Dr. Erin Nance, LITTLE MISS DIAGNOSED: A Surgeon's Guide to Breaking Bones and Bending Rules Erin Nance MD
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[0:45]Dr. Aaron Nance is the author of Little Miss Diagnosed, A Surgeon's Guide to Breaking
[0:49]Bones and Bending Rules, a biography of tragedy triumph and the high stakes world of modern
[0:54]medicine.
[0:55]Dr. Nance is an Ivy Leaked, educated, double-board-certified orthopedic hand surgeon who trained
[1:00]at the most prestigious surgical programs in the country, including the Hospital for Special
[1:04]Surgery, Lennox Hill Hospital, Memorial Sloan Kettering, Boston Children's Hospital,
[1:09]and Baltimore Shock Trauma.
[1:11]She has treated professional athletes and prisoners, world leaders, and houseless people.
[1:15]She is an international lecturer on social media, co-founder and CEO at Feel Better Health
[1:21]Visionary, and an inspiration to women young and old all around the world.
[1:25]Dr. Nance lives in New York City with her family.
[1:27]Welcome, Aaron.
[1:28]Thank you so much for coming on Totally Booked with Zibi Media Talk about Little Miss
[1:32]Diagnosed, A Surgeon's Guide to Breaking Bones and Bending Rules.
[1:36]Congratulations.
[1:37]Thank you, Zibi.
[1:38]This is the book launch day, so I feel like it's the birth book day celebration, and
[1:44]I'm like, so thrilled I could be sharing it with you.
[1:46]Oh, happy book birthday!
[1:49]Yay!
[1:50]And I'm sorry, this episode is not coming out then, but, you know, it'll come out eventually,
[1:55]and I hope by then, I can look back and see how awesome your whole pub day and everything
[2:00]was and how massively successful the book will be, because it's so good.
[2:05]And as you know, I inhaled it in two days, and I'm obsessed with the book, so yay.
[2:10]Thank you.
[2:11]I met your husband yesterday, and I said, it's always a good sign when the husband
[2:16]knows of the book.
[2:17]I feel like it's the same thing with my husband.
[2:20]If I hear something about his work, I'm like, okay, I know that's a big important project,
[2:24]right?
[2:25]It's so true.
[2:26]It took it as a compliment.
[2:27]Yeah, I am often reading next to him, and so I'm like, oh my gosh, listen to this.
[2:31]Oh my gosh, listen to that.
[2:33]Like, turn down your, you know, Instagram reels.
[2:36]I need you to focus here.
[2:38]Okay, so tell us more about your book and what they can get out of it.
[2:45]Of course, so little misdiagnosed is a memoir from my time as a female orthopedic surgeon
[2:53]in New York City, and it's about a girl who worked her whole life to become a surgeon.
[3:01]And when she finally does, she realizes it's nothing like how she imagined it would be.
[3:08]So that's kind of the, the big gist for, for people who are fans of the pit or graze
[3:14]anatomy or any kind of show that really humanizes doctors.
[3:19]I really wrote this book to number one, humanize what it feels like for a patient to be
[3:26]going through, you know, the medical system and difficult diagnoses and times.
[3:31]But then also to get the point of view from the doctor, what it feels like trying to help
[3:38]people, like what it feels like trying to work within a system that sometimes actively
[3:43]pits us against the people who are trying to help.
[3:46]Okay, I learned so much about being an orthopedist, by the way, at the moment, one of my kids
[3:52]wants to be an orthopedic surgeon.
[3:54]And so I am like, we'll be giving this as a gift.
[3:58]And also I pretend like I am a doctor.
[4:01]And so this book has, has fueled my own knowledge.
[4:04]But it's not really, I mean, it is about medicine, obviously.
[4:07]And we all learn so much and you're dad with such a like warrior as the medical doctor at
[4:12]Lennox Hill.
[4:13]And oh my gosh, learned so much from him as like a fixer.
[4:15]But it's really your story.
[4:17]It's a coming of age in medicine.
[4:19]It's your, and your family, how can you talk about it with your brother?
[4:24]Do you want to not talk about it?
[4:26]Because it was so moving.
[4:27]I think so.
[4:29]Before I wrote this book, I started a very popular social media channel called Little
[4:34]Mistagnosed.
[4:36]And I believe that every person has one Netflix worthy story about their life, right?
[4:43]Or at least lifetime worthy.
[4:45]Oh, my channel, yeah, the hard channel worthy.
[4:50]And I knew for me, that story was the story of my first day at work as a surgery intern.
[4:58]And what happened was I was on night shift, night float, they call it at Lennox Hill
[5:03]Hospital.
[5:04]It is my first day.
[5:05]It's to life, fourth weekend.
[5:07]Everybody knows that's the crazy weekend.
[5:09]Don't go to the hospital because all the new people are starting.
[5:13]my very first page I get is actually a phone call from my mom.
[5:19]And I'm like, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah.
[5:21]I'm like, I told everybody, like, don't call me.
[5:25]And she said, it's your brother.
[5:29]He was an accident.
[5:31]And we didn't have much details at the start.
[5:33]So I just, I kind of brushed it off and I said, I'm like, I'll make sure, you know,
[5:37]when attending reads as films, it's first day, people may not take it so seriously.
[5:43]And then I got a call from another brother who filled me in on what actually happened.
[5:49]And he was an a diving accident, broke his neck and was a quadriplegic and was being air
[5:55]lifted from the Hamptons to Stony Brook Hospital.
[5:59]So really the beginning of the book follows that journey from, you know, starting
[6:06]my first day to now I'm in the family seat, right?
[6:10]And I described that moment when I walk into the ER at Stony Brook.
[6:16]And everyone is looking at me like, oh my gosh, like here is like, this is our doctor,
[6:21]you know, like, and everyone is like counting on me.
[6:23]I'm like, I have an doctor for 10 minutes.
[6:25]Okay.
[6:26]I know nothing.
[6:28]And, you know, I feel like inadequate and I feel like so embarrassed is like, I feel
[6:32]so helpless.
[6:34]And I just realized that I can do the best that I can do.
[6:37]And if that means that everyone is looking to me to be the rock, like I'm going to
[6:42]fake it till I make it and be the rock in this situation.
[6:46]That story.
[6:47]I'm so sorry that that happened to you and your family.
[6:50]I loved the way you wrote about it.
[6:53]We, I was near tears reading the whole thing when you collapsed in the, the break room
[6:58]or sort of behind the scenes and we're just sobbing, you know, how can you not read without
[7:03]putting yourself in your shoes and just, anyone reading will think, oh my gosh,
[7:07]like what if this happens to someone I love and then you show us what it was like, like
[7:13]all of it and having the knowledge to from the medical side, but just everything about
[7:20]your family.
[7:21]And I feel like that was your way in because reading this book, you kind of fall in love
[7:25]with your whole family and all of those dynamics and your brothers and you being one of
[7:29]four and the only girl, you know, having finished the book, there was one moment where
[7:35]you were outside or on a walk with your brother or something and the wheelchair and you
[7:39]saw a toe of his move.
[7:41]And then we cut to the end where he's had a baby, which is amazing.
[7:46]Can you fill in a little more in between?
[7:48]Of course.
[7:49]So, you know, even as an orthopedic surgeon, I did not know what recovery was going to look
[7:56]like for someone with a spinal cord injury.
[7:59]At this point Christopher Reeve had had his injury.
[8:02]So it was a little bit more, I think awareness in the general population, but what I mean,
[8:08]no one would have known is that so my father was actually the general counsel or attorney
[8:14]for Lennox Hill Hospital.
[8:16]And one of his first days on his job was when a football player for the Jets, his name
[8:22]was Dennis Bird, was injured on the field and became a quadriplegic.
[8:27]My dad was the one to orchestrate all of that coordination, getting him because Lennox Hill,
[8:33]we are the team doctors for the Jets, taking care of Dennis from the field to taking him,
[8:39]you know, through, I think he ended up at a hospital, I believe in New Jersey, Kessler.
[8:43]But anyways, he had this exact like playbook of what to do when someone has this injury.
[8:50]And you think, okay, here's a family, the father is a medical attorney.
[8:54]My mother is a nurse, I'm an orthopedic surgeon.
[8:57]It was still so hard going through this process of recovery, getting him the right insurance,
[9:05]fighting for him to get the rehabilitation that he needs, fighting to get him, you know,
[9:09]to get a convertible van or a nurse.
[9:12]There could not have been a better equipped family to help with the situation.
[9:17]And it was still devastating for us and so hard.
[9:21]So that's just a little bit of like the background of what it's like being when you have
[9:25]a family member who has one of these devastating injuries.
[9:28]But, you know, when I talk with Kevin a lot, first of all, I want people to know,
[9:32]before I ever shared this story online, I actually texted him and I said,
[9:37]hey, Kev, I've been thinking of sharing the story from my point of view about your accident.
[9:43]Do you mind if I talk about it?
[9:45]And he said, he's like, hell yeah, I mean, I think he's always wanted to be famous.
[9:48]Like, and so, you know, so I, that story went instantly viral.
[9:54]On Tech Touch.
[9:56]And for the purposes of the book, I did want to kind of.
[10:00]It is my story, but I wanted to kind of show those moments of his recovery along the way.
[10:05]So it follows when he is in the, you know, straight after surgery and things as simple as
[10:12]when you're a quadriplegic, you can't, you know, scratch your itch. You know, when you're in
[10:18]the rehab facility, you are the only 21-year-olds among all the 80-year-olds recovering from
[10:25]hip replacement, knee replacement, you know, what it's like to move on with your life to realize
[10:31]you got to get a job. You have to make your own life for yourself. So I'm incredibly proud of Kevin.
[10:38]He actually can walk. I wouldn't call it functional walking, but he's able to do so many things.
[10:46]I never thought were possible as someone who takes care of these injuries on a, you know,
[10:51]a fairly regular basis. So yeah, I'm just kind of like a really proud big sister at this point.
[10:56]Oh, my gosh. Well, thank you for sharing the story and thank you to Kevin for letting it be shared,
[11:03]so moving, so powerful. So you captivate us with that early on and then how can we not want to read
[11:09]every word that you write after we hear the story? What was so interesting to me were all of the
[11:15]anecdotes about patients patient care and your interaction with other doctors. There's one passage
[11:22]or chapter rather that I am still horrified by, which is when the Riverdale student breaks his leg.
[11:29]It's an open fracture. So the bonus peeking out of his leg and at risk for infection. And
[11:36]the doctors you tried to reach one was on the way to the Hamptons and wouldn't turn around.
[11:40]And the other was at a concert in the Meadowlands and wouldn't come back and was like,
[11:44]I'll come back tomorrow and you had to scream at him. I know the chapter was illustrating
[11:48]using your voice, but I feel like what it was illustrating was such a failure on the part of
[11:56]doctors. Can you talk a little bit about that? Yeah. Well, I'll tell you when the lawyer for Harper
[12:02]Collins, you know, read this book, he said, I found it both entertaining and terrifying
[12:08]which is, I thought that's a good reaction. And you know, I, I wanted to share these stories not
[12:16]too necessarily like shame people or out people for bad behavior, but I think people should know
[12:23]what actually goes on. And that story, me trying to track down a doctor who's on call, who's
[12:32]non-responsive or just straight up refuses to see a patient, whether they're out of town or
[12:38]they find out the patient doesn't have insurance. These happen every day. And this was just kind of
[12:45]an egregious example that was, you know, one very memorable because I ended up cursing out my
[12:51]attending as an intern or something you do too. But it just kind of illustrates also the power
[12:59]imbalance between the trainees and the attendings. And listen, you have to have a structure
[13:07]to make things work. Right. Medicine is in essence the same structure as the military. And you
[13:12]need that to, you know, move things along to help, you know, with the pedagogy and teaching. But what
[13:18]it does is create a culture where those who are lower in rank don't feel comfortable speaking up
[13:25]or trying to like implement any change. So at this point, I mean, it's a holiday weekend,
[13:31]there is no doctor available to help this, you know, poor kid. And this could become a life or death
[13:38]situation. So it took a life or death situation for me to gather the courage to call out one of the
[13:45]attendings. But these like power imbalances are playing out every day all over the country.
[13:52]Oh my gosh. Well, that was terrifying. And I'm glad you spoke up and I hope more people follow
[13:57]your lead after they read this and do the same thing. You have also a lot of stories where
[14:05]your own personal life sort of intersects with your medical life. So when you decided to have
[14:11]a child and timed it to your like rotation and your fellowship residency rather. Talk about that
[14:20]and how you had said to one doctor that he had joked, Dr. A had joked, I hope you're not pregnant
[14:25]and then like two weeks later, you're like, yeah, actually I'm pregnant. Talk about that. And how
[14:31]how on earth you didn't take a day off in your entire pregnancy and we're doing all of that
[14:40]despite how you felt. How do you do all that? Yeah, I will tell you my pregnancy was the least
[14:45]stressful part of that entire year of my fellowship year. What's looking back is apps is an
[14:52]absolutely insane thing to say. But you know, I came from a big family, right? I'm one of four. My
[14:58]mom is one of eight. I love being like surrounded by by all my siblings and cousins. And I knew going
[15:05]into being an orthopedic surgeon that I was proud that was not going to be in the cards to have
[15:09]like a big massive family. Although I do write about Dr. Appoyard who has four children and who
[15:16]rockstar. But I and this is one of those things that to me is more of an unspoken rule, right?
[15:24]There is no nowhere written in stone. You cannot have a child when you are in med school or residency
[15:30]or fellowship, right? But there are some rules in place. Like for example, in training in residency
[15:38]and fellowship, you are not allowed to miss more than two weeks of work. Otherwise you have to
[15:43]repeat the year. Okay. So by all means have your kid and then come back within two weeks so you
[15:51]don't have to repeat another year, right? So there are just again systems in place that make it
[15:58]really difficult or at least 20 years ago when I was in training to to have a kid. There is no
[16:05]daycare at the hospital for residents, right? So you're on a resident salary making $50,000 and you
[16:13]need to find child care at 4.30 a.m. Come on. That's that's not reasonable. And I have to say there
[16:22]was a I was a second year general surgery resident. There was a gensurge intern who had a child.
[16:30]She had her mom come live with her. I write about in one of my other surgical interns. She sent
[16:36]her newborn twins to Korea to be raised by her family while she was in internships. So it's not
[16:44]that it's impossible, right? But do we have to make it so that you have to send your children to
[16:50]a foreign country to be raised by the only outside network that you have? I don't think that's
[16:57]you know, a very supportive system. Oh my gosh. Tell me more about your TikTok fame and how you
[17:06]reversed engineering the algorithm and how the use of these other platforms can really augment the
[17:13]most sort of essential profession around saving people's lives, healing others. Because you don't
[17:19]think about TikTok is a big healer. You know what? The reason why I started Little Bistock
[17:25]Nosed was I had another channel called the hand doctor and I got a DM. You didn't even know
[17:30]doctors had DMs, right? It'd be a lot easier to get medication. And this woman is a desperate
[17:40]and she said, dear Dr. Nance, I don't normally talk to strangers on the internet, but I'm desperate.
[17:46]I've had 10 years of fingernail pain and nobody believes me. I've seen five doctors. They can't
[17:53]find anything wrong with me. They make me think, feel like I'm going crazy. Is there any way
[17:58]you could help? And because I couldn't help myself, I said, dear desperate. I too don't normally
[18:05]talk to strangers on the internet. But out of curiosity, do you have a little blue dot under your
[18:10]fingernail? She said, I do have a little blue dot. So I told her, you're going to ask your doctor
[18:15]to get an MRI of your finger. It's going to show you have a glomus tumor. You're going to get a
[18:19]a hand surgeon to take it out and you're going to be cured immediately. And so about six weeks later,
[18:24]I get another DM. OMG, Dr. Nance, I got the MRI showed I had a mask and it took it out. It was a
[18:30]glomus tumor. And I have no more pain. Thank you. Thank you. And now what this woman did not realize
[18:38]is if you go on to Google and put in PubMed, glomus tumor, my name comes up or my maiden name,
[18:44]Aaron McDermott, because I'm one of the world's experts on glomus tumors. But she didn't know
[18:50]that when she messaged me. Right. And what she was looking for was someone who would believe her
[18:56]because if someone believed her, then someone could help her. And so that's when I started
[19:03]sharing just these stories of me kind of being a patient advocate. And these examples of me
[19:10]really fighting for patients and listening to patients. So people and everyone was just
[19:15]gravitating to these stories. They're like, Oh, like, I wish that's how I felt. You know, I wish I had
[19:20]a doctor who was fighting for me. And then I was getting inundated. And when I say inundated,
[19:26]I'm meaning over 10,000 messages and emails and DM's a week of people asking me to share their
[19:32]stories so that just one person wouldn't have to go through what they went through. And so one
[19:40]person wouldn't feel alone in what they were struggling with. And that's really how my channel went
[19:48]viral. And I use the medium of storytelling to get these messages across. So I did a very viral
[19:56]viral series called the 31 first 31 most common.
[20:00]missed diagnosed conditions in women and I would always start the video off with a patient story
[20:06]about what happened and then I would go into the details, the facts about, you know, what this
[20:12]condition is and then always a call to action for people to share their experience and their stories
[20:19]and if anyone is listening who wants to make a TikTok and go viral, the key to virality is the
[20:26]comments. There are more likes for the comments than the original video. So if you make something
[20:34]that compels someone to share something of their own because people are going to resonate with
[20:41]that comment, right? And then they're going to talk about their experience. Someone's going to resonate
[20:45]with that and that would be my big takeaway is make a piece of content that makes somebody feel
[20:53]something and feel compelled to pass that on. Well, okay. Well, thank you for doing that and all of
[21:04]the people who you've helped by doing that and I literally like, I'm like, wait, am I still
[21:10]interviewing Dr. Nance? I'm so compelled. I feel like I was watching a video myself. I'm like, it is.
[21:17]Why write a book? So it was funny because I had not really intended to, oh, that's a bit of a lie.
[21:26]Three or four years ago, I thought I would love to write a book, right? But I didn't really know
[21:31]where to start, right? I didn't know how to do it. I knew I had the story that I wanted to tell
[21:37]which was that story of my first day of work, but didn't really know what else like a book would
[21:42]amount to. So I ended up writing that chapter. I'm down. I sent it to a couple of friends. I
[21:49]said to someone who I didn't know actually and I said, can you read this and just tell me if it sucks?
[21:54]Okay. Like you don't know me. Like feel free. Like be brutally honest. And she was like, I love it.
[22:01]You know, this, this is great. But again, I didn't know like what to do with it. Like I don't know
[22:06]do I, do I write it as like an essay and send it to the New Yorker? Like I don't really know.
[22:11]So I just sat on it for a long time actually. And then when I started my, I tick top channel
[22:18]and I did these video stories, then I thought, okay, like this is now kind of like a
[22:24]maybe a collection of something. I had a ghost writer reach out to me and they said, have you
[22:30]ever thought of writing a book? And I said, you know, not really. But and he said, well, you know,
[22:36]I could help you. I'm sure you have a lot of literary friends that I don't have any literary friends.
[22:42]I said, but I do have one really big literary friend. And this is my friend Jenny Jackson,
[22:47]who is the author of pineapple street. And she is a, is an editor herself. And we had coffee. And Jenny
[22:55]said, you are the storyteller. You don't need to go straight. Like you're, you're the one who has
[23:00]the, the stories. So within a week, I was contacted by three agents. We worked all summer on writing
[23:09]the proposal. I think that's what it's called. And that October is when that 31 for 31 series was
[23:16]going super viral. And I said, I think we have to take the book out now. And I was very fortunate
[23:23]that I signed with Day Street at Harper Collins. They were the first people to believe in me. They,
[23:28]they absolutely saw the vision from the start. And what I really appreciated about them was
[23:36]it's actually not that easy to convert an audience from one platform to the next, right? It doesn't
[23:42]mean because you have a million followers that they're necessarily going to read your book. And it's
[23:48]also doesn't mean that just because you have a viral video that that's going to make a good chapter.
[23:54]So even though the book is chronological in nature, I tried to write it like a chicken soup for
[24:02]the soul style book where you could just honestly pick up any chapter and be entertained by the
[24:10]story and get like a life lesson from it. Cause I, I'm sure all your readers are like really
[24:16]serious highbrow readers. But if they're like me, I have a lot of books where I just like
[24:21]read the first couple of chapters. And then I abandoned them. So I wanted to make it a book that
[24:27]yes, you could read a cover to cover. Or if you just wanted to read a couple of chapters at a time,
[24:32]you could do that as well. Amazing. Well, well done. I think it's so consumable because
[24:40]it's so voice driven. Like I feel like you're just talking to me. And it's less a book than like
[24:46]the most engrossing conversation. So that's a huge compliment. And it's funny when I did the audio
[24:54]book, you know, like a first time author and they, I think they were impressed because I, you know,
[25:00]this is kind of what I've been doing for years. I've been talking one on one in these videos.
[25:06]And this is also a secret for people who are not on TikTok. TikTok is not a platform for dancing
[25:13]kids. Okay. TikTok is an information sharing platform. And for me, and I tell this, you know, people
[25:20]say like, what, why is everyone watching these get ready with me videos, right? It's not about the
[25:26]makeup. Okay. It is a cue that someone is about to tell a story. And TikTok is really at the heart of
[25:36]it, a storytelling platform. So I tell people also if people are kind of of my age, I'm in my,
[25:45]early 40s, the best place to start is on TikTok because no one you know is on TikTok.
[25:53]It's so less cringy. I mean, if you look back on your first videos and you don't feel cringy,
[26:00]you're not doing it right. Okay. It's, it's meant to feel awkward. It's meant to feel cringy.
[26:06]But you learn from it. And listen, there is a creator, his name is Mr. Beast. He is the world's most
[26:12]famous influencer and people ask him all the time, how do you make a viral video? How do you
[26:17]get people watch your videos? How do you make everything go viral? And he tells everyone,
[26:22]the question you should be asking is, how can I make this video the best possible video I can make?
[26:29]And just, just start. And you will grow from it. You will learn from it. I prefer storytelling.
[26:37]Other people do more, you know, vlog style or, you know, clip styles. You can experiment
[26:43]with the different strategies. And for me, I feel like medicine lends itself to storytelling so
[26:51]naturally that that's, that's my preferred way of getting both education across and also
[26:58]as a way to humanize medicine. Love it. Erin, thank you. Thank you for all that you do to help
[27:05]so many people. Thank you for this book. Thank you for even the entertainment of it. The
[27:10]emotional ride, the openness and vulnerability and the hope. I know hope is such a critical part
[27:18]of the journey. You want to hope for your brother. You have hope for so many patients. You have
[27:22]hope for people out there who are struggling. And that is in short supply these days. So thank you
[27:27]for that. Oh, you're so welcome. You know, the real takeaway is that the most powerful drug is hope
[27:33]and that people are good medicine. Love them. Congratulations on pub day. Go celebrate. Thank you.
[27:41]Fire and thank you. Thank you, Zibi. Bye. Thank you for listening to totally booked with Zibi,
[27:48]formerly mom's don't have time to read books. If you loved the show, tell a friend,
[27:53]leave a review, follow me on Instagram at Zibi Owens, and spread the word. Thanks so much.
[27:59]Oh, and bye the books.