Transcript
Will: [00:00:00] Today’s episode is brought to you by Microsoft dragon co pilot, your AI assistant for clinical workflow. Learn about how dragon co pilot can transform the way you work. Stick around after the episode or visit aka. ms slash knock, knock high again. That’s AKA. Ms slash Knock, knock, high,
Kristin: knock, knock,
knock, knock. Hi.
Will: Hello everybody. Welcome to Knock-Knock. Hi, with the Glaucomflecken. I am Dr. Glaucomflecken, as Will Flanary.
Kristin: I am Lady Glaucomflecken, known as Kristin Flanary.
Will: We’ve got a great show. Great guest. So we’ve been trying to get on for a while. Ryan Marino, uh, know him from back in the med Twitter days.
Kristin: Back in the good old days.
Will: Pre Elon. Uh, [00:01:00] and, um, uh, a great debunker of misinformation. He’s a, um, a toxicologist, addiction specialist, emergency medicine, uh, and, um, does a lot of, a lot of, uh. Of education around fentanyl and, and, and drugs and drug use and abuse and addiction. And he’s got, he’s got his hands full.
He does. That is a
Kristin: fraught topic in this country for some reason. He’s
Will: done some great advocacy work. So we talked to him a little bit about that and about social media and everything. Uh,
Kristin: he’s got a crazy story involving Tucker Carlson.
Will: Yeah, he got, you know, I always complain like about. About people who come after me, which honestly hasn’t happened in a while, uh, knock on wood, but, uh, uh, you know, it’s always when, when you, you get the, the ire of a group of people, it’s always kind of sucks because it’s, it feels like this onslaught of negative [00:02:00] attention of, of angry emails or whatever, like, Nothing I’ve experienced compares to, to, to his story about Tucker Carlson and whenever he came after him specifically, uh, and so definitely listen to that story.
Um, before we get to the interview though, before we start recording. You, we were reminiscing about, about my pre exam routine, which I don’t even really, I’ve, I’ve like blocked out so much of my. Of all the ex, like the med school exams and everything.
Kristin: Well, this started in college.
Will: So I do remember listening to music before.
I don’t remember like listening to.
Kristin: It was always hip hop or rap or both. And you’d turn it up real, real loud again. Listener, please picture the lankiest white boy you [00:03:00] have ever seen.
Will: In college. I probably weighed about 170 pounds. And you
Kristin: had like an Afro of curly hair.
Will: Yeah.
Kristin: Yeah. And you would. You would blast that in your car on the way or whatever, right?
I’m just like, sometimes, sometimes there were like. Chest pounding. I’m going to crush this test.
Will: I’m trying to remember some, uh, there was some little Wayne back in the day. There was some, uh, juvenile, back that as a
Kristin: 50 cent.
Will: This was, we were talking, you know, early. Mid 2008. Mid 2000? Yeah.
Kristin: Yeah. To 13 or so.
Will: 2000? It would be 2000, probably 7,007, 2008. Mm-hmm . The game.
Kristin: Yeah. Oh. I
Will: just, all right, now it’s, it’s starting to come back to me. Quality
Kristin: music .
Will: That was, that was good stuff.
Kristin: It, it was effective.
Will: It got me, it, it really got me pumped up. It got juices
Kristin: flowing. [00:04:00] Yeah.
Will: I had a in, um, in med school, there was a guy who would at the front of the auditorium right before we started taking a test, he would do like 20 pushups.
Kristin: Yeah.
Will: We all made fun of him.
Kristin: I mean, that is also an effective strategy. So maybe he was on to something. Yeah. You got to get like,
Will: what does that do?
Kristin: Just gets you going, you know,
Will: what’s the psychological impact of,
Kristin: look, I was not prepared for, I didn’t bring a thesis, but it just, there, when you exercise, you, you are.
I mean, you exercise, you know, you, you feel more energized. Even though your, your body might be a little more tired. It’s like, you got the endorphins yet.
Will: There’s nothing pumping. There’s nothing I do now, um, to like that I need to pump myself up for actually the only thing would be our live shows.
Kristin: I was going to say bedtime with the children.
Gotta have a pep talk before that. Yeah,
Will: but we don’t have to like perform.
Kristin: No.
Will: Right. [00:05:00] But our live shows, we, we, we do a chest bump, high five. We kind of punch each other. Like, come on, let’s go, let’s go. Let’s get, let’s get it done. Yeah. That’s
Kristin: mostly for your benefit. I don’t, I don’t need it.
Will: You don’t need it.
But
Kristin: you do.
Will: I think you could benefit from it.
Kristin: We do it.
Will: You’re too, you’re too like laid back before a show.
Kristin: I just, I, maybe I have more confidence in us than you do. I’m not so nervous. It’s
Will: about the energy.
Kristin: No, I have energy.
Will: You do have more natural energy than I’d like.
Kristin: Yeah. I’m like a, like a rabid squirrel.
Will: If too much, too much of the, like the, not the anxiety, not that you just like always coming out in different ways.
Kristin: Right. And, and just like, I’m just generally, you know, overstimulated. I just like have a lot of. Nervous energy, but not nervous as an anxious, nervous as in just nerves, right? Like I just have a lot of,
Will: I don’t listen to much rap anymore.
I don’t listen to, certainly not before we, we, uh, the [00:06:00] playlist we play to the, to the crowd before we were performed. I don’t think that’s because I made
Kristin: that.
Will: You’ve never been a rap hip hop fan. Well,
Kristin: sure. I was in college. Every that’s what all the music was in those years through
Will: a stage.
Kristin: Yeah, I mean because that’s what was on everywhere.
It’s on the radio. It’s on Restaurants
Will: you ever have a country stage. No,
Kristin: I was I
Will: did because my sister’s into
Kristin: country
Will: So you knew the songs
Kristin: of course, I lived in rural, Texas 13 years.
Will: Yeah. So now it’s 20. That’s how you do the
Kristin: songs. Yeah. Garth Brooks.
Will: Brooks and Dunn.
Kristin: Yeah. Dieppe. What
Will: else? The other ones?
Kristin: Billy Ray Cyrus.
Will: George Strait. George Strait.
Kristin: Ooh, big one. Yeah.
Will: Yeah, he was pretty big, wasn’t he? Mm hmm. Yeah.
Kristin: Yeah. I have, uh, uh, deep set memories of Achy Breaky Heart on the school bus. Is that George
Will: Strait?
Kristin: No, that was Billy Ray Cyrus. Oh,
Will: yeah, that’s right.
Kristin: That was big. It was a big [00:07:00] one. Whoo. All right.
Yeah.
Will: Well, anyway, you have any good pump up music, you guys? Let us know. Yeah. All right. We’re getting
Kristin: old. We’re tired. We need more strategies.
Will: All right. Let’s get to our guest again. This is, uh, uh, Ryan Marino, physician, emergency physician, toxicologist, addiction specialist.
Kristin: Triple board certified. That’s.
Will: Uh,
Kristin: feet
Will: and a social media personality debunker of misinformation. Here he is. Dr. Ryan Marino.
Hey, Kristen. What’s up? I’ve been grossing you out about these little guys. Demodex mites for months now.
Kristin: Yes, you have. Thank you for that.
Will: Well, good news. I have more facts to share with you.
Kristin: Oh, great. Yeah.
Will: These mites have likely lived with us for millions of years. Passed down through close contact, especially between moms and babies.
You know that?
Kristin: That’s. Yeah, they’re,
Will: they’re born, they live, crawl around and die on your eyelids and in your lash follicles. That’s lovely. The entire life [00:08:00] cycle from egg to adult lasts about two to three weeks. That whole time, they live right there on your eyelid.
Kristin: That’s making me itchy.
Will: It is fun to gross you out, but we do all have these, all right?
It’s really common. It causes a disease when there’s an overgrowth of these mites called demodex blepharitis causes the eyelids to get red, itchy, irritated. You get this crustiness to the eyelids, but I have really good news. This is actually really good news.
Kristin: Okay.
Will: We have a prescription eye drop for this.
Kristin: Okay. That is, that does make me feel better.
Will: Visit mites love lids for more information about demodex blepharitis and ways we can treat it. Again, that’s M I T E S. L O V E L I D S. com to learn more.
All right. Finally, we are here with Dr. Ryan Marino, Ryan. Uh, it’s, it’s a shame that it’s taken us so long to talk to each other in this way, because we’ve [00:09:00] been following each other on social media for quite a while.
Ryan Marino: Yeah, it’s been a long time. I’m excited to be here, though.
Will: Yeah, let’s, so my first question for you is just a really generic, uh, question.
I just want to get your gut reaction. Is social media worth it? Ooh, my gut reaction is As a healthcare
Kristin: professional?
Will: No, see, I, sometimes I feel like my answer goes back and forth.
Kristin: Yeah,
Will: like lately. I feel like it just makes me angry. It just makes me mad.
Kristin: Yeah,
Will: but sometimes I feel like there’s good still good in the world.
Kristin: I think it depends on what you’re what you’re talking. Like if you’re just consuming social media, stop that right away. But if you are talking about, you know, what Ryan is. Putting out there on social media. I think that’s absolutely worth it. He’s doing a lot of good. The tricky part though, is that you don’t get to hear about or see a lot of the good that comes of the education that you are providing [00:10:00] the general public.
So,
Will: so that’s a bummer. And so I have to first commend you because I feel like over the years. I, I have spent less and less time like trying to really, um, engage with the, like the misinformation stuff and like trying to debunk it. I still do it sometimes with like I stuff specifically, but I just, I, I’ve just gotten so tired over the years.
You are still going strong and I feel like every, listen.
Kristin: He’s triple board certified. This man has endurance.
Will: Exactly. That’s the thing. Maybe it’s the red bull. I don’t know. But, uh, what, honestly, what keeps you going with, uh, with all this stuff?
Ryan Marino: I don’t know. That’s a really good question. Um, and so, I mean, my gut answer to any question about social media is probably no, but like, obviously, I mean, I, I’m there.
Um, I [00:11:00] have, I still learn a lot there. I’m, I’m thankful for other people that are there. So, yeah, I think there is. Like possibility for good and, um, every like one little thing. I mean, I don’t know a specific example off the top of my head. I’ll give you
Will: I’ll give you an example. I’ll give you because this is here’s one thing that’s like if if because.
Obviously this is in your wheelhouse, uh, of, uh, you know, drug use and, and all the myths that come up with, with fentanyl and everything, and we’ll get into all that stuff, but here’s one example where if, if, if I heard this, I would just like want to turn off social media, like for months on end, it’s when people start thinking that dogs are getting addicted to methamphetamines by eating poop from people, unhoused, homeless people.
I’m
Kristin: sorry, what?
Will: So. Talk about this because this is a good place to start.
Ryan Marino: Yeah, that’s a real thing. Um, and unfortunately not just [00:12:00] a one time thing either. Uh, but I think it was a couple of years ago, some other social media character, uh, tried putting out there that dogs in San Francisco were getting addicted to methamphetamine because homeless people were pooping on the street and dogs were eating it.
And that was like picked up as a national news story.
Will: First of all, this has happened multiple times. You’ve heard this type of thing. Yes.
Ryan Marino: That is a popular rumor, whether it’s from, um, like dogs or children. Uh, and the dogs getting sick, getting addicted, overdosing is always. That’s when, you know, there’s something there, um, when like the fentanyl touch stories lose, lose traction, they’ll start saying that dogs are overdosing.
Oh, they change dogs. Yeah.
Will: Cause that’s when, when I, when I first started seeing your stuff, [00:13:00] um, it was a lot of the, the, the fentanyl craze, which I think, I mean, is it, do you, do you feel it changing over time or is it still the same storylines? With
Kristin: Fentanyl. That’s a good question. Are there patterns?
Ryan Marino: Yeah, I think for the most part things have improved, uh, but like that, that touch and exposure myth still seems really pervasive with like law enforcement and the news seems to still love picking, picking those stories up.
Kristin: So does law, law enforcement believes this to be true? Correct. It’s
Ryan Marino: actually included in a lot of training and like instructional materials. It. In law enforcement,
Kristin: I’m sure you must wonder this all the time. But, um, how,
Will: how does it get in there?
Kristin: I mean, did they not? Do they not consult any medical professionals about like, how, how is it that?
Misinformation gets into [00:14:00] official legal enforcement training, law enforcement training.
Ryan Marino: Um, that’s a great question. It, it came from the DEA, but I mean that the DEA has even corrected themselves. So I, I don’t know why it’s still being taught, still being considered true.
[music]: All
Ryan Marino: you have to do is, I mean, turn on the news for one of these stories and you’ll hear.
A dozen reasons why this doesn’t happen.
Will: Well, it’s this, the, the old thing that it’s, it’s, um, it’s easier to promote a false idea and get it to train, gain traction versus the work is like 10 times, a hundred times harder to, to get that idea out of, of public. I would
Kristin: just, uh, that there were systems in place to like for.
In the general public. Sure. Right. But like our law enforcement, I would, I would hope [00:15:00] they had like better information and procedures for that. So that’s disappointing.
Will: But then do you feel like Ryan that that it’s because I felt this and like you start talking about things like for me, it’s talking about the health insurance stuff and and even some stuff in ophthalmology.
Other people seem to care a little bit less about that. Um, But it just, it, it seems like you’re not getting anywhere on social media and you just end up in arguments. You just end up like, how do you, how do you feel about that in terms of, of all this advocacy, just talking about, uh, myth busting about drugs, about fentanyl.
Like, what do you, do you feel like you’re making progress? Do you feel like it’s helpful?
Ryan Marino: Yeah. I mean, I think it’s really easy to get bogged down into that, like. Individual arguments and and that is kind of what social media, uh, [00:16:00] prioritizes, like bickering and fighting and and that kind of stuff, especially some of the different platforms.
Um, but so, I mean, I think if you’re able to avoid that, which, which it can be really hard to do, then there’s more to it. But, yeah, that happens a lot. Um, and a lot of people’s. Minds are made up, like you’ll, you’ll never change their mind, no matter what.
Will: And so then you got to start focusing on other like areas of actual advocacy.
I feel like, like what you’ve been doing all, you’ve done a lot of, you’ve done, obviously you had your background doing a lot of work in addiction medicine. Um, tell us about, you know, some of the, some of the ways outside of social media you’ve helped kind of bring, you know, knowledge to, to accurate knowledge, you know, fighting misinformation outside of social media.
Ryan Marino: Yeah, so the reason I got into social media in the first place was just because I was having [00:17:00] trouble with the work that I was doing. And so, um, like addiction and substance use. I mean, those topics are like near and dear to me. That’s why I kind of pivoted. Um, into that career trajectory, but like the 1st thing, the reasons and I got onto Twitter back in 2017 was because I couldn’t even get my own colleagues to give out free Narcan kits that I had had funded had placed in the emergency department.
Um, we were seeing. In Western Pennsylvania, I mean, the same patients would come in multiple times in one ED shift, uh, for overdoses and people still didn’t want to give them Narcan, um, which was kind of ridiculous and then just realizing that it’s because people have all of these. Misinformed beliefs about things like that, uh, and then kind of went from there.
Will: Does this, does this just stem from just the, the, the, the feelings around the opioid [00:18:00] epidemic when it started and, and the, the villainization of.
Ryan Marino: I don’t think it’s just opioids because this, I mean, goes into pretty much every drug. I think the, the topic of like drug use and addiction are just so there, what people believe and what’s taught is so inaccurate and based in kind of these like stigmatized ideas and stereotypes. Um, and I mean, even like our laws and the practice of medicine, it’s been over a hundred years since they banned doctors from treating addiction medically.
Um, and we’ve had some, not loopholes, but like ways around that with things like methadone and buprenorphine. Um, but that law is still on the books. Like you, you cannot treat someone’s addiction with off label medications or use controlled substances like that. Um, and so I think that that is probably the biggest part because it’s [00:19:00] really any drug topic.
There’s someone who has a really strong opinion about it and someone who’s really wrong and they’re usually the same person.
Will: That’s a good point.
Kristin: Like that’s a life lesson for the children.
Will: Yeah. People are, uh, people who are really wrong are also very, very loud.
Kristin: Yeah, exactly.
Will: So, uh, speaking of that, actually, I want to congratulate you on this. I think this is a couple of years ago now, but congratulations on being the wokest man in medicine.
Ryan Marino: Oh, thank you.
Will: I just like, do you have a plaque on your wall? Is it, is, did you receive anything from the, the Tucker Carlson, uh, you know, whenever you found out about your achievement,
Ryan Marino: they did not send me anything, unfortunately, like a
Kristin: sash, you know, like
Ryan Marino: they did send like hundreds of online trolls. My way.
Um, so tell that story. Tell that story. Someone did get me a hat that [00:20:00] says that So, yeah, it was like two years ago or 2023, I don’t know it was a Christmas Eve and Tucker Carlson ran a segment about me and called me the wokest man in medicine Which was supposed to be an insult, but honestly, it’s my proudest accomplishment
Will: And what was the story of my CV?
It should, it should honestly go and certainly in your media reel, if you’re trying to do anything, um, but what was, uh, what was that in reaction to, why, why, why, how did you gain, what was the criteria?
Ryan Marino: Um, because I. It had something to do with fentanyl and vaccines that I make fun of overdoses or something was what he was trying to say.
I don’t know. There was like pictures of me that he showed from my personal Instagram. Um, oh God, someone did a lot of. Investigation [00:21:00] into into me for that and then decided that I was the wokest man in medicine. So
Kristin: interesting.
Will: And then, um, what was the reaction like online after that? I can’t even imagine this because this is I’m sure on Twitter, right?
You got this. This is pre Elon. Yes, I guess. So this is, um, before he ruined it. I think so
Kristin: 2023
Will: 233. I think that was 2024 when maybe it’s been like 2 years now that he took over. I don’t know. But anyway, uh, so, so it was on twitter. You got all over this across social media that people were coming after you.
Ryan Marino: Yeah. And in real life. I mean, I would say that was pretty terrible for like a lot of months. Um. So what way
Will: like emails people, you know,
Ryan Marino: emails, letters, uh, I mean, people wanted me to lose my job. All of that stuff. Um, did you get, [00:22:00] I would say like, no, is my gut reaction to social media is probably. From that whole experience, you could end up Tucker Carlson show
Will: that’s, that’s, that’s gotta be one of the worst things to, to, to get your face on something like that, um, where people are, are very, uh, extremely opinionated about this topic, but.
I’m curious how, for something like that, that bleeds into your real life, like I’m sure you said people are trying to get you fired. I’m sure you had like, you know, negative reviews, you know, that’s, that’s always been like a thorn in the side of practicing physicians is whenever you start seeing those pop up, um, did people call your employer?
Ryan Marino: Yes, calls letters. Reviews my, uh, online scores. There’s a lot of like interesting comments, uh, and there, I mean, most of them are all from like the same day. [00:23:00] Yeah.
Will: When you’re, when you’re, uh, subjected to that kind of abuse. That bleeds into your real life. Did you have to have a conversation with your, I don’t know how much you can go into it about, I mean, this was a couple of years ago now, so I’m sure it’s all kind of hopefully settled out.
But, uh, did you have to go in for a meeting with like the administrator or something and to talk about this stuff or how did that work?
Ryan Marino: Yeah, I mean, people were really, uh, fired up, I guess. I don’t know what the word would be, because these are like people who are out of state, don’t think medicine is real, don’t think science is real.
Um, but for some reason, I mean, a corporation running a health care system is going to take. This as a very serious complaint, even though this is not their customer, ideologically or geographically fear for your safety at all [00:24:00] during all of this, uh, I guess to some degree, I think more so just the way that people try to like weaponize everything at their disposal, like to try to ruin my life to try to get me fired because they don’t, don’t like what I say about fentanyl, that kind of thing.
Which is really bizarre because there’s nothing you can do back. Well, you can’t even get fake health grades reviews taken down. Um, that kind of thing. So I think in terms of like social media and advocacy, you really have to have good support because without that, why would anyone want to do this?
Will: It certainly takes courage.
I mean, I’ve never been subjected to that kind of, I are
[music]: actually,
Will: there’ve been a couple of times I’ve, I’ve, I’ve waded into like, uh, some like scope of practice stuff, which is a big hot topic, hot topic, hot [00:25:00] button issue. That’s what I’m trying to say. Hot button issue within the medical field. That’s gotten me into a bit of trouble, but, um, nothing where I felt like, you know, did you feel like you, like there’s a chance you might.
Lose your job. I have to go on leave or something. Was it, did it get that far?
Ryan Marino: Um, I mean, It has at different points. Yeah. The Tucker Carlson, I mean, is obviously a well connected person. Um, and you have to imagine that kind of corporate America, uh, and Fox news viewers have a large area of overlap. Right.
Will: But in the end, You’re, you’re talking about evidence based medicine, you’re talking about facts, you’re talking, I mean, if, and if people just don’t like to hear the truth about some of these things from, um, an actually board certified medical doctor, which is unfortunate, [00:26:00] um, and so you’ve got to, I don’t know.
I feel like you just have to take solace in the fact that, you know, you’re correct. And, and in the end, as long as you have the truth on your side and evidence on your side,
Kristin: you’re not doing anything wrong.
Will: Yeah. You’re not doing anything wrong. And, um, and you hope over time people will come to the, that conclusion, but I don’t know.
I have less and less hope that,
Kristin: well, this makes me curious. Like it’s not just this issue. It’s what you just said of people don’t trust, you know, Medicine anymore. People don’t trust doctors like, like faith in our institutions is eroding. And that includes the institution of healthcare and science. And, um, so what are you guys going to do about that?
Will: That’s a good question. Let’s take a break and then we’ll come back and try to answer how we get people to trust medicine again.
[music]: [00:27:00] Okay.
Will: Alright, we’re back with Dr. Ryan Marino. Ryan, I’ll let you go first because I’m not totally sure. What do we do about this?
Ryan Marino: Well, so I guess I never answered your question too about what I do like outside of social media for advocacy. And I think that’s one way that you can go about this. So, I mean, I mentioned, like, I give out Narkian, but I have worked with local, state, national politicians, gone and done education for them, for different groups, um, I mean, handing out supplies and stuff.
Uh, at the end of the day, the thing that I feel has made the most difference in this issue, um, and I mean, like, I wrote a paper that was used to change a law. Uh, but the thing I think that’s had the most impact is actually through social media. Um, and so maybe I come across annoying to some people, whatever.
[00:28:00] Um, I think that is how you connect to people. That’s how you kind of rebuild trust is like, why am I spending my time? Worrying about this kind of thing. Uh, and there’s more people out there who are actually open to or receptive to like learning, um, and, and want kind of better information. It’s just the problem is the ones who are the loudest, uh, and suck up all the air are the ones who are negative and close minded and, and all of those things.
Will: Yeah, it’s, it’s. One of those things I, I totally agree with you on the impact social media can have, and not just getting your message out, but, but finding the people that feel the same way that can actually then turn to, to, to add, you know, in person advocacy outside of social media, getting laws changed.
You, I know you had, um, actually shortly after the Tucker Carlson thing, you, uh, you had the removal of the X waiver on buprenorphine. Prescribing which i don’t know what’s
Kristin: [00:29:00] what’s the next flavor and what is.
Will: Tell us what that is. I think that’s a huge.
Kristin: Buprenorphine. Did
Will: I do it?
Kristin: Buprenorphine. It was perfect,
Will: yeah.
Kristin: Alright. I
Will: had an attending that just called it bupe.
Kristin: Bupe.
Will: So that’s easier to say. That’s much easier. That was a huge deal. And so that’s like an example of turning the social media presence and all the things you’ve been talking about for so long and your expertise, sharing that on social media, but turning it into To, to real change in the real world.
So talk to us about that experience.
Kristin: And what is an X waiver?
Ryan Marino: That’s good. Yeah. Question. So this goes back to that like silly law that you can’t treat addiction, um, medically. And so bupe is one of the two medicines or three, I guess now that’s approved for like opioid addiction, um, with methadone and naltrexone.
Um, and. People are probably more familiar with bupa as like suboxone, um, [00:30:00] being the, the brand name for one of the forms. Um, but you had to do a special training, which was eight hours of additional, usually, uh, it was In person, they moved to like in person and hybrid and then with covid when all remote, but 8 hours of additional training for physicians and 24 hours of additional training for, um, advanced practice providers to get a special license to be able to prescribe that.
Uh, and so bupe is technically like a opioid drug, but it’s. Not the same as any other opioids, which don’t have this restriction in the fact that it has much less addictive potential and like almost no overdose potential. Um, so it was this kind of arbitrary extra hurdle that just prevented people from prescribing this medication that saves people’s lives.
Um, And in, finally, a couple of years ago, uh, they got rid of that, that [00:31:00] requirement. And so anyone with a DEA license can now prescribe that. And it is, it’s kind of ridiculous just because if you had a DEA license, you could prescribe any amount of any other opioid that people could get addicted to, could overdose on.
I mean, I, as a ER doctor, can prescribe like chemotherapeutic drugs, um, all of these things that, I have no business and should not be prescribing, do not have restrictions. But once again, because addiction is treated so differently, so weirdly. Um, that was the one place where they put this, this extra hurdle.
Kristin: Well, that must feel good that your advocacy work was, I’m assuming fairly integral to getting that change.
Ryan Marino: I went to the
Will: White
Ryan Marino: House.
Kristin: Yeah.
Ryan Marino: Yeah, that was exciting. Um, unfortunately, I mean, not much has really changed since that, that policy changed, but it was a good thing. So I’m, I’m happy. That’s disappointing.[00:32:00]
Will: You had to, you had to dress up in a suit, which I know is hard for emergency physicians. So you had to, you had to dress up and then you don’t, you don’t start seeing the, uh, the effects of it. But, um, why, why do you think that is?
Ryan Marino: Uh, I mean, I think it’ll just take time. People are still hesitant to prescribe now that they’re allowed to because for the past 20 plus years, everyone was told that this drug was special, required.
Additional training was was too complicated. It’s really like one of the easiest things I do. I write prescript. It’s easier to prescribe, I think, than like ibuprofen. And so even I
Will: could do it, even an ophthalmologist. Yeah, look. I mean, I, I absolutely never, I absolutely won’t, but, uh, it’s, that’s very much outside of I’m maybe one of the last types of physicians who should probably be prescribing it.
I don’t know, but maybe I’m wrong, but, um, but anyway, that’s, that’s awesome. At least people [00:33:00] have the ability to do it. I’m curious, this, how does this work? How does that medication where I want to get in, you know, I’m sure Kristen’s not going to like care about like the mechanism of action of these medications, but I’m actually curious, like, how does it.
You said it doesn’t have abuse potential. So how is it? Is it acting on a different receptor? I vaguely remember this from med school, but not really.
Ryan Marino: So it, I guess, technically, like everything has abuse potential. I mean, ibuprofen, Benadryl can be abused even. But yeah, when it comes to bupe it. Acts on the same receptors, um, but it’s a partial agonist at your mu opioid receptors.
And so it won’t give you respiratory depression in adults at least, no matter how much you take. Um, and there’s much less of that like rush euphoria feeling people get. Um, it, it doesn’t work as well for pain a lot of the time. It does it, but
Will: it takes away like the craving [00:34:00] of that people will have that drives
Ryan Marino: them to abuse.
And one of the cool things about it is if people have it in their system because it has a much higher affinity for those receptors, even if someone went out and like the worst day of their life or got peer pressured really hard, uh, and used again, um, their. Much less likely to a overdose, but even have that like reward effect where you kind of reset the cycle of wanting to to use again.
Um, and so it is pretty cool.
Will: So give me, give me three things that you’re constantly, you feel like you’re constantly talking about trying to correct the misinformation of like three things that tomorrow, like you could just get rid of that misinformation completely. You could you would do it like you had a magic magic misinformation genie who like is to the snap of their fingers [00:35:00] like all of a sudden that thing goes away what would it be for you three
Ryan Marino: things three things
Will: you get you get three things
Ryan Marino: there’s probably three things just with fentanyl like right now the senate is about to pass a bill.
That’s scheduling every fentanyl analog as a, a schedule one, which is completely illegal. Um, and so, I mean, the misinformation around fentanyl is, is really problematic. Um, that I think would probably be like number one, two and three. This I explain,
Will: talk to that, talk to us about that, the schedule one thing.
I, I didn’t quite follow that. Well, so fentanyl.
Ryan Marino: Yeah. One of the things I think people forget or aren’t aware of is it is a medicine, even though it’s driving all of these overdose deaths and is very dangerous for people in street drugs. It’s the exact same chemical compound as like an invaluable [00:36:00] medicine, fentanyl.
Probably, I mean, I, I don’t have the actual numbers, but if I had to guess, probably like top five most used medicines in the entire world just ’cause of how u useful it is for treatment of pain, for sedation, for ventilated patients, for, for critical illness, all of this stuff. And I
Will: will even, even in, by the way, even in real quick, even in cataract surgery, like we give it for Yeah, just a small, small amount.
Kristin: You’ve had fentanyl.
Will: Oh yeah. I mean I’ve, because I’ve had lots of surgeries and stuff, but Well.
Kristin: And during the cardiac arrest, you were on, you were out for a couple of days. I’m sure I got all they were using.
Will: Sure. I got all kinds of medication
Kristin: trying to wake up. You were a problematic patient
Will: anyway. I needed more fentanyl, man.
I wonder how much I got.
Ryan Marino: Anyway, go ahead. Oh, but yeah, I think people don’t realize that. And I’ll have people in the emergency department with like broken [00:37:00] bones, horrible injuries, that kind of stuff. Turning down the fentanyl that we’re trying to give them to treat their pain, um, because they’re scared, it’s going to get them addicted, going to have them overdose, and I mean, you had a bunch of fentanyl and you’re not addicted, so there’s a good example, but yeah, I think that’s one of the big problems, and then Bill, uh, Fentanyl analogs.
So, I mean, I think some of these have gotten a pretty good amount of attention in our, like, overdose epidemic that things like car fentanyl that show up in the, in the drug supply and are 100, 000 times stronger than, than morphine or whatever it’s quoted as, um, and will, will cause, like, Overdose clusters, outbreaks of overdoses in in certain areas, but we’ve largely seen those kind of disappear.
Um, people seem to just want fentanyl. Uh, and so this law is going to make anything, um, that’s chemically related to fentanyl be illegal, [00:38:00] which will also prevent like research into treatments into how these compounds work. And so one of the things that they’re banning is actually in, um, Antagonist at your opioid receptors.
So it was potentially like a Narcan, um, could maybe even be like more specific for fentanyl, or maybe it works better for for certain situations, that kind of thing. Um, and that’s going to be illegal. Uh, and those, the, like, illicit drugs that get sold on the street, if you are some drug dealer, and you have.
Uh, idea in your mind that you can mess with the chemical structure to get around the laws, there’s a law going back to the eighties that doing that kind of stuff is already a crime. So this adds nothing. Um, if you like sell a drug that isn’t isn’t scheduled and it makes someone overdose that that’s already a crime.
Um, this is just going to [00:39:00] impede research and add criminal charges to people who get arrested. And so the big problem is that we use the criminal justice system to treat addiction in this country, and we don’t use things like bupe, um, that actually work.
Will: It’s just gonna take time to get people to change their thought process.
Kristin: Well, yeah, and I mean, no one asks for this advice, totally unsolicited, but just, uh, that’s why
Will: you have a podcast. You get to give unsolicited advice all the time. I solicit
Kristin: it. Uh, but applying my, um, psychology background for one moment and my communications. Um, here’s what I think allows, well, one thing that people that are spreading misinformation and people that are making laws like this, like things that are happening in that area, they are, they are being the tactics they are using are more effective than the tactics that healthcare is using.
So facts are facts, and that’s true. [00:40:00] But this kind of where healthcare stops, they’re like, that should be enough. That’s their self evident. That should be enough. If that doesn’t convince you, I don’t know what will, you know, what will is appealing to people’s emotions and telling stories. Connecting it to their real lives, lives of people like the people they know, the people they love and appealing to that.
And we do have a negativity bias, which allows, you know, scary, negative, fear based stories to have more impact than positive stories. But you can use that to your advantage too. You can flip that on its head and say, I mean, you know what? The scariest thing is to me is losing someone I love or, you know, bad things happening to someone I love.
And that’s what people are, are playing on when they, when they generate these fears. But the same is true. You know, we could be doing that in healthcare as well of if you. Don’t do these things. I mean, the anti vax movement is a good example, right? Like if [00:41:00] you don’t do these things,
[music]: your
Kristin: loved ones are in danger or, you know, whatever it is, whatever your message is, if you find a way to tie it back to emotions.
And storytelling and personal connections that is gonna go. It’s just neuroscience that is gonna have a larger impact on people than all the facts in the world and and using the facts to supplement is great because then it’s not manipulation. It’s just true. But you can’t rely on facts alone.
Ryan Marino: And I think your example about the anti vaxxers.
I mean, it’s good because a lot of this. Misinformation, well, misinformation, it seems like everyone who believes one thing believes like all of these things. And if you, I mean, scratch the surface of the, like, fentanyl truthers, um, they also are anti vaxxers and all of that stuff. And at the end of the day, a lot of that seems to boil down to this, like, very American belief [00:42:00] in, like, the individual and, like, personal liberty and American exceptionalism, whatever.
Like, I don’t need a vaccine because I have an immune system. My child’s going to be stronger. Like, if you’re worried, get yours, that kind of thing. And it is really hard to reach them because you do have to kind of make those appeals that are not as objective as Right. You want to be right.
Kristin: Yeah. I mean, you have to meet people where they are and then you can lead them to.
So
Will: try to scare the hell out of them about measles.
Kristin: If that’s what it takes.
Will: I mean, it’s a scary disease. It’s
Kristin: pretty scary all on its own. What’s happening right now. So, and I, there has been a vaccine spike in,
Will: but you know, well, the, we had the first death of a child, um, that we’ve had in more than 20, 20, 20.
I’m not sure how long ago it was, but it was a long time ago,
Kristin: one
Will: too many and, um, [00:43:00] unfortunately it’s, it’s still the, you know, the classic thing where, you know, people won’t care until it affects them personally,
Kristin: right? So you have to, you have to figure out how do I make this relevant to people personally?
Right. And social media is great for that too, because, um, you know, one of the words is media and that’s a great tool for storytelling. You know, that’s a great tool for appealing to emotions that people have and fears that they have and, and, you know, bringing them along on a journey to start where they are and get them to where truth is.
Will: Ryan, you said something interesting though, when you’re talking about, um, patients coming in to the emergency department, I would assume that because of what. We always see about fentanyl, all these lies about fentanyl, uh, as opposed to the truth, um, that people would be afraid of dying from receiving any fentanyl, but it’s more, people are afraid that they’re going [00:44:00] to get addicted to fentanyl.
Is that, is that a, is there a difference there? Do you see?
Ryan Marino: Yeah, it is. People are less scared of like, uh, having an overdose, um, I think because like if they’re in the hospital, that’s actually a good question. I haven’t really thought, um, super hard about that. But yeah, we saw like the same thing. I mean, after Michael Jackson, people wouldn’t want propofol to like, get their, their hip put back in kind of thing.
They were, they were really scared, uh, that it was going to, but not that it was going to kill that. I don’t really know what people are scared of. That’s a good point.
Will: But it’s not, and I know that, I know you know this and I know this, but to, to let all of the listeners know, it’s not just getting an exposure once is going to set off an addiction to something like that’s, that’s right.
That’s typically not how that works. Are there some
Kristin: things where that works? Is that like a [00:45:00] nugget of truth where that comes from?
Ryan Marino: So yes and no, for the most part, no. Um, and. I mean, addiction is still not greatly understood, I would say, but it is. It’s more than just like one exposure to a drug. And so someone like having a beer or getting fentanyl in the hospital is not going to end up addicted.
I’m sure there are stories out there where someone says that, but there’s probably details that are being omitted. Um, and so, I mean. The like whole social, cultural, economic, all of those things factor in way more than even just the drug itself. And I mean, we know that some people have genetic predispositions to addiction.
Um, some people can be addicted to like any substance. And so maybe it was the pain medicine they were getting and then they get over that, but then get into alcohol. Um, that kind of thing. [00:46:00] So, yeah, it’s not the one time dose. Uh, and for people, I mean, I think having like that conversation would be better if people told me they don’t want fentanyl ’cause like their father was addicted to Percocet or something.
Um, that would be a much easier way to start conversations and be able to help people with those kind of fears. But usually what comes out is just like fentanyl has become the boogeyman by, by the media President Trump said Fentanyl is bad, that kind of thing.
Will: Right. Well, um, I don’t know if you’re still the wokest man in medicine.
Uh, I don’t know if someone’s taking the title from you at this point, but, um, uh, I, I just want to congratulate you on your accomplishments. Uh,
Kristin: and I have to address the elephant in the room here is that you guys, you’re, you’re doppelgangers.
Will: Oh yeah. Oh, the curly hair and the
Kristin: beard and the face shape. I mean, there’s a [00:47:00] lot.
Ryan Marino: That’s true. I think I’m like more than a foot shorter than you though.
Kristin: Oh, well, most people are.
Will: Um, uh, let’s take one more break and then we’ll come back. Rob, I have a little activity for us. All right. A little game to play and then we’ll wrap up. So I’ll be right back.
All right, Ryan, last thing we’re going to play a game. It’s called ER or RR. So emergency room. I know you guys don’t like the term emergency room. It’s an emergency department. But for this purposes of this, we’re calling an emergency room ER or RR, rest and relaxation.
Kristin: Oh, okay.
Will: So should you go to the ER or the, or just a little bit of RR?
Okay. All right, so I’m gonna get, we’re gonna rapid fire. We’re gonna just run through these. All right, I’m gonna give you a scenario and you’re gonna answer. You spill hot coffee on your hand and the skin turns red, but doesn’t blister. ER or RR?[00:48:00]
You’re eating a drumstick and a small bone gets stuck in your throat. You can breathe and talk, but swallowing hurts. ER. That’s what I was going to say, too. I was like, get that bone out of my throat. And that could probably go, like, somewhere you don’t want it to go. Right. Eventually, right? Like, that’s probably a big deal.
Kristin: There’s all sorts of things down that tube.
Will: All right, here you go. You’re putting some furniture together with a drill. The drill slips, and it cuts your hand. You’ve been bleeding for 10 minutes, even after applying pressure to the wound. ER.
Yeah you probably need some sutures in that thing. Uh, your finger gets slammed in a car door, it’s throbbing, swollen, and starting to turn purple, but you can move it a little bit.
ER. That’s a tough one. Yeah, go to the ER
Ryan Marino: just in case. I would probably R& R that one.
Kristin: I was gonna say that has happened to me before, and my parents did [00:49:00] not take me to the emergency room, so, I don’t know what that says.
Will: That might be a judgment call right there. Yeah. I mean, If in doubt, I mean, you know, if you don’t know anything about medicine, you know, maybe
Kristin: put some ice on it.
You
Will: just see how it goes. I don’t know. Yeah. Here we go. The R
Ryan Marino: is never the wrong answer.
Will: Right. Yeah, exactly. You eat, you eat week old leftovers from the fridge. Later on, you feel nauseous and then develop explosive diarrhea. RR. What if the diarrhea, explosive diarrhea lasts for like more than three days?
Ryan Marino: The one thing though, is if you need to be on a toilet, you do not want to go to the hospital because
Kristin: it
Ryan Marino: is the worst place to need a toilet. Yeah. That’s a good point. Yeah. They’re all shared and they’re all disgusting.
Will: Oh God. Okay. That’s wonderful. [00:50:00] Oh, what
Kristin: a conundrum.
Will: If you, if you’re in the hospital, you need to toilet go find an ophthalmology department.
Kristin: There you go. Well, you won’t, you’re in a hospital.
Will: Toilets are, well, that’s, you know, occasionally they’re, they got, they got there. Sometimes they’re not in like the, the gross hospital part. They’re in like the cleaner, much nicer, like radiology.
Kristin: Somewhere near the library.
Will: That’s right. Exactly. All right.
Let’s look for the windows. Yeah.
Kristin: That’s right.
Will: Um, all right. You fall off your bike, your knee is swollen and you really can’t put any weight on it with, uh, uh, you can’t really bear weight without significant pain.
Ryan Marino: ER.
Will: Non weight bearing is a bad sign, right?
Ryan Marino: Yeah.
Will: Yeah. All right. Here’s one. That’s mainly kind of for me too.
You just bought a new can of pepper spray for self defense. While trying to unlock it, you accidentally spray yourself in the face. And your eyes, your eyes burn. [00:51:00]
Ryan Marino: You should probably just go to the ER.
Will: Yeah, I think that’s unless you have a
Ryan Marino: I wash shower and
Will: yes for pepper pepper spray, by the way
Kristin: Yeah, there’s a trick right open
Will: water
Kristin: soap.
Okay. Yeah,
Will: just rinse those eyes soap and water
Kristin: anything like oil based or
Will: yeah It’s because it’s oil based and so you want to just you got to use soap to
Kristin: use some other kind of oil What if you have like coconut oil? Like I used to take my makeup off with coconut oil. Would that work?
Will: I mean, it probably is not gonna help to try, but is that gonna help
Kristin: to try or hurt?
I
Will: mean, sorry, it doesn’t hurt to try. Like coconut oil’s fine.
Ryan Marino: Yeah,
Will: but soap is probably easier. , it probably would. It
Kristin: just seems like it would hurt to put soap in your eye. So, but I guess you got pepper spray and there anyways, so what, what’s the difference? Is the worst part ?
Will: Yes. How do you feel? How, how are you with eyeball stuff?
You good? How’s your slit
Ryan Marino: lamp skills?
Will: Love.
Ryan Marino: So good. Couldn’t even tell you where the slit lamp is. [00:52:00] Well, that’s not unusual. That’s pretty good. I find all of my ruptured globes on ultrasound.
Will: Yeah, I know. I didn’t.
Kristin: You’re gonna go there.
Will: We won’t, we won’t go there because we only have so much time on this podcast, but, um, uh, it’s, uh, that’s, that’s actually pretty common.
It’s not how we diagnose open globes, but it’s whatever gets you to the right answer, I think is okay. Um,
Ryan Marino: it was, I saw, I think it was Ted Cruz, maybe one of the people who’s trying to get like DEI taken out of everything, um, removed. Either all of the webpages or grants or papers that had POC in it, because they thought it was person of color, but it removed a lot of like point of care.
Oh, so I thought you would appreciate that. That’s
Will: great. We’re in
Kristin: the upside down, right? Point of care
Will: ultrasound. Well, that’s
Kristin: what explains that’s
Will: what’s [00:53:00] going on. Like with the, the doge stuff.
Kristin: I know
Will: it’s right. It’s like, uh, just. Just sure, you can, you can think and in a lot of areas, I’m sure like there is some government waste, you know, things that can be scaled back, but just to take a hatchet to it and just full scale, just like cut out.
Kristin: It’s like they don’t realize that words and acronyms can have multiple meanings.
Will: Like they’re like, these, these, these things exist like for a reason and there’s just, they’re like indiscriminately just anyway, that’s, that’s a whole nother topic. Yeah. All right. At
Ryan Marino: least they’re getting rid of point of care
Will: ultrasound.
Thank goodness. Absolutely. All right. All right. Last one. You had a Christmas potluck. And you eat uncle jerry’s dish that he didn’t mention contained peanuts you’re allergic are
Kristin: anymore
Will: that’s it don’t wanna mess with that [00:54:00] um do you have any have you ever been to the. Did, did you as a patient ever have to go to the emergency department?
Kristin: That’s a good question. Um, I don’t think you’ve ever been since I’ve known. You don’t? I don’t think I have. Yeah. Careful. It just, it’s amazing. A lot of
Will: considering how clumsy you are. I know you would think that you would’ve, but you’re also,
Kristin: you’re also very anxious. Yeah. You’re also very, it keeps me away from lot of danger.
Okay.
Will: All right.
Kristin: Yeah.
Will: You know,
Kristin: smart. But I’ve been smart, smart. I’ve to take a kid. I’ve had, you know, my, when I was a, when I was a kid, my brother had to go, he cut the tip of his finger off. I
Will: got, I got on a tall ladder the other day, Ryan, you wouldn’t have been proud of me. How tall was it? Uh, I was, I was probably like a good six feet in the air, seven feet.
I don’t know. I mean, it’s tall, high enough where, you know, it would have been a disaster if I had fallen. But, uh.
Kristin: Aren’t you six feet in the air all the time?
Will: No, my feet, the bottom of my feet were six [00:55:00] feet in
Kristin: the air. I mean, you gotta
Will: specify. I just like, there’s, ever since I’ve been doing all this like comedy for like, and making videos about all these specialties, I learn about all these different specialties.
And I, I, I know the things that like, just that they hate.
Kristin: Yeah. Mm-hmm . Pet peeves or that, that
Will: they keep, they always tell patients not to do re, you know, whatever it is. And that’s one of the things in an emergency medicine
Kristin: Yeah. Stay off the ladders and like
Will: ortho, it’s like,
Kristin: oh yeah. Like
Will: the, the middle aged male homeowner.
Kristin: Yeah. Which is you now.
Will: Which is me.
Kristin: But luckily for you. You are deathly afraid of heights. I
Will: really don’t like heights. I’m not it. That’s which is it’s a See here keeps
Ryan Marino: you from doing stupid stuff protecting me if you put a trampoline under the ladder Oh, yes, you fall you could hit two things.
Kristin: Yeah Yep,
Will: but just but more bouncy so it’s better.[00:56:00]
Kristin: Yeah, I
Will: like it.
Kristin: Just be sure you don’t have any pads around the Springs
Will: Any other safety tips you want to give our audience
Ryan Marino: always have a trampoline under your ladder. Yeah, yeah, that’s the main one
Will: definitely seek medical care. If you have any flashes or floaters, well,
Kristin: I have a lot of floaters and you tell me that it’s fine.
And
Will: I say that to Ryan because he’s a bit nearsighted.
Kristin: Oh, how nearsighted can you guess?
Will: Uh, yeah, he’s, oh, he’s gotta be, yeah, You’ve got to be like a minus nine, minus eight,
Ryan Marino: uh, minus seven,
Will: seven. Okay.
Ryan Marino: Like missing a chunk of
Will: my face
Kristin: because
Will: your lenses my near sighted lenses minimize your face
Kristin: yes for the for people just listening he’s not actually missing a chunk of his face
Will: that’s right it’s an optical illusion
Kristin: from the glass of the lens
Will: yeah well you’re in the right place you could pop on that [00:57:00] ultrasound and really go to town if you ever have any flashes of light so.
Just to let you know, and that’s, you know, all right. So let’s tell people where they can find you, Ryan. Uh, you’re on blue sky primarily now.
Ryan Marino: Yeah. Um, I mean, I guess I I’m on blue sky. Uh, yeah,
Will: that’s a good one. And, uh, where, where can people find like good, accurate information about fentanyl, give people like a resource for some of the things that you do around addiction around.
Ryan Marino: Um, I mean, I think there’s a lot of good resources out there. The things that I would say people should look for are probably like harm reduction groups. Um, and I think that harm reduction is probably which is like a very contentious point. Um, but that is probably the biggest like advocacy area and push.
And the reason that our overdose deaths are finally declining. Um, that’s, that’s where I would look. Yeah.
Will: [00:58:00] Awesome.
Ryan Marino: Well, um,
Will: thank you so much for joining us. Thanks for having me talk to you. All right. We’ll see you later, man. We should get you on blue sky.
Kristin: I’m there.
Will: Oh, you are. I’m not like
Kristin: checking it super often.
That’s just the thing that I need to get going on. You used
Will: to have, you used to have to have an invite to join it.
Kristin: Yeah,
Will: I’ve been
Kristin: there a long time. Like we’ve had accounts for a long time.
Will: Yeah, it’s, it has gotten better. It was, it was pretty rough initially. It’s gotten better. The more people that I like to follow on Twitter are now on blue sky.
And, and it’s for me, it’s, it’s like you, you see the things that you actually want to see. Yeah. Versus X, which I get fed a whole bunch of stuff that I, there’s no interest in, like I, the algorithm sucks on, it’s awful on X. I think the algorithm
Kristin: has its own agenda.
Will: That has pushed me away from that website a lot, but, um.
I wonder if
Kristin: that’s intentional. [00:59:00]
Will: I don’t know. Like, are
Kristin: they trying to get rid of the people that
Will: Uh,
Kristin: not into what they’re, what they’re peddling,
Will: you know, maybe, but, um,
Kristin: anyway, blue sky, Instagram too. There’s, there’s several old med Twitter people on Instagram these days.
Will: Everybody kind of got dispersed.
Kristin: Yeah, we gotta converge.
Will: Ryan Marino’s a great follow. Really smart and he’s funny too.
Kristin: Yeah.
Will: He’s got some really good, uh, He’s witty. Comebacks and quips, uh, when dealing with all these, these misinformation peddlers. Right. These fentanyl, um, scare. Accounts.
Kristin: Yeah.
Will: So anyway, check them out. Ryan Marino on blue sky.
Um, let us know what you guys thought of the episode. Uh, if you have any suggestions for guests or any, uh, any topics you want us to talk about, uh, we obviously covered our taste in music, um, in the mid to late 2000s. I don’t know what else. If you have anything else you want us to discuss, we’re [01:00:00] happy to take suggestions.
You can hit us up in different ways, email us, knock, knock high at human content. com business on our social media platforms, or, uh, you can hang out with a human content podcast family. We’re a big family, uh, on TOK at human content pods. We love our listeners. Thank you everybody. If we’re leaving any feedback and reviews, uh, we encourage you leave some reviews on Apple, uh, on Apple podcasts or anywhere you listen to our podcast.
Uh, we’d, we’d love to read some of your reviews. Yeah, we read them.
Kristin: Yeah. We see them. We take them into consideration.
Will: Absolutely. We’re always open to some constructive criticism.
Kristin: Or just, what do you like? What do you want to see more of? Yeah, absolutely.
Will: We’re doing this for you. Full video episodes are up every week on YouTube at Glockum Fleckens.
That’s our YouTube podcast channel. We also have a Patreon. Lots of cool perks, bonus episodes, react to medical shows and movies. Hang out with other members of the Knock Knock High community. We are there. I just, uh, recently posted a, a, a preview skit [01:01:00] Patreon before I put it out to the world. That’s
Kristin: right, early skit access.
Will: It’d be good. They can also, they can tell me if it’s, uh,
Kristin: if it’s no good. You really shouldn’t put this one out there, Dr. G.
Will: Absolutely. Yeah, I believe, I trust, I trust, uh, our wonderful Patreon community. Early ad free episode acts, acts, acts, acts, acts, acts. Early access, early ad free episode, access, internet q and a livestream events, and much more.
patreon.com/glock and flecking Oregon glock flecking.com To learn more. Speaking of Patreon, community perks, shout out to all the Jonathans. Mm-hmm . Patrick La C Sharon S Edward, K Stephen G. Mary W. Store. Granddady. Caitlin. C Brianna. LKH. K. L. Sorry. Mary H. Keith, G, Jeremiah, H Parker. Mohammad, L David H, time two, Kaylee, A Gabe, Gary, M Eric, B Marlene, s Scott, m Kelsey, M.
Joseph S, Dr. Hoover, Sean M, Bubbly Salt, and
Kristin: Seanity!
Will: Seanity! Patreon roulette, random shoutouts to some of the emergency medicine tier. Jennifer [01:02:00] B, thank you for being a patron, and thank you all for listening. We’re your hosts, Will and Crystal Planet, also known as the Glockenfleckens. Special thanks to our guest, Ryan Marino, our executive producers, our Will Foner Cordy, Rob Dolan, Ashanti Brook, editor and engineer, Jason Portizzo.
Our music is by Omer Binzvi. To learn about Knock Knock High’s pro I’m not gonna rap this. I’m just gonna say it. Say it like a normal person. Programmed. Although I’m, I watched the Oscars last night and um, it’s, uh, uh, I, I feel like I need to get in my dramatic mode. Like,
Kristin: Oh, okay.
Will: Like to learn about our program, disclaimer notes.
Maybe I should start like drops of tears to make it real dramatic. Sure. Do whatever you want. Lies in terms of hyper released. You can go to Glockenflaken. com or reach out to us. And that, that guy. At humanizedcontent. com, with any questions, concerns, or fun medical puns. Why are we crying during this? Is it sad?
It’s not even sad! Knock, knock, guys! A [01:03:00] human content production.
[music]: Knock, knock. Goodbye!
Will: Hey, Kristen!
Kristin: What’s up?
Will: You know what character people like the most?
Kristin: Easily Jonathan.
Will: Yeah, a hundred percent. Everybody loves Jonathan. Everybody wants a Jonathan as part of their healthcare team. Yeah,
Kristin: who wouldn’t?
Will: I can’t give you Jonathan.
Kristin: Well, that’s too bad.
Will: I can give you Microsoft Dragon Co Pilot.
Kristin: Okay, well, that might be even better.
Will: This is your AI assistant for clinical workflow. It’s incredible. It helps to streamline documentation, which is one of the hardest parts of being a physician these days. Yeah, it’s, it allows you to automatically convert conversations. Into specialty specific notes.
Kristin: That’s pretty cool.
Will: It really is. You can customize commands and templates. And, uh, it also helps you to summarize notes and evidence. And just makes your job so much easier by [01:04:00] taking away some of that, some of that administrative burden.
Kristin: Yeah.
Will: To learn more about how Microsoft Dragon CoPilot can work for you.
Visit aka. ms slash knock, knock high again. That’s A K A. Dot ms slash knock, knock. Hi. Thanks for watching the episode. You can find more on that playlist over there. If you prefer to listen, or you just had your eyes dilated, you can binge full episodes, wherever you get your podcasts or join the party around Patrion where you get early access episodes, hang out with us, get lots of exclusive bonus content, help you subscribe, leave a comment below, let us know what you think.
