Search for tag: "anxiety"

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Scot: Welcome to a very special Valentine's edition of "Who Cares About Men's Health." Did you hear that, Troy? Did you hear what . . .

Troy: That wasn't me. That was Mitch.

Dr. Smith: That was Mitch 100%.

Mitch: All of our very special episodes give me such anxiety. What is the topic today, Scot? Let us hear. What's Valentine's Day going to be about?

Scot: Yeah, you guess what our topic for Valentine's episode is going to be?

Mitch: I don't know. Emotional openness or . . . I don't know. What is it?

Scot: Vasectomies.

Mitch: You know what? I'll give it a solid B-plus. I think this is a good thing. Yeah, love this. Okay, great.

Troy: It works for Valentine's Day.

Scot: Does it? Did you get the tie-in? I was afraid you wouldn't get the tie-in.

Mitch: No, I feel it.

Troy: V-Day has a whole new meaning.

Scot: Actually, a vasectomy could be an amazing gift because women have traditionally borne the responsibility of birth control, right? And sometimes it impacts their hormones, and some of it is uncomfortable, and some of it is a daily grind, it's a responsibility, or all of the above, right? So what if you could take that weight off of your wife and put it on you?

From what I understand, a vasectomy is one of the most effective forms of birth control, and it can remove a lot of stress when you're having sex. But there are some crazy things on the internet about vasectomy side effects, and there are also some legit concerns. And we're going to find out what's legit, what's not, plus also how to figure out if vasectomy is right for you and your partner and what to expect.

This is a Men's Health Essentials episode about vasectomy for the vasectomy curious of "Who Cares About Men's Health," providing information, inspiration, and a different interpretation of men's health.

My name is Scot Singpiel. I bring the BS and I'm on Team V. The MD to my BS, Dr. Troy Madsen.

Troy: Hey, Scot. I just want to know did you give your wife a vasectomy for Valentine's Day? Is that how this kind of all came up?

Scot: No, I got it a couple of years ago.

Troy: But not on Valentine's Day.

Scot: But not on Valentine's Day.

Troy: I just wanted to know how many men have actually done that.

Mitch: What do you put in a box or card for that?

Troy: Yeah, exactly.

Scot: Always with his unique perspective, Mitch Sears.

Mitch: Hey. Hello. I'm not concerned about this, but I am curious to learn more about it.

Scot: All right. And the most manly guy on the planet because, get this, he performed his own vasectomy on himself.

Troy: This is amazing. This actually blew my mind when I heard this, so I hope you're going to describe this in detail for us.

Scot: It's urologist Dr. John Smith on the show.

Dr. Smith: Man, I thought my wife was the only person who loved to start conversations with that story.

Troy: That is seriously the manliest thing I've heard.

Scot: I know.

Troy: I have sutured myself up and I tell people that, and they're like, "Whoa, are you serious?" But to tell someone I did my own vasectomy, that would just be next level. I've never heard of that before.

Scot: Yeah, on a scale of one to awesome, how do you feel about that, Mitch? That John did . . .

Mitch: I just can't even imagine. Did you have to? Were you in an emergency vasectomy situation, or what was going on?

Dr. Smith: I mean, all of that is up for interpretation. My wife and I had surprise twins during the beginning of the pandemic, and that was a shocker. And so once we had the twins, she literally looked at me and said, "When are you getting your vasectomy?"

Scot: And going to another provider never was something you considered?

Dr. Smith: I mean, I considered it. I probably should have done it. I mean, probably not the brightest move I've ever made in my life, but it's worked out just fine. I mean, it was one of those where someone no-showed their vasectomy. I wasn't going to throw that stuff away, so I made the executive decision to just do it.

Mitch: You just sat down and did it?

Dr. Smith: Yeah.

Troy: And just to clarify for any listeners who are thinking of doing this, this is a . . .

Dr. Smith: Don't.

Troy: . . . procedure you do on a regular basis.

Dr. Smith: Oh, yeah. I mean, volume-wise, I'm one of the highest-volume vasectomy folks at the University of Utah.

Troy: So this is not an unfamiliar procedure. But you did it on yourself. That's amazing.

Scot: This is a "don't do it at home" sort of . . .

Troy:Yeah, don't do this at home.

Dr. Smith: I would not take what I did and make it something that's the smartest thing I've ever done.

Scot: So, as a guy who had the procedure, I had a misconception. I thought that I was going to show up and there was going to be an operating room full of people, right? I thought there was going to be just a ton of people, but there wasn't. There was one guy. That's one of the things we're going to talk about, one of the misconceptions people have.

But before we get into that, John, what are some of the crazy things that men hear about vasectomy on the internet that they ask you about?

Dr. Smith: I mean, a lot of them will come in and they'll be like, "I'm going to be able to have an erection? I'm going to be able to . . . I'll still ejaculate? This won't impact my testosterone levels? I'll still feel and have testosterone?" Pretty much anything that you can think of when it comes to your genitals being in the crosshairs. There's a lot of misconception out there.

Scot: And it's not true. All those things you said . . . I'm not going to all of a sudden have the desire to start watching Hallmark Channel movies or something, right? My voice isn't going to get higher.

Dr. Smith: No, not at all. And so yeah, a lot of the misconceptions are there. It doesn't change erectile quality. It doesn't even change the amount of ejaculate. The sperm themselves make up about 5% of the ejaculate. And so there's not even a really noticeable decrease in the amount of ejaculation. Your testicles make the testosterone and sperm. They don't stop making testosterone because you got a vasectomy. All those things are all misconceptions.

Scot: Mitch, Troy, have you heard about any kind of crazy things about vasectomy that you've wondered about? I've got one here that I saw on the internet.

Mitch: Yeah. The big one that I've ever heard and when I've talked to people before, they're like, "Ew, no, I'm not going to do that," is the sexual dysfunction stuff. It's the, "I won't be able to ejaculate again," or, "It won't be the same," or, "I won't have . . ."

Scot: Or the pleasure, right? It's going to be less pleasurable.

Mitch: Yeah. And I guess none of that is true.

Dr. Smith: It'll be less pleasurable if you had another kid that was screaming in the background. I'm just kidding. That was terrible of me. But consequence-less intercourse does have its appeal.

Scot: Yeah. And on the other hand, it's really almost freeing. It can make sex better because it's one of the most effective forms of birth control, if I understand correctly, right?

Dr. Smith: Yeah. It's very effective. The pregnancy risk after a vasectomy is 1 in 2,000. And that's not 1 in 2,000 ejaculations, by the way.

Scot: Sure. Okay. I mean, it kind of just makes things freer. And then knowing that I took the responsibility on and my wife doesn't have to go through the stuff she used to have to go through anymore, I think it's cool. I mean, that's my take.

I've seen on the internet that sperm will build up and that could be a problem. Is that true?

Dr. Smith: Very rarely is that a problem. There's a 1% risk of chronic testicular pain after the procedure, which that is one of the possible reasons you could have the chronic testicular pain. But oftentimes, that is not the case. The sperm have a life cycle, they die, and then they're absorbed by the body, so it doesn't really hold true.

But some people do notice chronic testicular pain and they get a vasectomy reversal and the pain goes away. So there is some thought that there may be some truth to that, but it's not a common thing.

Scot: I will admit that was the one potential side effect that I was concerned about, because that could impact your life for the rest of your life. But it's a very, very low chance.

Dr. Smith: You've got a 1% chance of chronic testicular pain is what most of the literature will say. That chronic testicular pain, often there are ways to mitigate that. It sometimes will involve another procedure or another surgical intervention to get rid of that pain. It is a rare occurrence. But when it happens, it's definitely not something that you're going to be like, "Man, I'm so glad that happened to me."

Scot: Troy, any misconceptions you want to clear up?

Troy: I don't know if it's a misconception. I know some people have talked about some of the pain they've experienced after a vasectomy and . . .

Scot: Like just procedural pain? Pain from the procedure itself?

Troy: Yeah, procedural pain. And I know it's a common procedure to have around the Super Bowl. I think some places make a big push then because the idea being that you're going to just sit on the couch all weekend and have an ice pack on your groin to ease the pain.

Scot: Or March Madness, right? You've got an excuse to sit around and do nothing.

Dr. Smith: We've done a Vas Madness a few years.

Troy: Vas madness, yeah.

Dr. Smith: Where you get them in and do it before the tournament.

Troy: And is that common? Are people typically saying, "Hey, I'm just going to have to sit on the couch for two or three days because it hurts too much to walk"? Or is that more of an excuse to watch a lot of basketball?

Dr. Smith: I'm not going to sell anybody out here. Most of the time, we recommend after the procedure to take it easy for a couple of days, about 48 hours after the procedure. Some folks are a little bit more aggressive. Some folks are a little bit more conservative as far as telling you to take it easy for four or five days.

I usually tell my patients ice 20 minutes on, 20 minutes off, for the first couple days and then get back to your routine as it feels okay. No heavy lifting for about five days after the procedure. You can't get in a pool or hot tub or submerge it in water for about 10 to 14 days while the small incision heals. Other than that . . .

I mean, some people will tell you that you can have sex within a couple of days. Some people say wait a week to have sex. It varies between who does your procedure.

Some people will say you can shower the night of the procedure. Some people say to wait to shower a couple of days after the procedure. Again, there's not a huge variety of people that are getting infections or anything from this.

Troy: No running?

Dr. Smith: I usually tell people they can go running when things feel better. I can tell you that I know a couple folks who went golfing the day after they did their vasectomy. Not that they did their own, but after they had their vasectomy done. And they said they were fine. There were no problems.

The big thing that you worry about when you are too active too soon is a small blood clot in the scrotum. Not the kind that goes to your heart or lungs, but a hematoma is what they'll call it. Just a collection of blood in the scrotum. And it makes things a lot more sensitive and painful during the recovery and makes the recovery a little bit more miserable for a couple of weeks.

Scot: Also, I've read that some people are concerned it can cause prostate cancer or it's been linked to cardiovascular disease. Talk about that. That's not true, though, is it?

Dr. Smith: No. A lot of that has been debunked. I mean, there's a lot of literature out there about other things as well that say that. But there's no clear link to getting a vasectomy and then having prostate cancer. There were some articles that came out and most of that has all been debunked, and it's not true.

Scot: And then I didn't know this. There's a no-scalpel vasectomy. Is that kind of the common way now, or what?

Dr. Smith: Well, it's all a gimmick, right? You've got to open up the scrotum to get where you've got to get to start. So it's one of those where you've got to make a hole in the scrotum at some point, whether you poke a hole with a sharp instrument, whether you use a scalpel, you've got to open it up anyway. There's no magic to just the vas deferens just coming out without making some kind of an opening in the skin.

Scot: Do I need to be concerned about, first of all, the way they're making the hole? I mean, is one way any better than the other really?

Dr. Smith: Honestly, no. I mean, the scrotum is very robust as far as its healing capacity it's going to be fine. In three to four weeks, you're not even going to know that somebody was there regardless of how they got in.

Scot: All right. And then as far as how they're actually going to . . . if they're tying or if they're cauterizing the vas deferens, does that make a difference? Should you request one over the other?

Dr. Smith: Well, most people will cauterize and then do something else, or just cauterize. And so the cautery is the one thing that the American Urologic Association says is best practice, is to have mucosal cautery of the lumen of the vas deferens. And so that's something that I'm pretty sure everybody does.

And then on top of that, some people will put clips. Some people will do something called fascial interposition. And that's pretty much where there's an opening in the fascia of the scrotum, and sometimes you'll tuck one end of the vas deferens underneath and put a clip or a stitch over the top of it.

So it's kind of like putting one of them in the basement and one of them in the upstairs so that they can never meet again, is kind of a way to think of it. They call it fascial interposition.

Some people will just tie a ligation stitch around both ends. I mean, there are different variations. You could talk to 50 different urologists and have 50 different ways to do it.

Mitch: What's the thinking behind that? Is it just if the two somehow accidentally meet up again it will heal?

Dr. Smith: Right. So the thought is that you can have someone who's . . . I call them super healers because I don't know of any other way that this happens. But where you can have those mucosal ends grow back together and just recanulate and make a tube again.

I mean, that happens. Very rarely does it happen. I have a friend of mine who actually had it happen where he had a vasectomy done, and he told me he actually had a second vasectomy done. I haven't confirmed that in his medical records, and he still says he has active sperm.

Mitch: Is he Wolverine?

Dr. Smith: He has to be, man. I checked for adamantium, but I did not see any on first glance. I'm not sure.

Troy: Did he know it had reconnected because he had another kid, or what? How did he find out?

Dr. Smith: Usually, we have folks get a semen analysis in 8 to 10 weeks. Some people say six to eight weeks. Again, it varies between folks that are doing this. You get to a semen analysis that looks to see if there are any mobile sperm, how much sperm there are if there are any, and if they're moving. And that gives you a good idea of whether you should lose the protection or not.

Troy: Well, speaking of reconnecting . . . I'm going to put this out there as a misconception, and maybe it's not. But the misconception being that it's very easy to reverse a vasectomy. If you get it done and you want to have it reversed in five years, it's a simple thing to do and you can go on and feel confident you're going to have kids at that point. Is that a misconception?

Dr. Smith: So a lot of it depends on time. The vasectomy reversal can be done. The longer that things are scarred down, the less successful the reversal is. But the reversals are pretty successful. I mean, a high number, we're talking three-quarters or more of them, are able to have sperm there after the reversal procedure. Also, individual doctors have different kinds of success rates that they'll quote you.

The thing that you've got to realize with that, though, is insurance is not going to cover that. So you're going to hit that on your own. It's going to cost you $6,000, $8,000, $10,000, depending on where you get it done, cash to do that.

Obviously, insurance paid for you to get a vasectomy so that they wouldn't have to pay for another kid. And so a lot of that becomes out-of-pocket expense for the person who gets the reversal.

Scot: So I think a lot of guys want to know what the procedure is like. It was almost a non-event. I was a little intimidated going into it. Like I said, I thought it was going to be this big procedure. I think it was done in like 15 minutes. The pain wasn't super bad. I went and bought a couple bags of peas and iced like I was told to and took it easy for two or three days, and everything was great.

I'd read some of the crazy stuff, that it was going to decrease your sexual pleasure, and yadda, yadda, yadda, and none of that happened. And it just feels great not having to worry about it. Is that pretty accurate? Did I describe the procedure pretty well? I mean, just kind of the overview, John?

Dr. Smith: Yeah. I mean, it's a simple procedure that's done in the office. And I don't want to simplify anything because surgery is never a big deal until it's on you. And then obviously, when it's on your genitals, it's an even bigger deal. But it's a very commonly done procedure. It takes 15 to 20 minutes, maybe 30 minutes, in the office. It's minimally invasive. I do mine through a single incision that's about a centimeter to a centimeter and a half long. Numb things up with lidocaine and just take care of it.

Scot: Don't even feel it. Don't even know. It is kind of weird though because you're sitting there in a chair, and you're kind of watching the doctor do it, but you're not seeing what the doctor is doing, because you've got some blankets or something up there. So you know something is going on and you're actually kind of seeing that something is going on, but I didn't feel a thing.

Dr. Smith: Yeah, once you're numb . . . I mean, the worst part is the numbing. When I did mine, that was the worst part, was getting numb. And most men when they're done, they're like, "Oh, the numbing was the worst part. After I realized I was numb, I could just relax and hang out."

Scot: I don't even think the numbing was that bad, really. I don't remember it.

Dr. Smith: Listen to this guy. What a tough guy. "It didn't even bother me, man. My name is Scot."

Scot: I still don't measure up to you, but . . .

Troy: Yeah, I think you're trying to outdo John on this one, Scot.

Dr. Smith: It hurt, man. I did not like numbing it up. I'm not going to lie to you. That was the worst part by far. But again, once it's done, that is the part that people say is the worst.

And then you had a great recovery. Most people do have a good recovery like that. I was very similar to that. I had some minimal discomfort for a few days. Bruising for 7 to 10 days in and around the scrotum.

I did not get a hematoma, thank goodness. I mean, they happen about 1 in 20 to 1 in 30 vasectomies. So they're not super common, but they're the most common "complication" that you have after the procedure. If you do get one of those, your recovery is not quite as fun. I tell you guys it gives you the man flu for a couple of weeks. You're not going to want to do much. But that's kind of what to expect for it.

A lot of guys come in they're like, "Man, I was really worried and scared about this and it wasn't as bad as I thought." I hear that quite a bit.

Troy: And you mentioned insurance coverage earlier too, John. It sounds like this is covered by insurance.

Dr. Smith: So a lot of insurances will consider this preventative care. You need to check, obviously, with your insurance company. But if you think about it, it makes sense for them to pay for a vasectomy. Then you don't have to worry about taking care of another kid on the insurance for 18 years, or 26 years. And so a lot of them will have that.

So we'll have a mad rush at the end of the year where people think that they've met their deductible and they need to go get their vasectomy. But then a lot of times, if you look at your insurance coverage, you could have done it into March, April, May, it didn't matter because it was considered preventative care.

Now, not every insurance is that way, but a lot of them are because it's advantageous for them to obviously have that done to decrease another kid coming on to the policy.

Troy: Yeah, a calculated decision on their part.

Dr. Smith: Yeah, exactly.

Scot: As we get ready to wrap this up, what type of guy would be a good candidate for a vasectomy? Are there some people that are better candidates than others?

Dr. Smith: Almost everybody is a good candidate. Oftentimes, if there is a difficult exam or something where we think it needs to be done in the operating room, it can be. Most everyone is able to be done in the office.

Obviously, a good candidate would be someone who's not interested in fertility any longer and does not want to have any more children. And so those folks would want to come in.

We have them have a consultation to go over all the risks/benefits before they have the actual procedure, and then come back for a second visit for the actual procedure. That way, they have the ability to do that.

Also of note, when we talked about insurances, government insurance makes you wait 30 days from a consultation to have the procedure done so that you have time to think about it.

I was told when I did my training that that was because some places were doing the vasectomies on people who were in mental hospitals, things like that, without consent. And so the government changed it to where they had to have consent and wait 30 days, and yadda, yadda, yadda.

But all of the government insurance does require a 30-day wait period and a form to be filled out. So Medicaid and other government insurance, you have to do that.

Scot: Something I remember, I had my consult and they asked me the same thing. They asked me how many kids I have. Zero. "Are you positive that you don't want to have kids?" Well, I'm to the age and my wife's to the age where that's probably not even a smart thing from a health standpoint, and we've decided that that's the case. And they did ask if I talked to my wife about it. You would recommend that as well? This is a conversation that should be had between both partners. You shouldn't just go out and surprise . . . do the Valentine's Day vasectomy surprise.

Dr. Smith: Right. If you've already had that conversation with your partner, and you guys have decided that's not what you're going to do, then I think you're pretty safe. But I think it is a wise thing to talk to your partner. If you don't have a partner, then obviously it doesn't apply.

Troy: And I have to ask this too, John. Let's say someone out there is thinking they're not married, but they don't want to worry about the issues with possible pregnancy with partners, and so they decide to have a vasectomy. How effective is a vasectomy at preventing STDs?

Dr. Smith: It's not at all.

Troy: So you're still using a condom for those guys.

Dr. Smith: Yeah, absolutely. I mean, that's not going to stop an STD in their tracks at all. That's just going to make it so you're not going to get someone pregnant, but it's not going to stop transmission of any of that stuff.

Scot: By the way, I think Troy knew the answer to that question.

Troy: I had to ask it.

Dr. Smith: Was Troy baiting me in?

Troy: I was baiting you. I had to ask it. I think that maybe potentially that could be a misconception, that you think, "Hey, I had a vasectomy. Great. I don't have to worry about pregnancy."

Scot:Yeah. Woohoo.

Troy:You're right. Not a big concern. Far more effective at preventing pregnancy than condoms or oral contraceptives, but doesn't do anything for STDs.

Dr. Smith:Absolutely.

Scot: Yeah. You might forget that. I could definitely see that.

Well, if you're considering having a vasectomy, of course, if you have any concerns or questions, if you've seen something crazy on the internet that we didn't address today, then definitely talk to a urologist.

If you have other concerns, like what it's like, for some reason other guys that have had them, it's been my experience, love to talk about them. I don't have any qualms about it.

I don't know if there are some people that think it makes you less manly or anything like that, but from my personal experience, I'm really glad that I got one.

I will admit it was a little strange thinking that this is it. I've made the decision that under no circumstance . . .

You do consult men that this is not a reversible procedure, even though there is potential to reverse it if you've got the cash and if you do it soon enough?

Dr. Smith: Correct. I usually tell people that this is reversible, but I don't do it to be reversible.

Scot: Yeah. Right. Your job is to do it so it works and those things don't grow back together. But beyond that, I mean, it's been great. So I would highly recommend it if you are done having children and you don't want to have to worry about birth control anymore.

Dr. Smith: I concur.

Scot: If you have any questions, you can email us. The email address is hello@thescoperadio.com. And we've just given you a Valentine's Day gift idea, so you're welcome. Just don't make it a last-minute gift. Have that conversation.

Troy: Last-minute gift. Yeah, it sounds like maybe the gift would be proposing the idea rather than coming home and showing the incision on your scrotum.

Scot: Yeah, that's a good idea. Thank you for listening, and thank you for caring about men's health.
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This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot: Hey, Troy. What was one of the things that everybody said about being a new dad, and you're like, "Eh, really?" and it turns out it's true? What was the one thing? Do you have something?

Troy: I think the anxiety that comes with it, that's probably the one thing. I heard people say, "You will lie there at night, and you will just listen to her breathe. And you will just make sure you are hearing her breathe." And I was like, "No way. I would never even do that." I have absolutely done that. So, yeah, that's definitely true.

Scot: Oh, man. Transitioning into fatherhood, like any chapter, can be really, really challenging and it can have an impact on your health. I mean, how many times have you heard guys say they stopped exercising or eating right after they've had kids, or their sleep is just constantly impacted after that? Or just even emotional health issues. It's a big change in your life. And we have a guy that has just become a new daddy, Dr. Troy Dadsen.

Troy: Dadsen, with a D.

Mitch: Dr. Troy Dadsen.

Scot: With a D.

Troy: There we go.

Scot: And this is a Sideshow episode of "Who Cares About Men's Health," where we're going to get a new daddy update, where Troy is going to tell us some of his experience as it relates to his life, and back to the Core Four that might be able to help other new dads.

"Who Cares About Men's Health" provides information, inspiration, and a different interpretation of men's health. My job, I bring the BS. I'm Scot Singpiel, and I chose not to have kids because I was afraid I'd screw them up. So that's why I don't have kids.

Troy: Scot, I was deathly afraid I would screw them up too. But I have a kid now, and hopefully I don't screw her up.

Scot: Now that is the MD to my BS, new daddy, Troy Madsen.

Troy: Yeah, that's me, bringing the baby to the show.

Scot: And nieces and nephews are enough for now, says Mitch Sears. He's on the show as well.

Mitch: Yeah. I'm good for a bit. Yeah, I'm good.

Scot: Okay. Because I just made that up to be clever in the intro, and then I asked myself, "I wonder if that's true. I wonder if he actually wants to have kids at this point."

Mitch: I don't know. No.

Scot: No?

Mitch: No. We'll see. I mean, we'll figure it out at one point or another.

Scot: Okay. All right. Troy, it's great to have you back on the show for a new daddy update. So I've got one question for this episode of the podcast. Tell us all about being a new dad.

Troy: So I'm just going to go into a 20-minute monologue now.

Scot: Actually, just give us an update to start off with. How's it going so far? How long's it been and how's it going?

Troy: So things are going incredibly well. It's been two months. She just turned 2 months old. Her name is Adeline. We call her Addie. That's her nickname. So she goes by Addie. She was born just over two months ago.

And I will say the delivery experience itself went incredibly smoothly. It was funny. It was just about . . . Well, it was one week before she was due. And Laura, my wife, was at the vet with one of our foster dogs, Arthur, who, Scot, you know well. You saw pictures of him at least. Very cute little guy. And Laura calls me and says, "Well, Arthur is doing well, and I think my water just broke."

Mitch: She buried the lede? Ugh.

Troy: Yeah, she totally buried the lede. She started with, "Well, Arthur is doing well. Everything is good. And I think my water just broke."

Scot: Well, from a comedic standpoint, that is the delivery. So good for her.

Troy: Yeah, exactly. From a comedic standpoint, yeah. So she came home. We went in to the hospital. So we got in there about noon. Addie was born about 2 in the morning. Came out with her eyes wide open and just the most beautiful little girl I've ever seen. Obviously, I'm very biased.

Scot: Of course you are.

Troy: And then I had about an hour with her alone because they just had to watch her over just in the pediatric . . . just the neonatal care unit. So I had about an hour in there with her alone, just sitting there with her, and just looking at her and just thought, "Wow, this is absolutely remarkable."

And every day since then, I've felt the same way. Every day it is just . . . Just to see her grow, and develop, and her mental development as she's become more attentive and more focused on our faces. Just in the last two weeks, she'll smile. I'll look at her and she'll see me and she'll smile, and look at Laura and smile and laugh. We'll laugh and she'll laugh, and it's just the cutest thing in the world.

And she's just my little best buddy. We walk around during the day. She loves to ride around in this pack. I've got this little pack that sits on my chest, and she's facing me and she just loves that. She'll ride around all day.

Some days, after a long run, my legs are tired and I'm like, "I don't know if I can be on my feet for another three hours carrying this kid around." But she loves it, and she'll fall asleep. And she'll look around, look outside at the squirrels and birds and whatever else.

It's like I've got this new little best friend at home now. And quite honestly, just really enjoying it.

And I think probably the biggest surprise in all this has just been how smoothly everything has gone. Again, me being kind of the pessimist, where I see so many things that go wrong in pregnancy just throughout my medical career, and just being aware of those things. And so I think just every day I'm so grateful that everything has gone as well as it has, and everything continues to go well, and just really enjoying the time I have with her.

Scot: You know what? As you were talking and as we're having this conversation, Troy, it just dawned on me talking about the new baby and going into depth about details about the new baby is something that we tend to think that women do, right? That's my perception.

Mitch: Yeah.

Scot: But then as you're talking about this, and I'm sitting here and I'm listening, I'm like, "I don't know if guys talk about . . ." Do you get asked by other guys about how it's going, and are they expecting an in-depth update? Are they just expecting, "Eh, it's great"? What's your experience with that?

Troy: Yeah, I think it is definitely less of a guy thing. I have had one friend in particular who has seemed genuinely interested, who has texted me. And we really haven't talked. It's been more just text. But he's always like, "Oh, send me pictures." I don't know if he's just being nice. I think most guys it's kind of like, "Hey, how are things going?" And you're like, "Oh, things are good. She's great." But he has seemed a little more interested.

But I think it is not a conversation I would say I've had a lot beyond having the same sort of conversation with my parents or siblings. Kind of telling them about things. And even then, when I say siblings, I'm talking about my sisters.

So, yeah, I don't know that guys have that sort of conversation a lot, but we'll see.

Scot: Yeah. I want to jump in and ask, this friend of yours that has shown some interest, does that make you feel different? Do you like that? Do you like talking about her? I guess what I'm trying to get at here is maybe we should do this more often for our friends that have become new dads, because they would enjoy talking about it. It would make them happy.

Troy: I think it would make them happy. But I also kind of feel like I don't want to be the guy who is always saying everything about his cute little girl and showing everyone pictures because I'm kind of like, "Do they really care? Am I over-sharing? Is this too much? Do they really want to know all this?" So there is that sort of guy thing in me too, where it's kind of like, "Do they really want to hear me say all this stuff?"

Scot: If the shoe was on another foot, if it was not you with the new baby, but a friend of yours that you would consider a close friend, would you want to hear about it?

Troy: That's a good question. Probably at this point I would a lot more than I would have a year ago. I think as you're going through it, and you're having those experiences, and then others share that with you . . .

I think six months down the road, if I have a friend who has a new baby and they're sharing their experiences with me, I think then there's a certain amount of nostalgia and reminiscing that you would experience as you hear their experiences.

But let's say a year ago, I don't know that I would've been that interested. And that's just simple reality, just because it wasn't really part of my life. I didn't really have a lot to relate to there.

So that's kind of where I'm sometimes hesitant to say too much and feel like I'm over-sharing, or being that kind of irritating person who's showing them 100 pictures of my new baby and they just don't care.

Scot: I mean, I am actually genuinely interested. Even though we're doing this for a podcast episode, I'm genuinely interested in hearing about your experience and hearing about it in depth. Although there are other people in my life that I would not be, but I consider you a much closer friend.

So I think I want to flag this as a little takeaway. At least my observation is if you have really close friends and you're not having these discussions, maybe open up because it's really going to make that other person feel really good. They want to talk about it, I would imagine.

Troy: They do. Yeah, I think so.

Scot: You say you want to talk about it.

Troy: I do. I love talking about her. I really do.

Scot: Don't just peg this as this is something that women do. Men can do this too.

Troy: Yeah. There are so many cool experiences just on a daily basis, just little tiny things. Again, like I said, when she started to just focus on us more, and you could tell her eyesight was improving and focusing on our smile, just the laughs, and the little sound she makes. And talking to her, her looking at me and then her moving her mouth and making little noises like she's trying to talk too.

It's just silly little things like that, but it's just like, "Wow, this is so cool." Every day she entertains me. I'm not bored at all. Every moment I spend with her I find interesting and entertaining in some way.

Scot: So you said what's been surprising for you, and definitely it sounds like you've been blessed how well things have gone, because that doesn't necessarily happen in all cases. But what's been kind of challenging?

Mitch: Sure.

Scot: What do you deal with there?

Troy: Yeah, I think some of the challenges . . . Fortunately, I think I did have some preparation for them. I will say this, and I don't want to say this in a negative way at all, but leading up to this, I received more unsolicited advice than I have ever received at any point in my life.

I can only think of a couple cases where I might have asked for some advice, but the amount of advice I have received was astounding, as people found out we had a baby on the way. But that's a good thing. I think it helped me out a lot.

But I will say one of the things that has been a big adjustment is just expecting everything is going to take a whole lot longer. If we're getting ready to go out anywhere, you just expect it's going to take a lot longer to do that.

There were some unexpected medical issues very early on. Not major issues, but just some things that came up where it was, in that first week, multiple visits to the pediatrics clinic. The first couple days, we were just down there every day. It was a little stressful. No question about it.

Scot: Yeah, I didn't know about that.

Troy: Yeah. It wasn't big stuff. I mean, it was just stuff that comes up.

Scot: But at the time, it probably was, right?

Troy: It wasn't. I mean, that's the thing. Again, I knew of so many things that could possibly go wrong that I felt very grateful that that was all that we were dealing with. It wasn't big stuff. It was just like, "Okay, I've seen this in the ER. I've dealt with this. This is what we do." But it was an added level of just a little more complexity.

Scot: Yeah, it makes your life even more busy because you've got all these appointments and more traveling and stuff.

Troy: Yeah, exactly. So that's why it was a relief to just kind of get through that first week. And then at the end of the week, the pediatrician was like, "Hey, everything is good. We'll see you back here in a couple weeks." So I was like, "Great. We have two weeks where we don't have to come and see a doctor." So that was nice.

But yeah, I think in terms of just unexpected things that have come up, I think it helps having . . . Working in the medical field definitely helps to at least kind of know a lot of what you could deal with.

I will say, though, maybe one of the most unexpected things I have dealt with is how you truly as a medical professional lose all objectivity when you're talking about your own child. It's very different.

I may see a rash in the ER and be like, "Oh, that's what it is. No big deal." I see a rash on her, I'm like, "Oh, wow. It could be this, this, this, this, and this, and I'm really concerned." I'm a little different because I'm overthinking it.

But I will say, I think every parent runs that risk of turning to Dr. Google. You Google stuff and you see every awful thing that it could possibly be. And that's kind of where my mind has gone at times, like, "Oh, it could be this, this, this."

Yeah, I think we all face those anxieties as this little person who we just are so involved in, and care so much about, and don't want to mess things up on, that we might overthink certain things. So I think that happens to everyone, regardless of whether you're in the medical profession or not.

Mitch: So one of the things that I'm finding really interesting hearing about this kind of dialogue is being someone who has not really thought about kids much. When I was younger, there were some medical things going on. I was told I might not be able to have them, etc. If you were to have talked to me a couple years ago about any of this, I probably would not have been interested. I just would've been like, "Uh-huh. Babies."

Scot: Even with Troy?

Mitch: Even with Troy. I would've . . .

Troy: No offense, Mitch. I would've felt the same way.

Mitch: I would've been appreciative of his excitement. But me, myself, I'd be like, "Cool. Let's see what else we can talk about."

But in the last few years . . . We made the joke about nieces and nephews, and I have some, and I've interacted with them. I was the youngest of my family. I didn't have babies to hold, and there was no real child interaction until just recently in my life. And there's kind of an excitement about it, right? They're new. They're trying new things out.

And so it's so exciting to hear Troy, someone I've worked with, someone that I care about, my friend, having these things for his own baby, and his own experience. So it's different and I appreciate it.

Troy: Well, thanks, Mitch. I will say that, too, in terms of what other people have said . . . and I've heard it for forever. Everyone has always said, "When you have kids, it completely changes your life." I never heard anyone say it changes your life for the better. They always just said it changes your life. I feel like my life is a lot better. I love it.

Scot: Oh, that's awesome.

Troy: This has been good. I will say this has been great. It has absolutely been a huge change.

And it's so funny because that weekend she was born . . . She wasn't due for another week. We had planned out at least five different activities we were going to do that weekend. We were going to go to the symphony. There was a Gorillaz concert that Monday. We were going to go to that. We didn't buy any tickets. We were just like, "We're going to wait until an hour before." So obviously we canceled all . . . we didn't do any of those things.

We haven't gone to any concerts, no shows, nothing like that since then. It completely changes your life. There's no question. But those are minor things.

Scot: The trade-off is worth it.

Troy: It's well worth it. I'm absolutely enjoying it.

Scot: All right. Well, let's jump to the Core Four check-in, because fatherhood does change a lot of things, right? Your life is flipped, turned upside down. And sometimes it can be hard to maintain some of those things, and a lot of stuff changes. So, Troy, how are you doing with the Core Four? Let's go ahead and start with eating. Has the eating changed at all?

Troy: No, it hasn't, and I feel fortunate there. The one big change I will say early on is that I wasn't eating as much. And it's funny, I actually lost a few pounds in the first month. I think I just wasn't eating as much. Just busy. And then with kind of sleep patterns being off, for me personally, I wasn't eating at night.

So in terms of the time-restricted eating, intermittent fasting, whatever you want to call it, usually I'm doing 12 hours. So then I was actually having nights where I was going 15, 16 hours.

Scot: Without eating? Okay.

Troy: Without eating. So I think that may have been part of it. But it's been good. I have tried to focus on that, on making sure I'm not eating a lot of sweets, or stress eating, or snacking in the middle of the night if I'm up, things like that.

Scot: So you have had to make a conscientious kind of effort?

Troy: Oh, for sure. Yeah, there's no question. And I knew that was potentially going to be an issue with snacking in the middle of the night if I'm up with her, or, like I said, kind of stress eating, turning more to sweets, that kind of stuff. So I have tried to make a conscious effort to say, "Stick with what you're doing." And it's been going well, so that's good.

Scot: How about activity? I think I already know the answer to this. You've been such a dedicated runner, and you've had such a running habit that I'd imagine that it's been pretty easy. Or no?

Troy: I would not say easy, but fortunately, it has been consistent. And I'm still fortunately . . . Again, this had to be a conscious effort, and I feel like we're in a good spot now where I feel like I'm good with keeping going with this. But I really wanted to say, "I'm going to keep doing this and I don't want this to be something that I just give up."

I think it was John Smith . . . He said a couple things that stuck with me. Number one, he said, "With every child, pick one of your hobbies and forget about it. You're going to lose it." So I was like, "I don't want it to be running."

But then he also said . . . He offered to go to Buffalo Wild Wings with me or something. And he said, "You just need to do stuff just so you feel like yourself."

And so kind of tying those two things together, I just thought, "I want to keep running," because when I run, that's how I really feel like myself. I just love that time. I enjoy it. I'm out there with my dog. And so I've been able to keep that going and be consistent.

It's been something with Laura where it's like, "Hey . . ." We both say we want to support each other to do these things we enjoy. She loves going to classes, like exercise classes, fitness classes, so I'm here to help her do that. She helps me to make sure I have the time that I'm going out going running.

Scot: That's awesome.

Troy: So that's been a conscious thing to make sure we're doing that. That's been good.

Scot: Yeah, communicating with your spouse and just planning out how that is going to be possible.

Troy: Yeah, exactly. It is so much more complex when you've got a little one at home, and you're trying to balance childcare and all that. It's a whole lot different than when you're just kind of doing your thing and like, "Hey, maybe I'll go running at 6 this morning. Eh, maybe I'll go running at 7. Maybe 8." It's much different when you're making sure you . . .

So, anyway, so it's just been a matter of organization, and making sure we're communicating, and sticking with what we like to do.

Scot: It takes more work, man.

Troy: Yeah, it does.

Scot: Not only are you bringing more work home with that kid, but it just takes more work doing the things you did before the kid. How about your emotional health? How's that doing?

Troy: It's been good. There certainly has been an element of anxiety. There's no question about it. Anxiety of making sure I'm not doing anything that would ever put her in harm's way, doing anything stupid, anything that . . . I don't know. You just read so much, like, "Put the baby back to sleep. They have to lie on their back. They can't lie on their stomach. Nothing in there that could suffocate them." I can't have any blankets in there, no toys. Stuff like that. I don't want to do anything like that, and I want to know everything I need to do to make sure there's nothing that could potentially harm her.

And these are just little tiny things. I'm not talking about dropping the baby. I'm talking about making sure there's not a blanket that she could somehow bunch up in her face and suffocate. So there's definitely that element of anxiety, and I think every parent experiences that.

So, yeah, from an emotional health standpoint, I think a little more anxiety. But at the same time, I think there have been so many positive things from an emotional health standpoint too. Just the reward and joy in being able to interact with her.

You asked about running and fitness. I think this kind of thing brings so much more meaning to just health and diet and all those things, just because I want to be a healthy dad for her. I want to be healthy. I want to be here for her in the long-term. I want to stay healthy. It's not just about me running marathons or trying to qualify. I want to keep running because I want to stay healthy.

A lot of things we talked about on the podcast have had a lot more meaning as I've thought about those in terms of just healthy lifestyle, and being healthy, and doing that for her too.

Scot: So there's a lot of extra overhead you have to deal with. If you think of the mind . . . And this is just an analogy, right? It's flawed like all analogies. But if you think of the mind as a computer, everything you have to keep track of is just another processing unit, right? You've added so much more, all the things you talk about that you're just trying to pay attention to make sure that your child is safe. So that kind of fills the cup.

Are you doing anything additional to help with your mental health or help bring a little bit of relaxation from that kind of anxiety or that stress?

Troy: I've been watching a ton of sports.

Scot: That's what you do, huh?

Troy: Watch so many sports. And it's been a great time to have a baby. The month of October and November, it's just like sports heaven. There was the World Series. NBA starts up. College football and NFL are in full swing. That's kind of my release in a lot of ways, watching sports. It's distracting.

Scot: It helps turn your brain off for a little bit.

Troy: Yeah, it turns the brain off. Yeah. And it's fun too, because it's time we're kind spending together. I'm carrying her around, have the TV on, walking around with her with the little pack on, and she really enjoys that. And so, yeah, that's probably been my thing.

But you're right, I think you do need that sort of release where you just be . . . And not to go down on the dark side, but you have to be aware that some people, it just becomes so overwhelming. And the sad part is, again, as a healthcare practitioner, I've seen the cases where it's become completely overwhelming and you see the shaken babies and you see those who have been abused, and it is just absolutely horrible. And you just ask what led to that? How did people get to that point? I don't know all the dynamics there.

And then there's postpartum depression. We've talked about it in men, as well as in women. So that's something. And I worried about that going into this. I wondered, "Is Laura going to experience this? Am I going to experience this?" I've had many patients in the ER, women in particular, who have experienced postpartum depression.

So, again, I think you do have to have that release. You do have to have those other things where it's a distraction. And we've tried to have other activities, like planning activities every week with her where we're going out on walks. We're planning this week to go do this little drive-through Christmas light thing where you drive through and see Christmas lights. Just little things like that that you can look forward to, activities you can do together.

And as I'm saying this, I kind of feel like a jerk. I'm sounding like I know what I'm doing. I have absolutely no idea what I'm doing. Let me just say that up front.

Scot: Fair enough.

Troy: I have no idea what I'm doing. We're just trying to figure this out. But this seems to be working. And again, two months into it, so far, so good.

Scot: Yeah. And I think the important message is I think sometimes people feel guilty if they're not 100% with the new child all the time. But you still do have to take time for yourself, whether that's something you enjoy doing, or just even some downtime where you can just turn the brain off for a little bit.

And if you're having struggles with that, that's an important thing to talk to a professional about and get some tools to help work through that.

Troy: That's it. And I've had to tell myself that a few times. I've had to just say to myself, "If I'm not in a good place emotionally, I cannot be emotionally available to help her out." I've got to be in a good place. Laura needs to be in a good place. I think every parent needs that.

Yeah, you've got to be able to . . . whatever that means. Like you said, if you need professional help, if you're just turning to family members, whatever, friends, to get some help, being able to . . .

Scot: No shame in it.

Troy: Yeah, no shame at all. You've got to be the best parent you can, and that's how you do it. You've got to be in a good place emotionally.

Scot: All right. Core Four check-in, the last one. I think I know what the answer to this one is going to be. That's why I saved it until last. Sleep.

Troy: Sleep. Again, this whole process has been so pleasantly surprising. I dreaded the sleep piece of this just because I've struggled so much with sleep. I really just thought, "This is going to be awful. We're not going to sleep."

So what we did very early on in the first couple days is we decided we're going to split up the night shift. So Laura took the 9:30 p.m. to 3:30 a.m. shift, and I took the 3:30 a.m. to 9:30 a.m. shift. And I set my alarm. Every night at 3:30, I got up, took over for her. I was then able to bottle-feed her. Laura had dedicated sleep time. At that point, she was feeding like every hour or two. She wanted to eat, and she needed to eat. She's growing a ton. So that's how we did it.

We did that for six weeks. And then at that point, she got to a point where she's sleeping more consistently and much longer stretches. So we haven't done that since then.

And Laura . . . thank you, Laura . . . has been the one who gets up with her at night now, which some nights it may be once or twice, fortunately.

But it was interesting doing that regular sleep schedule. So I was falling asleep at like 9:30, sometimes 9:00 before Laura's shift started. Doing that consistently, it actually worked out pretty well.

And I thought a lot about what Kelly Barron talked about, about sleep hunger. If I've ever had trouble falling asleep before, I now know if I get up every morning at 3:30, I will not have trouble falling asleep because I had no trouble falling asleep.

So it actually worked out pretty well, where just having that regular sleep schedule . . . It was kind of nice in a way. It was always tough to get up that early, but . . .

Scot: But it's consistent, which is . . .

Troy: It's consistent.

Scot: . . . not a thing you've ever really had before.

Troy: Yeah. I mean, in stretches I . . .

Scot: You're taking the male paternity.

Troy: Yeah, exactly.

Scot: Do you get crap for that from the other guys?

Troy: I sure do.

Scot: Do you?

Troy: Sometimes it's very subtle, like, "Wow, they didn't have that when I had my baby."

Scot: "Well, yeah, how lucky am I?"

Troy: I'm like, "I'm so glad I have it." So I'm very fortunate. Yeah, I have been on paternity leave. That's something the university offers, and I am so grateful for that. This would've been much different trying to do crazy shifts along with this for the last two months.

Scot: And it's something that not everybody has, so it's just one of those great things.

Troy: I know. I mean, that being said, I think most people, at least you can . . . Yeah, you take FMLA time, but . . .

Scot: It's whether you get paid.

Troy: I mean, I get paid. Yeah. For me, it's like eight weeks. Well, it's really six weeks paid, and then two weeks of just leave. That's technically how it works out.

Scot: You highly recommend it if it's available to people and they can make it work.

Troy: I will say that. I will tell anyone if you have that option, take it with no shame whatsoever. Do not feel ashamed. Do not feel you have an obligation as a man, because you're a man, to say, "Well, I'm not going to take it because I'm a man. I'm going to keep showing up at work. I'm not going to take paternity leave." Absolutely take it.

And I think it's a number of reasons. Number one, I feel like it's really helped me to be available to kind of do that shift schedule and help Laura out. It's been great for just being there with Addie, with my baby, to bond with her.

But then also, we've kind of been a little bit isolated. We're not really going out. And this is something our pediatrician told us, like, "Keep your circle tight. Don't be going out and doing a lot of things out in public. There's a lot of flu. There's a lot of RSV. There's COVID."

So it's been, I think, a good thing for her health too, where her immune system is very susceptible, where we've just got kind of our tight little circle here and we're not out in public a lot.

I think, again, don't be ashamed to take that time off for a number of reasons.

Scot: All right. As we wrap up this episode, what would you like to learn from our experts? Do you have any experts you'd like to have on the show to talk about dad issues?

Troy: We need pediatricians on here. I think every episode we have going forward should be pediatricians. What do I expect three months, four months? I know that's not practical.

I would love to have Kirtly on here more. I think she's so insightful. I thought so much back to what she talked about with pregnancy, and what to expect, and how to be emotionally available. And I think that's a really important thing going forward. How do you continue to do that as a husband and a parent?

Beyond that, I think diet and exercise are always going to be a challenge, because there are going to be different challenges at every phase of her life in terms of just her needs and the time investment. So I think anything we can continue to talk about there. It's just a great reminder and motivation to keep focusing on those things.

Scot: Yeah, reminder to keep focusing on maybe ways to make it simpler, or easier, or less time consuming, which isn't always possible. I mean, you can only shave it down so far. But those are good insights.

Troy: Yeah.

Scot: Well, Troy, congratulations.

Mitch: Yeah.

Troy: Yeah, thank you.

Scot: I'm so excited and happy for you, and every time your wife posts pictures on Facebook, I love it.

Troy: So many pictures. So many.

Scot: That's all right. It's a well-documented growing up she'll have.

Troy: There's no question about that. Yeah, no doubt.

Scot: All right. Well, Troy, thanks for sharing your insights about being a new dad. I hope that that is helpful to you if you're a new dad, and maybe you can take one of the things Troy talked about and apply that when you are expecting your child, whether that's, "Listen, I've got to make a conscientious effort to make sure that I still exercise, or that I find something that I can do that gives me a little break with my brain for a few minutes a day."

What were some of the other things you talked about? Don't have those stress foods in the house if you think you're going to eat them. But on the other hand, if you need some stress food sometimes, then go for it.

Troy: Yeah, go get those Oreos.

Scot: Everything is just kind of in the middle, in balance and moderation.

Troy, congratulations on being a new dad. Thanks for sharing your experience, and thanks for caring about men's health.

Troy: Thank you, and thanks for talking to me about it. Like you said, it's fun to talk about it. And this is the most I have talked about it since she was born and it's really fun to talk about it. So I appreciate you listening to me and letting me chat about it.
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Pandemic fatigue, we all have it. However, it is affecting children more than adults in many cases.

Pandemic fatigue by definition is the mental exhaustion caused by being in a state of heightened awareness and alertness in the face of COVID combined with the uncertainty of how the pandemic will develop. Parents are struggling to continue to juggle working from home and teaching their kids who are doing online school. Healthcare workers are getting burned out from the stress of working with COVID patients and seeing the numbers of infected patients continue to go up.

Kids are becoming more anxious and depressed, not just about isolation and not seeing their friends, but I'm having parents bringing their kids to me about anxiety over things they've never been anxious about before. This is especially true because just as COVID numbers started to increase locally, we also had a major earthquake. I have some patients who if they get a cold are asking me if they're going to die. I have others who are terrified of germs and think they will get COVID if someone touches their dog or they will change their clothes as soon as they get home from being out of the house, even if they just went to a store.

People are tired of wearing masks. People are tired of physically distancing, of not having normal life milestones being able to be celebrated in the way we have done for years. So since this is not showing any signs of slowing down anytime in the immediate future, how can you help your children do the best they can while dealing with COVID in the long haul?

First, continue to make mask wearing fun. I've said it before, and I'll repeat it again. If the mask is something fun, kids will want to wear them more. Have fun characters on their masks. Let the kids have enough variety in their masks that they can coordinate them with their outfits. That's exactly what my younger son does every day. His teachers comment all the time about his cool masks and how they match what he's wearing.

For hand sanitizers, have seasonal scents. If your child doesn't have eczema and they're not sensitive to different fragrances, let them choose what they want to smell on their hands all day long.

Empower kids. Let them know it's okay to tell family members and friends that if they just aren't masked or they're not social distancing, then your kid can't play with them. It's okay to remind others of the rules. Just make sure it doesn't turn into a daily battle and they don't turn into the germ police.

Let kids connect with friends online. I know we didn't use to be a video game family, but when the pandemic hit and schools went online, I caved. I bought an Xbox for my boys and I let them have a certain amount of time to play with friends every day. It helps them still feel connected to their friends, but in a safe way. It also lets them get a break from school and just play and be kids.

Finally, remember that it's okay for them to be bored and figure out new things to do. It's okay to let them cry, even if they can't tell you what they're sad about. It's okay to have breakdowns and just get angry and need you to hug them until they're screaming turns into crying and then I'm sorrys. As long as your child isn't disrespectful or violent, let them express their emotions. Then, if they want to talk about their feelings, if they don't want to, that's okay. Let them have their space. The bottom line is everyone is feeling pandemic fatigue in one way or another. If we all help each other, then we will get through this together.

Isn't it strange how you can still feel like a failure even after you've achieved your dream of getting into medical school? It's such a strange dynamic to be in. You know, on one hand, everybody in society or your family is praising you, and here I was sitting in my classroom, sitting among my peers and thinking, "I am the dumbest person here. I do not deserve to be here." And the amount of negative thoughts started building and building up in my head. And eventually, I started to spiral and I thought, "Who are you kidding? You're not going to be a doctor. You don't deserve to do this. You faked your way into medical school. You are not anywhere near the brilliance to be able to make it and become a physician who can take care of people."

And I remember sitting in Dr. Baumann's office. He's our academic advisor in medical school. And I'm telling him these things, and I'm telling him, I said, "I'm too dumb for this. Look, I'm too . . ." you know, "Look at my grade here. Look at my grade there." And I remember him saying, "Stop. You need to start changing the way you think. For every instance you start thinking, 'I can't do it, you need to start saying, 'I can do it.'" And I thought that's not going to do anything.

And I'm sitting in the classroom waiting for an exam to start. And the anxiety is just building and building in me. And I thought there's nothing else to lose now, might as well just say it, just say, "I can do this." And so I started to say that, and, you know, before every exam, it became like this crazy obsessive ritual. I would sit there and I would say, "I can do this. I can do this." And slowly over time, this "I can do it" phrase started seeping into various aspects of my medical school life. Before every patient interaction, "I can do this." Before I go and present to an attending, I would say, "I can do this."

Words never were powerful to me, but at the same time, the words that were doubtful were very powerful to me. So why can't the words that are positive also be equally powerful?

Slowly, these changes were happening, but I didn't really notice it until I was a fourth-year med student. I have been traveling across the nation for these away rotations. I'm living in different states for a month at a time, working at different EDs, working with different doctors and physicians and, you know, seeing how everybody thinks differently, and I'm thinking I'm actually doing this. And then I submit my application to go into emergency medicine I thought, "Oh my God, I did this." It became more apparent that my success comes from my ability to pull myself up rather than my ability to compare to others. And I started doing way more better in clinical settings.

It hit me how much self-doubt can block so much of your learning, so much of your growth, and that it hinders your path to success. It's so important to be able to see that positivity within yourself, that resilience within yourself and acknowledge when you're about to self-doubt and be able to beat it at the spot and recognize that it comes from a place of fear rather than a place of capability.

So, as cheesy as it sounds probably the most important lesson I learned out of medical school was that you have to believe in yourself first. Believing yourself is going to lead you to open your mind in order to be successful in the environment that you're so passionate about.