Transcript
Speaker: Everything on the podcast is for entertainment purposes only.
Speaker: Nothing I say is meant to treat or diagnose, or it's not even advice for you to follow.
Speaker: So remember, when you're listening to the podcast, I am a doctor.
Speaker: I'm just not your doctor.
Speaker: Welcome to On Call with Dr. Dave.
Speaker: Today we're talking with Dr. Jody and Dr. Jody has an interesting story.
Speaker: He is a doctor who is going through medical school and most doctors don't go through medical school.
Speaker: Most people go through medical school to become a doctor.
Speaker: So your situation is very unique and I'd love to have you take me through the first time you went to medical school, where you're from and what possessed you to do this twice.
Speaker: You must love
Speaker: medicine and caring for people more than anybody else.
Speaker: If you told me I had to start over, I love doing what I do.
Speaker: I just don't know if I could go through that again.
Speaker: So tell me about yourself.
Speaker: Tell me the story.
Speaker: First of all, thank you for having me on your show.
Speaker: For the questions I've had, it sure does bring so many emotions right now.
Speaker: So I'm from Nepal.
Speaker: Originally I'm from Nepal.
Speaker: I immigrated back in 2012 to the U.S.
Speaker: I was in Nepal.
Speaker: I did medical school there, graduated in 2006, 2007, and then started working as home critical care for five or six years, give or take.
Speaker: When I was in medical school, my parents immigrated to the U.S., but I was there.
Speaker: I was in Nepal, but my parents and my sister were here.
Speaker: So my mom started blackmailing me, saying, you know,
Speaker: So you gotta become your, we can't deal without you.
Speaker: And I was like, I think I have a good life here.
Speaker: I'm working as a physician and parents are, they, they wanted me to come.
Speaker: And then life happened.
Speaker: I met my wife, we got married and I came in 2012.
Speaker: Then went through the process of, you're suddenly the exams passed everything and then
Speaker: Because I would be an IMG, the international medical graduate.
Speaker: So I have to do a thing called USCE, the United States clinical experience thing.
Speaker: So I was rotating with internists.
Speaker: I was rotating with different hospitals and clinics.
Speaker: And then I started applying for residency.
Speaker: The first two times didn't match.
Speaker: I was like, okay.
Speaker: Then I started doing sub-Is.
Speaker: I found a place in Miami that name shall not be taken.
Speaker: And then I did survive for nearly five months on IM.
Speaker: I was on the floor doing everything.
Speaker: The program director really loved me.
Speaker: Huge shout out to him if he was listening to this.
Speaker: The residents, the second year people, even the people from Canada, everybody knew me.
Speaker: I did interviews, was very happy.
Speaker: And again, uh, it didn't match.
Speaker: I went into a bit of a turmoil.
Speaker: And then I asked him like face to face.
Speaker: I was like, okay, I know I didn't match, but could you tell me why or what can I do extra so that it solidifies my chance to get into a recent spot?
Speaker: Obviously he didn't have an answer.
Speaker: I don't think he was going around and I'm like, no, no, just give me the answer.
Speaker: Is there anything else that I can do?
Speaker: Like I had a couple of researchers, exam was done.
Speaker: Everything was done.
Speaker: I'm I had like us clinical experiences, shadowing and observer shapes and sub eyes.
Speaker: And he said, there's a panel that sets you into a resident spot.
Speaker: So the panel function was a problem, which was 2006.
Speaker: And I'm talking about now.
Speaker: And that really hit me hard.
Speaker: I couldn't think straight and coming back to why I'm doing medicine is if you asked me to, to fix a chair, like small bolt has come out and it's pretty fixed.
Speaker: So do you like the chair?
Speaker: I can't, I might go too much.
Speaker: If I go right too much, I might break the bolt.
Speaker: Like I'm not handy with this stuff.
Speaker: tire goes out, I don't know how to change a tire.
Speaker: Even if I do YouTube, I'm not sure.
Speaker: So you're not handy with tools.
Speaker: You can't fix a car.
Speaker: You can't fix a chair.
Speaker: That's what I'm good at.
Speaker: I'm a surgeon.
Speaker: My wife does that.
Speaker: Yeah.
Speaker: Somebody in the relationship needs to.
Speaker: Yeah.
Speaker: But, but fixing people, knowing what's wrong, medicine in general, figuring out what's wrong with a human, that's where your talents lie.
Speaker: Yeah.
Speaker: Yeah.
Speaker: Like,
Speaker: I wouldn't say like I'm the best, but I get pulled towards medicine.
Speaker: It's like a magnet to me.
Speaker: So yeah.
Speaker: Then after that incident, I went into a bit of turmoil at home.
Speaker: I was not happy.
Speaker: And a lot of people started saying, why don't you go into, with the huge respect to all the fields, people started saying, why don't you go to nursing or PA school if you want medicine?
Speaker: And my head was, yeah, definitely.
Speaker: Let's say I passed nursing or PA school, and then I'm working in a clinic or a hospital setting.
Speaker: And as soon as a resident walks by, the mind would be like, I could be in that position.
Speaker: Nothing would make me happier rather than being in as a, as a physician, I think.
Speaker: And believe it or not, I started going to a public library, getting LSAT books.
Speaker: Wow.
Speaker: That's a left turn.
Speaker: Yeah.
Speaker: Going to law school would be, yeah.
Speaker: I was very naive.
Speaker: I was thinking very childish, thinking that I would go into law and the first thing I do after I pass out is I start suing these programs that didn't get me.
Speaker: I was that heartbroken.
Speaker: Hey, you got to find that passion or fire someplace.
Speaker: Whatever kept you going.
Speaker: Channel it one way or the other.
Speaker: Then one day I was good one, one and a half months into LSAT studying.
Speaker: And then my wife came one day and said, I should support you what you do.
Speaker: I'm not saying, can you not do this?
Speaker: If you, if your heart is an end, go for it.
Speaker: But think about this.
Speaker: A law school is four years.
Speaker: Medical school is four years.
Speaker: Law zero about law.
Speaker: At least you know something about medicine.
Speaker: So if you want to go to school, which school should you pick?
Speaker: And now 30 medical students.
Speaker: So when you said Dr. Jody in the beginning, it shook me.
Speaker: I'm like, oh my God, I have not heard doctor in front of my name for a long time.
Speaker: And even now, like my friends, my peers, when they call me doctor sometimes, they don't call me the dot.
Speaker: I'm still a medical student.
Speaker: We'll get there though.
Speaker: We'll get there.
Speaker: You'll get it all.
Speaker: It's always been interesting to me because I've worked with a lot of people over the years that did their medical school overseas.
Speaker: And I know there's rules and there's this hierarchy, but so much of it's so...
Speaker: Not important.
Speaker: So some of the best doctors I've worked with have trained in foreign countries and then came over to the United States and they were able to get into residencies without doing medical school.
Speaker: Some of them did do medical school.
Speaker: You are a doctor.
Speaker: You earned that title and you came to a country that unfortunately didn't recognize your talents from the get go.
Speaker: but you are proving to everybody that you definitely deserve that title.
Speaker: So I worked with one doctor.
Speaker: He unfortunately was in a similar situation.
Speaker: He came from Nepal and he was an ophthalmologist and he came to the United States and he tried to get into a residency program and couldn't.
Speaker: And then because he already had a number of kids and needed a job, he took a job as a scrub tech.
Speaker: and he would assist on the cataract surgeries.
Speaker: And I was talking to him, I said, I don't know how, I don't think I could do that if I wasn't
Speaker: able to do the surgeries, to watch a bunch of people, especially residents do the case and know you could do it better.
Speaker: And he just said, you know what?
Speaker: It was hard, but I just love being here.
Speaker: And he would help teach and he would always hand people the exact instrument they needed, whether they asked for the right one or the wrong one, you'd hand them what they needed.
Speaker: He was the best.
Speaker: And he decided, he said, I'm going to be the best scrub tech I can possibly be.
Speaker: But I looked at him, I thought, but you could also be the best doctor.
Speaker: So I know
Speaker: that we have rules and regulations for a reason in this country.
Speaker: And yet, I don't know that it serves the public.
Speaker: Are we keeping good people out of medicine that could be better served by just coming here and working?
Speaker: I knew a doctor from Columbia.
Speaker: He trained me in residency.
Speaker: And same thing, he had to go through.
Speaker: And it took him seven years
Speaker: seven years to get into a residency.
Speaker: So he tried every year and he kept doing research and seven years.
Speaker: And I guess you're going to be at seven, at least with four years of medical school and three years of residency.
Speaker: And then fellowship, if you decide to do home critical care again, but
Speaker: It's, he could have been practicing and helping people for seven years.
Speaker: Do you find that going through it a second time has been beneficial for you?
Speaker: Has it been a good experience?
Speaker: Have you learned more or is it slowed you down?
Speaker: What's your impression of that?
Speaker: Going twice is, is difficult for sure.
Speaker: It's difficult.
Speaker: Like I, when I go to school, at least during my pre-clinicals,
Speaker: My friends used to ask me, oh, this must be easy.
Speaker: One of the exams came up and they come out of the hall and say, this must be easy.
Speaker: First week was not.
Speaker: Being a student is tough job.
Speaker: Like any student is a tough job.
Speaker: And given that medical students, like going back to immuno, micro, biochem, same creep cycle again, it was just very tough.
Speaker: But has it been beneficial?
Speaker: Yes.
Speaker: It
Speaker: I think it solidifies your knowledge more.
Speaker: I'm not saying there would be loopholes or there will be holes in your medical knowledge by the time you're a fellow or you're attending, but knowing the basics again really helps your understanding of the subject material more.
Speaker: That really helps.
Speaker: but with a lot of pain.
Speaker: Yeah.
Speaker: Yeah.
Speaker: Yeah.
Speaker: Just when you mentioned the Krebs cycle, I'm thinking, oh my gosh, I had to go back and have to learn that again.
Speaker: I had to learn it in high school, then in college, then medical school.
Speaker: And clinically, I don't use the Krebs cycle.
Speaker: None of us do, but they make us learn it.
Speaker: So yeah, I've pushed that out of my brain.
Speaker: That would be so painful to learn that again.
Speaker: Yeah.
Speaker: I did enjoy learning.
Speaker: It's a tough job, but I did, I liked learning.
Speaker: I liked going through different specialties in medical school, but that would be, that would test me to do it twice.
Speaker: I'm over here looking at my kids homework sometimes and going, I forgot this was even a thing.
Speaker: And that's like, yeah, easy stuff in fourth or fifth grade.
Speaker: Of course you remember that.
Speaker: No, you don't.
Speaker: You don't remember that stuff.
Speaker: Geometry.
Speaker: And I'll do a fair amount of geometry, like life geometry, but looking at it going, I forgot this even existed.
Speaker: One half base times height and yeah, no, there's no room for that up here.
Speaker: So I can't imagine.
Speaker: Cause I remember looking at this, the syllabi, right?
Speaker: Like all of these stacks and stacks of paper that Dave would bring home and just how much he needed to keep in his brain and how you need to keep it in there, but just how quickly it could just, I only need to know this for a couple of hours and then just exit right out to make room for more.
Speaker: Not that you can pick and choose what you forget and what you remember, but there's only so much room in there.
Speaker: And how did your wife take this?
Speaker: Yeah.
Speaker: I mean, she married you right before you came to the United States.
Speaker: So you get married and then you're like, hey, honey, we're going to move to a different country.
Speaker: And by the way, I may not have a job when we get there.
Speaker: Yeah.
Speaker: He has been nothing more than a pillar of backbone, spine, the air I breathe, everything of my life.
Speaker: So we got married in 2012.
Speaker: He was first year resident at that time.
Speaker: And then she was doing in Colorado, obviously.
Speaker: We ended up in Colorado.
Speaker: I'm in New York doing my school.
Speaker: She's in Louisiana.
Speaker: The home is Louisiana with kids and everything and her work.
Speaker: And okay.
Speaker: In pre-clinical years, I was able to go home at least a month after the major exams.
Speaker: It's called comprehensive comp exam.
Speaker: So I used to go after comp exams, but now it's rotation time.
Speaker: My time is not my time, as you said.
Speaker: So I've not been home for a long time.
Speaker: I was hoping to go on Thanksgiving, but it doesn't seem likely.
Speaker: So I'm hoping by at least on Christmas, I get to go home.
Speaker: And the support she is, I'm lost at words what she is.
Speaker: I hope, I don't say this on a daily basis to her.
Speaker: So when she hears this, shout out to her that has been such a big support in my life.
Speaker: I would not have been in a medical school second time if it was not for her.
Speaker: Yes, we are not together.
Speaker: Yes, we only talk on FaceTime three times a day or two times a day, not even more than five minutes because she's working.
Speaker: I'm at this hospital.
Speaker: but that you feel that strength even where this far apart.
Speaker: And yeah, keeping it short, I would not be here.
Speaker: I would not be doing medicine twice if it was not for her, never.
Speaker: Also with the beginning, like I said, she was the one who said, yeah, 40 years of law, 40 years of medicine, what do you want to choose from that till today?
Speaker: Yeah, it's the dedication that you have to stick with it, but the dedication and the trust and the love that she has for you is amazing too, to let you go through this journey.
Speaker: Ashley and I had similar conversations when we were looking at residency options and different specialties and what that mean for the family.
Speaker: And some were going to be harder on the family and some were going to be easier on the family.
Speaker: And she just said, I don't want you to have any regrets.
Speaker: I don't want you to be 10 years out in practice and say, I wish I'd done something different, but you compromise because of this.
Speaker: And so she said, I support you in whichever choice you make.
Speaker: And luckily for both of us, I chose something that was reasonable.
Speaker: It's reasonable, but you know what, if you had one that wasn't reasonable, if it was something that, that you needed to do, you just,
Speaker: You do that for your friends.
Speaker: And that's what I hear from you talking about your wife is that you guys are friends.
Speaker: You're buddies, you treat yourself, you're each other's support system.
Speaker: Sometimes we're just crummy friends to the people that we're married to.
Speaker: And but I feel that friendship from you two just, Hey, we're in this together.
Speaker: Let's do it.
Speaker: And hats off to her for holding down the fort and probably a practice and all the things that come along with that, running a house and
Speaker: kids and the craziness of life, but it'll be for a short time.
Speaker: It'll be over soon.
Speaker: I've been saying that to myself and it's been three and a half years apart from her and the family.
Speaker: And I've been keep saying myself, okay, six more months, six more months.
Speaker: keeping it short so that for the fourth year comes soon six months is here you can rotate wherever you want so i've been like guess where i'm going to yeah absolutely yeah were there early experiences as a doctor in nepal that really solidified why you would even go through this i have to imagine you had some experiences either personally or directly with patients
Speaker: that really solidified in your mind that this is what you're meant to do.
Speaker: Can you think of any of those stories?
Speaker: So many.
Speaker: It's a little bit different being a physician back home.
Speaker: You are really treated like a superhero, nearly God, if not God.
Speaker: One was a patient came.
Speaker: In the clinic, normal day, just income fever, blah, blah, blah, this cough and this and that.
Speaker: And then I send an x-ray, chest x-ray comes, I see pneumonia.
Speaker: And then she goes, yeah, I've been to doctors.
Speaker: I have got this fever for so many days.
Speaker: Nobody's able to treat me.
Speaker: She had her own complaints of other physicians and blah, blah, blah.
Speaker: And then I go, okay, why don't you take these medications and come back five days?
Speaker: We'll do some repeat chest x-rays and we'll see.
Speaker: She comes out of five days and she.
Speaker: touches my feet with her head.
Speaker: That's how we show respect to the elders back in the book.
Speaker: And I was like, okay, this is not happening.
Speaker: Okay.
Speaker: Not happen.
Speaker: For us at that time, as a physician, I think that comes to us natural that, oh, you write a drug or antibiotic.
Speaker: And then that's because we studied, that's not a rocket science for us.
Speaker: But for her, when she was from a very rural place where she couldn't find, you know, physicians or whatnot, and then she had to be with me, and then I gave her a medication, and that was such a huge relief because she was out of her ailments.
Speaker: And when she tossed my feet, I was like, that moment, I was like, oh, my God, this is not happening.
Speaker: And we talked, and it's okay, fine.
Speaker: And then when she was, like, with her tears, she goes, thank you so much for saving my life.
Speaker: In my head, like, you're, like, godlike, you're superhuman.
Speaker: You did all this for me.
Speaker: I'm still thinking.
Speaker: But I studied that.
Speaker: I didn't do anything heavily.
Speaker: It was just a bunch of medications.
Speaker: And it struck me, like, how many patients would be there that have not seen doctors for such a long time?
Speaker: The other incident is there's a rural place in Nepal.
Speaker: What I'm saying, there are way too many rural places in Nepal.
Speaker: So this place is called Jumla.
Speaker: And then the only way to reach there is by air.
Speaker: Or if you have a horse.
Speaker: We went there for a free health camp.
Speaker: A bunch of my friends, we had some lab technicians took some just to do simple labs like CBCs and not high-fives, but small tanks.
Speaker: And we took a bunch of medications.
Speaker: Two incidents.
Speaker: One is a guy came and then sat in front of me and he goes, how you doing?
Speaker: And I said, that is my question.
Speaker: You know, he was like, oh, I'm okay.
Speaker: I'm perfectly fine.
Speaker: And then why are you here for health camp?
Speaker: And something's bothering you.
Speaker: All good.
Speaker: What's going on?
Speaker: Yeah, everything is good for heartburn and one medication for diarrhea and one for fever, please.
Speaker: And I looked at him like, but do you have those?
Speaker: I was, no.
Speaker: Why do we need this?
Speaker: So he goes, oh, I walked four days.
Speaker: Four days because I heard a team of doctors are coming here to give medications and to check up on people.
Speaker: I haven't seen a doctor for seven years.
Speaker: To see a doctor, I have to walk eight days.
Speaker: So four days I can see you.
Speaker: I don't know when I'll be sick, but these are the common things that I might have that I think.
Speaker: So could you write me this medication so that I can go home before it is dark outside?
Speaker: That really shakes your belief in how you can help people.
Speaker: The problems that we think that we have is nothing compared to a person who walks four days just to see a guy wearing a white coat.
Speaker: That is, I haven't, that's unbelievable for me to think
Speaker: on today's day and age.
Speaker: Yeah, we take it for granted.
Speaker: I did medical school in Virginia and some people in West Virginia in these rural communities wouldn't go to doctors or it was rare for them to see a doctor.
Speaker: But even that, they could jump in a car, take a bus.
Speaker: Even when they didn't have easy access, they still have access.
Speaker: They didn't have to walk.
Speaker: Yeah, and that first patient that you shared, so grateful that she touched her head to your feet.
Speaker: For you, you wrote a prescription, you diagnosed something that was very straightforward and gave her the right prescription, but she's right.
Speaker: For her, you saved her life.
Speaker: An unchecked pneumonia could have killed her.
Speaker: And so we take all these things for granted that the knowledge that we have, the knowledge of hundreds and thousands of doctors before us and medical schools and books and all the companies that make the medications and test them,
Speaker: It's just exists in our world.
Speaker: But for so many people, it doesn't exist until we offer it to them until we give them that information.
Speaker: And that's amazing.
Speaker: I think about that man walking four days to take care of himself for the future.
Speaker: Like the amount of.
Speaker: foresight or the amount of ownership he has over his own health to be even thinking hey in the future perhaps at one point i might need these medications and i think that we're in danger of letting our health go too much because we take for granted how easy it is to access these things we're not looking we can get
Speaker: You can barely get people to think about what their health will be a year from now, let alone 10 years from now or any kind of preventative care.
Speaker: And this guy's, hallelujah, I only have to walk four days instead of eight days to get some medications that I might maybe need in the future to keep myself alive.
Speaker: How many people or patients do you know that take those preventative measures now?
Speaker: It really makes you think hard what medicine can do and what
Speaker: what can be done for the betterment of humankind more than patience of human being.
Speaker: You said you had two stories from that.
Speaker: The other one is funny.
Speaker: That place is very cold.
Speaker: It's up in the mountains.
Speaker: When I say cold, it's really cold.
Speaker: And obviously it's like the population over there is not well off.
Speaker: poor and they have that daily duties to do just to eat dinner.
Speaker: Maybe it's very tough life they have.
Speaker: So we have two big holidays, festivals, festivals in Nepal.
Speaker: One is called Dasay.
Speaker: One is called Tihar.
Speaker: 15 days is separated between these two.
Speaker: So the biggest festivals we have.
Speaker: So this guy comes and he has layer of skin on top of his skin.
Speaker: Like
Speaker: You can see that something's weird on his hands.
Speaker: And we've been talking and he goes, oh, we have abdomen and this and that.
Speaker: And then we give the medication and just FYI, I asked, oh, is that your regular skin?
Speaker: It's different.
Speaker: And it goes like this.
Speaker: And you're going, yeah, I don't know.
Speaker: This has been here for eight, nine, 10 months now, or even a year.
Speaker: Oh, can I like, yeah.
Speaker: I tried to scratch it up and easily get scratched.
Speaker: And before, yeah, okay, in the beginning, it might get, but it gets off.
Speaker: And the more I peel, it comes off like mud, mud kind of thing.
Speaker: And I'm doing this, I'm looking at it in the gloves, and it's mud.
Speaker: And I ask him, sorry, personal question, don't you take showers?
Speaker: He goes, Doc, it's so cold over here and I have to work.
Speaker: I am not taking shower every day.
Speaker: I'm taking shower once a year during the site.
Speaker: Wow.
Speaker: Wow.
Speaker: I have no words what to say about that now.
Speaker: Yeah, he just had a layer of mud.
Speaker: That was part of his body.
Speaker: He had it for nine, ten months, and he just didn't even think about it.
Speaker: That's his second skin, his mud layer.
Speaker: Maybe it kept him a little warm.
Speaker: I don't know.
Speaker: Probably.
Speaker: Exactly.
Speaker: That's what he said.
Speaker: That's exactly what I said.
Speaker: I'm not taking this out because it's taking me warm.
Speaker: But infection-wise, I'm fine.
Speaker: Just give me the medication for my abdomen pain, and I'm out of here.
Speaker: No words.
Speaker: Once a year.
Speaker: That's a new one.
Speaker: It's, but it's very cold.
Speaker: I stay, we stayed there for five days.
Speaker: Not gonna lie.
Speaker: I think I shower two days.
Speaker: You know, deal is fine.
Speaker: And also you warm up the water and then when you start taking shower.
Speaker: Oh, okay.
Speaker: Also, there's no,
Speaker: Gas eater, there's nothing.
Speaker: It's like a real role play.
Speaker: By the time the water's boiled and you're taking a shower, it's cold.
Speaker: I was going to say, I love how you're like, once a year, but I get it.
Speaker: Like, I get it.
Speaker: Not even judging him.
Speaker: Just thinking, yeah, I understand that choice.
Speaker: Yeah, yeah, I get it.
Speaker: Now to come from that, so to come from Nepal and to work there and to have these people that are so grateful, was it a huge culture shock when you started taking care of Americans?
Speaker: Or did you find a lot of gratitude in Americans you took care of?
Speaker: Did they just take it for granted?
Speaker: Is it a mixed bag?
Speaker: How is it coming from one completely different system to America where they may come in and say, oh, I've read that online or come in with their print off.
Speaker: Hey, I know I have this and give me the MRI.
Speaker: It's a mixed bag.
Speaker: It's a mixed bag.
Speaker: I have found patients that really know what they're talking about.
Speaker: They've researched.
Speaker: I know when I say research, it's not just Google research, like they research research.
Speaker: And then they know, like, and then there are some who know few medical terms, but don't know the full meaning.
Speaker: And then they Google research.
Speaker: And there are some who are completely oblivious of what's going on with them, which reminds me back at home.
Speaker: I have seen those like few percentage of the people like that.
Speaker: So, so it's a mixed bag, but in general, I think we take things for granted really.
Speaker: Oh, because I have a health insurance plan.
Speaker: You gotta treat me.
Speaker: I'm here.
Speaker: So do everything you can.
Speaker: The humbleness goes out of the window in a way, but there's a mixed bag of patients that I've seen.
Speaker: Some have no clue what's going on and some have heavily researched on everything.
Speaker: Like you said, oh, so I can't do MRI because I can't do contrast because my creatine is okay.
Speaker: But as a culture shock, I was not much culturally shocked because my parents were here and then we've been talking on phones and I was kept in the loop how things work here or stuff like that.
Speaker: I'll tell you a funny story.
Speaker: So when I came back in 2012, the first time I went to my parents where they were living in Maryland at that time.
Speaker: Think of that.
Speaker: They're still in Maryland.
Speaker: Never mind.
Speaker: My sister texts me...
Speaker: In our car.
Speaker: And this is the second day I landed.
Speaker: I fresh up the boat.
Speaker: English.
Speaker: This English, what am I speaking right now is my school English from Nepal.
Speaker: So there's nothing added here.
Speaker: So I said, look, I know English.
Speaker: America, people talking English.
Speaker: We good.
Speaker: So I come here.
Speaker: I didn't realize that English I know is not conversational English.
Speaker: And then she takes me to Chipotle the first time and she go order what we want to eat.
Speaker: And I'm in front of the person and I'm like looking at the menu and I don't know how to say what.
Speaker: And the person on the other side, oh, do you want a bowl or a burrito?
Speaker: I don't know.
Speaker: And my sister is like, I'm not helping you.
Speaker: I was that bad in converses in English.
Speaker: I don't know what to say.
Speaker: When people came up to me and like walking in the street and then we were walking and then someone was like, hey, what's up?
Speaker: I didn't know how to say it back.
Speaker: I was like, the words didn't come out.
Speaker: And I'm thinking, I know English.
Speaker: What is wrong with me?
Speaker: I can't even say hello back.
Speaker: I didn't know how to speak.
Speaker: I didn't know how to respond to things.
Speaker: That was the cultural difference that I went through.
Speaker: To be fair, I still don't know if I want a burrito or a bowl at Chipotle.
Speaker: English got nothing to do with it.
Speaker: I thought I knew a little bit of German.
Speaker: Like I thought I was conversational in German.
Speaker: And then I landed in Germany and a guy I was with accidentally grabbed somebody's bag and he came over and started yelling at us in German.
Speaker: And then instantly I'm like, I don't know what's happening.
Speaker: I'm scared.
Speaker: I want to go home.
Speaker: Yeah.
Speaker: Speaking it with people that are also a second language or you're learning it at school or you talk with your teachers that are speaking in German, you feel like having a conversation.
Speaker: It's so different.
Speaker: the pace and the speed and the just the words and the vernacular.
Speaker: It's so different when you're dumped in a foreign country and say, go for it.
Speaker: Yeah, it was difficult.
Speaker: Now, since you've been in the States, what's your biggest or your most memorable patient encounter?
Speaker: What was the memorable encounter when I got to speak Nepali with a Nepali patient?
Speaker: So by looks,
Speaker: I know I look like Indian or Pakistani or in that subcontinent.
Speaker: I know for a shot that I don't look like an Apollo person.
Speaker: I went into this room and the patient, I saw the name.
Speaker: It was the obvious name.
Speaker: So I went in and when I started talking in the English source, and then I said in Nepali, I said, hello, you're speaking Nepali.
Speaker: The amount of shock she had.
Speaker: face when I said in a while.
Speaker: I was like, what?
Speaker: And then she was very happy that she could
Speaker: share things that was easier to, for her to share in her native language than in English.
Speaker: I thought New York, every other person would be Nepali.
Speaker: That's what I was thinking.
Speaker: If I go in the hospital, every third or second or third person would be a Nepali patient, but I've never seen a Nepali patient and she was the first one.
Speaker: And till now she's the only one I have saw, seen.
Speaker: And that was a very, the way she had, she could explain her things to me in her language.
Speaker: It was quite nice too.
Speaker: I just talking about the inside of a hospital.
Speaker: I know how important it is for people to be understood and to have somebody that understands them.
Speaker: So for somebody to speak her language, I know when we have people that are deaf in my clinics,
Speaker: American Disability Act, we're required by law to have a translator.
Speaker: Some people waive that right and they just come in and we type on the computer or we go back and forth.
Speaker: But when we bring in the interpreters and we have that full conversation back and forth, I can just see how much it helps.
Speaker: And then it's just, it's touching to go that extra mile or to have something that they want understood.
Speaker: And then I have my patients that are deaf, they will often text or email me because it's just easier than calling.
Speaker: And they're just so grateful, like the extra little steps.
Speaker: I can only imagine how amazing it was for this patient to speak in her home tongue, in her language, and finally be able to say exactly what she needed to and know it was completely understood.
Speaker: And it's, it's hard even when you speak the same language to understand what patients are telling you sometimes the way they describe it, the words they use.
Speaker: And if it's not your natural language, it's just so hard to say the right thing and understand it.
Speaker: And just, I think about all the miscommunications, even people that are native English speakers have what I tell patients and what they hear.
Speaker: So I can only imagine how much of a great moment that was for her to just have you speak to her in Nepalese.
Speaker: Also my...
Speaker: I say that I'm a product of rejections and not in a bad way, but rejection has been my encouragement to pursue medicine.
Speaker: Again, I said this with the utmost humility that when I'm inside a room and the patient, after everything is done, we encountered a patient as we walk out, the patient holds my hand and says, you're going to be so good in coming years that really
Speaker: boosts up your confidence and makes you forget about those rejections that you had.
Speaker: That happened to me, right?
Speaker: I've seen so many rejections and downfalls every time.
Speaker: And I don't know what success is.
Speaker: I have not tasted it.
Speaker: I have not seen it.
Speaker: I don't know what it is because I've been in this constant downfall at least career wise.
Speaker: And when a patient does that, hold your hand,
Speaker: and says that you're going to be so good in coming years.
Speaker: Okay.
Speaker: At least I'm doing something good.
Speaker: This patient knows that whatever I'm doing is accountable for her betterment.
Speaker: And at that moment, you don't care.
Speaker: There's an attending looking at you like, oh, okay.
Speaker: This is happening to you.
Speaker: You don't care.
Speaker: Someone's, someone third person is looking it.
Speaker: It's between you and the patient and it gives you some belonging that, okay.
Speaker: whatever I'm doing is at least working for them.
Speaker: Yeah.
Speaker: And like you said, medicine by itself, the knowledge that we study, it's something available to a lot of people.
Speaker: The woman that came to Nepal that had pneumonia, it wasn't taxing for you mentally to come up with the right diagnosis and treat her.
Speaker: There are a lot of people that can help people.
Speaker: There's a lot of information online.
Speaker: If you're intelligent, you may be able to find the correct answer online.
Speaker: So what makes somebody a truly great doctor?
Speaker: And it really is your ability to connect with your patients.
Speaker: To be able to understand them, to be able to connect with them and then explain the treatment plan and be there for them.
Speaker: And so a doctor that has had nothing but success in her life or his life may not be able to connect with those patients as well.
Speaker: They may know everything.
Speaker: They may know every detail of every disease and they may be a horrible doctor and somebody that's known rejection like you, that's had to buckle down and go through it twice and to study twice and to swallow your pride and to go back to the beginning.
Speaker: That's going to give you an ability to connect with people that a lot of doctors don't have.
Speaker: And so what makes a good physician?
Speaker: Knowledge, but also humanity, like being humble yourself, knowing what patients are going through, having that empathy for their plight and their hardship.
Speaker: And knowing hardship, you can connect with that in a meaningful way that some people may not be able to.
Speaker: It really humbles you down.
Speaker: It really humbles you down.
Speaker: As you said, like following the pride, I'm not going to lie in the beginning.
Speaker: It hurt.
Speaker: When I saw people like four or five, I was class of 20 2006.
Speaker: So if I saw a class of 15 getting into fellowship and I'm still struggling, that hurt.
Speaker: I'm not going to lie.
Speaker: I'm not going to say, oh, that's because I'm a human being.
Speaker: It's okay.
Speaker: No, it hurt.
Speaker: It hurt.
Speaker: very badly when you see people getting what they they deserve what they wanted in life and you start questioning yourself if you believe in god you start questioning god like why me why and it's not a thing of me no why don't say why me say try me no do not try me you don't want to go through this it's i don't understand try me do not try this is very
Speaker: painful to go through.
Speaker: In the beginning, it really, I had to follow my pride.
Speaker: Yes, but it humbles you down.
Speaker: What they say, like time heals everything.
Speaker: It does heal everything.
Speaker: It takes time.
Speaker: Time takes time to heal, but it does heal.
Speaker: And then after some time you start getting humble.
Speaker: You start getting that peace within yourself.
Speaker: And then you really understand the fact that
Speaker: everyone's time will come.
Speaker: Someone will go there soon, someone will get later.
Speaker: Every one time comes.
Speaker: But in the beginning, you would not understand this line.
Speaker: Just a bunch of words, scramble.
Speaker: But after some time, you start understanding the real depth in what it really means.
Speaker: And now that you're getting to your third year, you're doing your clerkships, you're in the hospital training.
Speaker: Are you still thinking internal medicine and pulmonary?
Speaker: Have you just chosen something else?
Speaker: Are you looking at other specialties now?
Speaker: In the beginning, it was always home critical care.
Speaker: And then just to throw a curveball back.
Speaker: I started discussing with my wife, what if I want to go into other specialties, GI or endo.
Speaker: And she knows me better than I know myself.
Speaker: And she goes, at the end of the day, you'll go back to foam and it's still foam.
Speaker: But I wouldn't want to say you never know, but I think deep down, I know it's going to be foam.
Speaker: It's internal medicine fellowship and foam critical care.
Speaker: It's not getting out of my head.
Speaker: Hey, if you're meant for it, that's your path.
Speaker: That's okay.
Speaker: To each their own.
Speaker: And I'm glad we all like different things in medicine.
Speaker: I knew somebody that had matched radiation oncology, which is one of the better lifestyles and better income earners.
Speaker: And then he did his intern year and poem critical care, just this is what I'm going to do with my life.
Speaker: And so he left the residency and went into internal medicine and everybody have said, you're insane.
Speaker: You're going to make half as much money.
Speaker: You're going to work twice as hard.
Speaker: But that was his calling.
Speaker: He just, he found it and he said, this is what I want to do with my life.
Speaker: As somebody on my podcast, when I asked our deal, the osteopathic chief about medicine, and he said it beautifully that
Speaker: If you're in medicine to get rich, to earn money, just get out.
Speaker: You're not here to earn money.
Speaker: And I don't know what motivates me or what magnetizes me towards home critical care.
Speaker: And even the sound of small beeper sound inside ICU makes me like, oh my God, that's so beautiful.
Speaker: Sam, I don't know why.
Speaker: Hey, that's great.
Speaker: That's like I said, it's nice to know because at some point, if you don't love what you do, it doesn't matter how much money you make, you're not going to be happy.
Speaker: And so you need to first find the career that makes you happy.
Speaker: And if it also makes you money, that's wonderful.
Speaker: But it's yeah, money's definitely going to replace being miserable or doing something you don't enjoy or that you don't find a passion for.
Speaker: Right.
Speaker: Tell us more about your podcast.
Speaker: Oh.
Speaker: What started it and all that.
Speaker: I have this knack of, I used to make up stories in such a way that if, if I went to watch a movie and someone tells me, okay, did you watch this movie?
Speaker: I would say from the end to beginning.
Speaker: without missing a beat kind of thing.
Speaker: Okay, now the light comes, now the trailer shows, now the name comes, and this, like, all the way.
Speaker: I wanted to share my story of getting into medical school at least the second time.
Speaker: Because I wouldn't say problem, but the thing is, I think we only share stories of success.
Speaker: Like, in our part of the world, oh, he got matched into this.
Speaker: You know what?
Speaker: Like you said, the guy, like, after seven years, he got matched.
Speaker: We only share stories of success.
Speaker: We never say that poor guy, he tried for so many years and he tried to scramble, didn't get into match and still trying and he's working this, but still this.
Speaker: We never go through that.
Speaker: And then if that person got into, it's lost in some way.
Speaker: And only the new fresh stories of success are shared.
Speaker: So I wanted to share my story too.
Speaker: I know there are
Speaker: So many people are still trying to get into residency.
Speaker: I know people who are getting rejections after rejections and they don't know what to do.
Speaker: And if I say that, okay, I went through this path.
Speaker: If you want to take it, there is a path, like be a medical student again and then go through residency.
Speaker: That's what you really want to.
Speaker: So I wanted to share that story.
Speaker: I thought vlogging is the way.
Speaker: And then I researched how to do blog and what to do.
Speaker: And then one fine day with the ring light and the phone, I recorded myself and I kept it aside.
Speaker: Thank God I did that.
Speaker: For a couple of weeks, at least three or four weeks, I forgot about it.
Speaker: And then one day I was like, oh, I hadn't made that.
Speaker: Let me see.
Speaker: And then why not let me post it.
Speaker: And it was just an introductory vlogging.
Speaker: It was not the whole story.
Speaker: Like, Hey, my name is this.
Speaker: And then I'm starting a vlog.
Speaker: Hope you guys like, share, subscribe, the whole shebang.
Speaker: And then, okay.
Speaker: I watched it and I haven't watched the, the more cringiest thing than that ever in my life.
Speaker: I don't think I have ever anything.
Speaker: Nothing comes closest to that.
Speaker: It was, I was being very animated.
Speaker: I was not being myself.
Speaker: I was being very camera conscious.
Speaker: I was being,
Speaker: Timmy, I will everything was there.
Speaker: All the bad proportions were there, but I deleted it.
Speaker: Uh, I don't think I showed my wife to, I don't think that I would, it was that bad.
Speaker: Uh, then, then the idea of podcast came in my head.
Speaker: If I want to share the story, one fine day I started recording it and then the rest is yesterday, I think.
Speaker: Yeah, it's not too dissimilar from what I went through.
Speaker: So I had some ideas of things I wanted to share, stories I wanted to share, and I recorded three of my favorite stories.
Speaker: And when I tell it to people, I'm animated, I'm in the moment, I'm explaining things that's fun for me.
Speaker: And I sat down and recorded it.
Speaker: And then I watched the recordings.
Speaker: It was just flat and boring because I wasn't connecting with a person.
Speaker: I was just talking to a camera and I thought, I don't know, maybe I can eventually learn to be really animated and big on the video.
Speaker: But I said, I'd rather talk to people.
Speaker: And also, yes, I have a lot of stories from medicine.
Speaker: I have a lot of things I want to share about what I do and the experiences I've had, but yet I'm just one person with one set of experiences.
Speaker: So that's why we branched into the podcast as well, because at some point, I
Speaker: who cares about one person's experience?
Speaker: I want to hear about your experience and the next person is experienced and just this larger tapestry of cultures and beliefs.
Speaker: And there's that little thread that weaves in between every doctor, nurse, PA, nurse practitioner is that desire to help.
Speaker: Right.
Speaker: And that feeling of
Speaker: Caring for other human beings that we've seen everybody's story.
Speaker: Like you said, if you're in it for money.
Speaker: go, leave.
Speaker: There's other ways to make money.
Speaker: There's probably much better ways to make money.
Speaker: Oh, definitely.
Speaker: Yeah.
Speaker: So no matter where, Nepal, United States, if you enter medicine in one way or another, the common thread is people care about people.
Speaker: And that's what we wanted to highlight.
Speaker: And yes, some of the stories are funny.
Speaker: Some of them are sad.
Speaker: Some of them are gross.
Speaker: But yet it's all part of what makes it interesting.
Speaker: Yeah.
Speaker: Like I said, like I had an act to stop.
Speaker: tell stories and then that quickly changed into sharing my story with people's stories.
Speaker: Like everyone has their own.
Speaker: Okay.
Speaker: For the past one hour we've been talking and then I might have gone so many times saying then, Oh, I was, uh, deep down in a rabbit hole or I was bad or I had the rejections and I was feeling bad.
Speaker: And, but
Speaker: That is only my story.
Speaker: There are like way too many people that might have hurt or felt bad in more ways than one can imagine.
Speaker: I wanted to share their stories, but not only the bad part, but how they overcame that.
Speaker: And that could inspire other people who are listening.
Speaker: Oh, so even after all that hardship, there's a triumph.
Speaker: There's a light at the end of the tunnel.
Speaker: So that can be there.
Speaker: but I wanted to share those stories too.
Speaker: And then I started interviewing people, my colleagues, doctors and everyone, and then shared their story, how they became into, why they came into the field and everything related with their lives.
Speaker: Would it be at least in some way inspired someone like a person, if one person get inspired, I would be content.
Speaker: I would be very happy with that.
Speaker: And that was the reason for starting med school 2.0.
Speaker: See the name?
Speaker: Med school 2.0.
Speaker: That's great.
Speaker: We want to inspire people to, to one stay in medicine, but also people outside of medicine to look at medicine as a career.
Speaker: I can't tell you how many people told me not to become a doctor.
Speaker: Even the doctors told me not to be a doctor.
Speaker: They said to something different.
Speaker: And I'm trying to turn around and no, please be a doctor, be a nurse, join us.
Speaker: We need more people.
Speaker: We need more people that care.
Speaker: It's an amazing career.
Speaker: So part of what we want to do as well is tell people join, join healthcare.
Speaker: Be part of it.
Speaker: It's one of the most rewarding careers you can have.
Speaker: And there's going to be ups and downs, but we're all in it together.
Speaker: That's life, man.
Speaker: Ups and downs exist outside of healthcare as they exist inside of healthcare.
Speaker: Yeah.
Speaker: But it's a career that means something.
Speaker: So we appreciate you spending your evening with us.
Speaker: We appreciate your wife for letting you pursue your passion and being a support.
Speaker: And we need you.
Speaker: We need you as a doctor providing for our community.
Speaker: So thank you so much to your wife as well for supporting you and taking care of your kids while you pursue this, because that patient said you're going to help a lot of people.
Speaker: you're going to do a lot of good in the world.
Speaker: So thank you for Med School 2.0.
Speaker: Thank you for sticking with it.
Speaker: Thank you for being who you are.
Speaker: Thank you so much for having me.
Speaker: It feels really weird in a way that this is the first time I've been in this part of the mic and not that part of the mic.
Speaker: Thank you for letting me come to the show and share my story with you on your show.
Speaker: And as I said,
Speaker: If I could inspire even a single person who really wants to get into medicine or was trying to get into or was in my shoes a couple of years back, hey, there are options.
Speaker: There's a way to get into medicine and help people.
Speaker: If that's really your calling, you should.
Speaker: I was going down in obscurity career-wise, but I just wanted to have a chance to say that
Speaker: Well, you tried.
Speaker: So here, I'm trying.
Speaker: So thank you so much to have me.
Speaker: Thank you so much.
Speaker: Thank you.
Speaker: Bye.
Speaker: Hi, this is Dr. Dave.
Speaker: Thank you so much for listening to this week's episode.
Speaker: Please rate, review, and share this episode so that we can continue to get you more stories in the future.
