s, so what we call the 40s
squeeze.
So
Your professional career is at a different wavelength.
Uh-huh.
Your personal life, kids are growing up.
You want to spend time with them. You want to actually be a part of that life too.
Yeah.
Because their life is changing in a different way too.
So it's how do you balance everything?
Oof.
That's the key.
I've never heard that term. I think I'm in the 40 squeeze.
Could be.
You see this light bulb above my head?
Okay.
Well, asking for a friend, is
it possible?
Very much so, I would say.
There's a lot of living you can do in one year, six months, three months.
There is. Again,
like anything, so
if you get in that state where you're actually
in that moment... So,
have you read that book, "The Power of Now?"
No, but I need to.
Eckhart Tolle,
I think if I had to give top 10 books in my life, that would be definitely one of
them.
Oh my gosh, I'm going to add it to my 40 squeeze.
It's now on the list.
Perfect. So most of
our problems, and I'm guilty of that like anyone else, too.
Yeah.
Okay? We worry about, okay, what's the business going to be tomorrow?
What's happening tomorrow? Oh, did I do this for this person?
Did I take care of this patient? Did I do this?
Yeah.
It always goes on, that ticker
tape keeps going in your brain, right?
To-do list. Real.
Exactly.
Mm-hmm.
But whether I look into the Eastern
wisdom, which I practice yoga, so I've read quite a bit
into that,
or
even
some of the modern spiritualism, so to speak,
the solution to everything is in this moment,
because frankly, I love that line in
that "Power of Now" he'll say,
"Do you really have a problem in this moment?" And if you think of it-
No
... the problem is really never in this moment.
It's not.
It's always in the past or in the future.
It never is in this moment.
True. Yeah.
So I-
Right now, everything is fine
... exactly. So I try to kind of remind myself of that a lot of times, and there
are times we get caught in the emotion and keep moving.
Mm-hmm.
But, most of our anger,
rage, or frustration, they come from, as they call, place of
unconsciousness.
Mm-hmm.
Learned that in yoga also. If you're
conscious, I don't think you'll manufacture misery for yourself.
Or people around you.
I hope not. If I'm doing that to me, I really wish I would stop.
But we do that a lot of times unconsciously, though, right?
Oh my gosh. Yeah. It's true. Yeah.
So the answer is to just stop doing that.
Easy.
It's like keep it simple, stupid, right?
Just the simplest things.
It's the hardest thing, actually,
to be present.
Yeah.
Most of us, I think that's a disease with all of us.
Totally is.
Not being present. Most of us,
and it was bad enough, and then came the smartphones.
Mm.
And it got worse.
Yeah. Definitely, yes.
Now,
the ones who were actually still in the present are even now in the smartphone.
So...
It's overstimulation. It's constant.
Yes.
Constant things.
Exactly. So your attention and awareness.
So in one of my interviews, I talked to Dandapani
about awareness and focus, and that is
one of the main issues, our awareness actually is just all over
the place.
He was funny.
He was really good, huh?
Yeah. Yeah, there were a lot of good one-liners that I feel I
definitely apply and recycle.
Very nice.
Yeah, I give him credit. I can't say his name, though.
Dandapani?
Dandapani.
Yes.
Okay, that helps.
Yes.
I had to practice it.
Yeah, just imagining no problems exist
in the now.
It starts in your mind.
Yes.
It's been the theme of today. Really, it's come up so much, but why is it
so freaking hard to apply that, the actual
applying of it?
Because we need to consciously remember it in that moment.
Is there any tools that we can use?
He had a moon picture.
Mm-hmm.
So basically, what he taught was to, your
awareness is like an orb of light. Move it to that area
consciously.
Yes. In front of you.
Yes.
So you're looking at-- Like I'm looking at you, you're in my awareness and
consciousness.
Exactly. Your awareness is right now here.
Yes.
In this room.
But I could drift off in conversation.
Yes.
But-
You just have to learn to bring it back. That's called being distracted, right?
Were you there whenever I talked to your staff?
As you're in the team-building meeting?
I wasn't there that day, actually. I was out of town.
But I heard it was good.
Can I tell you? I don't know if anybody mentioned to you, but
everybody was facing me, and so I'm facing, I could see
outside.
And I was just in the middle of talking, and then I see this little
squirrel
that is like, he's looking in the glass, and I'm like, "Oh my gosh, you guys, this
squirrel."
I went from hormones to, "Look at his ratty tail."
So off topic. That is distraction, right?
Well, that is-
If people joke about it
... but then you found something cool and you went with it, and that's
okay.
It was definitely real.
Oh, gosh. And I find that the cadence that people speak,
that matters, too.
Mm-hmm.
Some people, and the rise and fall, tonation
matters.
Mm-hmm.
Some people have a slow, it's so slow,
I feel like I took five naps.
Yeah, I know I'm guilty of that, too.
No, yours is not too slow.
No.
Yours is-
When I'm listening,
I have a tendency, I zone out sometimes, and then I catch
myself doing that. "Okay,
stay here. Stay here."
It definitely impacts my listening skills.
If somebody talks too slow, I'm like, "What is the rest of the sentence?
I just took a nap, and now I woke up, and then what was the rest of it?"
You guys are slow talkers. Remember, people are probably taking naps and checking
out.
Or maybe not. Maybe we are just not good listeners. That happens.
I like that you identified with that.
It wasn't a shout-out to you or calling you out.
Do you think you talk too slow?
I don't think so. But again-
I don't think so
... I won't know it. Someone else will.
Well, your pattern of speaking is not too slow for me.
That works, then.
Yes. If it were maybe a few notches more,
then
maybe... I guess you'll see if I forget the question.
Exactly. Then the podcast episode will be two hours long.
Well, thank you so much for taking time and coming on. I appreciate it.
And that's a wrap. Thank you, guys.
Thanks for having me.