Transcript
[music]: [00:00:00] Knock, knock, hi, knock, knock, hi.
Will: Hello everybody. Welcome to knock, knock. Hi with us, the Glaucomfleckens. I am Dr. Glaucomflecken. Also known as Will Flannery.
Kristin: I’m Lady Glaucomflecken, also known as Kristen Flannery. I almost
Will: forgot how to do our introduction to the show. We’ve had a pause in recording. It’s been a few weeks.
Kristin: It has. The listeners won’t know because it has just continued on.
But we had to front load a whole bunch of episodes and then Take a long break to go on tour.
Will: Yeah. Have you been?
Kristin: Uh, I’m, I’ve been tired. Good to see you again. You too. You know, we were on tour together and also we live together. That’s true.
Will: We, uh, we’ve just, we have two more tour dates, uh, left, um, for 2024, but we’ve gotten through the majority of the tour.
[00:01:00] I, You know, knowing what it’s like now, because it’s really the first, first time either of us have ever done something like this. I don’t know how people do like legit tours. Like
Kristin: 80 cities. Right, right. Like, it’s exhausting. Yeah,
Will: like how does, how does Taylor Swift do it?
Kristin: Here’s the thing that is different.
We’re
Will: basically like Taylor Swift now.
Kristin: We are nothing like Taylor Swift, but Those people do get to go from one city to the other, to the other, to the, like, generally speaking, that’s how a tour works, right? You have a tour bus, or if you’re rich and famous, you have a private jet, or what have you, where you’re just kind of going around, versus what we have been doing, which is going around.
Fly from the West coast to the East coast, back to the West coast all in one weekend. And then do that three weekends in a row. And then at a fourth one where we fly to the central, you know what I mean? Like we’re going back and forth.
Will: Other artists, like musicians and such, they don’t have ophthalmology jobs to get back to.
Okay. Yeah, I guess that
Kristin: is what I’m saying. [00:02:00]
Will: That’s the. So per usual,
Kristin: it’s your fault.
Will: Oh, yes, of course. But it has been, it’s been awesome to see people in different cities and, and see family and friends as well. So, uh, are you sad it’s coming to an end for 2024?
Kristin: Um, no, because it’s going to continue. It’s good.
That’s right.
Will: And you’re like, Oh, we have other things we need to do with our lives too. That is
Kristin: true as well. There’s a lot going on over here. Well,
Will: we do. We are planning more shows cause there’s so much fun to do once we get there. Um, but there, we got a lot to catch up on and I, I, we have more segments for, for these Glock talk episodes.
Kristin: All right.
Will: So that we get to do something we haven’t done in a while. Just sit here and talk to each other.
Kristin: Yeah, for
Will: an extended period of time, uh, with, with nothing to do other than just talk to each other.
Kristin: Yeah. So do you ever, do you ever, uh, find it odd to come here and, and be full of energy and enthusiasm and friendliness when, you know, sometimes.
Not saying [00:03:00] today, but sometimes. Is
Will: this about to be a backhanded compliment?
Kristin: No, no. Sometimes we are, uh, you know, we’re getting through the morning rush right before this. So that tends to be a time when no one’s really at their best and it can be stressful and there can be bickering and things, and then we just have to like pretend like none of that happened.
And then just be like, Hey buddy. Oh
Will: my God. Did we just, were we bickering? I don’t know. No, no. I said not today, but
Kristin: sometimes that’s how it is. I
Will: think that we have. One, one change I’ve noticed in our, in our relationship over the years of marriage is that we are so much better at just like, recognizing that some of the bickering that we’ve, when we have like a, a A set, a period of time where we’re bickering about something, we both recognize this is like not something we need to like keep going.
It’s
Kristin: like not going to be productive. Right.
Will: And then like, we are much faster at putting that behind us and just moving on.
Kristin: [00:04:00] Yeah. We’re, we’re faster at just not continuing the conversation about it. I don’t know about, you know, it’s sometimes you still feel annoyed.
Will: Sure, okay, so
Kristin: like you carry those feel like I’m looking at you and I’m like, oh, it’s so freaking annoyed with you right now But hi, how you doing?
No,
Will: this is this is news to me. Okay,
Kristin: you don’t feel that way sometimes
Will: No, because I love you But
Kristin: anyone who works together and lives together
Will: unconditionally at all times
Kristin: No, you don’t,
Will: you never annoy me.
Kristin: That’s not true. I know that for a fact.
Will: Um, uh, I guess what she’s saying audience is we’re so good at faking it.
And we really do like each other most of the time.
Kristin: Yeah. It’s just a, it’s a little quirk of when you work with your spouse, right? That there, you, you don’t separate. Life very much, right? It’s all intermixed. And so that is one of the things that people find challenging, I think, about the thought of working with their spouse.
Will: Yeah.
Kristin: So
Will: now that we’ve set [00:05:00] the stage for how wonderful our relationship is, uh, this is a good period, a good time to do some marriage advice. Okay,
Kristin: this is Mary. Should we, we just said that we got better at bickering . Right. Got better at like, letting it go.
Will: We’re at bickering. We’re better at letting it go.
Yeah. And just bearing it deep down inside of us, uh, . So, and then a while back, we asked for, um, for people to, because we’re, we’re so good in marriage, , uh, to give us, uh, you know, if they have questions or they want some advice on how to, because I, well, I, I do, in all seriousness. I think it’s, it’s, it’s a bit unusual and, uh, great that we are able to work together and still be happy
Kristin: with our lives, right?
I
Will: mean, at the very, at least that’s, that’s something I think is, is remarkable.
Kristin: Yeah. It’s not common.
Will: So anyway, uh, we did get a few people reach out. And so I have one here from Ryan. This is [00:06:00] Ryan. He says, um, I am an MS3, a third year med student married, getting married in August, 2025. Congratulations. And currently in the wedding planning process, my partner is a psychiatric pharmacist and is absolutely brilliant, very outgoing, and has supported me every step of the way throughout medical school process so far.
Does that sound familiar? Despite a very demanding job herself, we love to travel and plan fun date nights together. I’m planning on matching into pediatrics and was wondering if you had any advice on marriage during residency as an attending and med school altogether or in medicine altogether. I want to make sure I’m the best husband for my partner while also devoting all My all to being the best pediatrician I can, I’m just a little nervous that especially while in residency, I’ll be pushing 80 to a hundred hour work weeks and won’t have the bandwidth to be there for as much as I’d like to.
So when I said like marriage advice, uh, in my head, I was thinking like, how do you like, you know, be [00:07:00] like cleaner? And like, put your clothes away in time. What if one of you squeezes
Kristin: the toothpaste tube from the middle and one of you from the end?
Will: Yeah, exactly. But this is like legit, like life stuff, and it’s a great question.
Kristin: Yeah. I mean, I have things to say about this, but I want to hear what you have to say about this. Oh man,
Will: okay, I gotta go first. Um, well first of all, the wedding planning process is very stressful. Um, I, I kind of remember, I, I blacked a lot of that out, I think, because, uh, Um, there was, there was conflict.
There was, it was challenging. Um, and
Kristin: conflict.
Will: Yeah. I just remember there being lots of stress, not between us. Like, just, there’s lots of
Kristin: logistics and it being very stressful. Are you remembering interpersonal conflict?
Will: Um,
Kristin: no, not
Will: really. Just, just, it’s such a stressful thing to have to go through. Uh, so, good luck with that.
Uh, but in terms of your question about, um, you know, how [00:08:00] to, you know, advice on marriage during this whole process. Um, it would help if you went into ophthalmology, that’s not, that would be good. No, I’m just kidding. We, we did, not everyone should be in ophthalmology. We need some pediatricians, there
[music]: is
Will: pediatric ophthalmology, or for now, you got to go through the ophthalmology side of things.
Um, but I would say, uh, take time every day to listen to each other. Uh, because sometimes you’re only going to have like on the order of minutes, Uh, amidst your busy lives. And that was one of the mistakes that I feel like I made a lot throughout residency and just medical training is just focusing so much on the medicine and the training that we just kind of ignored each other and I ignored you and that’s not good.
And so it, you, there, there will be stretches of time in [00:09:00] residency when you really, you are so busy. You’re right. You’re working a hundred hour work weeks, but, uh, if you can find, even if it’s like 10 minutes, like 10 minutes, literally 10 minutes, either on the phone or in person, uh, to like not look at a phone or at your study materials and at looking at each other.
I think that really does help get through those really busy. Difficult time periods.
Kristin: I got a lot to say.
Will: Go for it.
Kristin: Uh, okay. These are in no particular order. It’s just a bunch of stuff that when I read this, this is what pops into my mind. Um, one is, I think a lot of this has to do with a mindset. Rather than actions, right? And because if you have this mindset, it will be reflected in all of your actions. And the [00:10:00] mindset is that, you know, your job is not more important than her job.
Both are equally important. Both are important, but like, it’s not a competition. Like one doesn’t get to win over the other. And there’s going to be times in medical training where a lot of time and effort has to get put into medical training, but that. The mindset of, well, what, how can I support her career as well?
Because it’s just as important as mine, you know, that should be there too. And there may be some compromise for a few years, but then like, you know, maybe at the end of residency, if she had to sacrifice a lot during residency, maybe then it’s your turn to sacrifice after residency or something like that.
Will: It’s not about who wins. In fact, Oftentimes, you both will lose.
Kristin: That’s right. In a medical marriage, that is true. Um, no, but, okay. So that’s one thing. Uh, another thing, it’s not, this is, this is [00:11:00] related to mindset, right? It’s, it’s very easy. This is what will just naturally happen by default if you don’t counteract it, is that you fall into these, You know, patterns and ways of thinking that’s kind of like me and my stuff versus you and your stuff.
And, you know, who gets to, who gets to quote unquote win today, right? Whose stuff gets to happen or whatever. And so that is only going to lead to conflict and resentment. So it helps to shift your mindset to. It’s not me and mine and you and yours versus each other. It’s me and you versus our situation, right?
That you are on a team together. You’re not, cause it’s really easy to feel like you’re having to, um, you know, pit yourself against each other so that both of you can get your needs met, but, um, you know, just understand there’s going to be a lot of [00:12:00] stuff that doesn’t get met, but that it’s temporary. It’s just for this, like.
Period of time while you’re in training, cause it’s very intense. And then after that, you know, it’s, it’s a whole different world. So this is not forever. That’s another good thing to keep in mind.
Will: Unless you start a social media business, then it is forever.
Kristin: I was promised all sorts of free time after residency and look what happened.
Um, I had one more thing to say about it. Oh, I remembered. Okay. Here’s the other thing I wanted to say. Let’s
Will: do it.
Kristin: You won’t be able to be there all the time, right? 80 to 100 hour work week, like, you just won’t. But that means that she is picking up all of your slack. And that’s exhausting.
Will: That’s a lot of slack.
Kristin: And it is a lot of slack. And especially if, you know, you end up deciding to have children at some point along those lines, even more, right? So. If you can’t be there to help pick up the slack, at least [00:13:00] think about how can the slack be picked up, right? What can we outsource, for one thing, you know? Uh, best money we ever spent was housekeeper during residency because then we don’t have to worry about making sure the house gets clean on top of everything else.
Yeah, that was,
Will: that was key.
Kristin: Yeah, and it might feel like a splurge because you’re not making a lot as a resident, but it’s like, well, what are you getting for that money? It’s not just about spending the money. It’s about getting the time back and time is also valuable.
Will: One thing off your mind.
Kristin: And one thing off your mind and one thing less to fight about who’s going to do it.
Right. So if you can’t be there to do it, do everything you can to put someone else there who’s able to do it, either hiring someone or arranging, you know, for who’s in your network, who’s in your village, right? Arranging for somebody to, to help your wife when you can’t be there. And, and, and. Always be thinking about that, right?
Like, that doesn’t have to take a lot of your time. But if you go to the effort of saying, [00:14:00] I see what you’re doing, I see all the hard work you’re doing at home and at work, and I see that you’re tired and you’re doing this for me, or at least because of me, then, you know, I am going to think about how I can make your life easier.
And just a little bit of that will go a long way.
Will: I knew you’d have such a much better answer than me about this, so. That’s good.
Kristin: What does that say? I don’t know. I’m, I, I mean, that’s a complimenting me. So thank you. But also like you to have some good answers. Sometimes
Will: did I, I didn’t have a good answer.
That was a good answer. All right. I just, you just, you just have more brain thoughts. I do have more
[music]: brain thoughts, maybe that’s something you can work on,
Will: having more brain thoughts. I think at this point, my brain is fully formed and developed and I don’t think. And
Kristin: deteriorating. Yeah,
Will: if anything, I’m just going to get fewer brain thoughts over time.
Alright, let’s take a break. We’ll be right back.
Today’s episode is brought to you by Dax Co Pilot from Microsoft. To learn about [00:15:00] how Dax Co Pilot can help you reduce burnout and restore the joy of practicing medicine, visit aka. ms slash knock, knock high. That’s aka. ms slash knock, knock high.
All right. I’ve got some fun things to go over with you. Okay. Um, some new segments, some new things, but first. Let’s go to healthcare news.
[music]: Okay.
Will: All right. So I want, I’m going to read you the title of an article that’s been making the rounds.
[music]: Okay. It’s
Will: a wall street journal article. Um, and I just want to, I’m not going to tell you what the reaction in the medical community is.
I want you to guess what the reaction has been. Okay. All right. Here it is. Wall Street Journal. Young doctors want work life balance. Older doctors say that’s not the job.
Kristin: I’ve seen this.
Will: Oh, you did? You saw this?
Kristin: Well, a little bit. Physicians.
Will: There’s the subtitle. Physicians for generations [00:16:00] accepted being at the mercy of their pagers.
Now many are questioning medicine’s workaholic culture.
Kristin: Uh, I can guess what the response in the medical community has been, which is just what that headline said straight down the middle, you know, pretty much by age or, you know, year years in training, which when you did your training. Uh,
Will: I would say I’ve not seen anybody like support the idea that, no, that’s not true.
I’ve seen a few responses of people who support the, the idea that it needs to be like doctors need to, it needs to be like, all you’re thinking about is medicine and that’s your whole life is medicine. You know who I’ve heard that from? You would think it would be the older docs.
Kristin: No,
Will: no. It’s from people who are not in healthcare
Kristin: or patients
Will: who are saying things like, Oh, I, if I’m going to have surgery, I want my surgeon to, that’s all he ever wants to do in life [00:17:00] is just be a surgeon.
Kristin: What’s your take on that? Well, I see the thought process. It’s a scary thing. You want to make sure that it’s somebody who’s really good at what they do. Um, however, I would counter with, no, you don’t, no, you don’t want that, not really, because then that person is going to be exhausted, they’re going to be unhappy because they have no social life, and that is something that homo sapiens need, uh, they’re, they’re neglecting all of their needs, essentially, which is not sustainable, might sound good in the short term, but it is not sustainable over the course of a career.
Will: It also equates obsession. With competence.
Kristin: Correct. That’s true. Which is good brain thought.
Will: You like that one? Nice
Kristin: job.
Will: And, and I think that’s a fallacy. That’s not something that is, I don’t know the data behind that, but it doesn’t seem like that’s correct.
Kristin: No, it does not. And it’s, uh, [00:18:00] sometimes problematic in fact.
Will: So, uh, you know, and it really also discounts the, but if you read the article and I encourage people to go and look this up. There are some quotes from docs who are in their sixties, seventies, even one quote from a doctor who’s part time in his eighties. And to that person, I say, retire. Like it’s enjoy the rest of your life.
Like if you’re 80, like that’s just, that’s me. Maybe this person just loves being a physician so much, but
Kristin: it’s just, things change. Things change.
Will: But some of the quotes are like very much, I had to do this. And, and, and when I, when I, when I was a young physician, when I was coming up in training, like we really cared for, for patients, like the implication being like, because we want work life balance, because we want to be able to take, take sick leave and, uh, work four days a [00:19:00] week that we are not really, our soul is not in this.
Kristin: I don’t think that’s what’s, what’s. Making patient care deteriorate? No, I don’t think that’s it at all. It’s,
Will: it’s the systemic factors, right? Yes, exactly. It’s the, the consolidation of healthcare under predatory corporations and the corporation of healthcare insurance policies
Kristin: that are ridiculous.
Will: And I would argue that, that the newer, newer physicians.
The, this generation coming up, they are getting into medicine for all the same reasons that the previous generations have gotten into medicine. They’re not in it for the money or the, the, the, to become an influencer. Like that’s not the motivation. It still is not the motivation because
Kristin: there are much, much, much easier ways to do both of those things.
Correct. , if you want that. It really
Will: is. It’s, it’s the external factors. That, I mean, the majority of physicians now are employed [00:20:00] by Optum, United Healthcare. And so, like, yeah, it’s easy to label something as a calling. Like medicine, that’s, that’s the whole dynamic here is calling versus a job. But then
Kristin: that allows you to abuse the people that are doing it.
Correct.
Will: It’s easy to label something as a calling when you have control over your own destiny.
[music]: Yeah.
Will: But when it’s just literally a job that you’re working for a corporation, it’s hard to see that as like, like, I want to be this.
Kristin: You
Will: know,
Kristin: because then you’re not working for the patient anymore. You’re working for the company.
Right.
Will: And that’s, that’s the big, that is the one, the biggest difference, I think.
Kristin: Yeah.
Will: From docs who are 60 and, and grew up in the system where you can just throw a shingle out, start a practice.
[music]: Yeah. Right.
Will: And you are literally, you are working for the patient and you’re making an unbelievable living. Um, doctors are, they’re still making a good living now, but it’s under vastly worse circumstances.
Yeah. The, the work
Kristin: environment is not nearly as. [00:21:00] So
Will: anyway, the, but the, this, this article, it’s, it’s, it’s a little bit clickbaity. It’s like, I saw it and I knew immediately, oh, this is going to, and I commented on it on Twitter. And so we just like need this like pitting intergenerational, you know, physicians against each other.
Like that needs to go away. Do
Kristin: you feel like that actually exists? Like, Yeah. In the workforce, or do you feel like this is a narrative that the media has mostly created?
Will: I think it exists, but to a lesser degree than people think. I don’t think
Kristin: The media makes it seem bigger than it is.
Will: Yeah, yeah, I think so.
I think so. Um, and it’s just, it’s just getting less and less of a thing. Over time, now that we have like so many physicians have worked their entire careers now in this system where private equity is coming up and, and, you know, health insurance companies are becoming more powerful. So we’re, we’re losing more of [00:22:00] the physicians who worked.
Back in the day, we’re losing more of the back in the day physicians cause they’re retiring or they’re just, just getting out of medicine. So anyway, um, so that was a interesting thing that came up. All right. That’s our healthcare news. Uh, what else? Oh, let’s do this. You have a good one. You, you came to me a while back with a, why is it like this?
[music]: Yes.
Will: So why is it like this? A segment where Kristen, um, chooses a thing in healthcare that is a bit perplexing to her.
Kristin: As someone not in healthcare. As someone
Will: who’s not in healthcare and asked me, someone who is in healthcare, why is it like this? So tell me. What do you have for us?
Kristin: Okay, how come when I go, this often happens, I mostly go to the pediatrician because I have two children, there’s only one of me, there’s two of them, and they require various appointments, right?
So, most of my interactions with the healthcare [00:23:00] system are at the pediatrician’s office, but this is not specific to pediatricians because I’ve also had it in other places of adult medicine. Uh, why is it? And when I go there, I do all the online check in ahead of time to save time and, you know, answer all those questions.
Yeah. I like to do that ahead of time. And then, uh, you get there, you check in and then they hand you more forms. So first of all, you know, it’s like, okay, well you could have, I could have done this one ahead of time too, but okay, here we are. Take the form. Answer all the questions and you know, depending on what you’re there for, it’s, it’s asking you basically like for all the history of, of how have we gotten here, right?
Like family history, but also like, what have you been noticing in your child? What
Will: is this a new patient form? No, no. You do this every time.
Kristin: I wouldn’t say every time, but often.
Will: Okay.
Kristin: Um, I think like, it’s definitely like every annual appointment to [00:24:00] do this and any, any time. And yes, anytime you are establishing new patient or like you’re establishing yourself in a different part of the clinic.
Right. Um, but. Yeah, answer all these questions. It’s like a front and a back and all this stuff. This, and then there’s like the depression questionnaires and like things, and they’re good questions. I’m not, I have no problem with the questions they are. I see why they’re asking. I think they’re useful.
That’s great that they’re getting this information. My issue is, and my question, why don’t they ever look at it? Why do you make me do all these things? And then they don’t look at it sometimes. Well, cause sometimes it just gets left in the room and I don’t know, maybe somebody’s coming in afterward and doing something with it.
But like,
Will: are you carrying the forms? Don’t you give them to the front desk? No, they
Kristin: always say, give it to
Will: the person who brings you back. Okay.
Kristin: And so, you know, Often they don’t ask for it.
Will: Okay.
Kristin: Sometimes I will be like, um, did you want this? They [00:25:00] told me to give this to you. And then they’ll be like, oh yeah.
And they’ll take it. And then sometimes if we both forget, it just sits in the room. Um, and then this is my favorite. Sometimes this happens, this happened to me recently when I took our child in for an appointment. They gave me the form, filled it all out. Then I get in the room and they ask me all the same questions verbally.
And then I have to give all those answers. Again, but verbally this time, why did I write them all down if I’m just going to say them verbally and she was typing them in to the, to the notes as I’m
Will: talking. So what you’re describing is the, is taking an HPI. So it’s a history of present illness. And what’s happening is you are.
You’re basically doing, filling out the HPI yourself with like, how did we get here? What’s the history? What’s going on? And then, um, and then the person who’s bringing you back is, is also is [00:26:00] just redoing the HPI themselves. Why
Kristin: are we both doing this?
Will: That’s a good question. It seems
Kristin: like a more efficient thing to do would be to read over what I have written and then see what remaining questions you have.
Will: I think a fun research. Idea would be like to, to have patients like parents or whoever it is, right. Like something that’s like a buzzword in healthcare on the, on the history of present illness,
Kristin: like
Will: my, my child’s, uh, urine smells like maple syrup, which is like, Hey,
Kristin: but if that’s not true, I feel like this
Will: is not going to
Kristin: pass IRB.
Well,
Will: probably not, but like, you get my point, like. Put something in there that’s on the form and just see what happens. And, and, uh, you’re
Kristin: right.
Will: That would never pass IRB, but I, I don’t, I, I understand the [00:27:00] frustration from patients about like repeating HPIs, especially in that. In that type of situation now,
Kristin: we can literally have it right here, right?
Will: So what, what, what, what I think should happen is just, they just bring you back and you, you do the HPI there. Now asking about the medical history, see what we do in our eye clinic is all patients do fill out like a, a medical history form and that I don’t always look at, um, And that’s
Kristin: don’t make them fill it
Will: out.
And so here’s, I think part of the problem, I think a lot of this is regulatory burden that is on the medical practice to have a checklist that they have to like. Say we, we did this, we did this, we did this in order to be reimbursed for the
Kristin: visit. So here’s what I’m, what I’m hearing from you. It’s just something they have to do.
It’s not something they actually care about. And so what I can do is go in and just scribble [00:28:00] on it. They’ll hand it to me. I’ll just make a bunch of doodles. And then I’ll give it back.
Will: I mean, do it. Well, see, it’s not totally that way though, because, um, part of like our health history form, it’s like got medications and allergies and those we do like the technician does look at those and put them into the chart.
So there’s some parts of it. Not
Kristin: if they’re not taking the paper, they don’t.
Will: Well, you leave it in the room and often they’ll. Come and clean the room and they’ll, they’ll get there. Why
Kristin: are they looking at that after the appointment?
Will: So the, the one thing I don’t understand the health history stuff, like. I mean, that’s, that’s something that just you want in the record.
Um, but it’s like, but it’s
Kristin: relevant to why you’re there. Well,
Will: it, well, not all the things are irrelevant to why you’re there that, that day. Uh, it’s, it’s some just like, then why are having family history on the form so they can,
Kristin: why are you making me fill out irrelevant information that’s not
Will: irrelevant?
Because what if. What if you or your kid comes in with some, uh, some health issue and it’s like an [00:29:00] urgent thing, and then we already have some of that information. So the question you should be asking is like, why would you have to do it a second time?
Kristin: That is a question I have. I have filled out the family history.
It’s already in the chart. Why are you making me do it again?
Will: The health. The, the, the questions about why you’re here, that is something I don’t really get. Like for us in the eye clinic, like we would not, we don’t ask those types of questions in any form. What we do is when the patient calls to make an appointment, we ask them for like, you know, what’s the purpose of your visit.
Kristin: And so
Will: we, I have that information that’s actually helpful for me. So we know like what. Where to put them in the schedule, how long that appointment I can expect it to be. If it’s a double vision appointment versus a dry eye versus a dilated exam, like that all helps me, but I don’t, I totally don’t understand like having you write down the reason and talk about the symptoms and all the things, and then asking you right as you get into the room without looking at the paper.
I agree. That doesn’t make any sense.
Kristin: Yeah. [00:30:00] Oh, it’s so frustrating. It’s like, if it happened once or twice, it’s like, oh, okay, well, this is whatever, but it happens a lot.
Will: So, and I, I do think that some of this is, is just contributes to what we call like this note bloat. Where you have to have, you have to check off certain things.
Kristin: So I’m doing everyone a favor. If I just scribble, that’s what I’m taking away from this conversation.
Will: No, I don’t think you are, but I do think it would be interesting to see what the reaction would be if you just scribbled on the things that you don’t think is important and then see if anybody, If it changes anything, I would love to see like something done about like an outpatient world about this.
Kristin: Yeah. You know what this reminds me of? When I was a teenager, I’m going to date myself, but when I was a teenager, you know, and my mom was teaching me like how to write checks. Uh, she would sometimes have me write checks at, uh, right at the grocery store. Right. We would be at the grocery store and she’d let me [00:31:00] write the check or whatever.
And, and then I would get to the signature. This is, this is not parenting advice. Okay. I have to say, uh, but we’d get to the signature part and I’d be like, mom, you have to sign is asking for your signature. It’s your account. You know, you have to sign. And she’d be like, nah, you can put anything there. They don’t check.
She’s like, you can write Mickey Mouse in there. Watch this. She wrote Mickey Mouse. Nothing happened. I
Will: love those like
Kristin: that. Our parents,
Will: your, your mom, you know, got you to write the checks for my mom. Let me put the gasoline in the car, you know, our parents to just.
Kristin: The thing is I was a teenager at the time.
Oh, that’s right. About, you know, just a couple of years from being on my own. I was
Will: like eight.
Kristin: Yes.
Will: Uh, do we have to write checks anymore? Can you think of I
Kristin: sometimes have to write checks. Yeah. There, you know, with credit card processing fees these days, people are, I mean, they’re preferring it, especially like, like contractors and things that like come to your house and provide a service and plumbers and things like that.
Like they kind of prefer checks. Cause
Will: those can be costly things. And [00:32:00] if there’s like a one and a half percent fee on top of that.
Kristin: Yeah. And some people like,
Will: but we don’t get the points then.
Kristin: I know. Well, it’s not even about the points. It’s just, it’s much easier for me to hand them over a card, but yeah, a lot of small businesses, especially are not,
Will: is there a lot more like check fraud and stuff, you know,
Kristin: it feels like everything just swings back and forth, you know, like,
Will: you know, it’s not, you know, one thing’s never going to go away.
What the fax machine,
Kristin: that thing is the cockroach. You ever
Will: fax to check the
Kristin: technology industry? Probably, you know what, this is how old I am. When I was growing up, we’ve talked about this before, right? I worked at my parents, they had a dairy supply store and I, I worked there from a very young age and sometimes I’d be there after school, sweeping floors, dusting, stuff like that.
I’d be there after school and my friends and I would fax notes to each other in our separate locations. And we would just write little notes, draw pictures, whatever, and [00:33:00] then just fax them back and forth to each other. Yeah.
Will: That’s cool how, like, 30 years later, that’s still a thing you could do.
Kristin: I know.
Will: It’s kind of depressing.
Kristin: Basically, it was like texting before cell phones. Yeah, interesting. There you go.
Will: All right, we are, anything else you want to date yourself with at this point? No, I think I’ve done enough damage. Have you been faxing? Check writing? Checks. What else? Did you learn, you learned how to, uh, uh, uh, to use a stick shift?
Kristin: Oh yeah, of course.
Will: So did I.
Kristin: Yeah. I loved my little stick shift car. I miss having a stick shift.
Will: Should we get you that next time?
Kristin: I mean, it needs to be just a, for funsies kind of a thing. Oh yeah. I don’t, I don’t miss, you know, when you’re just like stuck in traffic. There is one of these
Will: days. I’m going to object to it, but you’re going to get yourself a motorcycle.
I can do it. I can feel it.
Kristin: I would love to do that. Cause I regret that I have not done that. I do.
Will: What, uh, listeners, what would be a [00:34:00] beginning motorcycle for? For
Kristin: a petite,
[music]: middle aged woman.
Kristin: All
Will: right. Let’s take one more break.
Hey, Kristen. What? You know what mites do when they get excited? They dance, they dance, they dance all over your face. You got these on your eyelids, you know that, right? I do not. Well, some people do. Okay. They’re demodex mites.
Kristin: Yes.
Will: They cause blepharitis, which is like red, itchy, irritated eyelids, like flakiness, you want to scratch your eyes, don’t do that by the way.
But yeah, sometimes that’s from a disease. Demodex
Kristin: dance.
Will: It’s the Demodex dance on the eyelids, except it’s not that fun because it gives you all those symptoms. Alright, so, yeah, but they’re cute, right? They’re not, they’re not gross.
Kristin: These ones are. These, these stuffy
Will: virgins. Yeah, right. Oh, the real ones, not so much.
Are
Kristin: the real ones gross in the microscope?
Will: Um, they’re, they’re still, I think they’re still cute, but again, I’m an [00:35:00] ophthalmologist.
Kristin: Yeah.
Will: But don’t get freaked out by this. Okay. Get checked out. Alright, you can find out more, go to eyelidcheck. com, again, that’s E Y E L I D CHECK. COM to get more information about Demodex and Demodex Blepharitis.
Alright, we are back, uh, let’s say our, our, um, our producer has recommended a Vespa.
Kristin: Yeah.
Will: That’s not like a, that’s like a scooter.
Kristin: Yeah. I would take a dirt bike. Doesn’t have to be like
Will: a dirt bike shirt,
Kristin: like a, like a motorized.
Will: Yeah. You’re like trying to injure yourself now.
Kristin: Just, I like to go fast.
Will: The, the crotch rocket.
Kristin: I like, I had the, my little sports car that was a stick shift. Oh, I love that thing.
Will: All right. It was a piece
Kristin: of garbage, but I love it.
Will: I think maybe we can. Instead of like having you go on like the road with other people, maybe we can like find a place, like a
[music]: racetrack.
Will: Yeah. Like I’m sure that [00:36:00] exists where you can just go and like, get your fix.
You can like, I think if you just rode a motorcycle for like an hour, you’d probably be good for like, you know, another five years, get your fill on motorcycle riding, or do you think it would, you don’t
Kristin: know what it’s like to have the need for speed.
Will: So we’re always, we’re always arguing about this cause our, uh, cause yeah, we
Kristin: have a child that has the need for speed.
Will: We have a child that you have the need for speed. And so we’re, we’re sometimes we talk about, you know, road safety and how to, and they, they are sometimes backseat drive us a little bit and tell us to go faster or drive better. And I always have to remind them, listen. It’s your mom that you need to tell this stuff to, because she is a speed demon.
Okay, but
Kristin: you’ve given them a false impression, like, they think that I continue to get Many speed tickets and am on the verge of losing my [00:37:00] license on any given day. No, that was a short period of time where I did get multiple speeding tickets close together, and if I had gotten one more, I would have been in danger of having my license suspended, but I did not.
The point is I have control over this. I, I. I toned it down, but I like to go fast.
Will: Yeah, you do. Okay. Well, um, let’s, you know, maybe start you off on like a motorized scooter or something and see how you do.
Kristin: One of those wheelchairs at the grocery store.
Will: Start with a scooter at the grocery store and move on to a motorized scooter.
Um, all right, let’s do something fun here.
Kristin: Okay.
Will: As opposed to what we’ve been doing,
Kristin: let’s change it up a little bit,
Will: something a little bit different. Uh, this last thing, uh, before we go, um, you know, I always joke, a joke I make during our live show is about how like [00:38:00] ophthalmologists are like below the nasal bridge.
We’re kind of dumb. Um, and I did have one person come up to me after the show. I forgot what show it was. And, and said in a very serious, um, look on their face, she says, you are not dumb. Trust me as if like, she was, I was convincing enough that like, like she actually believed that I believed I was not smart as an ophthalmologist.
And so let’s try to prove to people
[music]: that I
Will: am actually quite smart.
[music]: Okay.
Will: I want you to give me an MCAT question.
[music]: Okay.
Will: Now. For context. I am getting up there in years. It’s been a while. I am 39 years old and I took the MCAT just to, just to drive it home. I was the last group that took the paper and pencil MCAT.
[00:39:00] Scantron, everything, big auditorium, a hundred people in it. Pencil and paper, all those things. I
Kristin: kind of miss filling out those bubbles.
Will: Oh God, you would. But I bet you filled out the bubbles so perfectly too. You were never outside the lines.
Kristin: Yeah. And you have to read the instructions for if you change your answer, you got to do it just right.
Will: I was the last paper and pencil exam, which would have been 2007 ish. So anyway, so I, I think, so we’re going to see how this, I do remember the MCAT being the hardest test that, uh, I ever took. Uh, I felt worse after the MCAT than I have with any other tests in my medical journey.
Kristin: Yes. I thought
Will: you would never come out of your room.
I was despondent afterwards. You
Kristin: really weren’t. That is not an exaggeration.
Will: I was convinced Laying alone [00:40:00] in the
Kristin: dark.
Will: And I, when I, my score came back, I got a 31. Which is on like a 45 scale, which is, it’s, it’s a good score. It’s like, I w it opened a lot of doors for me. It allowed me the opportunity to go to Dartmouth.
I’m sure, because I’m sure there was a cutoff that you can go below. So anyway, um, so let’s see, let’s see what I still know.
Kristin: And have you learned your lesson about that? I feel like you’re still, you’re still working on learning that lesson. You’ve gotten slightly better, but it’s still a pattern for you.
About what? That you feel like you’ve done horribly on something when in fact you’ve done very good and you spend all this time beating yourself up about how horribly you did. Well, I don’t know, there’s not as,
Will: there’s not as And then it turns
Kristin: out
Will: it’s fine. Well, there’s not as many things that Are like that in my life that I could feel that way about.
Kristin: Mm. Yeah. You don’t have to take tests anymore. Yeah, I
Will: don’t have any tests anymore. Uh, ooh, that’s a good question. I have to think about like, what, what in my life,
you know, could be on that scale. So, I don’t know. Yeah. [00:41:00] I, alright, what do you got?
Kristin: Alright, here’s, gimme a question. Okay, here’s a question. Ugh. I don’t know if I’m gonna pronounce all these correctly, but here it goes. Acetylation, is that right? Acetylation?
Will: God, I already hate this question. Acetylation of
Kristin: lysine residues in histones increases gene expression because, acetylation of lysine residues in histones increases gene expression because, A, DNA is tightly bound to negatively charged amino acids on histones, this might backfire on you, you’re trying to prove you’re smart.
The carboxyloxygen atoms in acetyl groups form hydrogen bonds with nitrogenous bases. That
Will: doesn’t sound right.
Kristin: See, the salt bridges between charged amino acids and phosphate groups are disrupted. Or D, lysine residues in histones associate with positively charged phosphate groups in DNA.
Will: What was the question again?
No, no. Read the question one more time. [00:42:00]
Kristin: Acetylation of lysine residues in histones increases gene expression because.
Will: Increases. Okay. DNA
Kristin: is tightly bound to negatively charged amino acids on histones.
Will: Okay.
Kristin: The carboxyloxygen atoms. No,
Will: no, no. I think I’ve narrowed it down to A or D.
Kristin: Okay. So A is what I just said.
DNA is tightly bound to negatively charged amino acids on histones. D, lysine residues in histones associate with positively charged phosphate groups in DNA. Okay. I’m going to push D. Submit. False. It’s C. The salt bridges between charged amino acids and phosphate groups are disrupted.
Will: I cannot believe that is a question to see if you’re ready for med school cup.
What are they, what are they doing?
Kristin: You gotta know biochem.
Will: Not like that. You don’t
Kristin: know.
Will: You guys just know what, like, what is DNA? I think is, is enough. All right. [00:43:00] Okay.
Kristin: Well, I’ll give you an easy one. Nope.
Will: Nope. We’ll save it for next. I, I, my brain, I’m already tired.
Kristin: Oh, this is an easy one. You told me three, so I’m doing three.
One more. One more. Okay. No, two more. Which pairs of substances? Are released from exocrine glands, A, glucagon and tears, B, bile and insulin, C, insulin and digestive enzymes, or D, tears and bile. Exocrine glands.
Will: Okay. Tears are definitely one of them. Um. Okay. What was the other one with tears?
Kristin: Glucagon and tears, or tears and bile.
Will: Bile. So
Kristin: that’s a terrible band name.
Will: Bile, uh, comes, okay. That’s like from the, like the gallbladder. What kind of a gland is that though? Like, I, Okay. I’m going to go with bile.
Kristin: Okay. Tears and bile.
Will: Jeez. I don’t know. Yes. Okay.
Kristin: You’re right. [00:44:00] Hooray. Oh my God.
Will: Oh, I feel so good. I I’m going to go take the MCAT again.
I think I could, I, I don’t, Oh yes.
Kristin: I wouldn’t get carried away. I was going to also give you an organic chemistry one, but I feel like you need to study first.
Will: Yeah. Let’s end on a, on a high note there. Um, all right.
Kristin: So one win, one loss,
Will: we’ll do,
Kristin: it’s a wash.
Will: I like that though. I want to do more.
Kristin: Okay. We’ll
Will: do more later.
Like now who’s the
Kristin: nerd
Will: like you like
Kristin: to take tests for fun, like
Will: for bedtime. I want you to just, as I drift off to sleep, pillow talk,
Kristin: you want some MCAT questions?
Will: Um, all right. Uh, well, what do we do now? That’s our, that’s our show. That’s it. That’s, uh, that’s the end of Glock talk. We’ll talk to each other again in a couple of weeks.
Kristin: Yeah. See you then.
Will: Let us know what you guys think. If you have any suggestions, any, uh, things you want us to discuss about Healthcare about marriage, about whatever it is. You can also, you can, uh, email us knock, knock [00:45:00] high at human dash content. com tell we haven’t like done this in a while. A little
Kristin: rusty.
We’re shaking off the cobwebs.
Will: You just like, you get in such a groove and then you don’t record for a while. And then it’s like, you got to like figure out how to do it again.
Kristin: Well, and your mind’s still on these questions. I can tell. That’s
Will: right. That’s right. Um, you can also visit us on our social media, um, uh, apps.
Kristin: Are you okay? Are you having a stroke?
Will: Social media accounts. Hang out with us and our human content podcast family on all the apps. Uh, and a TikTok at human content,
Kristin: um,
Will: and thank you all, uh, for, for listening. Thank you for the feedback and reviews. We love those reviews. If you subscribe and comment on your favorite podcasting app or on YouTube, by the way, YouTube channel at Glaucomfleckens, steadily growing,
[music]: people are
Will: finding it.
Uh, we can give you a shout out like today. Zonular Apparatus, love that name, on Apple said, um, you questioned whether we would like to hear your bizarre opto terms. I was listening today. Uh, [00:46:00] ER and, uh, nurse practitioner here, uh, you said the word zonular apparatus to which I loudly proclaim now that is just completely made up.
I asked my husband who thinks he maybe learned about this in his opto rotation and it promptly forgot because I knew I would never need that info again. I love hearing these weird terms you use in eyeball world. Your podcast is great for down and dirty eye learning for wee plebeians trying. Uh, to not make people go blind.
Zonular apparatus is a real thing.
Kristin: It is a ridiculous word. You could have been Dr. Zonular Apparatus. That’s
Will: two words, by the way, Zonular Apparatus. It’s what holds the lens in place inside the eye. It’s very important and also a very scary structure if it’s not healthy. Because it makes cataract surgery much more challenging.
Thank you for that. Uh, I’ll keep up the, the, maybe that’s another segment we could do together. Could give you an ophthalmology term and you have to try to guess what it is. Full video episodes are up [00:47:00] every week on our YouTube channel at Glaucomfleckens. Tons of cool perks over on Patreon. You guys should check it out.
Bonus episodes where we react to medical shows and movies. Hang out with other members of our wonderful little community. Early ad free episode access and our Q& A live stream events. It’s much more patreon. com slash Glaucomflecken or go to glaucomflecken. com also like early access to like live show tickets, upgrades,
Kristin: upgrades, things like that,
Will: um, speaking of Patreon community perks, new member shout out Tierney K, Janet L, Wildwood Canine Fun Center.
That sounds like a fun place. Catherine N, always a fan, Gail, that’s the name. Always a fan. I like that. Gail M, Nikki T, Kelsey M. Thank you all for joining. Have Uh, shout out to the Jonathans as usual, a virtual head nod to you all. Patrick LaCiece, Sharon S, Edward K, Steven G, Marion W, Mr. Grandetti, Caitlin C, Brianna L, Mary H, KL, Keith G, Jeremiah H, [00:48:00] Parker, Muhammad L, David H times two, Kaylee A, Gabe, Gary M, Eric B, Marlene S, Scott M, Kelsey M, Bubbly Salt.
I’m sorry to say, Pink Macho has left us.
Kristin: It’s true.
Will: Pink Macho,
Kristin: We’re heartbroken. If
Will: you want to come back, we will accept you with open arms for a brief period of time only. Hehehe. After that period of time
Kristin: You’re dead to us. You’re
Will: dead to us. I’m sorry. No, it’s okay. No, it’s fine. We don’t know what’s going on You know, maybe she found another like a comedian ophthalmologist to hang out with Anyway, thank you all for listening.
We’re your hosts Will and Kristen Flannery, also known as the Glaucomfleckens. Our executive producers are Will Fenner, Kristen Flannery, Aron Korney, Rob Goldman, Shahnti Brooke, Editor in Engineer Jason Portizo, our music is by Omer Ben Zvi. To learn about our Knock Knock Highs program, disclaimer, ethics, policy, submission, verification, and licensing terms and HIPAA release terms Feels so good to say those again.
Oh, God. Scratch
Kristin: that itch. You
Will: can go to glaucomflecken. com or reach out to us, knock, knock, hi, at human content. [00:49:00] com with any questions, concerns, or fun medical puns. Knock, knock, hi, is a human content production.
[music]: Goodbye.
Will: Hey, Kristen. What do you think about clinical documentation?
Kristin: Boo!
Will: You feel that strongly about it?
Kristin: I do.
Will: Why?
Kristin: Because your doctor ends up spending all their time typing little notes on their little computer instead of like listening to you or looking at you in the eyeballs.
Will: Well it sounds like your doctors could use DAX Copilot.
Kristin: I bet they could.
Will: Yeah this is like a little Jonathan in your pocket. Yeah. It’s an AI assistant that helps decrease the administrative Burden that leads to burnout and leads to like your doctors not being able to look at you while they’re talking to you. Yeah,
Kristin: it helps them do their little typing and take their little notes without having to do it themselves.
Will: 93 percent of patients say their [00:50:00] physician is more personable and conversational with Dax Copilot. You love conversation.
Kristin: I do and I want them to be a person.
Will: And that, that’s, and that we need that because today’s physicians are overwhelmed and burdened and they feel like work life balance is unattainable.
That’s
Kristin: right. And
Will: we know that work life balance makes you a better physician.
Kristin: That’s right.
Will: To learn about how DAX Copilot can help you reduce burnout and restore the joy of practicing medicine, visit aka. ms slash knock knock hi. Again, that’s aka. ms slash knock knock hi.
