21. Lessons Learned: Ryan Inman, Ni-Cheng Liang, MD and Roudy Nassif

Hello everyone, I'm Dr. Darsha, and I'm Dr. Altamash Raja, and welcome to Medicine Redefined. A podcast where we will explore the often overlooked but necessary components of health, what we consider to be the fundamentals. We will investigate topics and practices that can give you and your patients the best chance to optimize a healthy lifestyle. It's time to move the needle forward and put the health back in healthcare. As a physician, you routinely check your patient's health. But when was the last time you checked the financial health of your practice? You could be needlessly losing money right now. Stop bleeding money. Get actionable insights about your group's financial performance with a free, no strings attached assessment from Care Cloud, a leader in medical billing solutions, electronic health records, and more. Care Cloud has over 20 years experience helping large and small providers boost profitability and has helped thousands of practices optimize their financial operations. Request your free revenue cycle assessment and learn more about your group's performance by visiting DrPotCastNetwork.com for slash Care Cloud. That's DrPotCastNetwork.com for slash Care Cloud. Hello everyone, welcome back to another lessons learned here on Medicine Redefined with Ultimash and I. In this episode, we will be covering the previous three, which are with one Ryan Inman to Dr. Nietzscheing Liang and then three Rudy Nassif. So let's start with Ryan Ultimash. I know you are pretty familiar with his work. I think you enrolled in his course if that's correct, so I'll let you let you take away the first word here. Yeah, I did the fellowship, which was super awesome. I highly recommend that for anybody who is interested in doing it a little bit themselves and just learning and more about finances, but this one was a super important topic. I believe, you know, I'm very much interested in personal finance and I'm actually passionate about it and was lucky I shared my story that I learned about disability insurance because a couple of insurance ages came to me and tried to sell that to me and this was actually right after maybe, you know, that last month and fourth year when you're kind of just in limbo waiting out and sometimes end of April, May before you start an intern year, I just kind of dove so deep into the rabbit hole sort of a disability insurance and this and that started learning about PSLF and finances and I kind of just got addicted to it. And I mean, I consider myself fortunate in that regard because there are so many opportunities for us to mess up, man, you know, along the ride. I mean, if you look at the lowest paying specialties, I'll pick on Peter Tishens because, you know, I can't, I mean, even they're going to make a few million dollars, right? If they practice for an average life of a physician 20 years or so. And so that's a lot of money and if they're smart about it and they take care of their finances, the way a lot of the just the big ticket items that we talked about, then you don't have to be broke when you're 55, 65 years out and still have to continue to need to work because you have loans and this kind of stuff. So I think it's super important. And hopefully people got some tidbits and, you know, just what to avoid and what not to avoid. And we'll get into some of those specifics of work. But yeah, I mean, I can't emphasize that enough and that's why we wanted to start off. Hopefully a couple of interns, I'm sure they didn't have any time to listen to podcasts nowadays, but when they do, if they do, they, you know, they can get some valuable lessons from this one. Yeah, absolutely. I remember when we first linked up, right, kind of doing this podcast and I was starting in turn year, you were probably one of the, you know, a few people who influenced me to get into kind of personal finance and just, you know, straighten things out, especially, you know, especially with disability insurance, right? And kind of went through you to learn about those things and I got it and it's one of those things Ryan talks about in the podcasting, you know, there's, there's no such thing as never too late and there's also no such thing as never too early, right? It's the time is now to kind of do those things because you just never know what's going to happen down the line. And he, he recalls these emails that he gets from people saying, you know, now my wife has MS and I'm stuck and I know you told me this and I should have done it when you told me, but again, now I'm stuck, what do I do, right? And that kind of breaks his heart. So it was just super cool to connect with him, you know, I know a lot of people talk about the white code investor. I forget, there's another one out there that I can't recall. Physician on fire. Physician on fire. And then there's something with, I can't think of it. There's another like small book that that people talk about, but I mean, there's lots of good them. There's passive and the, I mean, there's lots of cool people doing this kind of stuff with about personal finance, but yeah, right. But I mean, at least Ryan having a podcast to write call financial residency for those of you all that want to check it out. I mean, it goes into various topics that are super interesting, right? Things that us in medicine don't learn throughout med school don't learn as a premed. And maybe honestly, a bunch of us don't have interest in it, you know, I remember my dad telling me, why do you want to become a doctor? You should go into business or something, right? He's like, all of you're, all of us, the brown people go into science. I was like, you know what? It's, it's what I'm good at. I like it. I don't like business. I don't like dealing with money and these things, but you know, I look back and I'm like, man, I probably should have learned some of that stuff, you know, to where I am now, but hey, now, now is the time. Right. And how important is it to understand the business of medicine? Because what we talked about is, you know, we do spend a lot of time behind the computer documenting, making sure our notes are good for from the clinical side of things, but also from the billing side of things. I, I'm doing basically 90% of my billing now in this new role. And it is very important to understand. And so the business of medicine is just as important. And, and, you know, as, and, and that's going to also determine what kind of clinical care you're going to be able to provide for a patient. So I think that's really important to understand. But yeah, like you said, there's really no exposure. And, and we think there's no time to get that in. But, you know, Ryan would argue and, and I might agree with them that it's just as important. You know, and another thing that he mentioned is that we start so far, you know, behind in the game, right? If you think back to when we graduated, most people graduate undergrad at like, I don't know, 21, 22, somewhere in that range. And our friends at that time who are going to business school who are going to start off their, you know, maybe they're not going for further training, like we are for doctor training, they have, depending on how long with residency and fellowship we end up doing, they have anywhere from a 10 to a 12 year head start where they're accumulating wealth, they're building wealth. And not only are we not doing that, we're also digging a whole further down because we're taking on debt. Absolutely. And you bought up this concept of disability insurance. And I really like that. And if any of my co-residents are listening to probably cracking up right now because I've been feeding this disability insurance drum for anybody I talk to, I really like the analogy that he uses, right? He talks about that basically it's this business, right? We take on this business that's in our head, right? Here in this country, if you start a business, you need to have some type of insurance to protect it. You buy a car, you can't drive it without insurance, you buy a home, you can't, you know, you got to have home insurance, you got to have rent insurance. So it's almost illegal to have these big assets without insurance. Yet for us physicians, us young physicians, what's our greatest asset? It's our future income, right? We you know, I've talked about this before, right? And there's nobody out there saying you must protect it, right? And that's wild. And man, I've been, you're going to, now that you're in more in P. MnR, you're going to see these stories every single day where people are going to be in the outpatient clinic, whether it's going to be spinal cord or brain injury or stroke or whatever. And yeah, now they can't work. And MS, we see a lot of MS too. And for those who don't know, it's multiple sclerosis. It's technically, you know, I am a central nervous system disorder, so it can affect the brain and spinal cord. And so it's the asset that needs to be protected. And the return on the asset can vary if you're a pediatrician. It's not as great. If you're in orthopedic surgeon, it's fantastic, right? And so it needs to be protected somehow one way or another. So that is, I think, big ticket item number one. Actually, that's big ticket item number two. Big ticket item number one was, do you remember, let's see if you probably, oh, I would say like savings, right? I mean, what kind of, yeah, yeah. I mean, yeah, I mean, I think that I was thinking more of the way he talked about dopamine ostrich, right? Okay. Yeah. Yeah. Yeah. I mean, it's kind of just education awareness, which is kind of what we're talking about today. Right. Right. Which, yeah, I mean, I can't recommend his podcast enough. He's got an awesome book. And it's not just him. I mean, he's doing, you know, the good work with Jim Dolly from Wiker Investor. You talked about physician of fire. I forget what his name is. I had passive income MD. There's a lot of people who are doing a thing. The other thing is, like as he mentioned, is physicians and healthcare providers in general, we've got a big target in our back for, for people in the financial industry. And they're not all bad people. But like you said, it's because we don't understand the finances one and two, a lot of people don't care for it. They're like, you know what, I don't only have time for this. And sometimes, you know, they're just getting taken advantage of. Yeah, exactly. And you know, to, to bring back your point about how our colleagues and our friends make, you know, 10 years worth of money while while we're suffering in a, in dead and medical school and knowledge, imagine once we do make that, you know, the, the big bucks, right? What's our mindset? A lot of people just say, Hey, now I can finally live, right? I can get that car I wanted to that mansion. I was thinking of, I want to catch up to these people, right? And you're just digging yourself a bigger hole. So I know Brian talks a lot about being smart, saving, right? He talks about how his average client spends about $2,000 a week or a month, I think a month on Amazon. That's a while. Yeah, which is wild. No, I was, I actually, after that episode kind of went back to my Amazon. I was like, Okay, thankfully, I'm not there. You know, I was just like, you know, that's a lot of money, man. But yeah, again, it's, it's so true. And I think, yeah, it's just a great episode to kind of hopefully get people out of their comfort zone, right? You know, if, if finance is and talking about it makes you kind of want to crawl up and not talk about it, I think this is a good episode to kind of get you, get you out of your shadows and start to learn about the things that will matter. Yeah, I, and I'm, I'm really glad you talked about, you use that word behavior. He spent a lot of time talking about our relationship with money. And well, I think the, the word that he used is, it's kind of lifestyle inflation, right? You, yeah, we delay this gratification for such a long time. And the moment you graduate, the moment you get that big attending check, you're like, now I want the car, I want the this and that. And those are all nice things. And I think, I think our colleagues, I mean, we all deserve them. We worked hard to get them. But then that debt is still there. And again, it's that whole that we talked about where compound interest is very powerful. And that's 10 years of compound interest that we haven't had the opportunity to take advantage of. What I really like that he talks about is give yourself at 50% of a raise, which again, he mentioned any other industry that would be insane. And so for those of you who don't know this concept that run, routinely talks about him, really big fan of it's, you know, if you as a resident, let's just say for simplicity, make $50,000 a year, you know, the moment you graduate from training, spend 75,000 that year. I mean, that is amazing. Yeah, increase, right? Whatever else that you, because typically for those people who don't know, it's like in residency, you make like, let's just say you're making $50,000 every single year. There's an incremental increase. But all of a sudden you have a 4x increase. You go from 50,000 to 200,000 to 250,000. Like what the heck are you going to do with that money? And so he recommends, give yourself a 50% raise, go to 75, spend that money and put it everywhere else in kind of again, wealth accumulation, right? Whether that's saving, whether it's paying down debt, whatever it might be. I really like that because I think that we always talk about sustainability. I mean, there's this concept out there about living like a resident for five years. Actually, Jim Belly talks about that. And I think a lot of people can do that. It is a good approach for those who are really, really frugal to talk about that. And then you have the financial independence retirement early movement. That's awesome. But is this sustainable? It always comes back to that, right? And not only that, like what's your quality of life going to be? Like if you've delayed this gratification and your mental health this suffering for eight years, and now you want to kick the can down another four years, like, is that really worth it? I don't know. And also, I like that a lot. Yeah, I agree with you. Absolutely. I like that concept. Yeah. Increased by 50%. I mean, and like you said, any other industry you think of, that's wild, right? You don't hear about that in any other industry. So treat yourself, of course, but don't go full blown. Yeah. Awesome. I'm trying to think if there were any other actionable items that people can take away. I mean, he had a lot of different gems. Obviously, mistakes not to make is, I think the biggest thing would be is take some, you know, you have to invest in our own education. And to your point, you know, when we talk about at least in our fellowship or really our conversations offline have been that, you know, if you're in a whether or not you're in a two physician household, or if you have a significant other that you're sharing finances with or not, there has to be one person in the house who's the CFO, right? And if you're a physician and this is not an area of interest, and this turns you off in the thought of personal finance or finances, you just want to cry, then you better hope that somebody in your family is who's looking out for you and your best interest is going to have that relationship. And so for me, like honestly, in my personal thing, I'm very much about the investing insurance, looking at from the global picture, and my, excuse me, my wife, she loves the budgeting side of it. And I don't on day to day, right? And so we kind of split the load. And it also allows us to have these higher level conversations about, you know, our relationship with money and our future goals and stuff. And it's really awesome. Yeah, that's actually an excellent point to bring up now because money and finance is not really a solo game, right? Especially if you have a spouse or you're in a relationship, it's something that can be awkward to talk about, but people have different styles, right? And so I had a mind, when me and Mira finally moved in together, I had this one mindset of how we need to budget and invest. And she had this completely different idea. And you know, we weren't necessarily seeing eye to eye or reaching our goals. But once we started to say, Hey, what works for you? What works for me? How can we dumb it down so that we can be more goal oriented? That's kind of what worked. And we had to like remind ourselves that we're both goal oriented. So let's focus on goals rather than looking at what do we need to sacrifice? What do we need to cut down and start building towards a goal? So I think, yeah, that's an excellent point. Yeah. And this reminds me, you know, he also spent a lot of time talking about for when he has clients, he's always trying to figure out with them, like, what's your why? Right? If tomorrow you got all this money and Bill Gates basically left you all as money and whoever and search rich person. And you know, what would you do? Would you still work? Would you cut to part time with all that kind of stuff? So it's really important to start off with like, why are you doing what you're doing? And, you know, what are your goals? Kind of like, you know, having that money date. And if for those of you don't know what that means and check out, he's got a couple of episodes talking about having a money date with your spouse. And it's fun. Not highly recommend that. Guys, awesome. Anything else? Or should we shift gears here? Let's talk about what Neachang said, man. I think it's going to kind of tie in well when especially when we're talking about mental health. You know, I thought that this was a really powerful episode. I mean, we talked about a lot of deep things. And somebody that I've been looking forward to speaking for a while, I mean, obviously, it's a topic that we could have gone down different different avenues. But what were your initial impressions? What did you learn? Yeah, I think, you know, the reason I love this episode was that a lot of signs was brought into it. And I think a lot of podcasts or YouTube videos or things that I just hear about meditation, mindfulness, you don't really get the signs behind it. And that's why I think a lot of people aren't willing to stick with it, right? Because that why, right? A lot of people want the mechanisms. They want to understand why meditation helps them. You know, they need to understand that just doing a five minute session once a week isn't really going to do anything for you, right? And in terms of a physiological response. So, you know, Neachang coming in and talking about how, you know, meditation helps from a parasympathetic or sympathetic point of view, right? The rest of the night just kind of takes over the sympathetic is what causes us to stress out. And we've talked about this in multiple episodes. But that's really the backbone of mindfulness and meditation is that it allows your autonomic nervous system to kind of play tap into that parasympathetic system to really just relax you and help you out. And a lot of changes happen in your body. I couldn't agree more, man. And you know what's funny about this? I think we'll, for one, people use the terms, right? Mindfulness and meditation interchangeably. And I really liked the the absolute simple definition that used that, you know, essentially I'm paraphrasing here, but just talked about how, I mean, mindfulness is just being present, being in the present moment without judgment. If we think about it, especially today, I mean, even 10 years ago, it wasn't as challenging where so many different things are fighting for our attention, whether it's what you did five minutes ago, what you're going to do with 30 minutes from now, your phone, your spouse, you know what I mean? If you have kids that and it's really, really hard to be right there with your thoughts without judgment. Hey, that hey, I'm not doing anything productive. I think that we folks like us who are extremely type A in the medical field, it's always boards are coming up or this or the patient, what not. Yeah. It's very, very challenging. And I like this analogy that she used. She said, you know, meditation is the vehicle that you can build mindfulness way that's like I love my exercise analogy. So she kind of, you know, related to it's like exercising to build strength or a bit capacity. So, you know, you can train to be more mindful. And meditation is just a tool to do that. And you and I off time talked about so many different ways. I mean, you definitely have a great routine. So I'll let you kind of talk about what seems to work for you. And I'm actually curious to, I don't know if I know this. And when did you first start doing this? Like you were like, you know what I need to do this and how long did it take you before it was a staple where it was routine for you? Yeah. You know, a lot of people ask me that. So when I was younger, I've always been fascinated by like just the spiritual side of things, right? Like astronomy, horoscopes, like understanding how things were connected, right? Like how nature connects to us, you know, magnetic fields, quantum, if I can say that kind of stuff always just interested me. And so I remember being in college, this is before medical school. And I really, this is when meditation kind of just started growing and people are talking about and California started popping up with classes and things. I say, no, this is something I want to get into, you know, I started looking into different YouTube videos of yogis and yoga. And you know, yoga was one of the biggest things that helped me when I had a L5S1 herniation in my back doing a lot of yoga, awesome on stretching. So I really wanted to get into breath work and changing physiology. And that's what I was super interested in. So I found a free class in my hometown that did Sahaja Yoga. So essentially it's Kundalini Yoga. You kind of activate your chakras, the seven chakras, midline of your body, looking at like the third eye, opening up some things, but just feeling very relaxed. And so, you know, I definitely went to a lot of classes doing our meditations and just getting that sense of feeling, right? And, you know, a lot of times when you do these meditations, you'll start to see some colors, you'll start to, right? Like there's there's noticeable changes that happen. And, you know, obviously the yogis and stuff, attribute that to, oh, that's like the spirit or this is the energy and things like that. I just think it's, we don't spend an hour quiet with our eyes closed, being present. And if everyone does that, you'll probably notice like things happen, right? Like physiologically, things just happen. And that's when I just really, you know, really found it fascinating. And that's how I got into breath work and cold showers and then really started looking to the science of it. So that's, that's honestly how I got started. And now, you know, I got to admit, I haven't been the most consistent since internear. But now that, and it sucks, right? So this is what's funny. Now that I'm more free, I, I'm able to do it, right? Which shouldn't be the case because I'm a huge, huge proponent of someone who says, if you don't have the time to meditate once a day, you need to meditate twice a day. Yeah. Yeah. And so, you know, I finally have found an app. And I'm very OCD in terms of data collection. So I used to do the whole headspace and kind of check out my minutes. But now I'm at the point where I'll just use different different vehicles, right? I'll use Spotify and I'll use some binaural beats. I'll use night time meditation. I'll use nature music. I'll use guided meditation. I'll do breath work. So I like to just change it up and kind of just see, you know, what relax me and how I can have fun with it. For those who don't know really what you mean by breath work, can you just elaborate on that? Like, what do you mean exactly breath work? Sure. So, you know, again, there's different forms about breath work. So I think most people will be familiar with the box method, which is you breathe in for a count of four seconds through your nasal passage, right? So breathe in for four seconds. And then you might hold it there for four seconds. And then you're going to breathe out for longer, you're going to breathe out for eight seconds. And what that does again is you kind of retain that carbon dioxide. And that's going to change your physiological state to put you more in terms of parasympathetics, which is going to relax you. And so if you do that, a lot of people say do it three cycles, you'll start to notice a difference. And now there's actually certain products that come out. I don't know if you've seen like the whistle, like people wear it as a necklace, and you just breathe out into like, it's almost like a straw. It's like a metal straw. But it forces you to exhale with, with, with purse lips and essentially purse lip breathing, which I think Nietzscheing talks about in the, in the episode, is a good way to really just calm your body down. Yeah. Yeah. I think that's a key point, actually. I remember it. I think it was Andrew Huberman on Tim Ferris podcast, really talking about the, the whole relationship within Hill XL versus, you know, in sympathetic person, it's such a simple thing. And I want to go back to what you talked about how you initially started with yoga. You know, one of the issues, as Nietzscheing I mentioned is, you know, people have this action bias, right? I gotta do something, right? I gotta do something in order to have an effect. It's not like inactivity is going to make you better. Like that makes no sense, right? And, and so for a lot of individuals, finding stillness through movement is exactly what you're talking about. And that's not mine. I mean, I'm not, I can't articulate that. Well, I definitely stole that from, I think it's George Mumford, actually, who talked about that. But, um, and actually, Ryan Holiday in the next book that you're going to read is you'll read about that. But that's there, right? I mean, so for a lot of individuals, it's much easier to get into mindfulness and the practice and meditation through yoga. And so for some individuals, it's through, uh, lifting weights for others, it's running. You know, how many times just had an individual today would tell me he used to run miles and I was like, did you ever run for a track or, or, you know, cross country? No, he was like, no, I just pointed to his head. He was like, for this right here. Yeah. And so, you know, you get that runner's high. And I think that at a very basic level, people get that concept, but they're like, they need that because they feel that much better. And there are some meditative process about, you know, this recurred activity focusing on your breath. So, um, you know, I really like there's a million different ways to do it. Um, I think the ultimately what it comes in is different ways work for different people. And you want to start somewhere and, and ideally, you can get to a point where you can just be there sitting still. Right. Right. And I think, I think people, again, it comes back to finding your why. I think people need to understand why they're meditating. Are they doing it because they actually need to, you know, chill out? Are they doing it because they need better sleep? You know, I was doing it at some point because I just wanted to see how long I could test myself for, you know, I love embracing the suck. It's like, Goggin's mentality. I remember, I drove down from Philly all the way to North Carolina, seven hour drive with no music, no podcast, nothing. Just driving seven hours straight. Cause I wanted to test myself and see if I could do it. And then I did it. Right. And I was like, okay, I can go seven hours of silence, no phone call, nothing, just me. I can definitely do five, 10 minutes. Right. So for me, I love pushing my limits in that way. It's just kind of the weird way of how I, how I get motivated. Um, but I think people need to find that why and to see, you know, what is the purpose of it? Because like, there's so many different ways of doing it. And you're going to find that one way that suits, that suits you. Did you respond to any messages or WhatsApp or nothing like that? So no, no notifications, no social media, nothing. That's quite impressive. That is actually that's so impressive. Cause I'm just an autopilot sometimes where I'll just reach for my phone and I'll flip over my email. That's just, that's what chief life does to you. Yeah. Um, yeah. I mean, so this one, I mean, I think that I'm a huge fan of, I know it sounds, I feel like it's just redundant. Um, all these topics that we talk about are very interesting. But, but this one is a powerful one. For me, personally, man, I mean, full disclosure, this is the one that I struggle with the most. I find it challenging. I, you know, there was a period, maybe toward the end of 2019, where I had a six month stint of where I was really focused. And a lot of times, you know, it's, it sounds kind of wild, but I would describe people as like, you know, when you're, when you get to a point where you're mindful in this, it's, it's almost like watching a movie. Or, you know, for, for those people who played video games already, if you played Halo or you play some shooter games, you know what it's like to play a first person shooter game versus a third person shooter game, right? Or the other, the other analogy is, um, it's like you're, you're watching a play versus your, your in the play, right? And so like if you're watching a, a play, you can observe everything that's going around it. And all the actions of all the part is involved versus that if you're in the play, you only have the perspective of one person. And so when you, I think, I don't know if that I'm making any sense of whatsoever, this guy's absolutely wild. Um, but you know, I, I, I should be, you know, the practice of mindfulness, when you get to a practice, it's much more of, you're sitting in the audience looking at, and you can see the whole picture. Right. And, you know, reactivity is much less, you know, that pause between action and reaction. She talked about that with her personal story when, you know, she had a patient. Um, I mean, I think that's, that's such a powerful thing, such a powerful skill for us to develop that would honestly make the world a better place. Absolutely. I think you're so right, right? When you, when you start to meditate and you start to understand the gaps between your thoughts and translate that to real life and somebody attacks you, right, with, with, with verbally or whatever it might be or something bothers you, you take those 10 seconds and just think about it, right? As, as you would, if you're meditating. And that's the key, right? I think a lot of people think meditation is not thinking. You can be in the present moment and think, right? Like, I think thinking is meditation. Like a lot of my meditation is just me and my thoughts. And it's like emails, right? Nubble, Rubikun says it so well. Meditation is like going through your inbox. You delete, you delete, you delete. Oh, three come in. Okay, it's okay. You delete, you delete, you delete. Eventually, you're going to get to an inbox of zero, but it takes time. You just have to sit with your thoughts. Yeah. Let me ask you this. I know that, you know, a lot of, for people sometimes they'll start on this practice, right? And, and they have difficulty to, to slow down their thoughts because they're just coming from a revved up job or they're about to do something or they had other adversity in life that they're thinking about. And I find that people tend to get frustrated and I'm, I used to be in this camp as well. They, they get frustrated with, oh, man, I can't turn those thoughts off. I'm talking exactly what you're saying right now. And there's one strategy that she talked about, but what is your strategy when you do have that that, you know, without judgment saying, hey, right, it's okay. This is not a failed practice, right? Because I can't turn the volume on these thoughts down. Yeah. Yeah. Do you have any other strategies? Yeah. So my strategy is how do I take these thoughts and turn them into tweets, right? How do I turn them into like advice from lessons for other people, right? Like what, I think about what is my philosophy on life? Why are these thoughts coming up? What can I take away from this that I could write in my own biography? You know, because there's a reason I'm thinking this. There's something subconscious that's making me think of this and I need to know what that is. And so I sit and it sits on replay and replay and then, oh, there's an offshoot. There's another thought. How is this related to this? And honestly, I'm at the point of my life now where I can just be doing anything. I'm just thinking about random things and seeing how everything's interconnected. And that can be a blessing for some people and it could be also the worst nightmare. For me, that's, it's honestly a lot of my tweets and stuff on Instagram and stuff come from that. So will you pause and then write some of this stuff down? Yeah. As you're sitting there. Yeah. Yeah. Absolutely. In my notes, I'll kind of have a lot of this stuff. It's also been awesome. Why I read a lot. I just, I make, I can make those connections as to why the author, oh, this, you know, Ryan Holiday wrote this. This is kind of what I was thinking about. Oh, that's, that's a coincidence. Like, yeah. So I'm always trying to tap into the subconscious of thought. And I think that's where a lot of people go wrong with meditation is that they think your subconscious shouldn't hold anything. And I think it's important to understand yourself. I think meditation, the word itself comes all from, from reflection, right? Looking at a mirror and dusting the dust off the mirror to clearly see yourself. And so I think people just need to understand that you're just getting a deeper version of yourself. You're, you're, you're, you're getting clear vision of who you are. That's, that's a beautiful, sad man. And the other thing I think that, you know, I know that you do or at least did at some point is journaling, right? And that's, that's a version of it. So talk a little bit about how are you doing both still or just one, one of the other things I need to get back into. So I just read Matthew McConaughey's book, Greenlight, absolutely fascinating. And it's, it's, his book is essentially a journal. It's, since he's been journaling ever since he was little and you really see his thought process, you see how he's developed as an adult and as a just a human being and how he looks back at his life. And because these journals literally expose who he was at a deeper level. And I, you know, I keep telling myself I need to go back and I need to start doing that. You know, again, the problem is I'm tired. It takes a lot of time. But I'm getting to the point where I just jot down notes now. I literally just jot down thoughts this, this, this, this, that's it. I'm not going in and writing paragraphs. But I am making sure I'm constantly thinking. And again, that's the reason why I tweet a good amount now is that that's almost like my journal, right? It's, it's, it's the same reason why I get tattoos. It's, it's, it's a, it's, it's a brand. It's a branding at the present moment of who you were in that moment. And you know, you look back 10 years from now and you're like, oh, wow, that's why it was at 29, you know, so. Yeah. I like that. It's document. The journey, right? Yeah. Yeah. Exactly. Yeah. Awesome. And well, hopefully people will be able to take away, you know, be inspired to at least start some type of practice, whether it's yoga, whether it's just being more mindful of their actions, whether it's being inactive in some instances. And I think that, you know, Nietzsche, I mentioned that in her patient encounters that are sometimes 20 minutes, she'll invite them to, to join her in a one minute breathing thing. And, you know, what's interesting about it is, you know, we have a good amount of literature supporting that has little is one to three minutes a day. And it's just, you talk about three breaths, right? I mean, how long does that take if you're doing four eight? That's 36 seconds, right there, right? I mean, I would call that a win. If somebody's not starting, can you take three seconds out of your day, just focus on your breath. I have, I mean, now we're in Apple Watch or something cool. You know, it just, yeah, it'll remind me, you know, focus on your breath. And it's a 60 second thing. And just pause as long as you're not in traffic. I mean, I don't recommend that. You know, sorry, God. No, no, that's. Yeah, I was going to say, this is then Tim Ferris's book, Tools of Titans. Um, forget if some role, some, some guy at Google, maybe like chief happiness officer or something, uh, he came up with just, it's one breath a day. That's always says he says, take one deep breath a day, whatever it is in the day, just one. And he's like, that is a habit in itself. And you'll start to build on that, right? So, yep, it's all it is. Awesome. Awesome. I love it. All right, man, let's shift gears and let's talk about light. Um, you know, we're, these, these topics for people to grasp are probably getting more and more challenging. But it's, it's funny because, uh, something that, I mean, the, the way that Rudy nots have explained it, it was like, wow, this is such a fascinating thing. This can't possibly true. But it's like thousands of years. I mean, it's available to everybody. There's an abundance of it. And we neglected, uh, to a certain degree where it's becoming a serious problem. That's why such a hot topic now, right? I mean, you'll see article every single day about, oh, blue lights this and more softwares and that kind of stuff. So, um, you know, give us, give us your initial thoughts. I know you've been, you've known him for a long time and, and you got a good friend. So we're going to even go with this. Man, light is just such an interesting thing. It's a mind boggling, right? It's one of those mind efforts when you think about it because we can think about it in terms of our podcasts, right? In terms of our own health. But you can also think about it in terms of just like light determines the past, present and future, right? Like if you ever guys are watch like Neil deGrasse Tyson's like documentaries and if you're traveling towards light or away from light, it changes your whole perspective in terms of what the present moment actually is. It's, it's absolutely mind boggling. But to keep it in terms of health, um, yeah, this is, this is something I actually love in this episode because blue blocking glasses have been something that I've been wearing now for about two years. Um, and I'm really glad to have aligned with, uh, Viva Rays or Rudy's company because through my whoop data, the number one factor in terms of giving me better sleep and better resting heart rate and all those factors is wearing blue light blocking glasses. And that was actually very surprising to me. I really didn't think so. I thought it would be, you know, not eating late or meditation or just sleeping in the same bed every day and having that circuit, you know, the, the cycle that I usually have or the routine that I usually have, but no, it's been blue light blocking glasses. I love that. And you know what, what, what, what I personally enjoyed a lot was him kind, kind of breaking down the science for us, giving us the mechanistic explanations. But we all know that sunlight to a certain degree is good for us and we know that blue light isn't not so good in artificial light. Obviously, it's, it's unavoidable in today's day and age, literally every single thing that we do. And it's, it's a must. But, um, we have been over the years getting. Obviously, there's less natural light, more artificial light and we're getting it in opportune times, right? I mean, here we are at 930 at night and you get your glasses on. I don't, but I really enjoyed the explanations because, you know, he I think mentioned that he learned from Dr. Wallace that, you know, we that light helps us have control of our genetic expression, right? If you remember, we go back to Dr. B who talked about the microbiome is sitting at the switchboard, right? We all have these genes. And this is the whole concept of epigenetics that our environmental factors influence which genes get turned on and which ones don't. And Dr. B had mentioned that the microbiome is sitting at the switchboard flipping them on. And you know, Rudy's arguing that light is another one of them. It's another controller. We have millions of reactions happening in our body, right? And as an allergy of light being kind of the spark, right? If we go back, it's funny. We go back to this car analogy. It just seems to work all the time. And, you know, the if food is the quote unquote fuel, some people hate that. But he had talked about light is kind of the spark for the ignition, right? That's going to kickstart a lot of these mechanisms and they're going to have a cascade of both positive and negative effects depending on what type of light you're getting. I personally found that to be really interesting. It's not something that I've ever learned about in my life before. So I thought that was that was awesome. Yeah, I mean, I think you look at the basis of life, right? And our evolution with light, right? It was so such an important factor for how we became the species that we are today, right? Even even learning to start fire and building fire and using fire as a tool. And what's interesting is fires, you know, you can look at fire without having blue light blocking glasses, but it won't affect you the same way as light would, right? So there's there's a difference in sunrise, sunset, uh, the the the sun at high noon, uh, and then, you know, versus the sun, you know, after sunset or whatever. I mean, after sunset's gone. But, uh, but it kind of just prove a point there is to say that the sun affects you differently. Like light has different wavelengths and these colors affect us differently. And this is an emerging topic, right? Dr. Andrew Huberman talks about this now as well, because it's just such a big topic that we're learning more and more about, right? Quantum biology is becoming a thing, you know, hopefully in the in the in the future, we can get people to talk about water and how high hydration works at a quantum level in our body. Um, but it's just it's such a fascinating thing. Yeah, I was just talking to my buddy right now. Actually, I think Dr. Huberman was on Tim Ferris podcast recently, maybe a couple weeks ago, and they were talking about the interplay between the vestibular system and vision and light. And I thought that was really interesting one too, that I don't know if you get a chance to listen to that one yet. I have it though. Yeah, and there's some actionable tips that I'll bring up towards the end. That one of the things that I'm sort of doing in on my daily, um, my day to day routine that, you know, we'll see what kind of effects that it has, but let's bring it back down to the concept of sleep, right? Because you and I, I forget what we're talking about before the mic was on or not, is, you know, for you, you got interested in it because sleep, you mentioned your you woke data, you saw a positive response there. And I think most people have heard of the concept of circadian rhythms, right? And so for those who haven't, what is that, you know, our body, people will argue will is on a 24 hour clock. Some people will say it's actually, I think Matthew Walker will say it's a little bit more than 24 hours. Yeah. I don't really know. I don't care. I think it's close enough. Yeah. But what's interesting, if for people who are familiar with oxygen pandas work, he talks about how every single organ in our body has circadian rhythm, your liver, your heart, your muscles, every single thing. And so a lot of these, you know, metabolic reactions, these chemical reactions, they are going to be controlled at a hormonal level by the hypothalamus and by the, um, super chiasmatic nucleus, right? And that's kind of sitting up in your brain. And Rudy talked about that eloquently. So I won't repeat it. And it's, you know, the analogy that he gave is kind of the conductor for this symphony. And so what is it triggered by, it's triggered by light. So this goes back to that concept of, you know, when we first get up in the morning, it is super important. And this is one of the things that Dr. Uberman recently mentioned is there are a few things that can kind of kickstart our circadian rhythm, you know, tell our body hates. This is the starting point. This is T zero, right? And one of them is movement exercise, right? So you get up, you get moving, five minute flow, one thing coming future, a lot of teaser for people. Um, another one is food, right? Kickstart the circadian rhythm, your body starts digesting, okay, it's time to eat, it's time to move around and third one is light, right? That early sunrise exposure in those melanops and cells that are going to transmit signals to the brain that, hey, it's time to get up. Let's reset everything to point zero. And, you know, that's when, you know, you're going to have that teaser, and then 16 hours or so, that's when the melatonin is going to start increasing. And almost every single person heard a melatonin, what it does. So, um, I mean, I think that that is such an important topic for people understand is that your best night's sleep starts from the moment that you wake up. It doesn't, you know, people are like, oh, you know what, it's, it's 10 o'clock. I want to get to bed by 11 or whatever. So I need to start winding down at 9.30. Now you need to get things dialed at like 6 a.m. Yeah. Or probably then some people would argue the night before because that's going to determine the quality, right? And so I think I know some people might listen to this and be like, man, that sounds ridiculous. Like how my, you know, my whole day is going to be planned around that. And it just keeps coming back to, if you remember, I guess this one stuck with me is every single one of these people in these three interviews that we talked about. The one common thing is, they all talked about behavior. Behavioral changes, behavioral changes, Ryan talked about behavior, relationship with money. Neat checked talked about implementing a daily practice, having an intention. And you know, what we're doing it for. And then when we asked to Rudy, you know, how to help them that can help care. And he, yeah, he talked about light and everything that he's passionate about it. He's created a whole company around. It's about the behavioral changes, right? Kind of looking at a holistic approach. And it's almost comical to me that's so basic. But it's, that's just what works, man. Yeah, it is. And I think again, it's a fascinating episode for people. I think it's, it's, we talk about the basics, right? We don't go very heavy into the science in this episode. I mean, maybe we can bring them back or well, again, get some more sleep experts that kind of talk about melatonin and sleep medication and, and really delve into those phases. But this was just a great overview on light and how we can interact with light and how we could use light to our advantage. And why can light be bad for us sometimes, right? It's not this all good or all bad thing. We just have to know how to interact with it. And, you know, Rudy himself had this personal journey of being depressed and not in a good mood and, you know, growing up with ADHD and, and, and just being in a rut and finally figuring out as he started to learn about biology and quantum physics and being an engineer, he started to learn how much light impacted his daily life and he kind of got out of that. And now, you know, he's here starting this company trying to, trying to impact others in a positive way. Yeah. And last thing I'll mention is because of this was something really fascinating. You know, speaking on the science and anecdotally, a lot of people will talk about, you know, when they get up, they feel better, right? And we've got a whole disorder called seasonal affective disorder, right? And for those who don't know, you can quickly Google it. And we have a light therapy. We've got red light therapy. People have even get blue light therapy. We give light therapy to children, right? Depending on, and for obviously under supervision, but he explained some of the mechanisms behind and he talked about how sunlight provides the energy through the eyes, like, for instance, trip to fan is a precursor for serotonin. Serotonin is your happy hormone, right? And that could be a possible explanation for why you feel good when you see sunlight, right? And it's not just, I mean, I would argue there are some associations with sun equals summer or equal summer break, you know, I mean, so that's kind of an addition to us. But I think that there's something even more innate than that. Another one, you know, I talked about tyrosine and how tyrosine is a precursor for dopamine. Dopamine is the go-go, right? So if you get that more of a dopamine response, you are going to be more active. So hey, if you want to try to get that workout in the morning, how do we make this actionable? Get a little bit sunlight, increase that dopamine response, you will be more inclined to want to do something, right? That's what dopamine is. And Dr. Huberman talks about this as well. Dopamine is less of a, I think people think because they associate and when talking about drugs, which associates cocaine with dopamine, right? And they give you, it makes you feel good. Yeah, it does that. But its primary function is to motivate you, right? I think he even talks about some of the bit endorphins, right? So it's that quick hit of sunlight. So pretty much across the board, sunlight's causing a positive response for, I think, almost everybody. Well, I think on this year of vampire, you're going to have a positive response. So I thought that was pretty cool as well. Yeah, absolutely. I mean, I just highly recommend all the listeners to check out the Viva Ray's website, not only to shop, but even to just subscribe to their email list, they're standing out some pretty good content, some out of the box approaches. But everything related to light, light therapy, they just recently had one about sunscreen. And their thoughts on light and the skin, why we need to get out into the sun mooring, condition our skin actually so that it doesn't get burned so easily. And they're bringing up data and different things like that too. So just a lot of the out of the box approaches that will make you think and kind of change the way you interact with light. You know, speaking of sunscreen, I was watching or not watching. I was on Dr. Dr. Barathe's page on Instagram. He posted some, I don't know if you saw that. So there's just like 14 or 15 year old girl who had gone to Central America or South America. And she was surfing and found like a really cool sunscreen that wouldn't wash off when they're catching waves. And then when it came back to Florida or something for you where she was in the States, she wasn't able to find it. It was like all natural, organic, and you know, environment friendly type stuff. And she basically made it until those were really cool. Do you get to see that? It's on this page. There's a really cool story. That has nothing to do with here. There just reminds me of the cool story about sunscreen. I'll have to check it out. Yeah. Sorry about that. No, whatever. It's cool. I'm trying to work on my skin routine anyway and stuff. So man, things fall in here. Okay. We're messed. Cool. All right, buddy. Well, this has been really good. As again, I can't recommend these enough. I mean, I think that, you know, these aren't quote unquote the sexiest of topics. I think some aspects of them are obviously people want to learn more about mindfulness, meditation, how to incorporate their new practice. And I really encourage people to check out each end of the episode because she gives you some actionable ways to do that and simplifies it. I think that it can be something that can be intimidating. I know for me personally, it has been. And, and, you know, I've been guilty of being judgmental against myself. And, and I think, you know, if you listen to this episode, people start appreciating that, hey, maybe, maybe we don't have to be that harsh to the person in the mirror. You know, in terms of light, again, we talked a lot about blue light and stuff like that, junk light, and Rudy does a great job explaining the differences, the science behind it. And then lastly, Ryan, the money makes the world go around, man. So, um, can't recommend that enough. Absolutely. Yep. Cool. Well, all right, people find your why out there. And, uh, behavior modification is the, is the theme of this, I guess. Yes, sir. All right. Hi, man. Hi, great night. Hey. Thank you. Thank you so much for joining us in this Lessons Learned episode. You know, this is something that UltimaSh and I really enjoyed doing because we understand that it takes vulnerability in our health journey in order to make improvements. And, you know, this is a time where we can at least share the things, the actionable steps that we are taking from what we learn from the gas. And, you know, also those things that we might not be the best at. Um, and so I think it's just crucial that we all kind of accept that, you know, we have strengths and there are certain things that we need to work on. But in the end, we can make incremental changes to become healthier. And before we go, let's give another shout out to our sponsor, Care Cloud. Don't let bad billing processes keep you from your hard-earned revenue. Care Cloud's free revenue cycle assessment uncovers billing mistakes so you can see how to claim every last dollar. Get your free assessment by visiting DrPodcastNetwork.com for slash Care Cloud. Again, that's DrPodcastNetwork.com for slash Care Cloud. Don't wait. Care Cloud is ready to help your practice thrive. And here's the time for the quick disclaimer. Everything in this podcast is for educational purposes only. It does not constitute the practice of medicine and we are not providing medical advice. No physician, patient relationship is formed. And anything discussed in this podcast does not represent the views of our employers. We recommend that you seek the guidance of your personal physician regarding any specific health related issues. And until next time, please rate, review, share and subscribe.