THE DOCTOR AND THE DJ
Unlocking Mental Resilience: Insights from a former NBA Sport Psychiatrist
Ever wondered how NBA stars like LeBron James maintain their mental sharpness under pressure?
Join us as we sit down with Dr. Choulet, a former NBA team’s Sport Psychiatrist and mental health expert.
This episode offers a deep dive into the mental challenges athletes face, from the intense scrutiny of professional sports to the use of innovative treatments like ketamine for managing depression and anxiety.
We explore the NBA's evolving stance on substances like marijuana and the use of FDA-approved therapies such as Spravato (esketamine). Dr. Choulet provides valuable insights into alternative treatments like Transcranial Magnetic Stimulation (TMS) and Electroconvulsive Therapy (ECT) for severe depression, all within the context of sports psychiatry.
This conversation sheds light on the critical role of mental resilience, psychological readiness, and the mental conditioning techniques used by elite athletes, including examples from Alex Rodriguez. We also discuss the transformative power of sleep and healthy habits on overall performance, the mental hurdles of injury recovery, and the day-to-day responsibilities of sports mental health professionals.
Whether you're an athlete, coach, or sports enthusiast, this episode is a must-listen for anyone interested in the mental side of high-performance sports.
If you want to connect with Dr. Choulet
https//www.brookchouletmd.com
Ever wondered how NBA stars like LeBron James maintain their mental sharpness under pressure?
Join us as we sit down with Dr. Choulet, a former NBA team’s Sport Psychiatrist and mental health expert.
This episode offers a deep dive into the mental challenges athletes face, from the intense scrutiny of professional sports to the use of innovative treatments like ketamine for managing depression and anxiety.
We explore the NBA's evolving stance on substances like marijuana and the use of FDA-approved therapies such as Spravato (esketamine). Dr. Choulet provides valuable insights into alternative treatments like Transcranial Magnetic Stimulation (TMS) and Electroconvulsive Therapy (ECT) for severe depression, all within the context of sports psychiatry.
This conversation sheds light on the critical role of mental resilience, psychological readiness, and the mental conditioning techniques used by elite athletes, including examples from Alex Rodriguez. We also discuss the transformative power of sleep and healthy habits on overall performance, the mental hurdles of injury recovery, and the day-to-day responsibilities of sports mental health professionals.
Whether you're an athlete, coach, or sports enthusiast, this episode is a must-listen for anyone interested in the mental side of high-performance sports.
If you want to connect with Dr. Choulet
https//www.brookchouletmd.com
We're talking about health and wellness. We're talking about biohacking, we're talking about mental health and, dr Shulay, you are the Phoenix Suns psychiatrist consultant. What's your exact title for the Phoenix Suns?
Speaker 2:I am the team licensed mental health professional and the consulting sport and performance psychiatrist.
Speaker 1:And do you get a lot of playtime? Are the players coming in your office all day?
Speaker 2:I like to say I make myself readily available. So then, if there are needs, then I'm there to chat with them. But yes, I work a lot with players staff, anyone who needs help within the organization.
Speaker 1:And when you meet with a player is it mostly like do you do it at the arena or at Footprint Center or at that practice facility in Arcadia?
Speaker 2:Really all of the above. So I'll meet with them at the practice facility, at the arena before games, at my office, in their home or virtually so. Any of those five.
Speaker 1:And is it on the down low or the other players know that? Oh my God, you're meeting with Brooke today.
Speaker 2:Uh, it is on the down low, I would say mostly, except for, like, if it's before the games and they just finished warming up on the court and they're like hey, can I grab a few minutes? So we're just sitting out there on the court chatting. So that is public and I only do that when they initiate that publicly.
Speaker 1:Yeah, and what about when a player gets traded? I always thought, like, like watching the emotional rollercoaster, or that there would be emotional rollercoaster being traded. Do they ever continue talking to you, even though they're with another team?
Speaker 2:That is such a tough question because clinically we can only practice medicine in the States that we're licensed in and where the patient's located. So let's say we trade someone to Memphis. Now I'm not licensed there so I can't continue clinical kind of care with them. But what I can do is just be a person and just check in and be like hey, this was a really tough time, we miss you here, How's it going? And just like be a human with them.
Speaker 1:They can't call you and do service that way.
Speaker 2:They can call me, but again for that more like casual conversation. It can't venture into like a clinical patient relationship again since I'm not licensed in that state.
Speaker 1:So how long have you been with the Phoenix Suns?
Speaker 2:I've been with them for three seasons and with the Mercury for two seasons. Okay, all right.
Speaker 1:So we had like a bunch of things we wanted to get into right, carrie.
Speaker 3:We do. We absolutely want to talk about some of the issues in mental health, not really as much as you know what you do day in, day out on the regular mental health side, but some of the ideas that the players might go to or they might search something on the web that says this is a cool new trend, of something that can help me get better. So we specifically want to ask you about the use of ketamine, and ketamine is a drug that has become pretty common in the mainstream market for people helping to deal with clinical depression anxiety. We know players deal with a lot of performance anxiety, which is why you're helping the team out.
Speaker 3:And what has been your thought process on this new rollout of an old drug? Ketamine's been around forever. We used it in the emergency rooms to help sedate mostly young children if we were doing an invasive procedure, but ketamine has been used now to help people overcome the barriers with depression and with generalized anxiety disorder. What are you seeing happening with, specifically in the NBA? Is there any use or is that a loud drug for the players? And what has been your take on that?
Speaker 2:Yeah, I think that it's really easy to get caught up in what seems to be the newest fad of things, and in the NBA, especially when we have players that are performing at such a high level, it's so critical to make choices and medical interventions based on like the most minimal side effects possible. So, to me, like that is like the very end of the conversation and should not even really come up, because ketamine, just with the general population, can have so many potential side effects, so much so that at a place that's doing it well, you're monitored for two hours after a spravato nasal spray. So I think that it's something to keep in mind, especially with NBA players and especially in sports. Psychiatry training is like what intervention can you have that's evidence-based, that has the least amount of side effects possible?
Speaker 3:Can you help the listeners understand more about the drug ketamine itself, Because this falls within the psychiatry realm to some extent right now. It wasn't originally developed for that. Of course, it was more of an anesthesia medication, but psychiatrists have embodied it and found new applications for it. So what has been some of the literature? What has been some of the medical studies that have been done around this drug and using it on the psychiatry side?
Speaker 2:Yeah. So I think it's been studied for a few different things, some for PTSD, some for depression, and recently the FDA when they approved Spravato, they approved it as the nasal spray for depression with an antidepressant, which is interesting because they're not saying you should just go use ketamine without evidence-based pills that are already available. They're saying that you can use it in conjunction with antidepressants. So in the study that was done that the FDA had cited in their statement for Spravato specifically, it was seen to have superior efficacy when compared to a placebo nasal spray with an antidepressant, compared to the Spravato plus antidepressant, so that did have better efficacy in terms of treating depression.
Speaker 1:Isn't it an IV drip?
Speaker 2:The Spravato. So ketamine can be given IV IM, and then Spravato is the nasal spray as well.
Speaker 1:Spravato is ketamine.
Speaker 2:Is esketamine yes.
Speaker 3:As a nasal spray, but what you're referencing is most people are actually seeing the clinics pop up as an IV drip.
Speaker 1:I talked to a guy yesterday and I think he's a pretty clean guy and he goes. Oh man, I gotta tell you about this ketamine drip I did he goes. It was amazing. He was like I was spinning, I was out of control, it was like I was high and I don't think this guy drinks or does drugs. Then I have another buddy of mine who is pretty healthy. Well, he, I mean, he's a fitness guy and he was like dude. I got to tell you I did ketamine and it was the. He's done every drug in the world Right, and he's like and this made me never want to do drugs again. He was so amazing and I was like well, I don't do drugs, so I don't need that feeling. I remember, right after that conversation, carrie, I went to you Carrie's my doctor, by the way, my real doctor and she was like don't stay away from it.
Speaker 1:Then I watched this documentary and actor David Arquette, who's been on every drug in the world and addicted. He goes for these ketamine treatments and they show the ketamine treatment and it did not look pleasant seeing what he was going through.
Speaker 2:So now I'm like this is coming up all the time, why? Why are people doing it Like non-athletes? Yeah, I think that people want a quick fix and they want something that will act fast and give them a high when they think it's medically indicated.
Speaker 1:And so it's a high, it's like, it's like a I can't speak to that.
Speaker 2:I've never tried it, nor have I had my patients try it, cause I don't recommend it but I just go back. I'm so conservative in how I practice but I just go back to like evidence-based medicine. There's so many other options we could try before we even start talking about some of these other things, including things that are more studied, like TMS or ECT for very severe treatment, resistant depression. So sure there's some utility possibly and maybe if you do it in the right setting, but I have never referred a single one of my patients to go get ketamine.
Speaker 1:So is it an NBA thing? Are people in the NBA doing ketamine, or is this just?
Speaker 2:No people in the NBA are not doing ketamine.
Speaker 1:Okay, well, that's good, that's good news, good, we're making progress.
Speaker 2:Yeah, and psilocybin as well as a prohibited substance in the NBA.
Speaker 3:So for people who don't know what psilocybin is, yes, that is like magic mushrooms.
Speaker 2:Oh, Also banned, also banned.
Speaker 1:But marijuana not banned.
Speaker 2:Marijuana not banned. Synthetic marijuana banned.
Speaker 1:What's that? What's the difference?
Speaker 2:So I'm not a marijuana expert, because I'm also anti-marijuana.
Speaker 3:So I'm not the person to ask about the synthetic versus. So just synthetically manufactured versus deriving it from the plant.
Speaker 1:Like when you go to these places, everywhere that sell it, that's normal marijuana, like the plant behind you, carrie. No, I'm just kidding. Synthetic, that's not gummies. No, no, no, I know you're talking about synthetically manufactured, pharmaceutically manufactured.
Speaker 2:Yeah, they're chemically making.
Speaker 1:So the normal marijuana is legal in the NBA.
Speaker 2:So I wouldn't say it's legal. It's not on their prohibited substance list, okay.
Speaker 1:Because there is a very well-known NBA player that was pushing this and talked about doing it all the time. In fact, I have two sons that play basketball and I didn't want them to watch that clip because you know they're very what's the word I'm looking for affected or influenced by players in the NBA and things that they do. If so-and-so's got a pair of shoes, they want that shoe. If they see a very well-known player that might play for the Suns talking about smoking weed before and after games. In fact, there's one player on the Suns that I heard. He's not on the Suns anymore. There was lots of complaints about him from the people I knew because he wasn't training hard, he wasn't working hard. They said he smoked weed all the time. To me that seems like a big side effect, because isn't marijuana a depressant?
Speaker 2:Well, people react differently to marijuana. Some people it makes them extremely anxious, paranoid, jittery, and for others it can just make them totally apathetic.
Speaker 3:Neither of those good yeah neither good, so why do?
Speaker 1:players want to smoke that stuff, so there's no benefit to being a better athlete on it, is there?
Speaker 2:Well, I think that people think that in the short term it can help with anxiety and depression. So, yes, that may be true in the short term, but there was a study I just read this morning actually that when they looked at marijuana use and PTSD, in the short term it was seen to have some benefit possibly, but in the long term, for long-term users, there was no benefit and they just developed a greater dependence on it. The other interesting thing to note too, in terms of young players or teens that are non-athletes, is that the American Psychiatric Society actually put out a statement about marijuana in adolescents, because if you use before the age of 25, when your brain's fully myelinated, it can have a lasting effects on your frontal lobe, um, which kind of develops like your executive functioning, how you make decisions, your impulsivity. So it can actually have negative effects on your frontal lobe development with marijuana use before age 25.
Speaker 1:But then you see these players playing great, getting $100 million contracts and one of the things they talk about is smoking marijuana. Kind of bums me out. As a dad, you know what I mean.
Speaker 2:Yeah.
Speaker 1:So I'm going to shift gears on a couple things. If that's cool, we're just gonna jump around right, be all over the place. So I've been looking for someone in your field for a long time for a personal use, for for mike. I have three boys, two of them are basketball player athletes and, um, my middle son, who plays basketball in hawaii. Uh, we would go when he was in the aau program. We would go these long drives and I was always listening to a book or something motivational, and I landed on a book written by a sports psychiatrist or psychologist, I'm not sure and I thought it was one of the most amazing books I've ever read in this field. So you're the only other person I've talked to in this field, outside of this guy, who I've never talked to. I tried to track him down and I believe he passed away and I now I can't remember his name, but the book is called Mind Gym.
Speaker 2:Okay, have you heard of it? I have not heard of that book, but I've heard the term Mind Gym actually used in Formula One Medicine. So they developed a physical gym and obviously for physical strength and conditioning, and then a Mind Gym that's just as big as the physical gym. So Formula One Medicine has a physical gym and a mind gym and in the mind gym they have different modalities that are available, like things that can help your mental resilience, cold plunge, mindfulness practice, meditation, things like that. So that's where I've heard the term mind gym.
Speaker 1:Oh well, if you get a chance, the guy was in Arizona, like he was this guy that had, he had the Cardinals and he had, um, all the baseball teams. He was the football player Cardinal guy and he was a guy for a lot of the all the spring training teams that came here and he would tell all these stories about working with players mentally Like how, um, you know, you hear like the secret, like I think the forward of the book is by Alex Rodriguez and he says he goes every night when he was in high school he'd go to bed. He lay in bed, look at the ceiling and say I hit the ball hard, I hit the ball hard, I hit the ball hard and he had his batting average. He would say his batting average loud, over and over and over again. And the guy goes on to be, you know, world series champion and gets all this stuff and so he's in the book. A couple football players from the Cardinals are in the book about having a positive mindset and manifestation and like, where are you on that?
Speaker 2:I think that's so critical. So in a lot of the mental skills training for athletes of all sports is that positive. They call it positive self-talk. So it's like affirmations, habit building. I think like to that habit building is so important for these players that you know there's so many NBA players or just basketball players that are great athletes but what makes like the LeBron James, steph Curry's, what makes them different is also that mental resilience and that kind of immediate decision-making ability in a game. So how can you hone in both the mental skills part of things and the physical skills is partly by doing things like that. That positive self-talk, verbal affirmations, guided and visual imagery, those all play a big role in really differentiating those that excel.
Speaker 1:So when you say visual imagery, what exactly do you mean? Can you have an example?
Speaker 2:Yeah. So an example would be like a five-minute guided thing maybe, talking about. Imagine yourself in the locker room. You're just about to go out on the court. You can feel the positive energy of your teammates. You see yourself taking your first shot and it's literally guiding them through a positive and a successful encounter in the game is that something you say to the guys on the suns, If you're talking to them? That's one modality I use for those that are interested in pregame, kind of guided imagery. Yeah.
Speaker 1:Yeah, Cause I would tell my sons I'd be like, visualize, visualize, Like when you go to bed at night, you see you walking on the court, you see the ball going in, you see, you see everything ahead of Watch this documentary called In Search of Greatness, If you get a chance to see that. It's amazing too, because that's where you have Tom Brady, the greatest quarterback of all time Excuse me, the greatest quarterback of all time. And he, at that combine where they measure you, he's the worst performing ever. Right Now he's the greatest quarterback of all time, but at this combine place he was the slowest, he was the most out of shape, but he's the greatest quarterback of all time. So the documentary goes on to say we measure things because we can measure them. I was talking to you about this the other day.
Speaker 3:We were talking about it the other night, yeah.
Speaker 1:I was like, because it's like, you know, just because you went to Stanford doesn't mean you're the best doctor in the world, right? So here's Tom Brady, who is the best quarterback of all time. Um, why is he so great? What, what is it? And he talks about motivation. Same with muhammad ali, same with jerry rice. He's like. Jerry rice said he would go to bed and throw a football in bed every night, every night, and visualize every single game. Before the game happened the next day. He had it all in his head, he knew, he saw everything. So did michael jordan. So I feel there's got to be something to that.
Speaker 2:Yeah, and what's really interesting, too, is like at what point does it become unproductive? Like I talk a lot about with people unproductive versus productive anxiety, and a productive anxiety is something you could do something about, so like oh, I'm worried about my SAT score, okay, well, you could study more, whereas an unproductive anxiety is, oh, I'm worried, I'm going to get cut from the team Well, there's nothing you can really do about that worry, and it's it's derailing your performance. So I think it's important for people to change their worries into productive worries and then act, instead of just sitting with the worry.
Speaker 1:That's good, that's really good. How about athletes that suffer an injury coming back from an injury?
Speaker 3:That's a mental game.
Speaker 2:It is, yeah, a lot. Because you know, especially at the start of a season, for example, let's say, you get a big injury. You've mentally prepared all summer to be able to get back out on the court and potentially win a championship, and now you get a season ending injury. That's devastating to a lot of athletes.
Speaker 3:It's devastating and that what if? Is still in the back. They know they have a weak link in their armor. Right, they're going to go out. But in the back of their head they're constantly trying to battle this issue of what if I go down again? And it's. Even though physically we tell them you're 100% back, you're 110% back, you're even better than you were, they go out there and they play as if that injury is still there. And that's a well-documented issue with players coming back, and that's something that I think definitely psychiatry gets more actively involved in to try and help them work through the anxiety, the performance anxiety, because that's where it shows coming back off an injury and teaching them how to act as if you know you're talking about throwing the football a hundred times, you know envisioning the game. We're trying to tell them to go back out and act in their mind as if that injury never occurred, because they keep replaying the injury over and over again.
Speaker 1:Yeah, like my kids, my son was hurt. He won't watch. No, there's a couple of famous injuries on video of ballplayers, right, paul George broke his leg and he's like, oh, check it out, paul George, I don't want to see that. I don't want that in my head, right? I don't want to see that. I don't want that in my head, right. But so you're saying so. You train like you never had it, pretend you never had it. You never had the injury.
Speaker 3:You have to get them to train as if they never had it. And that's the hard obstacle because it's really deeply imprinted. It's a form of PTSD almost, for that player. So you've got to find a way to overcome that and really get them to believe they truly are intact, they are uninjured. At this point they may actually even be stronger than how they got injured the first time.
Speaker 1:That's what I heard. Have you been to her facility?
Speaker 2:I have. It's beautiful, thank you.
Speaker 1:Like the athletes that go there, I think you go to a hyperbaric chamber, like she has at Menis Air, and you come out. Better to keep doing it. I watched this documentary on this hockey player, Connor McDavid. Did you watch it? I did, yep. So this dude tore everything, everything and they were gonna have him have surgery. He didn't wanna do the surgery, so he went in a hyperbaric every day two hours for 45 days straight and then he did his MRIs and you just see the ligaments all starting to get back together again right, that's crazy.
Speaker 1:Yeah, he signed a $100 million deal at 23 years old after his injury.
Speaker 2:That's amazing.
Speaker 2:One thing that I'm trying to bring in more to light is that there's so many physical indicators of when you can get back to your sport right, like you go through physical therapy and they look for certain markers and mobility and measures and force and strength. But one thing that is just starting to be introduced is psychological readiness to return to play is just starting to be introduced as psychological readiness to return to play. So that's a big thing in sports psychiatry world that I've been diving more into recently is what measures are there to validate or measure your psychological readiness to return? And what I've found is that kind of dividing injuries based on length of injury. So like, okay, if your injury timeline is one to two weeks, it's not as detrimental as, like, a four to eight week or a 12 to 16 week.
Speaker 2:And so what are questions that we can ask that are validated and studied, that measure your confidence and resilience and confidence in yourself to get back out on the court? And not using that as prohibitive, like, oh, your score was a 40 out of a hundred, you can't go back, but using that as an indicator of where are the weak areas, like what would get you from a 40 out of 100, you can't go back. But using that as an indicator of where are the weak areas, like what would get you from a 40 to a 50 in confidence. Because if we can identify those steps, then we'll have a better likelihood of you being more successful when you get back out on the court.
Speaker 1:So you have that already or you're working on that.
Speaker 2:We have implemented that already this season.
Speaker 1:So what are some questions you ask? To find out if they're okay mentally to come back on the court after an injury.
Speaker 2:Yeah, Like um, how confident are you to take your shot that you normally take on a scale of one to a hundred?
Speaker 1:But will they be honest with you, cause I think they'd be like a hundred, a hundred percent, but really, how do you know you're getting?
Speaker 2:Well, I think I I always like um say ahead of time like your score is not going to determine if you're going to get back out on the court or not, the physical rehab side of things is going to determine that. So, like, let's just have real conversation and this stays internal. So any conversations I have with players or really anyone um, is confidential. So if they talk to me and can be honest, it could help their performance If I can help them identify some areas where they're still feeling uncomfortable and work towards those.
Speaker 1:So let's say, I had a hurt oblique, tore my oblique. Now I'm ready to come. I feel like I'm ready to come back, like, how do you? What would you ask me?
Speaker 2:Yeah. So the goal is that every week during your rehab that we would be checking in and going through that same seven question scale and so so then I could measure your progress. It's not just like, okay, you're ready to go back out on the court. What's your measure today? You?
Speaker 3:would give him homework, essentially goal targeted direction, that would help him go back and kind of revisit why he's hesitating, feeling anxiety towards going back. It would help you guide exactly what modality, if you will, that you're going to give him to work on For goal setting.
Speaker 2:I like to try and get them to set their own goals first before I. I never want to try and tell someone what I think their goal should be, so I just try and work with them on goal setting. I just facilitate their mental exercise of setting goals for themselves.
Speaker 3:Have you ever had a player that you worked with where the physical medicine team said, okay, they're ready to go back, let's push them back out there, and you've had to pull back and say he's not ready to go, he's going to get re-injured? Has that ever been a problem?
Speaker 2:Not yet, because the psychological readiness to return we've just implemented this season Okay, and it's quite early in the season still.
Speaker 1:So how can you walk us through how you became the team psychiatrist for the Phoenix Suns? Like was it? Was there a job opening posted on? Oh, no, I was on LinkedIn.
Speaker 3:I'm just wondering how that works.
Speaker 2:What's interesting is that the league mandated this, I think back in 2019, either 2018 or 19, that teams had to have both a consulting psychiatrist and a licensed mental health professional, and that could be it's not the same thing, no.
Speaker 2:So that could be a social worker, it could be a psychologist, but then regardless they have to also have a consulting psychiatrist. So us and two other teams are the only teams that actually have the psychiatrist in both roles, that does, the therapy and the med management. Most other teams have a therapist and psychologist, because I think in a lot of areas the consulting psychiatrist is affiliated with whatever the team sponsor is. So, like in town, here it's Banner Health, so out in Utah, like the University of Utah, is the consulting psychiatrist, but they have their own in-house person. So here we're unique in that I provide both and I'm in private practice and have the time to really dedicate to both.
Speaker 1:So when you go to work, you go to your private practice, or do you get up and you go to Footprint Center, or you go to the practice facility.
Speaker 2:I get up and I go to the practice facility. I'm there until about one o'clock and then I'll go to my office.
Speaker 1:But you get there. What time?
Speaker 2:I get there around 8 am.
Speaker 1:And literally you get there at 8 am and like there's someone at your door, I need to talk to you.
Speaker 2:It's so strange. Like I try to explain this to people all the time. I'm like, okay, so I get there and like I'll go up in the breakfast area and I'll just sit and work and make myself available, because the number one thing with professional athletes and on any team, any sport, is familiarity. Like I think what people forget is that these guys' lives and women are really isolating. I think what people forget is that these guys' lives and women are really isolating. Like they are constantly worried about motives of people, friendships, like who can they trust? Who just wants money from them? I'd hate to have my salary posted online, so I'm sure they hate that.
Speaker 2:Like they're they are constantly getting badgered by people wanting something from them. So I think like it took me a season and a half just to make myself like known that I was trustworthy and not there to tattle on them or tell the organization what issues they had. So I think it took a lot of time just to even get buy-in of of like this is a confidential resource.
Speaker 1:Did you watch Ted Lasso? I did. Okay, remember how Ted would have these anxiety, panic attacks. Is that a real thing? Like, have you had players have that? Like, how would you describe what he was? Gary, he's on the soccer field and he's the coach and all of a sudden he just had to freeze up and leave.
Speaker 2:right, yeah, Does that happen in real life? I think typically it does happen in real life. I would say it's just situational, Like it may happen in the locker room before a game. I'm not saying that happens here. I've just heard that this happens, that you know before a game is incredibly stressful, or after a loss. I think typically during a game people are pretty locked in and focused.
Speaker 1:So after a game you sometimes have to meet with a player. A player wants to meet with you at 11 o'clock at night because the game's over at 10 30.
Speaker 2:I've had phone calls late in the evening just to talk about things or decompress, you know, not just players but people throughout an organization so they have access to you all day.
Speaker 1:Yes, they call you at 11 o'clock at night.
Speaker 2:You pick up luckily that doesn't happen too often. I think the latest call I've ever gotten and it wasn't even related to sports was 10, 30, oh, and I did pick up like I was at the game the other night.
Speaker 1:It was like over at 10 and and or some of those games start at 8 and they're over late and I would think after, like, my son had a game, a scrimmage, last week. Um, of course he's in hawaii, so he's three hours behind. But I went to bed, woke up in the morning, he was like I played terrible um, and he just he just got very emotional and I wish I was there for him, but it it was late, it was midnight at one o'clock, and then a half hour later he's like it's okay, I'm just gonna have to work harder, is what he said, right, and 45 minutes later. So I felt like if he had access to someone like you, or I feel bad. I wasn't there to take it, but he was fine the next day. But sometimes I think, do they call you like that, like I? Just they're driving home, man, I don't know what did I do wrong?
Speaker 2:So to me I would see that almost like as a failure of my role if they needed to do that, because my goal is to give them the skills and the tools that they can kind of like process it themselves. And I feel like if they can't, I haven't done my job.
Speaker 1:So get specific. What's something like like what tell us like how, what's it something? You give them a tool, what's a tool that we can give somebody watching this right now?
Speaker 2:Yeah, I think some tools are like a mindfulness kind of breathing exercises. So if someone is having a panic attack, they're now having physical manifestations of their anxiety, right, they're getting short of breath palpitations. Sometimes they show up in the ER to their their outpatient physician saying that I'm dying no-transcript about this the other day of like setting boundaries. So both her and I practice concierge medicine and one of the questions I get a lot and I'm sure you do too is oh, do you get called at 2am?
Speaker 3:Always. Yeah, everybody swears, everybody must call me all night long because they have my cell phone. And it's so not true.
Speaker 2:Right, it is so not true, and I feel like our job to be good physicians is to give our patients tools to work through things themselves, whether it be for physical medicine or mental health care, and then, if things are bad, of course, call us, but I think it would be a disservice to people if I was just like their lifeline that they needed to just call and I was the only fix, if that makes sense.
Speaker 3:I think the family members end up being the lifeline. So I wanted to ask you do you also help with mental health for the family members? Is that part of the extension of your services?
Speaker 2:I do, but in my private practice. So if someone of course that's a family member is welcome to come see me, it's just done outside of the building in my own private practice.
Speaker 1:Would you say that you've met with every player on the Suns?
Speaker 2:I can't say for certain whether I have met with every player or not, but I will say that it is a requirement, just like physical health to get clearance at the start of the season and how long is that session? I can't say, you can't say no, those are all way too specific, would you?
Speaker 1:say that the players on the Phoenix Suns if they saw you at a grocery store, they would know who you are.
Speaker 2:Yeah, I mean, I would hope so. I'm at the practice facility like three days a week, so I would hope that they would know who.
Speaker 1:I am. But would they say hi, yeah, so that means every player knows who you are, but not because I mean that's like she sits in the cafeteria. Yeah, we're late in the cafeteria over there.
Speaker 2:Yeah, but for the first season and a half I think, it was like who is she? Why is she here? And so it just takes time and buy in what about for you?
Speaker 1:like when the new owners came in, did you think you were secure or did you go through anxiety going? Oh man, they're getting rid of everybody that's a question.
Speaker 2:I think I was more so focused on helping everyone else during the transition that I didn't really think about me, and I think the reason that I didn't think about that, too is because I have a private practice and that wasn't my sole job.
Speaker 1:Right. Okay, but it's like sometimes I feel like in my career that there's a lot of parallels with basketball, the NBA it's kind of like with, I would assume, players. Do they get freaky or nervous about being traded? And if they do, do they come to you and they say the rumors are they're going to trade me? Like I've heard rumors about my job and it makes me sick to my stomach and my wife's, like that's not going to happen. Get it out of your head. You can't control that right.
Speaker 2:I would say that there are certain peak times of anxiety throughout the season playoffs, trade deadlines, all of that, I think, are high anxiety times just because of the uncertainty. But unfortunately it's a part of the business and I think people just know that. They just hope to be playing somewhere.
Speaker 1:And have you ever been like? Thank God, they traded that guy I really enjoy meeting every single person.
Speaker 2:I think they each bring a different flavor to the team, so I have not had that thought.
Speaker 1:So you don't go to any of the coaches that guy with number 25.
Speaker 3:So we keep talking about the male players. Let's talk about the female players, because you also work with the Phoenix Mercury. So do you see a big difference between WNBA, nba?
Speaker 2:Yeah, I'd say just on a broad scale. I feel like the WNBA is still getting accustomed to having mental health services because it was brought on a little bit later, I believe, than the NBA, I think one or two seasons later if I can remember correctly. But I think that the gender dynamic is interesting. So I think some teams really vibe with a female mental health person. I think other teams prefer a male. It really depends on the team culture. So I think that's an interesting dynamic. I've seen is like I think sometimes the male players more like to seek a female provider versus the female players might prefer a male Do you think the stressors are the same between the two for gender dynamics, or do the women bring?
Speaker 3:do they have a added level of stress that men don't have to carry?
Speaker 2:I think there are different levels of stress. I think that there's a lot of viewers and people in attendance and sponsorship, money at stake and things like that for the men, um, on a smaller scale for the women. But I think that there's just different types of stressors, because it almost throws me back to thinking of like 20 girls in a sorority in college and I think that the it can present difficulty and high tensions at times.
Speaker 1:You know I brought up Ted Lasso. He had a psychiatrist too, remember, mm-hmm. Is that what it's like? A session like the session he had?
Speaker 2:I don't think so. It's not like that I don't think so.
Speaker 3:It's made for TV. Yeah, it's made for TV.
Speaker 1:I know, but it makes it seem like he comes in, sits down in her office. They a while.
Speaker 2:That would be if I had an office. I've had to get creative then there and I use a patio. So a private patio with four chairs?
Speaker 1:Yeah, do you go on the trips with them when they play in another city?
Speaker 2:A few times Last season I was traveling up until I hit about 34 weeks pregnant and then I decided to stay home. So I traveled through January or December of last season and then for this season I just traveled for the preseason trip and the first regular season trip.
Speaker 1:How important is sleep for mental health.
Speaker 2:So important I mean for everyone, I think anywhere from pregnant women experiencing mental health crises that are trying to not precipitate a manic episode if they have a history of bipolar disorder. Sleep is so protective and same for athletes like. Your body needs to recover both physically and then your mind needs to recover mentally, so you need good sleep.
Speaker 1:So what's a good amount of sleep?
Speaker 2:I think it depends on the person. I think it's really difficult, like I can probably thrive at about seven hours of sleep and my husband, up until he got his CPAP, needed like nine to 10 hours of sleep.
Speaker 1:I have a CPAP. Yeah, so wait was he snoring and keeping you up.
Speaker 2:He was snoring and then he would stop breathing and then I thought he had narcolepsy, because he was sleepy in the afternoons and he had all of it.
Speaker 1:So and how long has he had the CPAP?
Speaker 2:He's had it now for a year and a half and it changed his life.
Speaker 1:Right. Yes, I love my CPAP, but does he get marks on his face? I got marks, he has a nasal pillow.
Speaker 2:Oh, I can't stand those.
Speaker 3:So you have your own concoction, yeah.
Speaker 1:I do, I have, I've rigged up something, but I I think I wish I would have focused more on sleep earlier in my career, because I was working on four hours sleep. I just thought that was the way to do it. And up until actually, up until I started training or working, having Carrie as be my doctor, where she told me to get the aura ring and I became obsessed with monitoring my sleep and now everybody in my family has the aura ring and we compete to see who has better sleep, and it's great.
Speaker 1:And then it's like you know, because you can, you can see everybody's sleep. It's like so what happened? What happened last night? And all of my roommate's birthday, we went out, or I had to study for a final, so it's really it's or my youngest son sneaks out to go see a girl. We're like why is your sleep score at 70?
Speaker 2:or ring outed him yeah, that's pretty cool so how much sleep do you get now after living at four hours?
Speaker 1:now I've pushed this six and a half, sometimes seven, okay, right, for which I wish I would have discovered this 15, 20 years ago. It's crazy and I feel better, but I'm still shooting for eight and I and I really it's, it's almost like but eight's not a real number it's not talked about that.
Speaker 3:No, eight is just. It's kind of that rumor that everybody needs to have eight hours and, just like Brooke was saying, it's so dependent on the different individual, their chronotype and their sleep algorithm. So for some people, four hours is actually adequate. What we discovered with you is four hours was far from adequate.
Speaker 1:Right.
Speaker 3:For the rest and recovery for the REM and the deep stage that you needed. It just didn't work.
Speaker 1:Well, it's like so on no sleep. I was miserable, right. So now I'm trying to get a little bit more sleep. And I started. We got stem cells. We went to Mexico and got stem cells and I feel like I'm operating at a whole different level with stem cells, which I just can't imagine. What I'd be like without stem cells and a little sleep. Do you know what I'm saying? I mean, it's crazy.
Speaker 2:What did you notice? The biggest difference with stem cells.
Speaker 1:I just feel like I don't take naps anymore, like I'm just moving all the time. I feel more creative. I feel Mental alertness yeah, physical exhaustion.
Speaker 3:We experience mental exhaustion a lot of times in our careers and the mental exhaustion actually is one of the things that you notice goes away, which is weird, I find myself being because I'm getting better sleep.
Speaker 1:I find myself being more kind to people, more willing to. I think I have resting bitch face. You know what I mean. So when I walk up and down the hallways at work people would be like, oh, he's a jerk. And I'd be like, why would they say that? But I think it's because I was always so tired. So now I find myself working well with other departments at the radio station and other people.
Speaker 3:Increased tolerance.
Speaker 1:That's a great way of putting it, cause I used to be like not have tolerance.
Speaker 3:No, get out of here.
Speaker 1:Now I'm a little bit boy, that's such a great way.
Speaker 3:Increase the. But one of the things we do notice after stem cells because so many people who get stem cells also have aura ring tracking and you can track with the WHOOP it's not just an aura-exclusive deal but we notice that their deep sleep and their REM sleep actually increases percentage-wise. So if they traditionally sleep six and a half hours, the percent of time spent in deep and REM sleep within that six and a half hours increases, and that's one thing we see consistently across everyone.
Speaker 1:Do you have an Oura Ring?
Speaker 2:I don't.
Speaker 1:Do you monitor your sleep? I do not. Do you tell the players to do that?
Speaker 2:Well, I think that with the players, it's very important. So I have an eight-month-old so I think it is not helpful to monitor my sleep right now, but I will say she's a rock star. She started sleeping through the night at four months, so I now know like basically my alarm's going to go off at six, so I just backtrack and try and go to bed at 10.
Speaker 1:Does she have an aura ring?
Speaker 3:Will you leave the show today and get an aura ring.
Speaker 2:I think I've been very interested in monitoring, so I think I could see myself using something like the Whoop more instead of a ring. But yeah, I think the tracking is very helpful and it gives someone some good data. Who might not put the pieces together about how much sleep they're actually getting? Another big thing to consider, too, if someone says they're having a hard time sleeping, is to ask about naps, because one time I remember just in my office I asked someone about like you know, they're like oh, I'm having so much trouble sleeping. I get like three hours of sleep at night.
Speaker 1:I'm like well, do you take naps? And they're like yeah, I nap about four hours a day. I'm like, well, that's the problem, right, I can I go. I'm going for 10 minutes and she's like no, you got to and she'll sleep for four hours. Oh, my gosh, right, but then she'll go back to sleep again, like I think it's the stem cells too. She got some stem cells too. What about recovery? And you brought up cold plunges and all that stuff. Where does that fall in the mental Well?
Speaker 2:I think that there's some good evidence that it could help with mental recovery as well as physical recovery, just helping people with their overall mood and the dopamine and norepinephrine surge can help with mood overall.
Speaker 1:So the cold plunge have you seen all this stuff about the cold plunge? They say it's the same dopamine as doing cocaine. Have you seen that?
Speaker 3:No, I haven't seen that I've heard that.
Speaker 1:Is that real or is that not real?
Speaker 2:Well, I think that it it boosts that reward system like the dopamine. That is like with THC activates and other drugs. That activates the reward system. I you know, I can't say I know scientifically that that's true. But I I do know that people that do use cold plunge and get up to their neckline with the vagus nerve kind of being activated do have mental benefits from it.
Speaker 1:What's your take on, since you're a psychiatrist but also a child psychiatrist, family psychiatrist? This whole thing with vaping right now, right, it's everywhere. Teens are doing it like crazy.
Speaker 2:Yeah, yeah, and it looks so subtle too, like I had someone telling that they found something that looked like a bookmark or a USB plug and they opened it and it was a vape pen. It's like terrifying how easy it is to hide and how discreet it can be.
Speaker 1:And I've seen do athletes vape.
Speaker 2:I don't think they would want to tell me much about it, because I think they vape the weed too.
Speaker 1:Yeah, you can vape right, yeah, marijuana but that's the thing that the marijuana and the vaping and the drinking, it's like. I, like you know, I always use devin booker as an example to my kids, because there's this interview I saw with him where he talks about he didn't go to prom, he didn't go to homecoming, he didn't have a lot of friends, he played basketball and he trained, he. He trained with his team called the Alabama Challenge, and I always tell my son, if he's going to go to a party or something, I go. Hey, man, alabama Challenge, alabama Challenge, get back in here, get some sleep and train and train and train. And that's what that book, mind Gym talks about. This is the different mindset you have to have to be there's, there's what everybody else does, and then you have to be better. Right?
Speaker 2:yeah, there's a push to be the best. You have to work hard and eliminate all the distractions and eliminate all the noise, and you could argue maybe that and I you know that players that are out there partying, staying up late, you know, drinking, drugging, whatever they are going to have severe impacts on their performance because they're not going to get that restful sleep and recovery.
Speaker 1:So Carrie had a patient that I met and he was a wonderful guy. He was very open about his health because I know you can't talk about stuff, but he was like ask me anything and then we did it. We did it, yeah Right, anything. He had heart problems, he had all kinds of stuff. He was like talk about anything. And I kind of feel the same way, like I'm willing to talk about anything if I can help somebody. Now, has there ever been a patient of yours or an athlete of yours that has had the same thing that you can talk about?
Speaker 2:Unfortunately not.
Speaker 1:Like you can't say oh, I sat down with Charles Barkley, you, there's nothing like that.
Speaker 2:No, unfortunately I can't.
Speaker 1:Dang I know, but is there anybody? Have you had a player though that you were like they had some serious concerns, or is it stuff that's textbook that you can handle? Yeah, I think I don't think you can handle any, but I mean, you know.
Speaker 2:Yeah, I think that there's definitely clinical things that come up in sports, and I think that's the thing people need to understand is that, you know, athletes aren't perfect, they're not superheroes. They have clinical concerns, they can have general anxiety, they can have major depression. Just because someone's a star player doesn't mean that they don't have things going on off the court. And so I think that's the thing a lot of fans miss is that they treat these players like assets, right, and they don't treat them as actual human beings. And you know, like I think just just witnessing the like, almost like heckling and name calling and like you must sign my t shirt and like yelling at them as if they're things, is really, really hard for them.
Speaker 1:I'm sure don't. It's like they signed 75 t shirts the 76 one they got to go right and that one person says they're a jerk, that whatever, because they didn't sign it, but at some point it stop. Right now is there. Have you had a meeting with a player where you're helping them? There? It is what it is, but you kind of in your mind you're like I can't believe if the world knew that this superstar player had this question or that they have this insecurity. You know, it's like what I'm asking, I guess, is that some sort of peace of mind that sometimes these mega players are human like us and they have the same insecurities that we have.
Speaker 2:Well, I think that that's true with all high performers and achievers, like corporate executives that are high up in their positions, athletes, like everyone some sort of insecurity about themselves, or what like I clinically call a cognitive distortion, where it's like something in your mind. Like a cognitive distortion, for example, is like fortune telling. So it's like before, let's say before I walk in to record this podcast and like I know I'm gonna suck, he's gonna hate me, I'm, I'm gonna totally ruin this show. That's a cognitive distortion. Everyone has some type of cognitive distortion. It just plays out differently for different people. So I think that everyone has something that is a deep insecurity to them.
Speaker 1:But you're saying so. If you go into the mindset of this podcast that we're going to hate you, it's going to be terrible, then, using that manifestation, it could turn out that way. But if you go into the more positive outlook right man, this is going to be great. I'm at the best podcast in the world. It's gonna be like that. Doesn't that change the vibe?
Speaker 2:A little bit. So this is all. The premise of cognitive behavioral therapy, or CBT, is like, how does an automatic thought impact your emotion, which then impacts your behavior? Right? So like if I had that automatic thought, then I could use some CBT skills on myself and be like, well, out of the last 15 podcasts you did, how many of them were absolutely horrible and they said you sucked? Well, zero. And then you start to rationalize and use that logic. So then the emotion then is not feeling bad and then sucking in the podcast. It's going to be like feeling hopeful or optimistic and it's going to lead to feeling hopefully good overall about it.
Speaker 1:What about with these elite players that you deal with? Do they? Do you see anything a common denominator with them? I have a couple of friends. One is a world series champion, another one is a world Superbowl champion, and they have there's just something different about them when they compete Even it's a board game game Like they want to kill you, Right.
Speaker 2:Now, is that a common trait with champions? You mean the kind of just super competitive?
Speaker 1:mentality. Yeah, there's just something different about them. I can't place it exactly, but there is a different operating system with these guys.
Speaker 2:I don't think so. I think everyone brings their own flavor, which makes each team each year very interesting. You know, some people are just really kind nice people that you know get ready quietly and go out on the court and smile at people, whereas other ones are like locked in and serious looking and, you know, look like very scary when they're out there. So you know, I think that it just is really dependent on the person. But that doesn't mean they achieve differently. I think is the point.
Speaker 1:What about rituals or OCD behaviors? Do a lot of players have that?
Speaker 2:Yeah, so in the sports psychiatry training they actually have a whole kind of module on ritualistic behaviors and that's not OCD, right? Because the difference between like rituals and OCD is that it causes dysfunction to your daily life.
Speaker 2:OCD does, ocd does so that would be like if I had to wash my hands 200 times a day. That probably gets in the way of me functioning in my day-to-day life Versus, if you know before. Let's say, if I'm an athlete and I go out on the court which thankfully I'm not very athletically talented but, um, but that would be like maybe tie my shoe in a certain order. Uh, watching a video, listening to the same song, like those are all rituals, but not necessarily OCD, because it doesn't cause dysfunction.
Speaker 1:Well, that's good to know.
Speaker 3:Rituals are positive.
Speaker 1:Yeah, because I have been a shit ton of rituals so I always thought it was OCD stuff. Man, it's freaked me out. What about medication Like what's your take on the Vyvanse and what's the other one, adderall?
Speaker 3:We've got a whole bunch of different stimulants.
Speaker 2:Yeah. So I think that in people with true ADHD that they can be life changing. But the thing to always screen for and be aware of is are you also using marijuana? Because if someone's using cannabis it can actually precipitate like psychotic paranoia, hallucinations, and it can be really dangerous. So I've seen that throughout my child psychiatry training is kids coming in after using some sort of like a wax pen or some really like strong cannabis and then it kind of pushes them over the edge into psychosis. So I think you know the ADHD medications have real utility if they're not using marijuana and they actually have a diagnosis of ADHD.
Speaker 1:Are there players that take ADHD medicine?
Speaker 2:So in the league there's definitely players with ADHD, but there's certain protocols that throughout the league, if a player has ADHD, you have to submit the appropriate documentation, because they will fail a urine drug test, and so you want to kind of get ahead of that stuff, that's that med, comes in a urine test. Yeah, because it's an amphetamine.
Speaker 1:Oh yeah, you know I was talking to you earlier about the new trainer at the Suns who I know, keegan right, does that position like that. Is it a trainer? What do you call it? What he does. He's the guy that, the PT guy, athletic trainer. Do they come to you and go, hey, so-and-so, tore his ACL, he's six months out. Can you talk to him Like, do they do that? Or does a coach or somebody ever come up to you and go, can you talk to so-and-so about whatever?
Speaker 2:I think they're feeling a little down and you know there are like department meetings and in those meetings it's discussed like what the injury updates are.
Speaker 1:What about management and ownership? Do you talk to those guys, or is it just players?
Speaker 2:So I mean in terms of just talking to them.
Speaker 1:Yes, I interact with them. I mean therapy sessions client.
Speaker 2:I can have sessions with anyone in the organization. So I can say that.
Speaker 1:Really so, even the person that's ripping the ticket if they want to talk to you.
Speaker 2:So anyone that's at the practice facility. So that's really like basketball ops.
Speaker 1:Do you ever use any of the things at the practice facility?
Speaker 2:In terms of for myself.
Speaker 1:Yeah, like the cryo machine You're asking if she shoots hoops, no, like I heard that there's a cryo machine in the back that no one even knew about forever and then they started using that and I think they got the ice baths and all that stuff.
Speaker 2:Okay, yeah, if that's all in the male locker room, then I don't have access to that.
Speaker 1:Oh, so you don't go in there and lift weights. So you don't go in there.
Speaker 2:No, I probably wouldn't want to be walking around in my bathing suit over there.
Speaker 1:Is that how you lift weights In my?
Speaker 2:workplace and the cold plunge.
Speaker 1:Well, good, this has been very cool, right yeah?
Speaker 1:It's been cool. Anything else we need to bring up Carrie. I'm fascinated with all. You should, in my opinion, check out that book, mind Gym Okay, I will, because I think it is. I've listened to it, I've read it twice. I listen to it as much as I can to interview him because I was just blown away, because it's also old enough to where I feel it's a secret weapon. You know what I mean. Like not everyone's doing that now. And also I mean he name drops everybody that he works with, from the Cardinals to famous baseball, and it's at that point where you might know some of the players you might not. Like I'm not a sports guy. I mean I'm turning into one now because of my three boys, but back then, oh yeah, I remember that guy's name, I remember so-and-so, you know. So it's kind of neat. And they get specific. How you help them manifest and project stuff. See, what you put out in the universe comes back. Do you believe that?
Speaker 2:Yeah, I think so, really believe in that. One other book.
Speaker 1:I recommend to everyone is Atomic Habits. That book is fantastic. My son, who I had read Mind Gym with, he told us to read Atomic Habits. It's great. What other books that you?
Speaker 2:like Flow State. So any books on maintaining a flow state are really I'm super into. Right now I'm reading a lot about flow state and just how can you get in the zone. Another one called Deep Work I love that term, so flow state. And just how can you get in the zone. Another one called like deep work. Um, I love that term is like so if I don't want to be bothered and my husband comes in and I'm like actively working, I'm like deep work, honey, deep work.
Speaker 2:So I love yeah, I love um books that are talking about, like, how to really enhance your performance and get in the zone.
Speaker 1:Okay, so for my son who plays basketball in Hawaii, I should tell him to get Deep Work.
Speaker 2:And Atomic Habits.
Speaker 1:He already read that one. Okay, and what was the other one? You?
Speaker 2:used Flow.
Speaker 1:State. That's the name of the book Flow State.
Speaker 2:Yes, I believe so it has a light blue cover.
Speaker 1:What's your favorite TV show?
Speaker 2:Oh, that's so hard. Right now it's the Golden Bachelor. She's dissecting that apart from a psychiatrist standpoint. And Morning Report with Jennifer Aniston, morning Show.
Speaker 1:Morning Show yeah, you know what? I started watching season three and I just the first episode bothered me Really. I couldn't get it just seems so I forget what it was. It was so silly almost. Oh, she's going into space.
Speaker 2:Oh, yes, yes, and I was like come on, it does get better from there.
Speaker 1:Oh it does. I was like I can't. This is silly.
Speaker 2:What's your favorite TV show?
Speaker 1:I'm watching. It's called Generation V Gen V. Oh yes, I'm watching that. I'm watching that. I just finished a movie called Painkillers or Pain Hustlers.
Speaker 3:Pain Hustlers, which is different?
Speaker 1:yes, there's Painkinkiller and then there's um, what's the one same thing. It was the doc I told you, uh, it won all these awards on hulu. It was all about the opioid crisis, it was uh oh, I know, I see the cover in my mind. I know what you're talking about that was with the guy that played batman, michael keaton, and then they did another one called pain killers, and that's what the guy that played ferris bueller.
Speaker 1:Correct and then this came out and this is the guy that plays Captain America, and it's a true story about the pharmaceutical companies, but it's fentanyl. In six months, they were making hundreds of millions of dollars and now all the people are in prison. That's number one on Netflix right now.
Speaker 2:Okay, I'll check it out.
Speaker 1:What about you, Carrie? What are you watching? What are you reading?
Speaker 3:Well, I'll check it out, but good, what about you, carrie? What are you watching? What are you reading? I'm not well. I read medical journals every day, so that doesn't really count. It's like an endless.
Speaker 1:She knows more about anything than anybody you've ever met might tell her.
Speaker 3:I'm kind of a history buff, so I'm actually re-watching Band of Brothers.
Speaker 1:Oh yeah, that just came out on Netflix, didn't it? I know, or on Netflix, or Max.
Speaker 2:Yeah.
Speaker 1:Yeah, but that's why she's good at what she does.
Speaker 2:She's constantly reading.
Speaker 1:Oh, I know, Like you don't like normally I'll Google something. She's a human Google in the medical world. Yeah Well, thank you for your time.
Speaker 2:Thank you Appreciate it.
Speaker 1:Yeah, very nice, thanks, bye.