Dr. Lucy McBride, BEYOND THE PRESCRIPTION: A Doctor's Guide to Taking Charge of Your Health
[0:00]Welcome to Totally Booked.
[0:02]I'm Zibi Owens.
[0:03]I've interviewed more than 2,000 authors on this show and learned endless amounts about
[0:09]storytelling, reinvention and life itself because when you talk about books you're really
[0:13]talking about life.
[0:14]So get ready to hear from today's best authors.
[0:18]The best-selling and the not yet discovered.
[0:20]Come find your next great read and the story behind it.
[0:24]Enjoy!
[0:27]Lucy McBride MD is the author of Beyond the Prescription, a doctor's guide to taking charge
[0:33]of your health.
[0:34]Do you ever meet somebody and feel like maybe you guys would be friends in another
[0:37]life?
[0:38]Maybe it's because we have a shared mutual friend who we've both known for ever, but
[0:42]I don't know.
[0:43]I could have...
[0:44]I don't know.
[0:45]I just really enjoyed talking to Dr. Lucy.
[0:47]Anyway, Dr. Lucy McBride is a primary care physician and co-founder of the Acryly McBride
[0:53]Group in Washington, D.C.
[0:55]For over 25 years, she has practiced evidence-based relationship-centered medicine, a graduate
[1:01]of Princeton and Harvard Medical School with a master's degree in pharmacology from Cambridge
[1:05]as a full bright scholar.
[1:07]She completed her internal medicine residency at Johns Hopkins Hospital.
[1:11]She writes the popular weekly newsletter, Are You Okay, Unsubstac, and hosts the podcast
[1:15]beyond the prescription.
[1:17]Her work has appeared in The Atlantic, The Washington Post, and USA Today.
[1:20]She has contributed to CNN, MSNBC, and PBS, advocating for a holistic patient-centered
[1:25]approach to health, and, by the way, she will be at our event in New York City on October
[1:31]25th, where we're doing a whole day of fun panels and more, so save the day, Dr.
[1:36]25th, enjoy our conversation.
[1:39]Welcome, Dr. McBride.
[1:40]I'm so honored to have you on my show to talk about beyond the prescription, a doctor's
[1:45]guide to taking charge of your health congrats.
[1:48]Thank you so much.
[1:49]I'm thrilled to be here, Zippy.
[1:50]Yay.
[1:51]Okay.
[1:52]I'm going to take a page out of your book and start this conversation by asking you
[1:56]something you ask everybody else, which is, what does health mean to you?
[1:59]Wow.
[2:00]Great question.
[2:01]Health used to me to me being a certain body size, being fit, eating my broccoli, and feeling
[2:10]good, you know, like my labs were normal, but health over the years has come to me in
[2:18]something much more nuanced.
[2:19]And this is what I talk about in my book.
[2:21]To me, health is not just about a set of lab tests.
[2:24]It's not about someone else's protocol or prescription.
[2:27]It's about an internal sense of agency where you have control over things, and it's
[2:33]about learning how to accept the things you cannot control.
[2:36]It's having the wisdom to know the difference.
[2:38]I basically think of health as a secular version of the serenity prayer.
[2:42]As a way of helping my job as a doctor, as to help people understand where they have
[2:47]to accept hard truths, genetic predispositions to disease, things that happened to them,
[2:54]environmental factors out of their control, and where they have control.
[2:58]Because guess what?
[2:59]We have a lot more control than we think, and health comes from knowing the difference.
[3:04]I love that.
[3:05]Well, your whole approach, which is seeing, essentially seeing the whole patient, right?
[3:09]Like it's not enough to just look at your labs is you have to see what is going on.
[3:13]You have so many examples in here.
[3:14]Are you dealing?
[3:15]Are you a primary caregiver for your Alzheimer's, written loved one?
[3:20]What do you have on your plate that could be affecting all the things and taking it all
[3:24]into consideration?
[3:25]Then you reinvision the health care system in a way that literally I felt like I sighed
[3:30]and my shoulders went down and I was like, yes, this is what we need.
[3:35]Can I read just this one paragraph of your vision of what health care could actually
[3:40]look like?
[3:42]Imagine walking into a primary care office where your doctor spends the entire appointment
[3:46]looking at you, not a discreet.
[3:49]Behind the scenes, AI has already synthesized your latest lab results, updated your medications
[3:54]across all systems, flagged potential drug interactions, and prepared a detailed report
[3:59]of all outside records and specialist recommendations.
[4:03]Your tetanus shot from that urgent care visit last month, it was automatically integrated
[4:07]into your record.
[4:08]The chest pain you mentioned to the cardiologist, your primary care doctor already knows
[4:11]about it.
[4:12]Then together, you and your doctor create a personalized treatment plan that no AI agent
[4:18]could arrive at.
[4:20]Boom, love, discuss.
[4:22]The point here is that AI is coming from medicine is here already, but caring for human
[4:28]beings is a uniquely human endeavor.
[4:32]And so what if we had AI do all the grunt work, the collecting of all the disparate
[4:37]pieces of information about you through in different medical systems, and then allowed
[4:43]AI to elevate the patient doctor relationship?
[4:47]That's where the action happens.
[4:49]The most important moment in my office isn't when I write a prescription for libitor,
[4:53]a prozac, or a zepic.
[4:55]If the moment when the patient realizes I'm paying attention, it's when they understand
[5:00]that they can talk about their sex life, their body image, their worries about their memory,
[5:08]the things they're embarrassed to say out loud.
[5:10]That is the ground work, trust between two human beings for receiving information when I'm
[5:16]listening and for dispensing advice tailored to the person.
[5:20]We need a whole school of Dr. Lucy McBride practitioners.
[5:25]It's nice.
[5:26]It's nice.
[5:27]Here's the truth, Zibi.
[5:29]It's not about me.
[5:30]Thank you.
[5:31]But most of my friends, I'd say all of my friends who are in primary care, most of my
[5:36]friends who are doctors all went into medicine, not just to treat lab results or CAT scans,
[5:40]but to treat the person, to treat the human being.
[5:45]But the system is broken.
[5:46]I don't need to tell you that doctors have very little time when they are being reimbursed
[5:51]by insurance companies.
[5:52]They are working for insurance companies, essentially.
[5:56]Interrupt patients in 11 seconds, that's what the data shows.
[6:00]How can you possibly feel comfortable disclosing information or even thinking it's relevant
[6:06]information about your life to your doctor when you don't have that much time?
[6:10]What we need is not more, we need more primary care doctors who already want to care for
[6:15]the whole person.
[6:17]We need doctors to understand that there is possibility out there to be in a primary care field
[6:21]where you aren't morally injured by having to tell an 80-year-old patient,
[6:25]I've got 10 minutes to go over your 13 medications, the loss of your wife, your recent
[6:29]hip fracture, and your chest pain.
[6:33]We need to incentivize graduates of medical schools to go into primary care fields by showing
[6:39]them what is possible, leveraging AI.
[6:42]We need patients to demand to first know what's possible, and then to demand that one
[6:48]person at a time.
[6:49]That's why I wrote my book to empower patients one at a time to start.
[6:53]the already existing movement to demand what patients and doctors want.
[6:58]We both want the same things, the system won't allow it.
[7:02]Okay, and just one more note on this before we get into some of the specifics so that the
[7:05]average person listening can be like, okay, here's something I can take away today, but how
[7:11]when you say we all need to demand it, like let's say I feel empowered after I read your book
[7:16]and read this conversation like, yes, this is the new model, this is what I want, what do I do?
[7:21]Okay, so you're going to read the book and the book, so the book is not a, it's not a
[7:26]here's what to do, here's do what I say, a book.
[7:28]It's a here's how to think about your health in a more nuanced way, and how does that happen?
[7:33]It starts by asking better questions, so health isn't about having all the answers, it's about
[7:38]asking better questions, so my book gives you a whole library of questions to ask yourself.
[7:44]The questions that your doctor doesn't have time to ask you, so for example,
[7:49]patients ask me all the time, do you think I have anxiety?
[7:53]What they're really asking me is do I need to be treated for an anxiety problem,
[7:56]but what they're asking is do I have anxiety? And the answer I have is we have anxiety, all of
[8:01]us, it's part of the human condition, it's built into our DNA. The question isn't, do you have anxiety?
[8:06]The question is, how much does your anxiety, your fears, your worries, your ruminations,
[8:12]affect your mental health, your physical health, your chest, your head, your gut?
[8:20]To what extent is it informing your relationship with alcohol, your relationship with food,
[8:23]your relationship to work? And to what extent is it interfering with your quality of life and
[8:28]occupying too much brain space? Because if you go into a doctor's office who has 10 minutes and you
[8:34]say I have anxiety, you're more likely to walk out with a prescription for Prozac or a pamphlet
[8:38]about deep breathing? You need to empower yourself first by asking yourself these important
[8:45]questions about your mental health, about the relationship between your lab data and what you eat
[8:52]and where you live. So the book contains like a taxonomy of questions to ask yourself you have a
[8:59]whole set of data and information that no doctor is ever going to get and no doctor is likely
[9:04]ever asked you. So you need to package yourself up and then bringing a more honest and sort of
[9:09]wholesome, that wholesome, full sum rendering of yourself to those appointments, whether it's
[9:14]the ER or your primary care doc. So what I'm saying is that you need to ask yourself questions
[9:21]that no doctor will have time to ask you and that's what the book does. It helps you map your
[9:25]whole ecosystem so that you can squeeze the juice out of that 15 minute medical appointment.
[9:31]I love that. It's so important and it's sort of a continuation of the body keeps the score
[9:39]framework of thinking about okay well maybe my neck hurts not because of XYZ but because this
[9:45]really terrible thing just happened and I'm holding it all in and you know let me take a beat and
[9:50]just think what things in my life could possibly be affecting my health and then go from there.
[9:56]That's it. Literally I just saw a patient two weeks ago who has been tooth.
[10:00]three neurologists is on all these different medications
[10:02]for her migraine headaches.
[10:04]It turns out when I examined her, her jaw is tight,
[10:08]the right side of her neck here is jammed up,
[10:12]and she has a really toxic workplace.
[10:15]So there's no pill, there's no prescription
[10:18]for just taking a moment
[10:22]and her understanding the connection
[10:25]between her desk posture, right?
[10:29]The way she sits at her desk,
[10:30]the weakness between her scapula muscles
[10:33]that is informed by flouching over a desk like we all do.
[10:37]The stress that is causing this one particular muscle
[10:40]to jam up and trigger migraines,
[10:43]that is a combination of insight on her part.
[10:47]Me asking her questions, having time to ask those questions,
[10:50]and then her realizing that the treatment
[10:52]isn't a set of pills, although they might help temporarily.
[10:56]It's physical therapy, it's posture,
[11:00]it's self-compassion for the enormous stress
[11:02]that she's holding in her muscles,
[11:04]and then asking for help at work,
[11:06]advocating for herself talking to HR.
[11:08]So sometimes people don't need prozac,
[11:10]they need a divorce.
[11:12]Sometimes they don't need,
[11:13]sometimes they don't need ozempic,
[11:16]they need to have lunch or accept their body
[11:18]that's not overweight.
[11:21]Sometimes we don't need, you know, hormone therapy.
[11:25]Okay, I'm a huge believer in hormone therapy.
[11:26]So this is not a knock against HRT,
[11:28]but sometimes we don't need HRT, we're 30 years old.
[11:31]We just need permission to take a day off
[11:35]and stop counting our steps on our sleep.
[11:38]Amazing, I love that.
[11:40]Can we back up for two seconds?
[11:41]Where, what is your personal story?
[11:44]And I know you include some really, you know,
[11:47]vulnerable moments in the book,
[11:48]and you talk about your disordered eating in college
[11:51]and depression anxiety and all that,
[11:53]and I really appreciated you opening up about yourself
[11:56]in the context of this whole health journey.
[11:58]But like, what is your story?
[12:00]How did you become a doctor?
[12:01]What were you like as a kid?
[12:02]Like, how did we get here?
[12:03]So lovely to be asked that question, Zibi,
[12:06]because I'm always like caring for other people.
[12:07]So it feels really nice to be asked that question.
[12:10]So I'm the typical, like, I'm the oldest child,
[12:12]I'm the only daughter, like, overachiever,
[12:15]like anxious, perfectionistic, like people pleasing.
[12:18]I'm a recovering people, please,
[12:19]or as I tell people, I still like being liked.
[12:22]But I don't like hang my hat on other people's opinions
[12:24]of me, right?
[12:25]Like that's part of the beauty of getting older.
[12:28]But yeah, like, where did you grow up?
[12:30]In Washington, D.C., nations capital, stone throw
[12:33]from, you know, the Capitol Hill.
[12:36]New, I wanted to be a doctor in high school,
[12:38]I mean, to the extent you know anything
[12:40]when you're in high school.
[12:40]But I liked biology and I liked math.
[12:43]I was like a total math nerd,
[12:45]but also played sports and was social.
[12:47]That's wonderful.
[12:48]What sports did you play?
[12:49]Field hockey in the cross?
[12:51]Amazing.
[12:52]Field hockey in the cross.
[12:52]Yeah.
[12:53]Yeah.
[12:54]I mean, some of my best friends are my friends
[12:56]who we, you know, riding the bus together to games
[12:58]look across.
[12:59]I mean, we like, it's like my gaggle of friends still.
[13:01]My best friends from high school went to college,
[13:06]met my husband, he wasn't my husband then.
[13:08]That was like a bad word when we met.
[13:10]Like marriage was like, you didn't talk about marriage
[13:12]when you were 19.
[13:13]But he was cute.
[13:15]He was the soccer player.
[13:16]There was sort of a handsome, like, jock.
[13:18]And I'm the pre-med student and everybody thought,
[13:21]oh, that'll last five minutes.
[13:22]And here we are.
[13:23]We've been together for 31 years,
[13:25]maybe for 25, we have three kids.
[13:27]And we're the into each other's gang.
[13:29]I mean, he is like, the reason my book
[13:31]is dedicated to my husband is because he's the best.
[13:33]Where I am like hard, he's hard charging.
[13:36]Like he's smart and he's ambitious.
[13:38]But he's so balanced and so I learned a lot from him.
[13:42]Just like I've learned from my patients and my children.
[13:45]Was an art history major in college.
[13:47]Cause I knew like, you know, I'm an art person.
[13:50]Like I'm not really like all science all the time,
[13:53]kind of person.
[13:54]But was pre-med, went to medical school.
[13:57]And it was during college where I got really anxious,
[14:00]didn't know what it was.
[14:03]I just was, I think in that era, in the 90s.
[14:09]Like we didn't have a vocabulary with which
[14:11]to talk about our feelings.
[14:12]We certainly didn't talk about it in my family,
[14:13]even though my mom's now a therapist later in life.
[14:17]We didn't, I didn't connect the dots between how I was feeling
[14:21]internally and how my, I was thinking.
[14:24]And I got into a situation where my body was failing me.
[14:28]I had digestive problems, headaches, vertigo.
[14:31]I was tested for everything from Jardia to brain tumors.
[14:34]I saw neurologists.
[14:36]And no one ever asked me, you know,
[14:37]here's this like 1920 year old kid at Princeton University,
[14:42]like ding, ding, ding, like over a cheaper vibe.
[14:46]Like, no one ever said to me, like, what's going on in your life?
[14:49]And what I would have said, I think, is like,
[14:52]I feel anxious, I feel vulnerable, I feel scared, I don't know what.
[14:57]I don't, and every time you tell me my labs are normal,
[15:00]it makes me feel like I'm crazy.
[15:01]And then I had a doctor say, once you run,
[15:04]start running to take some of the like stress out of your muscles
[15:09]or something, or I don't know what, or to help with your head.
[15:11]And then I lost weight.
[15:12]And then you're off to the races with like a perfectionist of kid,
[15:15]restricting calories.
[15:17]Somehow I recovered from that on my own.
[15:19]I think I took myself to therapy when I was in medical school.
[15:22]I found someone in the yellow pages in Boston.
[15:25]And like walked into her office.
[15:27]And I was like, this is weird to talk about feelings,
[15:29]but it felt intuitively right.
[15:31]And she gave me two important things.
[15:33]Permission to ask myself questions about my interiority
[15:38]and permission to be compassionate with myself.
[15:42]It's not that I don't like myself.
[15:43]It's that I was just a hard-charging person
[15:45]who didn't think I had needs.
[15:46]I didn't think I'm, I didn't think it,
[15:48]I like, why should I have needs?
[15:50]Like other people have needs, I don't need needs.
[15:52]And that was transformative.
[15:54]And you know, since then, I've seen everything
[15:57]through the lens of emotional health and mental health,
[15:59]not that understanding your emotional health
[16:02]or how your brain works can prevent you from breast cancer
[16:05]or, you know, treat your toe fungus.
[16:09]But having self-awareness and insight
[16:12]about how you think, feeling, behave
[16:15]has everything to do with your sense of agency
[16:20]over your medical outcomes.
[16:21]Behavioral health, the way we relate to food
[16:24]and alcohol and other people,
[16:26]the way we relate to our doctors,
[16:28]whether we take their advice or not,
[16:29]has everything to do with our internal narratives,
[16:32]the stories we tell ourselves about worthiness or,
[16:36]you know, control.
[16:38]And so, you know, I'm kind of like a psychiatrist
[16:41]in a primary care doctor's costume.
[16:44]I'm really just a communicator of risk
[16:46]and helping people understand where,
[16:49]what their needs are, what their goals are.
[16:51]And I'm a communicator who happens to have an MD.
[16:55]If only all doctors could be like your type of doctor.
[16:59]I mean, that's the problem when you try to find somebody.
[17:01]Like, it doesn't say that in zach-dach.
[17:04]You know, like, it's hard to know
[17:06]when you're so busy and trying to book appointments.
[17:08]Like, how do I make sure I get a compassionate caregiver
[17:11]and if you go and you don't like, okay,
[17:13]well too bad, miss that onto the next.
[17:16]Yeah, I think you have to trust your intuition.
[17:18]I think one of the sad tragedies
[17:21]of the modern healthcare system
[17:22]and also the wellness industry
[17:24]is that a lot of people have outsourced their intuition
[17:27]to either doctors or protocols
[17:30]or kind of other people's ideas of what is healthy.
[17:35]And I think, you know, we have wisdom,
[17:37]I think women in particular are very wise.
[17:39]We have a lot of information internally.
[17:41]It shocks me when people say to me,
[17:43]it doesn't shock me anymore, when they say like,
[17:45]hey, I started using my aura ring
[17:49]and I realized that when I drink like four or five glasses
[17:52]of wine, my sleep isn't that great.
[17:53]I asked a patient recently who told me that.
[17:56]I'm like, did you not know that you slept well without it?
[17:59]Not trying to make her feel bad,
[18:00]but she's like, yeah, I did.
[18:01]I just, she wasn't trusting her intuition.
[18:06]We need to understand that if you feel
[18:08]in a relationship with a medical provider
[18:10]that you are being dismissed, talked over or not heard,
[18:14]like you're probably right.
[18:15]And in my book, I give you some vocabulary
[18:18]with which to have a conversation,
[18:20]not a adversarial conversation,
[18:22]but a conversation that invites curiosity
[18:25]from the provider and that signals that you're wanting
[18:29]to partner with this person.
[18:31]Because again, it's not always the doctor's fault.
[18:33]It's the system.
[18:34]So there are ways in which you can ask for help
[18:37]and advocate for your needs
[18:39]and make sure you're being heard,
[18:41]but that requires work.
[18:42]This is like slow medicine, this book.
[18:44]This is like, this is not a quick fix.
[18:46]Like here are five ways to lose 10 pounds in a week
[18:48]or how to get what you need.
[18:50]The list of labs you need at your doctor's office,
[18:51]this is how to communicate,
[18:54]how to get what you need from your doctor's office.
[18:57]And you break it down into these four very helpful quadrants,
[19:00]which, and I love even the puzzle pieces,
[19:02]because it is.
[19:03]We're all just like putting together the puzzle
[19:04]of our lives and our environments.
[19:06]The insets, the outsides,
[19:08]talk a little bit about the four quadrants that you've outlined.
[19:11]So they're called the four eyes.
[19:14]And in the book, I help you map your health ecosystem.
[19:16]Health is an ecosystem.
[19:18]Health is conceptualized by patients
[19:20]and sometimes doctors as a set of labs,
[19:23]like your data, your hard data.
[19:26]So quadrant one is informatics information.
[19:29]Data matters.
[19:31]Equally important as your biometric data,
[19:33]your cholesterol, your APOB, your mammogram result
[19:38]is your biographic data, who you are.
[19:41]I need to know the information, quadrant one,
[19:45]that you were raised by an alcoholic parent,
[19:47]that you were raised in poverty,
[19:49]that you had a major shoulder injury in college.
[19:53]Like all of that biographic data,
[19:55]we need to put in the informatics quadrant.
[19:58]Quadrant two is inputs.
[19:59]Inputs meaning everything.
[20:00]Everything you put into your ecosystem,
[20:02]from broccoli and kale to alcohol, marijuana,
[20:07]supplements, vitamins, people do not disclose
[20:10]the things they take.
[20:11]But everything you put in your body,
[20:12]whether it's natural, pharmaceutical, FDA approved,
[20:16]or not legal, or not legal, all has relevance
[20:20]to your whole health.
[20:21]Third quadrant is infrastructure, literally your container,
[20:24]like the vehicle that drives you through life.
[20:26]We have to take care of our skeletons,
[20:28]like we do our cars.
[20:28]In fact, people take their cars to the shop.
[20:31]More than they take their skeletons
[20:33]to physical therapy or think about their skeletons,
[20:35]like they need to maintain it.
[20:38]Because having skeletal health, bones, muscles,
[20:40]joints that are working, helps us move and function.
[20:44]That's important, especially as we get older.
[20:46]And then the fourth quadrant, the fourth eye is insight.
[20:50]Insight, self-awareness about your anxiety, your moods,
[20:53]your relationships, your self-concept,
[20:58]your biases.
[20:59]One of the favorite chapters people have in the book
[21:01]is about, I talk about the patient personality.
[21:05]Now, this is about how people bring,
[21:08]what version of themselves they bring to the doctor's office.
[21:11]Are you an optimizer?
[21:13]Where you want every tea crossed and every diet I dotted,
[21:18]sometimes at the expense of your own intuition
[21:19]about what feels right.
[21:21]Are you an outsourceer?
[21:22]Where you don't want to understand mechanism,
[21:24]you just want the prescription, the referral,
[21:28]but you don't want to know the why.
[21:30]What I'm talking about is in this insight quadrant,
[21:32]it's about knowing who you are,
[21:33]knowing what your biases are,
[21:35]so that you understand how to play to your strengths
[21:37]and understand your vulnerabilities
[21:38]when you're in the patient position.
[21:41]The health ecosystem, when you flesh it out
[21:43]and you populate the ecosystem like a map with your stuff,
[21:48]then allows you to connect with us
[21:51]between, like my patient with the headaches,
[21:54]your work stress and your migraines,
[21:56]your alcohol, gravitational pull after work
[22:01]and your liver function tests
[22:03]and the imaging study that showed
[22:05]that your liver has fatty liver.
[22:07]It helps people be their own detective
[22:09]before then bringing themselves to the doctor's office.
[22:13]You're like the Gretchen Rubin of healthcare.
[22:15]Yeah, she has all these categories, right?
[22:18]Now you have the categories.
[22:20]Do you have, and I must admit,
[22:22]I have not researched this enough,
[22:24]but is there like a Dr. McBride app or website
[22:28]where we can take all the quizzes
[22:29]and the things that you put in the book
[22:31]and input our own information?
[22:34]Well, so the companion book I wanna maybe do,
[22:38]which is like the workbook, you know how Lori Gottlieb
[22:41]maybe she's not just someone who has the workbook,
[22:43]but in the meantime, the book itself has,
[22:46]at the end of each section,
[22:47]it has a self-reflection and action guide.
[22:51]Yes.
[22:52]You can, if you pre-order the book,
[22:54]you can actually get, or now if you order the book,
[22:57]depending on what this podcast comes out,
[22:59]you can get that from the book itself.
[23:01]And if you've pre-ordered it,
[23:02]you get access to some of the self-reflection
[23:05]and action guides in advance.
[23:07]So you just go to my website,
[23:08]leucinepride.com or beyond the prescription book.com.
[23:12]Awesome.
[23:13]Are there any health issues you're having now
[23:16]that you're like, I'm so busy and launching a book.
[23:18]I have a million things going on,
[23:20]but I can feel that I need to deal with this
[23:22]and I haven't yet.
[23:23]Oh my gosh.
[23:24]Are you living in my mind, city?
[23:26]So I am my othmorse enemy.
[23:28]Like I do what all my patients do,
[23:30]or a lot of my patients do,
[23:31]which is deny that they have a problem
[23:33]until it's like, you know,
[23:34]the muffler is like on the floor of the garage.
[23:37]I have a shoulder problem that I, you know,
[23:40]the denial, so I have a shoulder problem.
[23:44]The denial plan was not working.
[23:46]I was taking like fistfuls of Advil, stomach was aching,
[23:49]and I'm like, why do I feel awful?
[23:52]Oh, because I was taking Advil to treat something
[23:54]that was not gonna get better with Advil alone.
[23:57]I also did what a lot of people do.
[23:59]When I go to the doctor and get an MRI,
[24:01]I went on the patient portal
[24:03]before my doctor had time to call me
[24:05]with the shoulder MRI results
[24:07]with a medical context lens applied.
[24:10]And I was like, oh my gosh, I need shoulder surgery.
[24:13]I like planned, you know, some week
[24:16]where I could have shoulder surgery
[24:17]and like had a little pity party for myself
[24:19]about who's gonna like comb my hair
[24:20]when I'm out.
[24:22]And my doctor calls me and he's like,
[24:24]you have a 53 year old shoulder,
[24:25]you need to do some PT, no surgery.
[24:28]And I'm like, oh my God.
[24:29]So I'm human like everybody else.
[24:31]So I do my PT last night, my husband and I were watching
[24:34]television and I'm doing my little like rows
[24:37]and my little, you know, shoulder up the wall kind of things.
[24:40]I probably need to get more exercise.
[24:42]Like I used to be a mad exerciseer
[24:45]and now I'm like in my sort of, you know,
[24:48]not exercising mode.
[24:49]And I'm like a lot of people were,
[24:51]it's either I'm all in or I'm all out
[24:52]and I need to, you know, be better about navigating the gray.
[24:55]I love yoga.
[24:56]I love walking with my friends, being outside.
[25:00]I just need to do it.
[25:01]Yes, we are in our desk areas.
[25:04]Yes.
[25:05]Yes.
[25:06]Okay, last question.
[25:07]One of my, this is a selfish one perhaps,
[25:09]but one of my kids is pre-med
[25:10]and how do you feel about the next generation
[25:14]sort of entering this landscape today?
[25:18]Like what would you tell the new doctor to be?
[25:22]It's a great question and my daughter is pre-med as well.
[25:25]She's a junior, a rising junior
[25:28]and my boys are not medical.
[25:31]They're like lovely in other ways.
[25:34]They're older, 22 and 24.
[25:36]So Stella, so I literally talked to her about that.
[25:39]I'm not, I've not been pushing medicine on her at all.
[25:42]But so I'm the only doctor in my family
[25:45]and I remember my parents, friends who are doctors
[25:49]being very negative about medicine
[25:52]when I was going into medicine.
[25:53]I remember how like unhelpful that was
[25:55]because when you're bright eyed in bushy tail
[25:57]as a youngster and you want to like help people
[26:00]and save the world, like that it's just not helpful
[26:02]because you don't know what to do with that information.
[26:05]It also suggests that like medicine is going to be the same
[26:09]but the time they're out, which it's not going to be.
[26:11]So I would, the short answer to your question is,
[26:15]if you are someone who wants the best job in the world
[26:19]where you get to care for patients
[26:21]and you get to care for other human beings
[26:23]at their most vulnerable moments,
[26:27]then that's what you should do.
[26:29]That's what you should consider doing.
[26:31]If you're someone who doesn't like being in a classroom
[26:34]doesn't like a lot of studying and tests
[26:38]and then you don't like science, like don't do it.
[26:42]But I think if you like the relationship side of medicine,
[26:48]that's always going to be there.
[26:49]In fact, I think once AI is here even more than it already is,
[26:54]there's a real window of opportunity
[26:56]for doctors to kind of help center the relationship
[27:02]because what AI can never do, I really believe this,
[27:06]is sit at someone's bedside who's facing a big decision.
[27:10]Like should I pursue further chemotherapy?
[27:12]I have ovarian cancer or should I call it what it is
[27:16]and lean into hospice and acceptance?
[27:20]Have that family meeting?
[27:22]I mean, those are human judgment calls.
[27:25]They are about listening and understanding
[27:27]the person in front of you.
[27:29]But even on a more mundane level,
[27:31]deciding between lipitor versus diet and exercise,
[27:34]it really requires understanding the human being
[27:36]and the context of that person's life.
[27:38]And AI just can't ever integrate
[27:40]among all those different domains.
[27:42]It'll do things better than already is than doctors can.
[27:45]Like, you know, things that are algorithmic.
[27:50]So I would say to any young person who wants to be a doctor,
[27:52]go for it.
[27:54]If you're really like caring for people,
[27:55]you like the rigor and you like the intellectual exercise
[27:58]of problem solving and helping people in a meaningful way,
[28:01]do it.
[28:02]Amazing, thank you.
[28:04]Dr. McBride, I'm so impressed.
[28:06]I am so inspired by the way you're just approaching the world
[28:09]and health care and all of it.
[28:10]And the book was fabulous.
[28:12]And I am so grateful that you spent your very precious
[28:16]minutes that should be with other patients
[28:19]talking to me about this.
[28:20]So hopefully we can scale your approach to lots of people
[28:23]before they even get into the exam room.
[28:26]Debbie, thank you for having me.
[28:27]And thank you for reading the book.
[28:28]It's really an honor to thank the Zibio and Red, the book.
[28:32]That's awesome.
[28:33]I'm really truly, truly, truly.
[28:35]So thank you and thank you for having me.
[28:38]And yeah, let me know how I was looking for.
[28:40]Let's do more together.
[28:41]I would love to do more together, Zibio.
[28:43]Okay, I'm going to email.
[28:44]We'll email.
[28:45]In that thought, put that thought.
[28:46]Yes, yes.
[28:47]Okay, bye.
[28:48]Thank you for listening to Totally Booked with Zibby,
[28:50]formerly mom's don't have time to read books.
[28:53]If you loved the show, tell a friend,
[28:55]leave a review, follow me on Instagram at Zibby Owens
[28:58]and spread the word.
[29:00]Thanks so much.
[29:01]Oh, and bye the books.