Beyond ADHD: A Physician’s Perspective

Beyond ADHD A Physicians Perspective Ep 24 Dr. Tamara Beckford (Board-Certified Emergency Physician. CEO UR Caring Docs & UR Caring Society)

Dr. Tamara Beckford: Self care is aligning yourself. Self care is more than I carve out to, to go and get a manicure and pedicure and a massage each or every two weeks or every month. Self care really starts from within. So what you're doing on the outside is good, but what you do on the inside is even better.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a Family Medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes. The last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Hello I'm so excited today. I get to interview one of my dear friends, Dr. Tamara Beckford. She is a speaker. She is a wellness expert, a coach, and a board certified ER, doc. She is the CEO of URCaring Docs and UR Caring Society, where she helps busy professional women put their health and their wellness first without feeling any guilt.
Did you hear that? No guilt take care of yourself. She's a very sought after speaker and she's been on like thousands of podcasts and she's delivered so many presentations, both nationally and internationally. So today it's a really amazing treat to have her here. She teaches organizations how to implement self care programs for employees so that they can be more productive and of course manage their stress.
So in her spare time, she interviews doctors from a cost of world and they get into the ins and outs about self-care wellness and the fantastic things to do outside of medicine. Today, she's going to talk to us about self-care and she's going to get real with us. So I'm super excited to have her on. Welcome Dr. Beckford. .
Dr. Tamara Beckford: Thank you. Thank you for having me.
Dr. Diana Mercado-Marmarosh: Awesome. So this is an ADHD podcast, but self care, I think is a word that most of us, when we associate self care, we don't really understand what that means. Could you define self care for us and why you think maybe it'd be relevant to ADHD?
Dr. Tamara Beckford: Absolutely self care is aligning yourself. I break it down into three main portions, which is aligning your mind, your body and your spirits. Self care is more than I carve out to go and get a manicure and pedicure and a massage each or every two weeks or every month, self care really starts from within.
So what you're doing on the outside is good, but what you do on the inside is even better. So, self care, really, when I talk about the mind, we're talking about a lot of mindfulness. We're talking a lot of alignment on. Where you'd want to see yourself and are you really doing the things that you need to do to get you there when it comes to your health?
When it comes to how you're feeling? When we talk about the body, we're talking about really alignment of movement of, when we talk about the spirit, we're really talking about interactions, things that's really going to release some of those positive hormones that are within the body. That gets us feeling good. And being well overall. So it's an alignment of the mind, the body and the spirits. So self care, as I said, it starts from within, it's great to do a lot of things with on the outside, but really started from the inside is the best place.
Dr. Diana Mercado-Marmarosh: Yeah, I think we can get ourselves in trouble, meaning we can arrive at self neglect if we are not practicing self care. And I know when I say the word self neglect, a lot of people are like, oh my God, you overreacting. Am I really like,
Dr. Tamara Beckford: No, absolutely not.
Dr. Diana Mercado-Marmarosh: Because we all been there and we're not even aware that were there.
Dr. Tamara Beckford: Yeah, no self neglect is the I'm too busy to. So I said that we live in a world of feeling of a lot of self-importance like, you know, and this might sound, some people might get offended.
Like, what do you mean I am. You absolutely are important, well self-importance becomes when you are too important to do things for yourself because you're doing things for others, right? So my boss needs me. This person needs me, or the person needs me. So what about you? You need you, so that's where self neglect comes into place.
You're just so busy. We love throwing that word around. Oh, you know, it's really great that I'm doing all these things. And you feel important, but your body will let you know, as, as the added Manchester, if you don't take care of your body, your body will not take care of you.
Dr. Diana Mercado-Marmarosh: Yes. You know, this morning, I was listening to a book called The One Thing. And in there the author was talking about how their doctor plain asked him. So if health and your mind are not the most important things, what is? Like your body's not going to take care of itself. Again, if your mind is not aligned, like you said, the internal thing is not producing the external thing. If your mind is not telling you that your time is just as important as that person who just told you need to, then you're not going to physically put on the calendar a space for you to take care of you.
Right. You're not going to book that appointment to see your doctor. Book that massage, book that time with your girlfriend, book that date. Right. And I know it sounds like, oh, that's not self care, but it is because it's like, if you want to stay married, you need to plant and continue to water that seed. Right? If you want to have a relationship with a friend that you value, again, you have to continue to provide value to that friendship.
Right? It almost seems like, well, you just said, I had to like do it for me, but you are doing it for you because you're choosing them. You have decided. So that's very different from all my friend needs me, but...
Dr. Tamara Beckford: You need them. And that's so important. Interestingly, you know, During this particular recording, we're still in the pandemic, however, we're not as deep in it as we were say two years ago. Now, when we talk about the pandemic, you know, we have people who have a lot of different personalities entering into the pandemic. There was this shutdown, right? The whole place shut down. Unless you were an essential worker, you have to stay home, stay put, and figure it out.
Now, those who are introverts, you know, you're like, yes, this is great. I don't like hanging out with people anyway. At least that's the thought process, right? So this is like really awesome for me. So I'm able to do this by myself. I finally get to just lock myself away and it's mandated. So there we go. But interestingly, you know, as some introverts, well, how long did it take before you realized that like, Alrighty, I'm going back crazy here.
And I need to like, interact with people. One month, one month. Right? So as much as we sit and think we don't need others, irrespective of your personality type, you do. And that's part of self-care. Right? So you're thinking like, oh, I'm being by myself. I'm great. This is really well, it that's a part of it, but socialization, which is why I called it. It's it's really aligning with the spirit. Socialist socialization is a part of healthcare your self care, which is also part of healthcare overall, well, it's a part of your self care because human beings are social beings. We're not loaned some walls all the time. You know, there are periods of time when you want it and need to be by yourself, but there are also periods of time when you need others, you need to socialize.
You need to feel a sense of belonging and that's very important. When you're talking about watering, that seed watering that, aspect of your relationship, that's just as important as you take in time for yourself.
Dr. Diana Mercado-Marmarosh: Yeah. And let me ask you this, have you personally, or maybe a family member that you know, and I know you and I have had conversations before where you shared with me that one of your brothers has ADHD, have you noticed if there is any type of correlation with self care and like how well pulled on quote, you can focus. Or you can concentrate or you are not as irritable whenever your self care is quote unquote in alignment or the self care battery's full. So to say.
Dr. Tamara Beckford: Absolutely. So my brother does have ADHD and he was recently diagnosed and this is.
Probably literally one year ago now. And to give those who are listening to perspective, my brother and I are roughly 18 years apart. And, you know, seeing him grow up. So it's like you're 80, almost 18 years older than someone you're literally just watching them as like a child. And then, you know, moving on throughout.
That throughout his life. So now he's an adult and he's going to be starting medical school in a few months. But through out the years, there are certain, especially seeing him as a young adult. You know, we have noticed my family and I like, there were just like ways where like his name is David. David just thinks differently than the rest of us. Like, what is it like, why would you make that decision? The others, but then now it makes sense. Now when it comes to his self-care, he has been very adamant. And exercise enthusiastic to me, you know, and he does it regimentally and I feel that that helps part of his self care.
I've also noticed, like, you know, when you're talking about growing up with someone, now, some people might get diagnosed with. ADHD or ADD at a younger age, right? There might be like five or six. But when you see someone get diagnosed in an adult, there's such a difference because it's like, ah, finally I knew something was like, I couldn't put my finger on it.
Like. Well, and this is not from our perspective, his perspective, like, oh, I knew it. So there were certain things that I've noticed along the way that he, you know, David incorporates into his life, like one we've talked about, you know, his self care of his exercise and just like his stress reduction.
And he gets very, stressed. As an adult now, you know, he knows how to channel it through exercise and just letting that go as a kid. I remember doing, I think he was in the fifth or between, junior high, fifth grade. He started having a little tick. You know, and it's just the stress and it manifested in a tick like I am, and I'm going to just say, well, you know, you get them evaluated.
And I'm like, you know, he doesn't have a tic disorder. So you recognize that this is really the stress and not being able to let it out because when you're five or six years old, some fiber in fifth or sixth grade, you can't really express yourself as well as you can. And you know, that something's different and, you know, You are trying to your body's way of manifesting it.
It was just the stress release was just his tick, that tick emotion. It didn't happen very often, but when it does happen, that's an external manifestation, like, okay. You're obviously under a lot of stress. Some of the other things that he started in, but he incorporated, to get through life when we talk about, and that's one thing you talk about pretty frequently is that time blindness.
So. And learning to prioritize, but which one of these is important right now? So I've seen some of the challenges, especially during the first, years of undergrad, just trying to determine like, well, you have all of these assignments. Which one is important now, you know, so there were times when I would sit with him and I'm listening to, you know, when I have this and this and this and this, and he might, you know, go and work on assignment, number three.
And I'm like, well, where is assignment number three due? Oh, you know, that's due in like six weeks. Well, what about assignment number one, that's due in two days? Like why would you work on assignment number six? You know? So it's, those are some of the aspects that we just had to like, just tease through and just go over and over to just understand it.
Like, yes, your mind might want to take the path of least resistance at this point, because assignment number three, it sounds like, oh, it's easy. I can knock this out. But in the relative timeline, what's important assignment. Number one is what you need to really hit the nail on the head. You know, you need to overcome that, the mindset, way of trying to block you by saying like, ah, this is too hard.
How do you want to sit down and exert excess energy towards this? You know, these are things that's important to you. And one of the things that he also does right now in the time-blocking is he had some alarm on his phone, every 15 minutes. It's telling us the time it is now nine 15. It is now nine 30.
It is time for you to get off the phone. So he's using all of these techniques to just really. Get through and, through life and believe it or not out of all four of us who? Our family, my mom, my dad, my, he and I, he's the most organized out of the, all four of us at this point.
Dr. Diana Mercado-Marmarosh: Yeah. So it sounds like once he got the diagnosis, he became curious enough to understand how his brain works. And that was a form of self care for him because he started to use tools that maybe he would have never have even considered. Cause he didn't even know that was something going on. Right. But now he didn't make it mean anything. He's like, okay. I have ADHD. My brain just thinks a little bit different and therefore I'm going to use some of the tools to help me set up a system that will help me. So like, like he had the best intentions he wanted to do all six assignments. Like that was never a question. Right. Did he find some of them more boring than others? Probably. So of course, knowing that he wanted to jump onto the one that was probably quote unquote the easiest and didn't have a time crunch because it was due six weeks from now, versus that one that is due in two days from now, and you feel burned and you feel that little pressure and you feel a little bit uncomfortable and it makes sense. Why not until in his mind, it's just six assignments, but not until you have the quality of the question will give you the quality of the result. Right?
So if the question now, like you were wise enough to direct him was, well, which one is due? Time-wise not how boring or how easy, but time-wise, what is the most pressing thing? And so if you have that same concept that you apply for yourself, like in terms of today, what is the one thing that will help my self care, therefore decrease my stress level. Therefore get me out of this overwhelm hamster wheel.
Dr. Tamara Beckford: Absolutely. No, it is, this is very, very important. And this is one of those techniques in self care. When you're saying, what are some of the one, one or two few things that I can do, for self that can get me through my day? And so I think it's so important now, a lot of people, we definitely recognize that your day really is as important and the way your day goes really is manifested by the way it starts.
Right. So how are. Starting your day. Are you starting your day by going through things that are bringing anxiety starting your day, by going through things that are bringing guilt? Are you starting your day by things that are making you angry, or are you starting your day by, going through a process, that can keep you centered so that whatever is coming at you, you can respond to it versus react to it. And that's why I think this is one of the most important aspects of a self care routine. And for me, that self care routine begins upon awakening. So when I wake up. I am not reading that email from work. Trust me. It can wait another five to 10 minutes. I am not listening to like an argument and reliving an argument through my mind. I am not jumping on social media to see who's arguing with who, or, you know, whatever things that's going to bombard me with insecurities and, bringing that up. No, I'm starting my day by investing in my mind and investing positively so that when I enter into my day, as I said, I can respond to whatever comes my way.
So it's self care. When I say that your mind, body, and spirit, there's an alignment that occurs investing in positive reinforcement in your mind. Actually the first thing of your day. I don't say in the morning. And I'm specific by saying, by not saying morning because I work nights. So my morning is 4:00 PM.
That's the time that I wake up and that's when I invest in my mind. So when from 4:00 PM, when I wake up, I'm investing, first thing I'm doing for me, part of it is spirituality is reading my Bible. And I'm really centering myself. Right? So frame you, if you're not into reading your Bible, reading anything spiritually, maybe it's reading, some gratitude things that you've written in the past, that's making you recognize and say, like, I'm very grateful that these have happened to me. Maybe it's you writing down and expressing your gratitude for what's going on right now, maybe it's listening to. Positive affirmations that you've, that you've spoken into a recording for yourself, or maybe it's looking at it on the wall, whatever it is, you're infusing yourself and you prepare your mind for that day. And it helps a lot.
Dr. Diana Mercado-Marmarosh: Yeah. You know, that's one of the tools that I teach my clients and my coaching group, that how you begin your day or what you focus on is what's gonna get magnified, right. So if you're thinking of the 10 things I didn't do yet. You're going to be all anxious. Right. But if you're focusing on what are the three things I'm grateful for? What are the three things that today, if I did, I will feel like I have accomplished what I needed to do. When I have accomplished that, then nothing else really matters until those things are accomplished. Right. And that it is a form of self care. And it's also a form of living in being uncomfortable. That it might be a little chaotic. While you're focusing on those three things, because you're not allowing yourself to be distracted with the dishes. You're not allowing yourself to be distracted with the laundry because we, even though we don't like doing that, we can easily want to go do that because we haven't done the really thing the matter, because there is a lot more work to do, learning, to be uncomfortable sometimes with a little bit of chaos or deciding who can clean up that chaos because that's not your one thing. Yeah.
Dr. Tamara Beckford: Who can you delegate that so that you can focus on self so that you can focus on the task ahead? And that's why when I even talk about self care, so self care. It's a process that will allow you to achieve any goal that you want in life. It really starts with self. So when people hear self-care, they're not thinking that self care is a process that helps me to achieve goals. They're like, well, self-care is a positive. That helps me relax. No, it's 10%. It's only 10%, you know, because once you've aligned all of those three aspects of your life, can you imagine, even, like we said, during this pandemic, a lot of people, even the intro that if the introverts was sick and tired of being by themselves, you can imagine those who were extroverted, those who needed to be seen to be heard.
One of the ways that they found were on in online communities and that's where you and I met, right. When you're aligning yourself with like-minded people that's self-care because you no longer feel like an outsider, you no longer feel like you're disturbing the other person, because all these people think just like you now, when you're around people who think like you, what do you think that you're feeling at that time?
Are you feeling anxious or stressed? You're feeling belong. You're feeling a sense of belonging. You know, you're feeling yourself some bonding that's oxytocin release right there. You're thinking, you know, you're bonding with others and you're all having an alignment, you know, and you want more. Right? I said, we want more and more and more because you're feeling it, you're feeling a sense of belonging. And so that's a process of the self care. How can I align myself with like-minded people? That's feeding into your spirit of self-care.
Dr. Diana Mercado-Marmarosh: Let me, let me ask you this question, which I already know kind of what you're, where you're going, because I know you, but this is a question I think that needs to be asked, you know, I think you and I, have never been afraid to like, do the hard work and you as an ER doc, like you're used to juggling 10,000 things and then learning on the spot too. Like what is the most priority, but do you think taking rest is a form of self care or do you think yes. Or do you think that's like, you're not being productive and that's not like worth of.
Dr. Tamara Beckford: Oh, that's a such a great question because we live in the hustle, hustle, hustle society. And one of the unfortunate mindset of being in a hustle society is that rest is for the week. No! Without rest, you will become weak. Now rest is a part of your self-care and it's an utmost part. And that's the part of taking care of your body, right?
There are so many positive benefits from resting. Now, rest, of course, it's challenging for you. If you work shifts that are really. Especially as an ER, doc, some your knots up, it's a very unpredictable schedule. Most emergency physicians schedule. So rest is something that you battle, but rest is so important that without it, you start having negative health. Risks that start to manifest within yourself.
You start having memory loss, you know, rest is such a restorative part of yourself. Making time for it is just one of the utmost things that you have to do. Now, if you weren't that important, then it wouldn't be part of our cycle. Right? So even if you are constantly on the go and they've done studies, they've done studies that well, most of the studies that done is in doctors or residents, because we are really one of the professions at the very sleep deprived, but it's shown that if you have a resident or a person that's been up for 24, 48, going, going on 48 hours, your cognitive skills have declined tremendously. Right? So those important decisions that you're trying to make, you're not going to make them that well..
It's just as if you're making the decision while drunk in that's what this, you know, that's what the statistics shows. And that's what the studies have been shown that it's, as if you're making a decision drunk, when you are completely sleep deprived. So rest it's restorative, it reinvigorates you and it brings back a sense of not just understanding, but all the decisions that you truly want to make in life and the important decisions needs to be done with rest.
Dr. Diana Mercado-Marmarosh: That's a great point. Now, as an ER doc, I'm pretty sure you see all kinds of things come through. Right. And I'm pretty sure that some of those, crazy accidents sometimes happen to people with ADHD because they forgot to put on a helmet or they decided to speed paths because they were late. Have you noticed any correlations? You know.
Dr. Tamara Beckford: So I haven't directly looked to see, and, you know, that's something that's important because a lot of my patients who are coming in, who have, um, ADHD, there's still a subset that probably will not let me know that they have ADHD. And yes, and there's also another subset where they do have ADHD. They are taking their medications and they are, managing it as well as possible. Um, so with those who are managing the ADHD, you know, th whatever accident occurs, it occurs. Because it's an accident, not an intention it's not done on purpose. So, and that's so important for us to really express to those of you who are with ADHD or without sometimes things happen. It's not your fault. And you know, a lot of times I know we get into this aspect where we try to blame ourselves, man, had I not done this? Had I not done that? Maybe this is related to my ADHD. You know what, there's a subset that if you were using your skillset, you know, especially for, your clients, I know you teach a lot of skills on a lot of skillset for them to incorporate. If you've been incorporated in your skillset and things happen. It just happened.
Dr. Diana Mercado-Marmarosh: And like you just said, like, you can have all the techniques, but when things are going to happen, they're going to happen. And it might be that they don't happen to the extent I do not apply this.
Dr. Tamara Beckford: I do not apply their skills.
Dr. Diana Mercado-Marmarosh: Absolutely. So that's. So important to have some certain checklist, like, do I have XYC is my kid in the car? Not behind my car. Like, things can happen at an instant, whether you have ADHD or not, but having some checklists, even though they seem boring and repetitive can really saving two minutes. Like trying to save two minutes can cost us five hours or cost us a lifetime right.
Of something. So sometimes we just have to slow down enough because we're so excited about life, but we got to slow down enough.
Dr. Tamara Beckford: I've seen that. And, you know, interestingly, um, with us even talking off camera, when we talk about like the ADHD mindset and lifestyle, You know, I said that within the different specialties in medicine, the one that's more aligned with an ADHD lifestyle and mindset is emergency medicine.
Emergency medicine is a, one the most challenging specialties to stick with one line of thinking for say even five minutes, because you're constantly being interrupted. You're constantly being interrupted. You're interrupted at least within an hour. I wouldn't, numerous times within an hour, you're interrupted by signing an EKG.
You're interrupted by, Hey, this lab is back. You're interrupted by what are you going to do with that patient? It's like, Hey, this family member wants to talk to you. And this is all while you're picking up new patients. You know, discharge a prior patient, call it in a physician about the patient, you know, going to the patient, informing them what's going on, getting new information, processing the new information and you know, the disruption continues.
So when trying to have, as you mentioned, checklist, to ensure that you check all the boxes so you can give each patient the best care possible. You can see how using that and the time block. Next thing you know, this patient's been there for hours. You know, did you do, did you at least go see that patient because you were interrupted so many times a trauma came in, a heart attack, came in.
This patient is lovely little old lady. Okay. Cause she sprained her ankle. She still needs to be seen, you know? So it's important to that. You said you use these techniques and these checkboxes and this awareness that time flies. This time, blindness that occurs within our lives in order to give the best possible care.
So it applies to not just those with ADHD, it applies to those, those of us in specialties that really have a lot of interruptions in our brains.
Dr. Diana Mercado-Marmarosh: Yeah. And it's interesting because. When I started my coaching group in my mind, I thought it was going to be properly just like I thought it would be like, ER, doctors with family medicine, doctors, like in my mind, that's what was going to have.
And interestingly enough, I have. All ethnicities of people working with me, but more importantly, all specialties, like I've had a pathologist, I've had psychiatry, pediatrics, like OB GYN, ER, docs, nocturnes, like, family medicine, like you name it. Like they've all even had a, I have a couple pain management doctors. I have a couple, PMNR and like, it's so interesting that. Our brains each have a uniqueness to it because even surgeons. Right. And they're like, people ask me if I have ADHD. Cause how can I sit there or stand there for that many hours in that specific like body part when I can't even have a conversation with somebody for five minutes, right?
Again, it's what you focus on or hyper focus on that, your zone of genius that just lets you be. And so it's so interesting how self care implemented, regardless of what specialty you're on or in can really make a big difference. Because if you think about it, like we all have to go all those rotations, right?
When we were medical students. And then depending on what residency you did. So me as family medicine, I had to still go to them all again. Right. And so internal medicine, I guess, has a little bit of that. Pediatrics. Probably not to that extent because they're not having to go catch babies, but, but still you could see how some of the primary docs are able to go through all that and then they can cope or not if they don't have their self care. Right.
Dr. Tamara Beckford: Absolutely. And you know, one of the highlights that really had me. Focusing on the self care was really this pandemic because when I looked at a lot of my colleagues in emergency medicine, I mean, you know, they were going through so much and I'm not, and I'm saying they not as if I weren't going through it, but being able to handle like, you know, the anxiety level.
Skyrocketed, you know, am I bringing this onto my family? Am I going to survive this? What is this? Because the beginning of the pandemic, we just heard there's this virus that, you know, it attacks respiratory track and people are dying from it. And, we don't know how to protect it, but you need to use PPEs.
But. You know, by the way, you need to start reusing these things
Dr. Diana Mercado-Marmarosh: By the way, we don't have PPE.
Dr. Tamara Beckford: And we don't have enough. So, we need you to start using this mask that normally you would have thrown away each time you enter the room, but now I need you to use it for this couple of days. So, you know, there's so much as going through one's mind.
However, incorporating some of the small to, self care techniques that I've mentioned throughout this interview. So far, I was actually able to get through all of this without feeling exhausted or burnt out because. Even though I'm still working full time. I mean, we're still building businesses, I'm still interviewing doctors.
I'm still doing my own podcast and, and it's just like, well, how are you able to do all of this? And you still have a family because I'm incorporating self-care. So the most important thing I've invested in is in my mind, And I've invested in my body and my spirit. So this self care routine that I have invested within myself has gotten me through and I've recognize it, wow!
Now if an ER, doctor in the middle of a pandemic, which is one of the worst things that can happen to somebody in the ER, because while everyone can run away, we have to run towards it and I'm able to get through this. So then obviously whatever I'm doing is working and that's why I'm here preaching on my soap box about the importance of self-care within not just the community in medicine, but outside of medicine.
Dr. Diana Mercado-Marmarosh: Yeah. I think you just brought up such an important point. What distinguished you from other people? And I think it was the same thing for me, was being willing to feel I was worth the investment into looking on how could I find tools to support my brain, my heart, my soul. For me, it was tools to help me understand about executive function.
It was tools to help me with time productivity or time blindness, but really at the end of the day, it went back to the self care because not until I felt my time was just as important as my patients' time or my family time. Did it make sense for me to invest in myself? Because I mean, none of us who are physicians ever knew, we were going to be like, you know, almost half a million in debt with loans.
Right? And then when we talk about coaching or therapist or psychiatry or whatever, We're like, oh, that's too expensive. It's like, how do you measure too expensive means like, does that mean keeping a job? Does that mean not having an ulcer because you're not, you know exactly. Right.
Yeah. Which one is it? And so I think what. Finally had to learn was that I could either stay in the victim mentality. I could keep arguing for my limitations. Right? And then I get to keep them.
Dr. Tamara Beckford: Oh yes. Because you're going to win because it's in your mind that your limitations are yours and it is way more important. So what others are telling you. That's nice, but you just do not understand this and apply does not apply to me. You don't understand.
Dr. Diana Mercado-Marmarosh: Yeah. So I could keep arguing for my limitations or I could decide. To do it a different way so I could get different results. Right. And so I have to learn the hard way, you know, that if you kept barring on your future, not protecting your energy, you were borrowing on your futures ability to function. And it's ventrally it was going to come to a point where you were going to slowly die out or quote unquote burnout or something was going to happen. Right. Something was going to give. Yeah. And so I think all of us could relate whether you have ADHD or not. If you're a physician working through the pandemic, If you did not prioritize yourself care, you eventually got to burn out and you didn't even know.
I didn't even know I was just irritable. And I thought that was the norm because how else would you feel? And I just thought I was angry and I, how else would you feel like I didn't realize that I was feeling that because of what I, what I was telling myself, I was in victim mode.
Dr. Tamara Beckford: You're you're telling yourself, well, I'm just tired and you know, so why shouldn't I be tired if you really think about it? A, B, C, D, right?
Dr. Diana Mercado-Marmarosh: It does add up.
Dr. Tamara Beckford: So what are you going to do about it? What do you mean, what am I going to do about it? You know, I'm tired because I'm just tired. You know, so yeah, there isn't a particular thing to do about it. I'm just tired. And so now that you've recognized what's going on, like, how are you going to improve upon it? Like, you know.
Dr. Diana Mercado-Marmarosh: So what's your next step. Okay. So yeah, so that's where like the shit hits the fan when you're like, okay. The system that , got you here, got you here. Do you like being here? Oh, you don't. Okay. What are we doing? Let's go
Dr. Tamara Beckford: What's next? Yeah. And that's the thing too. Your systems got you to where you need to be.
And as life is very dynamic, you know, it's not a static process. So the systems that you needed five years ago to get you to where you are now, if you continue using those systems, it's doing its job. You're still going to be right here. So if you want to get to the next five years, there's a chance that you might have to change those systems because the system from five years ago is to get you to the present the system to get you to five years in the future might not be the same systems. It's going to work and keep you in the present.
Dr. Diana Mercado-Marmarosh: And I think in order to even realize what five years down the line looks like, you have to start getting yourself in the room with individuals who are asking those same questions, right?
Dr. Tamara Beckford: Absolutely. Socialization aligning your spirits with those who are thinking like you, those who want to do things that are similar to you, or even more importantly those who have done things that you would like to do?
Dr. Diana Mercado-Marmarosh: Yes, exactly. Because that's what I feel at the end of the day. My take home point for people who are listening is that self care can be you asking yourself the question, where do I want to be in five years? Like. Our wise mentor, yours and mine Dr. Una, always tells us that there's no dream police, right? There's no gold pulleys, right? There's no imagination police. So you get to decide how you practice medicine, but here's the thing, self care has to be at the front and center. Your systems have to be aligned. And like you said, you don't have to know how, because obviously we, might've not even be aware we're missing that piece. Right? But you need to be able to talk to the people that are leaving. Proof in our, the example of what is possible and invest in yourself. And so with that being said, Dr. Tamara, please tell us where to find you because we need this. Self-care.
Dr. Tamara Beckford: Absolutely. Thank you so much. So, if you would like to have me as a speaker on any of your podcasts conferences, I am available also for retreats. You can find me at drbeckford@urcaringdocs.com that's D R B as in boy, E C K. F O R D at your caring docs, you are C a R I N G D O C s.com. You can also find me on LinkedIn with the same name, Dr. Tamara Beckford and on all the other social media platforms. It's your caring dots? That's U R C A R I N G D O C s.com.
So that's on your Facebook, on your Instagram, on your Twitter and also on the tik-tok.
Dr. Diana Mercado-Marmarosh: Awesome. Okay. And I always say this last thing and people laugh, but you know, we have ADHD, so we tend to tune out. So let's say that my readers or my listeners just finally started paying attention right this second, what is the one final nugget that if you tell them this, they're going to feel like they got the whole episode.
Dr. Tamara Beckford: Absolutely. So the final nuggets is that self-care is really aligned in your mind, body and spirit to help you achieve all the goals that you would like in your life. It's not only about the manicure, pedicure or a massage. That's your self care.
Dr. Diana Mercado-Marmarosh: Woo. That was awesome. Okay. She brought it home. So there you have it.
If you want to get, you know, Oprah's doctor, she is, she is the doctor that can speak like Oprah. You need to get in contact with Dr. Tamara Beckford and she will set your retreat, a straight work environment that needs self care or your own self into alignment so that you can get where you want to go five years from now.
Dr. Tamara Beckford: Absolutely.
Dr. Diana Mercado-Marmarosh: All right. Thank you again for coming.
Dr. Tamara Beckford: Thank you for having me
Dr. Diana Mercado-Marmarosh: As someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group: Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends they too can can learn to live life and stay in their own lane.
 
Dr. Tamara Beckford is a speaker, wellness expert, coach, and board-certified emergency physician. She is the CEO of UR Caring Docs and the UR Caring Society, where she helps busy professional women put their health and wellness first without guilt. A sought-after speaker, Dr. Beckford has appeared on dozens of podcasts and delivered presentations on wellness and self-care. Today, she teaches organizations how to implement self-care programs for employees, so they are more productive and have tools to manage stress. In her spare time, Dr. Beckford hosts the Dr. Tamara Beckford Show, where she interviews doctors from across the world about self-care, wellness, and all the fantastic things they do inside and outside of medicine.Today, she teaches organizations how to implement self-care programs for employees, so they are more productive and have tools to manage stress.
 
 
Website: https://www.urcaringdocs.com/homepage
 
LinkedIn: http://www.linkedin.com/in/drtamarabeckford Facebook: https://www.facebook.com/URcaringdocsFacebook personal:https://www.facebook.com/drtamarabeckfordInstagram: https://www.instagram.com/urcaringdocs Twitter: https://twitter.com/URcaringdocs Podcast: https://podcasts.apple.com/us/podcast/ur-caring-docs/id1553710706
 

Beyond ADHD A Physicians Perspective Ep 23 Dr. Grace Esan (Board Certified Pediatrician)

Dr. Grace Esan: I want to be able to give a voice to woman, a lady, a gentleman, a child who's not being diagnosed and does not know how to get to the next level so that their doctors are able to help them.
Dr. Diana Mercado-Marmarosh:  Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a Family Medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes. The last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
So I am really excited today. I am talking to one of my friends, Dr. Grace Esan, she's a pediatrician in Evansville, Indiana. And she's Nigerian American who grew up in Legos, Nigeria. She received her medical degree from the college of medicine, University of Legos. She completed her pediatric resident trainee at the Brooks Le'Veon Hospital Center in Bronx New York City.
And she's a certified pediatrician. She specializes in the treatment of infants, children and adolescents at all stages of the growth development with the emphasis on ADHD, anxiety, depression, and oppositional defiant disorder. She's been in medical practice for over 20 years. Dr. Esan is happily married and she's the mother of two beautiful children and her pet chihuahua.
So please, please, please, everybody listen up to Dr. Esan. She's here to share everything. How are you doing today?
Dr. Grace Esan: I am very well. Thanks for having me.
Dr. Diana Mercado-Marmarosh: I am so excited. I am doing well myself. I just got back from a Disney vacation with my family. So I am still in the process of recovering and getting back to work.
You know how we were a little slow after those vacations. We were smart this time around because, we did Disney break Disney break instead of like all the way straight, like we've done in the past. So that was good. We need a break sometimes. All right. So I understand that, you were diagnosed with ADHD yourself.
Would you mind sharing with me the circumstances surrounding your diagnosis? Were you surprised at all?
Dr. Grace Esan: Actually, yes. I was quite surprised. It was, it was a self-diagnosis really, because I was evaluated a friend of an adult friend of mine who was having trouble. She's having lots of trouble at work.
Punctuality to work, timeliness to get projects done. And then now it was now extending into the home where she was forgetting to take the kids where she needed stick the kids too. So I got to an adult self reporting screen and I took it home to her and I had her feelings out and whilst I was feeling it out, I was just looking through the questions that was the first time I'd actually looked at the questions for an adult.
I'd done the Connor's, I've done the Vanderbilt for kids, but I've never actually looked at it on an adult scale. So I'm looking at this adult screen and I'm like, yes. Oh my gosh. That was so I had this aha moment. I'm like, oh my gosh. So after thinking about it for a few weeks and actually acknowledging the fact that yeah, most of those things are true and they're struggle for me.
Then I, went down and they said with my family physicians. For how to actually do a formal evaluation and come up with options for me.
Dr. Diana Mercado-Marmarosh: Were you surprised, like you said you were surprised, but were you like when you looked at it, were you surprised in the sense that may maybe many people in your family behaved or acted or did certain things in a certain way. And so you just didn't think anything of it or what were you thinking? Like, were you one who was tardy or what, what was the things that like, kind of gave you that, oh, maybe there's something.
Dr. Grace Esan: Okay. So definitely tardiness is an issue because I, definitely suffer from time blindness.
 I started to do stuff and I totally, I have no concept of how long it takes to do anything things that I think should take five minutes, actually take an hour and things I should take an hour, actually, five minutes. So, punctuality was kind of a problem. The ability to actually be having a conversation with you while I'm actually listening to a conversation over there or doing two other things at the same time that just came naturally to me, , it wasn't anything that I thought.
So I really didn't think that I just thought it was me. I didn't think it was a medical diagnosis and stuff from there. And I did not think it was a problem now, after, the diagnosis, then I realized that there were some things that I definitely could do better because like I said, time, blindness is still, it's a huge problem for me, really.
Especially when we're seeing patients. I don't know whether you you've experienced that before, when you're seeing patients and you're really into what it is you're trying to do for this patient, then time disappears. Because you're intent on what you're doing. So I've had to have a walk around to where my staff will send me a flash.
Through the computer. It's still me. Hey, you've got to get a move on. And that kind of helps snap me out of it. I put clocks in the room, so lock them in areas where I can actually see the clock so I can pay attention to, you know, like, but sometimes that doesn't doesn't work so that my backup work around was to then have my staff send me a text during the visits, telling you that you have 2 in the waiting room, or you have one waiting it's time to wrap up that kind of thing. And so that's how I've had to navigate that.
Dr. Diana Mercado-Marmarosh: Yes. Everything that you just said, I could have said, I also have the time blindness and I got diagnosed during my first year of med school.
And. It was funny. Cause like my husband, I guess he just kind of knew and he's not medical, he's an engineer, computer engineer. So anytime I gave him a time and he's like, okay, let me add an hour or let me add an hour and a half. And I'll be like, no, what are you talking about? I'll see you in an hour and a half.
And so it was funny because like my family, we had to give them like for graduation and for wedding invitations, like for my side of the family, with like an hour, earlier than the event so that everybody could show up. And then his side of the family, like it was normal time. Right. And so it's just funny how we don't realize that we do hyperfocus usually on the things that we really enjoy. Like, you probably love talking to your patients, but whether it's five minutes or 45 minutes, like to us, time is fluid. And so we don't realize it's been that long. And then I don't know about you, but then all of a sudden, like you said, you're on to the next patient and you don't want to slow down enough to write the note because you just did an amazing interview with that patient. And you're like, feel bad that you're rushing to the next one. Right. And so it's like you're here, there, and, not any everywhere. And yeah, so I ended up also like having some workarounds, meaning like I would tell my nurses to come like knock on the door and like try to help me out.
But then when I finally started like getting an ADHD coach for myself, like they told me. Just set a timer. And I know it sounded silly, but I didn't have that external cue. So setting the timer made a big difference because then they would either knock on the door or come and ask me, is there anything you need, which was helpful because then I could be like, oh, this person needs a vaccine or this person needs a UA or whatever.
And so it, and it was my cue to wrap it up. But yeah, otherwise like sometimes when I forget to put the timer on vibrate or on instead of just silent then. They have to come in. Cause they're like, oh my God, like, we didn't realize you forgot to put the buzzers. So they were waiting. They're all conditioned to hear the timer and then come knock, you know?
And so, yeah, it's, it's interesting. I've been using the timer almost for two years and even randomly when I would forget it, it's not like you would think two years you're conditioned. You're not like you just don't have that.
Dr. Grace Esan: I think. Yeah. The time blindness is, it really is a thing. And the hyper-focus, it really is a thing.
Cause I don't know about you, but I love, I think if I was not a physician, I might have been a policeman or policewoman because I love, I love the puzzles. Oh, we've got this and this and this is over here. Let's see if we can put it all together. Okay. So when, if I'm in that zone doing just that, then that kind of just disappears.
Dr. Diana Mercado-Marmarosh: Yeah. And usually like what you were saying, the things that you think is going to take an hour and it really takes five minutes of the things that are boring because our brain has like decided that's too much or too painful or too boring. So you should like try to avoid it like a playground.
Yeah. So do you think like your diagnosis impacts like you and your family or those around you? Like, have they ever told you oh my God, like you're interrupting me or have they ever tried to do the time thing? Like my husband does to me, like, try to make the time, like gives you extra plenty of time so that you could make places or stuff like that.
Dr. Grace Esan: I really, really, really, really do my best. To, not to schedule things around times that I need to go someplace because I'm very conscious of the fact that it's different if it's just me, but it's frustrating to my kids because they want to be, they want to get to school at the right time. And I think the worst feeling as a mom is to know that your child has tardies because of you.
It's totally different if the child was tardy because they were doing something else though, when it's because of you. I mean, you just have that. It's just bad. It's bad. Exactly. So I, I try not to schedule anything of interest, anything that is really interesting, at that time. And then the other thing I do, especially in the mornings, because the mornings are usually.
When, we have to like, you know, be on time. So I, I do everything as a routine in the morning. You get up, you brush your teeth, you take a shower, put your clothes on, and then you head out. I do not look at my phone, looking at my phone. It's a huge distraction. So let's not look at the phone. It's just head on out.
Dr. Diana Mercado-Marmarosh: Yeah, that is so important. What you're pointing out, you know, we all want to be a creature of habits. Habits, right? That's human nature, but we also have to be aware that there are certain things that can derail us. And like you just found the hack there, like to get you out the door, you have to do XYZ. And you know, that the pinpoint could be, we get on Facebook or tick-tock or Instagram or email or whatever.
Like sometimes I try to look at the labs before I go in and I'm like, I'm just going to call them on my way, because I'm going to get distracted by, you know, by a callback or something else. And before, you know, it you're like, oh my God, the kids are late. Like you said. Yeah.
Dr. Grace Esan: So I, I try not to do anything else. Just focus, get the kids to school. And then, everything else, I can do.
Dr. Diana Mercado-Marmarosh: And then everything flows. So, I mean, we've been talking about some of the things that, you know, can be sometimes a little bit more challenging with ADHD, but of course we all have amazing traits also with ADHD that make us who we are and have helped us to become who we become.
What do you think are some of those traits that you feel that might've been helpful and responsible for you succeeding and becoming the physician that you are.
Dr. Grace Esan: Okay. So the upside of having ADHD is, that we're very creative. We're creative, we're impulsive. Impulsivity is not always bad. Impulsivity can be actually. quite really, really cool because that impulsive, reach out to touch somebody when, you know, just instinctively touching a person and calling that person down or making that person feel better. That's impulsive. Oh my gosh, absolutely amazing today. You know, that just comes out of nowhere, makes that of a person's day. Having a problem. Something just crops up and everybody's like, oh my God. Oh my God, am I going to, I'll do this? Like, what's the big deal. Okay. So that happened. All right. You just, you do this, you do that. And the other person does this and it's really not a big deal. You know, the ability to kind of just like. I think because we're always late.
Maybe that maybe that's why
 So your dress ripped. Okay. It's not a big deal. You know what? Come with me. We'll find some tellers to facilitate. We'll turn the dress inside, out, tape it back, tape it out, and then you can go finish up what you're doing. And then we can get rid of the dress, you know, the creativity and the spontaneity. I think is a huge gift. My kids never know what might be coming. I might turn around and look at them and say, you know what? Let's go get ice cream. Oh yeah. Or. Let's go away for the weekend, you know, without necessarily planning for it. And those, those kinds of things I actually think are priceless.
And so I think the creativity, the impulsivity, the ability to think outside the box, I think the plus is actually I whole lot more than the negatives. If, if I was to be asked about.
Dr. Diana Mercado-Marmarosh: Yeah. That's so important because anytime we talk about ADHD and of course, this is why I'm doing this podcast to show that it can be a beautiful gift.
If you just pay attention and realize. How to unwrap it, right? Because with everything comes responsibility. And like you said, because we can think on our feet and because time is fluid for us, I feel like you said we are don't make it mean anything. If we have to try, A B, C, D until we kind of get to the solution.
And I think, like you said, we're not really judgemental with other people because sometimes we have to try different things and really not trying anything it's the fastest way to get stuck. Right. But if we're at least trying something, we know we're walking towards the solution. I think that's a, such an important trait because that allows you to be present with your patient right there.
And then you're not, you know, a thousand miles away you're right there. And then, and you're fluid with the situation and you're able to prioritize. If something else needs to take priority, you are able to jump onto that.
Dr. Grace Esan: To make a quick pivot.
Dr. Diana Mercado-Marmarosh: Yeah. So what do you feel like you spend most of your time doing and you wish maybe you would do a little bit less though.
Dr. Grace Esan: Are you talking about professionally or...
Dr. Diana Mercado-Marmarosh: However you want to answer
Dr. Grace Esan: Professionally? I spend a lot of time, you know, working, doing documentation. I really hate that. That's my nemesis. That's right. Actually skill is documentation. I'm not a big fan of documentation. And it seems like going from when I was in medical school to where we are now, it seems like I spend more time documenting stuff because we're collecting data.
And as far as I'm concerned, I really don't, you know, I'd rather just see the patients are. Yeah, I know the data is helpful, but I wish I didn't have to be the person to have to collect all that data. So documentation. Now at home, what would I, what would I say that I wish. For whatever reason is that I would say to actually just sit still,
for whatever reason, I'm constantly moving. Well, I know why I'm constantly moving constantly moving. I'm constantly on the move. I gotta do this. I gotta do this. I got to do this, but yeah. Seems actually just sit still.
Dr. Diana Mercado-Marmarosh: Yes. I totally relate to what I would want to do less of. And it's like, Less documentation as possible. And, I've tried to get the whole system and my clinic because I'm the medical director. So I'm like, if they can do it for me, they can do it for everybody else. So that it looks the same. So we, we get like the nurses to start the note so that they can, we know why they're coming. Of course they tell you one thing and then they tell them another.
So sometimes it works, sometimes it doesn't right, but at least the note has started. And then I've gotten away from writing paragraphs to like more like, bullet and try to get the HPI
Dr. Grace Esan: 'cause I do bullets too. I'm like, I do not do paragraphs. I want to be able to just look at it and know what it was. I did the last I don't the paragraphs. I do bullets. Here for this, and this and that...
Dr. Diana Mercado-Marmarosh: Yes. And then I tried to get that HPI to like mimic my assessment and plan. So that next time I see them, like, I can take the assessment and plan and plop it into the HPI if we're following something or whatever. And I try not to like put a lot of stuff. I just tried to put like diabetes dash on control dash, no changes done because A1C was a 10th patient noncompliant with meds, period. Like I'm not going to like, you know, and sometimes, you know, I give myself the five minutes between walking into the next patient to at least do my assessment and plan. And I try to give myself like so many nuggets to where I'll put like right foot cellulitis, X size. Dada allergic to antibiotic penicillin, given backdrop, like, so that later on, when I go do my note, I know it was the right versus the left foot.
Like I know more stuff to fill in the things that it's easier and doesn't take as much executive functioning thinking, right. Because I don't know how your EMR is, but mine, I would have to go into one area to see what meds I order another area to see labs or another area to see like problem list. So it would just take too much to try to construct what I had, what had happened that day. Right. And the 15 to 20 patients a day, like out of sight, out of mind. Right. So it was hard sometimes.
Dr. Grace Esan: Right, right. That is, that is very true. I'm going to ask you a question though. I'm going to ask why, why did you actually get evaluated for ADHD inmed school?
Dr. Diana Mercado-Marmarosh: So it was actually my roommate at that time, as she told me, she said, Diana, I think there's something wrong with you.
And I was like, why? She's like, I see you studying like 80 to a hundred hours. And I think I'm maybe studying like half that, if that she's like, I don't know if you're over studying to where you're so exhausted and you're not retaining the amount of information she's like, or maybe you're anxious or depressed.
My dad had just gotten diagnosed with cancer at that point. And so she's like, I don't know if that is keeping you from like, kind of being all in or whatever is going on. She's like, I think you need to go see somebody again in my mind. I didn't think it was a problem. That's what I've used to always do.
Like, I was always the last one to finish a test. I was always the last, I was always the one who even when they're pulling away the test, I'm like, hold on, let me just do C all the way down. Like in the last five or 10 that I didn't finish. Right. And so I didn't think that was a problem. I knew that whatever, my test scores were not super high to get into med school. And I was even put like on a probational program, like to get into med school, like they selected at the like 20 or 30 of us. And they said, you have to do the six week course before you start med school to make sure blah, blah, blah, blah, blah.
And so in my mind, I was used to working hard. I would outwork anybody if you gave me the opportunity to go into med school. Right. And so I didn't think it was a problem, but to her, she said, I think there's something going on because the amount of information, the amount of time you're doing it, I don't see you retaining it.
So that's how that happened. I ended up getting tested and sure enough, I had this time blindness, because again, I didn't even know it was a hundred hours. Like we get so focused into things that I thought it was like, you know, five hours or something. Right. So I didn't realize that was a problem. And I think now I understand that I didn't really have that much of a problem in high school because I was running like 10 miles a day, like with my cross country team and I was dancing and I was active. So I was getting all that dopamine. I was getting it from there. And then I get. College in my first year, like I almost like I was put on probation and I was like, oh my God, I'm like, I'm a straight A student. Like, how am I on probation? This doesn't make any sense. But now looking back, it makes sense because I didn't run anymore. Right. I was just sitting there, studying and I couldn't prioritize, it was a different style of testing the way that they were doing it from where I came from. And so I remember getting a C in chemistry and going to talk to the professor and they're like, and I was like, well, how did I get a C I've never got an, a C in my life.
And he's like, oh, this is average. I was like, I'm not an average student. And so it was just that realization that. I didn't realize I had gotten away with my grades because I would talk to people about it and I never had to prioritize like the whole book. Like to me, everything in the book was a priority.
So I couldn't tell what was more important than others. So then, but later on I realized, oh, I I'm more visual. So if I went to look at the pictures, then I could understand it. And then it was a lot easier than if I just ran into trying to read the book. And so when you were saying earlier about reading a book, I was like, oh my God, I haven't read a book in a while, but I've been listening to the audio.
So that's the work around the audible.
Dr. Grace Esan: Yeah I do audibles, all the time.
Dr. Diana Mercado-Marmarosh: So somebody else is reading it here for you. And then if you really want to, then you have the opportunity to go buy the Kindle or to, you know, because I already know that if I buy them, they're just going to be sitting on the shelf. I'm not going to open.
Dr. Grace Esan: The thing also is, with the articles, then I can still be puttering around.
And I guess I just have. , I don't know what it is unfortunately, or I am doing, but I just kind of constantly have to be touching something or doing something. So at least I am listening. I have the airport in my, in my ears and, and then I'm moving around. Like I said, I don't know what it is I'm moving around doing, but..
Dr. Diana Mercado-Marmarosh: No, but I mean, that makes sense because that also increases your dopamine.
I didn't realize that, that's how I got through med school. Like I will listen to the audio recordings and I was walking in. Two or three miles. And that's how the information would like sink in. Or if you were doing a task, like I hate doing the dishes, you know, doing the dishes or laundry or something that I'm not like, not so thrilled to do think when you pair it to something that you are enjoying, then it's like easier for you to retain, but because you are being active, it kind of gets, you know, more, more connections in your brain to step.
Dr. Grace Esan: That makes a lot of sense. Yeah. I'm more auditory. I retain things that I.
And some visual, but like med school was mostly what I heard. I could not write notes to save my life because I couldn't, I couldn't focus on, on processing what was being said and writing at the same time. It was not, that was not a thing I could not do that. So my work around for that was to know the people with the really good handwrites and on good notes and to spend all my pocket money..
Dr. Diana Mercado-Marmarosh: Hey, like that's the thing, right? Like one quickly learns how to help yourself if you know that that was not the thing. Like I knew, like I had to get a tutor. So that way, when we were talking, I could hear what they thought was important. Everything's important. And how do you want me to tell you? So you could only, I'm pretty sure.
I don't know if you have this problem, but you know, our notes at the beginning are always like a book. You're like, what? like they told me all this thing, how am I supposed to know? That's not important.
Dr. Grace Esan: Exactly.
Dr. Diana Mercado-Marmarosh: But you know, now you can laugh about it, but then it was like, life or death in your mind
Dr. Grace Esan: because you didn't know where.. It's overwhelming.
Dr. Diana Mercado-Marmarosh: Yeah. It's really funny. Like, you know, now, like I said, now you look back and you're like, oh, the irony of it, you know, I remember my first clinical rotation was actually family medicine and I did not pass that shelf exam. I was like, oh my God. And that's what I went into.... and I'm board certified now. Right. But it's just funny that you were supposed to have so much knowledge to do family medicine. Like you supposed to have known a little bit of surgery, a little bit of OB GYN, a little bit of like pediatrics, you have to know a little bit of everything. And that was my very first one.
So. Well, of course I didn't pass it. Like, how's that going to pass it? If I'm like brand new off the books and all of a sudden, like I have to do this test. Right. But then later on, of course, as you went through the rest of the rotations, you come back and you retake it and it was, it was fine, but it's just tells you how sometimes your experiences don't match up with the book.
So it is what it is. You just don't have to make it mean anything. And unfortunately, as we go through school, we're so used to validating ourselves through some like test scores.
Dr. Grace Esan: That's that's the only, I mean, there's no other instrument by which to measure, just how well we're doing re that's all we've got. And so based on that, because I don't know about other ADHD'ers, but I did not believe that most ADHD 'ers actually test as well as the intellect is.
Dr. Diana Mercado-Marmarosh: Right. Exactly.
Dr. Grace Esan: So because they have all this other things, and then you also have the fact that, you know, some people also have dyslexia in addition to the ADHD and have dysgraphia and you know, all the things too.
Dr. Diana Mercado-Marmarosh: Yes, exactly. So what do you think are your next goals for the next year?
Dr. Grace Esan: Next year . So this year is kind of, the beginning of a different chapter in my life because I am going to be an empty-nester this year. Both my kids are off to college. And so now I have all this time on my hands.
Now, the fact that I have all this time on my hand, um, I want to be, I want to make sure that I don't just use it for just, you know, just filling it with nonsense things that don't make sense. I want to actually make an impact or do something that is meaningful. And for me, what is meaningful is there's this ADHD journey that, I found myself being passionate about.
Being passionate about having children be diagnosed at an early, earlier age than middle school. Because like I tell the parents, I think the biggest thing for me is not really the academic performance, it's the hidden insults, emotional and social insults that's afflicted upon these kids because they can't remember stuff.
So they think that, they are constantly moving. So they think that they're troublesome. People are constantly redirecting them. So they think they're not liked or love because they're rough and they have no idea what boundaries are. Other kids will avoid them, so they don't get hurt. So they just think that nobody likes them.
And I think that it's not, I think that's horrible to have to grow up thinking that you're a problem you're lazy or you're a troublemaker. Nobody likes you. And it's only because you have this disorder that can be treated that makes you constantly move, makes you inattentive to visual cues, makes it inattentive to things going on around you makes you such that.
You're not performing well in class. So, that's my big thing. My weak thing is that. And then the other thing that's I have also found out in my practice is that there are women, there are lots of moms that actually get diagnosed in my office when I'm diagnosing their kids. So that's the other thing.
So my big thing for this next year is to actually, I've already whichever. I set up a business or sell. I say, it's not a practice because I'm not practicing medicine there. But what I want to do is I want to be able to give a voice to a woman, a lady, a gentleman, A child who's not being diagnosed and does not know how to get to the next level.
Does not know how to articulate what it is they're going through so that their doctors are able to help them. Because I read online where in all these places and chat rooms, Where you have all this ladies who have all the symptoms and the doctors are like adults don't have ADHD. ADHD is only something for a child.
So to where, if you come to me, I can help. I can help; A - evaluate you. And B - We give you, somewhat of a portfolio that you can take back to your physician, telling your physician, that based on all these symptoms. Yes. You meet the criteria for having ADHD or ADD, and then have that discussion with you before you go to your doctor about what your options are.
And therefore, when you go to your doctor, you can have an informed conversation with your doctor about what it is that is going on with you and how you want to navigate your ADHD diagnosis. So that's what I'm working on currently. I have a website, thrivewithdrgrace.Com. And then my emails thrivewithdrgrace@gmail.com, and then I have an Instagram handle, which is @thrivewithdrgrace.com, so if you want to go check it out, you can check it out. But that's what I'm working on. That's what I've been working on for the last few months. That's really, really my passion, because like I said it's crazy going through life and not even realizing that your life could actually be a whole lot better than what it is.
If only you knew what your diagnosis was and if only you're able to, to navigate your diagnosis. So that's what I got.
Dr. Diana Mercado-Marmarosh: Yes. That's such an important reminder that sometimes we forget about the females, like you said, this is an ADHD diagnosis that is hereditary, right. And a lot of females don't get diagnosed until their kid gets diagnosed or until they go to med school or law school or some college or they get promoted or they hit menopause. Right? And so. Probably because unfortunately, sometimes the females are the quiet ones in the room, so they're not causing too much ruckus. They're just kind of daydreaming. And there's not a lot of studies that have been made on females again, because " " there's too many hormones going on and they don't want to deal with that situation. Right? But I think it's finally changing. And what you're doing is so needed, 'cause like you said, you don't know what you don't know. And if you're not aware that you've been working like two times or three times or 10 times harder than somebody else, you're not aware that you're driving, you know, without your glasses, then it's kind of hard for you to do it any other way.
But being aware of what to say or how to advocate for yourself and what to expect. You know, that's the first step, right? Because unfortunately, if you do get the diagnosis medications, while they're going to help, they're not going to help everybody. And then there's also that emotional component to it. And all these other systems where coaching can be so helpful or a therapist or both, right?
Or in the addition of other stuff like, you know, exercise and meditation and journaling and all kinds of stuff. Right?
Dr. Grace Esan: All kinds of things. Yes. And I think also the other thing is if, you know, if you understand the reason why you're a certain way, then it explains a lot of things that then makes you know that you're not going crazy.
It doesn't become an excuse for you that not trying to figure out work around for yourself might help you understand the fact that you know what, I'm actually not a lazy person. I'm actually not, you know, I might be a procrastinator, but there's a reason why I'm the way I am.
And that's not an excuse. Cause I know what I need to do is figure out ways around the reason why I'm always late. Maybe I need to come up with a routine or the reason why I get that, like I just discussed our time blindness we've kind of figured out how to get it. We'll get the nurse to come knock on the door or I'll get the text message on my computer telling me it's it's time to move on, but you have to come up with workarounds, but if you don't even know that that's a thing you're just going to continue. You're going to beat yourself up. Like, I will tell you that I used to sit and wonder why it's, why it was that, my contemporary's to get all their work done much faster than I could. And I was walking as fast as I could. But what I didn't realize was that I was very inattentive. So even though I thought I was walking really fast, the truth is I'm working on this, but my, my mind is, is doing this. It's thinking about. All the things that thinking about what would happen if abstract things, lots of abstract stuff going on in my head while I am supposed to be doing this one task.
And so, you know, it just helps, it helps you in that. Oh, that's a reason for that. Okay. I get it. And so I don't feel so bad about it. I don't feel like I'm incompetent. I don't feel like I'm inept. I just know that I'm inattentive and therefore I need to figure out how to get my attention to focus.
Like you said, exercise helps, yoga helps,, meditation helps. Medication helps, like you said, not everybody needs medication, but there are some people who do. And so. Yes.
Dr. Diana Mercado-Marmarosh: That's so important, everything that you just shared, like the more that we understand ourselves and approach it from a curiosity point of view and understanding and being self-compassionate because all our life. We probably felt frustrated or irritated that we couldn't perform to the level that we wanted to. Right? And it's like a catch 22 because you're like, well, I want to lose weight. But then all of a sudden you're eating all these sugar when you're trying to complete a task. And you're like, I don't understand myself, I just have this goal, but then you don't realize that you're using that sugar as dopamine to get you to complete the tasks you have to do.
Right. But what are you doing? Meanwhile, you're like beating yourself up and telling yourself, like I'm broken, I'm dumb. I can't even do this. I can't stay on task. You know? But your body's going to ask for what it needs, you know, and for some people, unfortunately, it's, you know, alcohol smoking drugs and it can get us into all kinds of trouble. Right? If we're not aware, right. If we're not aware again. And so yes, it's really having this conversations to figure out, is there something else that might be going on other than me just thinking X, Y, and Z, because unfortunately, we're so busy that we don't slow down enough to ask. Is there a better way or is there a different way sometimes, right?
Dr. Grace Esan: That is very, very true. We don't, I mean, we just, we just go and it's not just us. It's everybody. We just would just go on and go and go. It's really difficult if you, if you're just going, going through all the motions and. Yeah, like this has done the wheels pedaling really, really, really, really hard, but not getting anywhere fast because.
Dr. Diana Mercado-Marmarosh: So my two kiddos are jumping on. They're trying to be part of this podcast as well. Anything else you would like to share with us before we let you go?
Dr. Grace Esan: No, I think, just to re-emphasize the fact that or that, I'm all about helping people thrive with their ADHD diagnosis from the very beginning, which is I'll help evaluate you and tell you, all right, here's, here's what I think I actually will set up a one hour consultation where I will consult with you and tell you, you know, Tell me all your, all the symptoms. And I'll tell you whether I think it's ADD and then I'll put together something for you to take to your doctor and also discuss with you what your options are.
Because like we just, we just went through all the options. Now there is medication there's therapy. There are alternatives is yoga. There's meditation, hen. There's wanting for those people who can ride, you know, that will all, all things that are guaranteed to increase the amount of dopamine release that your brain needs in other to be able to be focused. So.
Dr. Diana Mercado-Marmarosh: Well, thank you so much for coming, Dr. Grace Esan, it's been a pleasure to have you here. So like you heard her follow her on Instagram. Her handle is @thrivewithDrgrace or go to her website, thrivewithDrgrace.com and definitely reach out to her as you heard, both of us are here, sharing our story so that hopefully if you or somebody you know, is struggling and, you know, feels like maybe they're not fully realized they need to figure it out.
And don't be afraid to get a second or third opinion because unfortunately like Dr. Grace was saying earlier, you know, sometimes, people are easy to dismiss you because unfortunately, they don't realize how hard you're working, because maybe you're thriving in some other areas of your life, because like she just said, your emotional intelligence is not a marker of your ADHD.
Like you can be an amazing professional and it doesn't mean that. You know, you don't have ADHD, so definitely reach out. And, that way, either of us could help you, but, thank you again for your time,
Dr. Grace Esan: Thank you very very much for having me on thank you so much.
Dr. Diana Mercado-Marmarosh: As someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group: Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends they too can can learn to live life and stay in their own lane.
 
About Dr. Grace Esan:
Dr. Esan is a Pediatrician in Evansville, Indiana.
She is Nigerian American who grew up in Lagos, Nigeria where she received her medical degree from the College of Medicine, University of Lagos.
She completed her Pediatrics residency training at the Bronx Lebanon Hospital Center in the Bronx, New York City.
She is board certified in Pediatrics. She specializes in the treatment of infants, children and adolescents at all stages of their growth and development, with an emphasis on ADHD,Anxiety/depression and Oppositional defiant disorder.
She has been in medical practice for over 20 years. Dr Esan is happily married and is the mother of 2 beautiful children and her pet Chihuahua.
Website: thrivewithdrgrace.com/
Email: Thrivewithdrgrace@gmail.com
Instagram: @Thrivewithdrgrace
 

Beyond ADHD A Physicians Perspective Ep 22 Dr. Mitra Ayazifar (Ophthalmologist, Oculoplastic Surgeon, Owner of Capital Eye Medical Group)

Dr. Mitra Ayazifar: I should. And what I do, are two different things..
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
 
And in the past year, I have undergone radical transformation after discovering  ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Hello? Hello. I am so excited today to have one of my good physician friends here with me today. We're just going to be having a conversation that is probably a conversation that you might be thinking yourself. Whenever you get a little bit scattered mind or you feel like you get squirreled, you might be wondering if you have ADHD yourself.
You know, sometimes we're pulled in so many different directions. So me and Dr. Mitra Ayazifar are going to be talking today about what kind of questions you should ask. How can somebody gets screened for ADHD, and then is there anything wrong with us? Like, are we being perfectionist or are we being procrastinators or like, what's going on?
So we're just going to have a conversation and see where this takes us. But I want to introduce her. She's a very, very special guest and I'm so honored to have her here with me today. Dr. Mitra Ayazifar ,she is an MD of course, and she's an ophthalmologist in a solo, private practice in California. She is the owner and the CEO of Capital Eye Medical Group with two locations in grass valley and also one in Roseville.
And she partners. Patients to develop their best potential vision so they can live fully and enjoy their hobbies for many years to come. And we are so excited that she's also an ovarian cancer survivor. So, so much to talk about today. And I am so excited. She's here and she's willing to be all in to ask the certain questions, go for it.
Dr. Mitra Ayazifar: Thank you so much, Dr. Mercado for having me on here. I'm so excited to kind of express, I guess, some of the questions that go through my mind on a daily basis. And I'm sure I have so many colleagues and probably so many patients that, you know, wonder. Is it just that I'm disorganized? Is it that I need more organization systems?
Is it just that I have too many things on my to-do list? Or is it just that I don't want to do the things that I procrastinate on, so it always makes me wonder, Hey, is there a particular, you know, is there like a scale? Having ADHD, are there different variations or is it just that, you know what? I procrastinate and that's plain and simple, I guess I need answers to those questions.
Dr. Diana Mercado-Marmarosh: Awesome. Yeah, those are very good questions and you're right. People that sometimes have no awareness, whether this is just like, you know, too many things, it makes you wonder. But let me ask you one question before we jump into that. Do you feel like you have so much potential, but like you never fully reached that potential?
Have you ever felt that way or do you feel like no, I'm pretty content where am at.
Dr. Mitra Ayazifar: You know, obviously I felt that way before I joined, you know, Dr. Una's EntreMD business school, because I always felt like I wanna, you know, I want to provide more for my patients. I want to do more, more than just check their eyes more than just, you know, uh, check on their visual complaints. There's so much more that goes into it. And I think part of it just came from being on the other side and being a patient myself and wondering, wow, you know, there's so much out there that not necessarily every single physician, like, no, but we need to be our own advocate. And I try to be an advocate for my patients too.
Having joined the school. I think now I have so many things that I want to. You know, I love my practice. Thankfully. I love doing what I do. And I feel like, gosh, you know, like these experiences that I have, I want to somehow share it with, with patients or people. What else can I be doing? So that's, that's how I feel. I feel like now I have a path where I have the network and the support to kind of do the things I want to do.
Dr. Diana Mercado-Marmarosh: Yeah. And the reason I asked you that question is because a lot of my patients, because I'm a family medicine doctor, and when I do diagnose it, when they come in, you know, we do the screening questionnaire for anxiety and for depression.
And then I also give them the screening questionnaire for ADHD, which we're going to go through right now with you, just so we can see where we're at. But one of the things that they always tell me is that. They feel like they have a graveyard of unfinished projects that they have like 10,000 ideas and they feel like they can't do them all at once because they're so excited.
They want to do them all at once. And so they feel like they're never a hundred percent like realized or they had so much more potential. And like you said, maybe it, is that something that is so good that you pointed out that sometimes you might have ADHD and you're just not aware that you do because you unconsciously have set up your own systems or have placed yourself in an environment that allows you to thrive.
So for example, you might've married. Somebody who is very OCD and you didn't know. Right. And so they're kind of compensating for you, or maybe you be in a work environment where they don't mind that you're a little bit late. They don't care as long as you get your work done. And they're not like, why aren't you here at 8 51, you were supposed to start at nine.
You should have been 10 minutes early to be on time. And you know, you roll in at nine 30 and they would already fired you because you rolled it in at nine 30 and. Oh nine because you know, 9, 9, 59 it's still 9, you know? And so I don't know if you have felt any of this. Did you ever feel like you weren't a hundred percent realize where you want it to be.
Dr. Mitra Ayazifar: I think, you know, now that you're mentioning that this is probably why I respond, well, maybe I do better when I have a coach. So I feel like definitely, you know, having started the EBS has helped a lot. Also with like the health coaching. I feel like, okay, I know what I'm supposed to eat. I know what the philosophy is behind, you know, intermittent fasting and all of that.
But somehow that accountability seems to put me in a situation where I'm much more successful with it, you know, with the mindful marathon, shout out to Michelle, Quirk, you know, joining her program. I feel like, okay, if I told myself I'm going to train for a 5k. I'm not sure that I would, you know, stay on task, but then having these weekly, almost like homework helps me keep up with it and actually be excited about doing that.
So I wonder if everybody's like that or is that. Portion of ADHD that, you know, makes me do better with that. Just accountability in general. The only thing I have to say, you know, I'm my own boss at the moment. So she's really mean. And the only thing, the only thing I see is like on my, my desk, especially at one of my locations, goodness, you know that these papers are piling up and it's like, I've already taken care of the patient.
I've done the patient care, I've done the surgeries and it's all the other stuff that I need to do that that's not medical necessarily that I just don't like to do. Yes, I do.
It's painful. I barely get on my, I'd rather get on my, you know, on my phone and, you know, listen to a podcast or something else rather than do that. Oh my god. Yes. Yeah, yeah, yeah.
Dr. Diana Mercado-Marmarosh: And the thing is that even though it's boring and painful, you are probably going to delay it till the last minute. When somebody tells you I need this, otherwise X, Y, and Z concept. Because, and that's the thing with ADHD, and I know I haven't asked you the questionnaire, but the thing with ADHD is that it's almost a missed namer on the diagnosis because you hyper-focus on things that are of interest to you. Oh my God. Do we hyper focus? Like sometimes we think we're going to spend 20 minutes doing XYC two hours later. Are you done? And you're like, oh, what? Like you were so in the zone. So to say, and it could be very complex thing.
So like you just concentrated in a surgery and then, like you said, this other thing that seems like should take you literally five minutes to complete a form, they take you an hour because it's painful, like you just said. And so it's the executive function tasks that are boring, or when we decide to do it, like at the end of the day, when you already made 10,000 decisions throughout the day, and you're like, Ooh, I can't wait to do this task that is boring and painful, but I already did what I needed to already took care of the patient.
They have their meds. I'm done. Right. And, I always joke around and I say, how come nobody was videotaping this? Like, this was an amazing encounter. Like why don't like can't just somebody submit my video from them, like, and pay me like we did amazing. They just compliment me. Why do I still have to sit down and write it?
It's the thing where you leave your heart in the room and you realize how long you were in the room and then the time blindness of it. And then you go because you're a little bit late and then more late and more late, it adds up. And then you don't have time to do this boring thing that is the chart. Or the callback or some paper that has for FMLA or whatever.
Right. And then some of these things, unfortunately, are not paid for like the FMLA paperwork or something else that you're having to do. So it's like an additional task that you don't want to do. And so I don't know if any of that resonated with you, but let me ask you the questionnaire and see what you think.
Okay. All right. So to make it simple, we'll just say, we'll do like a 1, 2, 3, 1 being does not apply to me, three being like, yes, for sure. This is totally me. Okay. And then a two is like, yeah, I could see that, but it's, it's definitely not a no. Okay. So 1, 2, 3, but if we were doing the questionnaire, it's like five of them.
So I get, I don't know if you could remember five, but it's usually harder to remember. Never rarely, sometimes, often, very often. So that's why I'm just giving you either as a, never to sometimes, or the very often. Okay. That's what I'm going to have. Answer it think about it, like never sometimes or very often.
Okay. So the first question is how often do you have trouble wrapping up final details of a project? Once the challenging parts have been done? Let's say you already got like 80% of it done, but then you still have to wrap it up the final details. Like how troubling is that for you.
Dr. Mitra Ayazifar: Sometimes.
Dr. Diana Mercado-Marmarosh: Okay. How often do you have difficulty getting things in order when you have to do a task that requires organization?
Dr. Mitra Ayazifar: I guess. So right now I'm only focusing on my patients. Right. So without the systems that I have set in place where I double and triple check, you know, like the lens number and all of that, I would say it would be, I guess, sometimes still number two.
Dr. Diana Mercado-Marmarosh: How often do you have problems remembering appointments or obligations?
Dr. Mitra Ayazifar: Often, unless I have put it in my calendar and the alarm goes off.
Dr. Diana Mercado-Marmarosh: When you have a task that requires a lot of thought. How often do you avoid or delay even getting started?
Dr. Mitra Ayazifar: Often.
Dr. Diana Mercado-Marmarosh: How often do you feel like you're fidgeting or squirming with your hands or your feet? When you have to sit for a long.
Dr. Mitra Ayazifar: I would say a one.
Dr. Diana Mercado-Marmarosh: And how often do you feel you're overly active or you're compelled to do things like you were driven by a motor kind of like impulsive, like you just have to get to that right now.
Dr. Mitra Ayazifar: I would say not compostable. Never.
Dr. Diana Mercado-Marmarosh: Okay. So those were the first six. So if you had scored five of those had been up sometimes, or very often you would have scored a positive.
Right now you scored 1, 2, 3, 4. So you're a little bit shy of saying that you have ADHD right now. Let's do the bottom part and see what it shows. How often do you make careless mistakes? When you have to work on a boring or difficult project.
Dr. Mitra Ayazifar: Never. Because I just avoid them.
Dr. Diana Mercado-Marmarosh: I would say often that okay. Was they never because avoiding. Okay. Number eight.
Dr. Mitra Ayazifar: I don't even get to that point.
Dr. Diana Mercado-Marmarosh: How often do you have difficulty keeping your attention when you're doing boring or repetitive work?
Dr. Mitra Ayazifar: I would say a three because it's so boring, you know, it takes me longer.
Dr. Diana Mercado-Marmarosh: Yeah. How often do you have difficulty concentrating on what people are telling you, even when they're speaking directly at you?
Dr. Mitra Ayazifar: I would say never that's you know, that's the best part of, I feel like that's the best part of my job when I'm in the room and I'm listening, coming up, listening to patient's stories that I take so long in the room, my ma has to come and knock on the door. So I am paying. attention to what they're telling me.
Dr. Diana Mercado-Marmarosh: How often do you have misplaced or have difficulty finding things at home or at work?
Dr. Mitra Ayazifar: At home? I would say, often. It's usually my phone, my keys. Where's my computer.
Dr. Diana Mercado-Marmarosh: How often are you distracted by some activity or some noise that is around you?
Dr. Mitra Ayazifar: I would say sometimes. So that would be a two.
Dr. Diana Mercado-Marmarosh: How often do you leave your seat in meetings or another situation when you're expected to remain seated?
Dr. Mitra Ayazifar: Oh, never at work. I behave.
Dr. Diana Mercado-Marmarosh: How often do you feel restlessor fidgety?
Dr. Mitra Ayazifar: I guess sometimes it depends on the activity. I would say two.
Dr. Diana Mercado-Marmarosh: How often do you have difficulty unwinding and relaxing when you finally have time for yourself?
Dr. Mitra Ayazifar: I would say sometimes, two.
Dr. Diana Mercado-Marmarosh: How often do you find yourself talking too much when you're in a social situation?
Dr. Mitra Ayazifar: Never. I actually am pretty quiet.
Dr. Diana Mercado-Marmarosh: When you're in a conversation. How often do you find yourself finishing the sentences of other people when you're talking to them before they can even finish it themselves?
Dr. Mitra Ayazifar: I would say I actively am aware of that. So I would say never to sometimes I wish there was a one and a half somewhere.
Dr. Diana Mercado-Marmarosh: Okay. How often do you have difficulty waiting your turn in situations when there is turn-taking that is required?
Dr. Mitra Ayazifar: I would say, I would say never. I follow those rules. I mean, I am able to follow those rules.
Dr. Diana Mercado-Marmarosh: How often do you interrupt others? When they are very busy?
Dr. Mitra Ayazifar: Never.
Dr. Diana Mercado-Marmarosh: Okay. So on the bottom, an eight or more would have been considered positive. And on the bottom you scored 1, 2, 3, 4, 5, 5 out of eight. So on the top you scored four out of six and on the bottom you scored a five out of 12, so there's obviously some of the things that are there that could say, you know, that you have some possible ADHD characteristics, right. But this is a screening test. Like if you really wanted to know a little bit more in detail, they do have what is called neuropsych testing. And that's a little bit more eight or nine hour tests where it's almost like a neuro psych test. Right? So they'll give you some things for you to answer some pictures, some things to draw back they'll ask you questions, like math, all kinds of stuff, because they're trying to see how you're functioning.
The thing with ADHD is that especially in females, they don't tend to be diagnosed until later in age. Like usually after the birth of a child or after they go to like college or med school or law school or some type of professional school or. Promote it like to now be like the CEO of this, or like some level leadership thing, or sometimes even when they get to menopause because of the changes in the hormones and the low estrogen, like that can cause stuff to be more obvious.
And then females tend to be more inattentive type than hyperactive. So there might be missed. So it's like that female who was in the back of the room was quiet. Who's not screaming, who's just daydreaming. So they're like the perfect student for the teacher. Right. Because they're like, great. She's just in class.
And she said a little angel. She's not saying anything. I know aware that her mind is in 10,000 other places and not really right here. Right. And that's why I was asking some of those questions as you saw. How often do people tell you, Hey, but you were looking at me, how come you didn't catch none of that.
It seemed like you were like, did you space out? Like what happened, basically? What happened? You know? So that's the thing with that, right? Sometimes it gets, it gets a little fuzzy because they automatically assume, okay, well, she is. She's gotten this far, she graduated from college and sometimes they ask you, did you graduate from college?
And you say, yes. Are you married? And you say, yes. Do you have a job? And you say, yes. They're like, okay, you don't have ADHD. That's the old way. Like, but they don't know how hard it is for you to be carrying all the hats in the air. You might be doing it out of obligation or because you love what you're doing and you don't realize that you're doing it harder than somebody else is doing it.
And I think even in the profession, I feel like there's all these norms that get thrown at us. You know, you're supposed to work like you don't have a family and you're supposed to have a family. Like you don't have a job. I was asked recently by one of the male physicians that joined my group. He asked me, he's like, why is it that I'm one of like many females in this group?
He's like, how come I'm the only male? And he's a psychiatrist. And so I say, I'm not sure. Do you have any insight, am I saying the, the content wrong, you think I might not attracting male? Like you think I'm being exclusive. And he said, you know, I think it's because males tend to delegate tasks a lot easier than females do.
And so he said maybe his wife needs like the males, wife needs to come to your course. Cause I'm pretty sure they're burned out. He said, I'm pretty sure the males have no idea. That they even have ADHD because they're used to be in tardy and somebody else picks up their stuff. He's like, I'm not trying to generalize.
He's like, but as a male and a psychiatrist, he's like, I can tell you that males, you know, usually don't come to see me until they have hit rock bottom because somebody else has. Picked up their slack. Like maybe they got a divorce or maybe they failed board exams or whatever. He's like, otherwise they're not going to come and seek help.
And so it's just interesting how there's so much regarding ADHD that we still don't know. And then you throw in the genders in there and then like what sometimes we feel as females, like, we feel like this mother nurturing thing, we want to take care of everything. And we want to be perfect in all the areas.
Yeah. And so why do you think you procrastinate? Like, do you think it's just like you asked me that question, which we still haven't even acknowledged or discuss whether it is for procrastination or whether it's really just a form of, you know, of you just doing all the things. And sometimes we do need rests, but what makes you think that you procrastinate?
Dr. Mitra Ayazifar: You know, I actually was puzzled about this because we were, I mean, in a group and you might be too where we were going to read book about Brian, Tracy, with something about frogs. I forget it right now.
Dr. Diana Mercado-Marmarosh: Eat that frog!
Dr. Mitra Ayazifar: Eat that frog. Okay. So I downloaded it on my audible. I knew I'm like, okay, I'm in this group or I'm going to be listening to this on my commute because you know, when I go to my one location, I have 45 minutes each way. This is the perfect time to listen to this. Can I tell you it's been several months and I haven't finished it. I mean, I'm procrastinating on listening to a book on procrastination. I don't know what to say about that. I'm like, okay, I need to gain some insight. About what Brian, Tracy is saying about this.
And I haven't finished a book. I don't think it's because there are so many other things. I mean, there are so many other things that I want to do
Dr. Diana Mercado-Marmarosh: So tell me what what's going on. Like, are you putting it in, are you putting play, forgetting about it? Like what, what do you think is going on?
Dr. Mitra Ayazifar: I think I know it's there, obviously, because, you know, I even came over with the Tik Tok laughing about it, but I don't, there are other things obviously that I like to listen to also, but I know it's there. It's like it's it's right here. Saying, you know, Mitra, you haven't listened to me. This is no, you wanted to find out, you know, how to get around procrastination.
That's why I'm thinking. Well, maybe it's not just pure procrastination. Maybe it's ADHD. I need to figure it out. It's in my phone.
Dr. Diana Mercado-Marmarosh: Did you find it boring?
Dr. Mitra Ayazifar: Maybe, maybe I almost felt like, oh, I really need to sit down and take notes with this. And so if I was walking the dogs or if I was driving, that was probably not the best time for me to, I guess, take advantage of it.
But then when I do sit down, there's so many other things I, I need to do. Like that's not at the top of my list and yet I should figure it out. You know, I should. And what I do are two different.
Dr. Diana Mercado-Marmarosh: I give you a quick tip there any time we say I should do X, Y, and Z. We're never going to do it. No, it's it's like a innate wire thing somewhere, somebody told us we were supposed to do it a certain way. That's why you're saying I should be doing XYZ, but inner gut is telling you no. Fucking way. I'm not doing that. Like, it's just telling you, like, it's creating some type of visceral response, no matter what you're not going to, because it doesn't feel aligned with you.
It's not a value of you, at least not right. The second. It just doesn't feel right. And so just catch yourself any time you use that word, just get curious and become interested in why did I think that? So there's the thing like that. Yes, you're correct. There are certain books that you need to maybe hear two or three times, or you may have, you need to hear it and come back and you can get the gist, but you really need to sit down and like you said, journal on it or outline what it means or whatever.
And you're not going to catch everything at once, but at least you can go through. If you find it interesting with an open mind and curiosity, but I think some of us, we are like an all or nothing. It's either I'm all paying attention or I'm not paying attention at all. And so we want to get perfect. Like you said, all the notes, and like you said, when you sit down that all of a sudden that's not as important than something else.
In general people with ADHD. And even though we maybe with this screening tests, it's questionable whether you have it or not, but there's a lot of stuff that maybe that I'm saying that's still relate to you and can still be applicable for most of us it's now or not now. And if it's not now, if you don't put it in the calendar of when you're going to pick up that nugget again, it's just not going to happen.
It's just, won't, there's never going to be a perfect time when you're like. Oh, this is the perfect time to learn how to overcome my procrastination. Like never are you going to be like this is it! Right. And so if you, this is an intention of yours to like, at least get curious about it. It doesn't mean you have to apply anything, but if you get curious about it, then you're tapping into a different thing versus if you're walking in with, I should know how to figure this out, then you come in in with like an expectation that it's almost kind of negative. Like I should have already figured it out. Why am I so slow at this? Or why, why am I so dumb? Whatever, insert the line that your brain is probably offering.
That is probably not the best way to approach it. Anytime we throw the word around procrastination, our brain. It doesn't matter who it is. Our brain has equated efficiency or effectiveness to equal, worth or productivity. Right. When we talk about procrastination, we're like, that's a negative feeling or that's a negative thought or that's something I should not be doing.
Somebody, one of my clients pointed out to me the other day. She's like I had the most validating experience with my therapist the other day. She says, it's really beautiful when you're opening up to understanding yourself from a non judgemental way. Although I wasn't, she said I was being judgmental.
Like you just said earlier, when you said my boss is, so mean, we have this inner critic, right. For some reason, things that. They beat you up. Nobody else can tell you anything worse than what you already told yourself. So supposedly that's going to motivate you to like do it, right? Like put the fear in Jesus, in you.
So to say so that you can get it right. But we already know nobody functions their best when they're feeling like that. Right. But if you feel like loyal to your boss, like you're going to do all this other stuff. Right. Because it's aligned with you because it feels right because you're being accountable, like you said, and that's something with ADHD too.
We will do anything and everything for anybody else, not for ourselves, we forget. And so that's why self-care is so important, but you've have figured out the hack, that's showing up with somebody being accountable to somebody that's going to get you to then be like, okay, I can be tethered somewhere.
Like I had to come back to earth. Cause they're asking me questions right. With this being said, like, when you, you decide, okay, I'm going to. so what, what her therapist told her that getting back to that point was with a procrastination. She asked her, you know, she was telling her, I can't believe I did this again.
I have not done my grand rounds. I know I had to prepare this lecture. I knew like three weeks ago I had to prepare this lecture and like it's next week. I have to prepare my next, your legs weak. And haven't started. I like I knew for so much time and she's like, I always do this. I should show shoot.
So she was doing the shoot shoot, shoot. And then that there were solar. Whoa, whoa, whoa, whoa, stop. Stop. Right there. Stop right there. She said, do you work well under pressure? She said, yes. Have you finished your stuff under pressure before she said yes. So then why do you have to do it any other way? If this is a way you do it, then do it again.
Yeah. And she said, everybody says, I should have everything she's like, should, should, should. So she said, I felt validated that I didn't have to do it differently than I was doing, because I she's like really only takes me three hours because I already know what I want to say, but not until I have a deadline, do I have to jump in and do it?
And she's like, and I feel good about the outcome of that.. So she said I did it, I did the three hours, like, like I, she gave me permission to keep doing it and to not feel guilty about it. And she was like, and I felt proud that I was able to be somebody who could complete it. And she said, I felt good for the first time to use my own system.
Even though it looks like procrastination for somebody else, but this is the way I function. And it has never failed me before. Why do I have to beat myself up for listening to the way I function? That was so insightful. Now I'm not saying that to going Kershaw, everybody to leave everything to the last minute, but I'm just saying that sometimes depending on what task it is, especially a task that you have never done before.
You might have to break it up into chunks. Like maybe the first time, you know, you think of the idea, maybe the next time you researched the idea. Maybe the next time you do a dirty draft, maybe the next time you go and insert it, whatever, like you might have to break it down. But some of the stuff that we procrastinate on could be that either they're boring or in our brain, we have decided they're too big of a task to do right this second.
So we rather buffer with some other low hanging fruit.
Dr. Mitra Ayazifar: So I'm curious, like with someone, when do you say to someone that has ADHD and I'm sure you approach this many times where like they have to study for a board exam where it's not, you can't cram that. Like how do, how do you even coach them into doing
something like that?
Yeah. So with that, this is what we have to always explain to people is. Our brains, the ADHD brain is still curious. Like we are always going to be lifetime learners. It doesn't matter, which is good. And it's bad. I mean, it's always good, but it's bad in the sense when, like you just said, you're having to do this board exam, you're just supposed to give back the facts.
Like if they say. What are the three pre-renal, blah, blah, blah, blah, or pause Reno, blah, blah, blah, blah. Like you should be able to spit it out. Or like, if you see an MCV of a hundred, you should automatically be thinking, okay, well, it's going to be macrocytic anemia. I has to always be bottoming, B12 deficiency, or fully like, those should be things that you could put right by.
Dr. Diana Mercado-Marmarosh: People with ADHD, they're going to go read everything about macrocytic anemia, everything about folic acid. Like they're going to get lost in the weeds. They can't see the big picture when they read. They want to read every single letter. Because they're afraid they're going to miss something because they can't figure out that they need to prioritize and they don't get through the whole thing, but they need to learn to do it their own way to study.
They have to learn. Do I have to synthesize this by drawing? Do I have to synthesize this by making a flashcard? Do I have to synthesize this information by. Talking it out with my tutor because my tutor would tell me what is the actual prioritization of that data? Because in our mind, everything is a priority.
You can't figure out which one is the priority, and therefore you can see why some of them go through like questions and they do 10 questions. Three hours. You're like, sweetheart, you're not going to have three hours to do 10 questions, but they really want to learn every single little detail. And so this is where I say, I'm sorry, but the board exam is a memorization exam and you're never going to have 30 seconds.
To examine your patient. So right now, when you see this, you think this, when you see this, you think this, this is gonna be a different type of tests. This is not the type of test that you are going, the way you learn, which is okay, because you learn by further understanding. But you're going to have up-to-date in your exam room when you're seeing your patient, it'll be okay.
You're going to have time to bring them back and do whatever you need to. But for this board exams, they need to really know themselves. And this is where they have no insight what has worked before and what won't work before. This is where they really have to get curious. And it's so important that they use.
Work with like a learning specialist. There are some out there, or even with like an ADHD coach or just any, uh, learning coach, because then you start to figure out how your techniques work only for you. And you don't have to, it's normal for us to compare, like it's human nature for us to compare, but what you make it mean after that is what makes the difference, because if you were comparing and you're like, but they're so fast who cares?
You, how do you learn? How do you do it? Because they're not taking your test, you're taking the test. It's your name on the test? And so it's bringing it back and sometimes again, people want the all or nothing. They want the highest grade. I'm like, who cares? You just want a pass, a pass means MD. And so that's where, where we have to get back to that.
But that's a good question. Yeah. The standardized testings do not reflect how smart and how driven and how motivated somebody with ADHD is because it's just not a fair test because we're not used to spinning things back. We're used to understanding so many different levels and sometimes too detailed for what the test is asking.
Okay. So I think I
have a couple of plants, obviously. I think the book where I say, oh, I should listen to this. I think I've been trying to do it perfectly the first time. Right. So as you said, it's okay to go through it once, listen to it once, whether I'm walking or doing whatever, and then come back to it, listen again.
And then if I need to take. Take notes. And as far as I should, I think I need to get better with planning it. Okay. When am I planning on doing this? You know, and calendar. And just get to it, put a task list, prioritized and, and basically
get it done. Yeah. And even if you decide I'm going to listen to this for 10 minutes, if my ride is 45 minutes, I'm going to listen to it for 10 minutes.
I'm just, or I'm just going to listen it for one chapter. When he sees, he says, he's done with a chop there. Perfect. Then I'm going to listen to something else. Like it doesn't have to be all or nothing. Right. What have you just listened to it for five minutes is better than nothing. And it's just, you just get curious.
And that's the thing too. When I tell people when you're reading something, don't just jump into it. Like, look at the titles, look at the pictures, ask yourself a question from what you're looking at. Like, huh? What are the two types of blah, blah, blah. Like when you're looking at it, if you ask you questions from what you're doing, all the sudden you're reading with intention.
To grab information of the questions you create it from the, the bold words and the big titles, right? Not just diving in for, you don't even know for what. Right. And so now you're reading with intention. And so a lot of people have district Tuk, which I haven't done yet, but some have, whereas. If they like the book the first time around, or if they listened to it.
But they're like, like one of the books that I've been listening to, which is the way of integrity, each chapter has like a journal prompt, which like, again, you're on driving, so I can't be doing it. Right. But then I ordered the book. And then I'm like, oh my God, that's a big book. Thank God. I first listened to the audio because I wouldn't have opened the book otherwise.
Right. But then now, because I can go exactly to the book where I wanted to do, and then you can read the book with intention as, as well. You know what I mean? And so it's just doing it a different way and doing it and not being worried about it. Yeah, that, that definitely
makes sense. So yeah, I think just this perfectionism thing is not helpful at all.
It's like, why does it have to be perfect the first time? And there, there are definitely some of the books where audio books that will take me a lot longer. Like you said, it's like, I will listen to a chapter and it's, it's boring. It's good information, but it may be boring and I can't do it all in one sitting and I don't have to, so I'll come back to it at a different time.
And books like those, like you want to listen. So that's why if you break it up into chapters, like if you decide I'm just going to listen to one chapter, I'm going to just listen for 10 minutes and you're listening with the intention of what can I implement today? Like what little thing can I implement today?
Like eat the frog. He, he talks about doing the biggest task. First because that's like what you're trying to avoid, but, you know, while that's a good idea, not necessarily the right idea for everybody, because that might send them through a rabbit hole and three hours are gone, which might be okay. Right.
But what if for you, it worked better that you decided that you were going to do. Two of the tasks of when to take five minutes and that's going to get you pumped up and then you jump into the tasks. That's the hardest, because you're already going the brain can't tell. So once you start something you want to continue, right.
And so, again, there's not a right way. It's just, how can I implement? And the thing with all these books you take, what fits you, try it. And you let go of. It's just meant to, it stimulate your own brain to come up with your own ideas or try some of lawyers. Right. But these types of books where they're like self care books, they're not just meant to be like passive they're meant for you to try to.
Implement. And we already know, none of us are like, Ooh, I can't wait to change all my life today. You know, most of us are comfortable and even most of us are comfortable in being uncomfortable sometimes because we at least know where we are. And I always joke around. I see the tick there. Let me remove it.
You're like, Nope, Nope. Don't move it. I feel the pain. I know the pain and I'm like, no, I can pull it out. You'll be okay. No, no, leave it alone. You're like, okay, you're going to walk around with a tick on your butt. Yes. Leave it alone. Okay. You know, and so it's just funny how our human brain gets used to different things.
Absolutely. Absolutely. Is there a book about like, that's your favorite. You know, maybe not eat that frog something other than that, as far as like organizational skills or something
that you would suggest, well, I don't know about organizational skills per se right now. I'm still working on them myself, honestly.
But one book that I would suggest that I think you would really love. It's the four hour. Like, that's my goal, like to one day have only work four hours a week. Like how amazing would that be? And again, the way he talks about it, it's fun. He's telling you stories and he's telling you all kinds of stuff.
So it keeps you interactive and it makes you like, almost be like, Huh? That sounds amazing. At one point he goes through the whole thing. He says, you know, there was one time I had three VA's who were working for me all over the world. And it was funny cause I was in a fight with my wife. And instead of fighting with my wife, I send my VA a message to send her an email telling her blah, blah, blah, blah, blah.
And then of course I had to send the other VA a message to buy her flowers because I knew I had lost that fight, but still, you know, So it's so funny how he was like, you know, it's amazing to shoot somebody a quick email and be like, Hey, take care of this. And then you go to sleep and somebody in India or the Philippines or Australia takes care of it for you.
And because they're working, that's their norm or time zone. And so I think that's a book that you should definitely look into. I did listen to eat the frog. I liked some of the stuff, but other stuff, I was like, eh, For our workbook. I think that you would a four hour Workday that you would like that. Okay.
I'm going to
look into it for sure. And one more thing before we wrap this up, I mean, with procrastination and I think this is the thing for everybody. Sometimes it's not procrastination sometimes it's just that we're tired and we're trying to do things at a certain time. That that is just not ideal.
Like we're sometimes like some of us are trying to pajama chart, right? Like, you're trying to do something that requires executive function. Like when you have no time, like no energy, like, it just doesn't make sense. So sometimes some of these tasks, it's not that we're trying to procrastinate. It's just we're we feel like we're ignoring it, but we're at the same time, we're kind of listening to our body that this is not ideal.
Like, yeah. Jump on there. And it's going to be three hours for you to do, like what a, probably taking you 20. The next day after you had slept. Right. And again, I think we go back to this thing that society keeps shoving your procrastinator procrastinator. Well, what if I am like that? What if it means I'm an ideal restaurant?
You know, I like to rest, right. And so you just gotta figure out how are you using it and don't be using it to like, keep telling yourself there you're only worth the. Doing producing money for somebody else, you know, or for yourself?
No, that's, those are very valid points. It's almost like, oh, well, if I have the diagnosis of
ADHD leading that, that, that makes
it okay.
That I'm, you know, procrastinating. I don't know what I was looking for, but I know these are definitely questions that probably other people have also. And. I, you know, obviously for my patient care and everything, there are certain things that I have like 10,000 checkpoints, just because I want to make sure and double check and triple check everything about them.
But this is more like the things I need to take care of.
And here's the thing that it just, because today, maybe the way you answered the questionnaire, it doesn't seem like you have ADHD. It doesn't mean that that was correct, because what happens is people with ADHD, they might tomorrow my ask you, and you might have a totally different answer.
This is funny, but it's not funny because people with ADHD. One day, my answer, based on what they're thinking and another day based on what they're feeling, sometimes they don't match. And so the people that don't have ADHD, you ask them the question. It doesn't matter what day you ask them, or what year you ask them.
They'll give you the exact same answer. People with ADHD. I'm telling you one day to the other, they changed. And then you can see why everybody around you is so confused. They're like, but yesterday. I said, and I was like, yeah, that was yesterday. What about it? You know,
You know, and so, so you could see how you're not meaning to be difficult, but they say, they call you difficult, but you're not trying to. And you're just like, yeah, that was what I was feeling yesterday. But today I'm thinking this and you're like, they're not the same. No, because yesterday I was mad and today I'm super excited.
And today, and today I'm thinking that this is doable, but yesterday was an impossible. And they're just like, oh my God. And so, so I'm just telling you this, because what I have seen is that, that at work, because again, our level of responsibility that we might be functioning, because you answered a lot of question based on how you were doing work.
But if you answer the question based on work and home, it might show something else because. You might've already spent or your executive energy at work and you come home and you're like hot mess. Like you almost feel disconnected. And so that we, something else to like look into, because like you said, you might have all these checks lists and you have developed your systems unaware that you have developed systems, but it could be because you were so careful.
Not on purpose, of course, because this is something not that we do. It's just that again, we jumped from one thing to another, to another, uh, and we have a time blindness and everything comes at us and we get overwhelmed and sometimes irritated because we can't prioritize because everything seems so important right.
At that moment. And so what happens is then you have those checklists. So therefore you don't think there's a problem there for ADHD, but if you were to take away those systems, damn hot mess here. See what I'm saying, they could have been somewhere along the way you might've gotten burned and you're like, oh no, we're going to way over turn it all the other way.
And so now you're way compensated by checking 3, 4, 5 times where somebody else never checks more than once. Like they just totally trust themselves. Not that I'm saying that you don't trust yourself. I'm just saying in general people overcompensate, sometimes for that.
Dr. Mitra Ayazifar: Yeah, no, I totally understand.
Dr. Diana Mercado-Marmarosh: Yeah.
So now I just give you more things for you to go home and think about, and just be curious and just observe don't judge, just observe and don't judge, right. Just be like, huh? Like when, when do I function? And what am I not wanting to do? And just get curious with it and be like, where is it a hot mess?
Because you know, in my, in my course, it sounds funny, but I actually have a declutter coach. And like, you would be surprised like that my, my physicians are like, yeah, keep that part. Don't don't let go of that part. Like, you wouldn't think that. You know, people like paper clutter, or like systems with like, I don't know why we have 10,000 lids that don't match, you know, and, and socks that don't match.
And you're just like, where did they go? I know it was like the stocks become lids. I dunno. The
Dr. Mitra Ayazifar: clutter coach did that. That would be very interesting. Yeah.
Dr. Diana Mercado-Marmarosh: Hey, I'll refer you. She's amazing. So tell me, where can people come and find you? Cause it sounds like you're doing amazing things over there taking care of people's eyes.
And, and I always think that they should go see a physician, especially our diabetic patients. Right.
Dr. Mitra Ayazifar: Right. Um, so I am, um, my website, you can find me at www cap. I med.com, C a P E Y E M
Dr. Diana Mercado-Marmarosh: E d.com.
Dr. Mitra Ayazifar: Um, I will share my link tree, which has my tick-tock has my Instagram and my Facebook, but basically my practice is in Northern California.
And it's called capital I'm medical group. I am my boss. That's why I said she's mean. And
Dr. Diana Mercado-Marmarosh: so I get to say that she's working on she's working on getting better and I'll give you another trick real quick with that. And I picked up this trick at an emotional intelligence course. I didn't even know they had those courses, but they do basically.
Any time you catch yourself being mean to yourself or a thought that just pops up, that you don't even realize that it's not the truth, but it's, it's kind of hurtful picture your, your S your niece who's three years old, or your daughter who's three years old saying that thought to you. Or that somebody's told that thought to them, like, let's say if the thought is like, you're too, you're too loud or you're too, you're too fat or you're too slow.
Whatever thought all of us have a thought that keeps popping up in whatever we're doing. Picture a three-year-old being told that somebody, you, you carry that your daughter like that, they just told you that you're just. Or you're just low or whatever. Right. And she's coming to you asking you for advice.
Like what would you tell her? You're probably going to give her some advice that you're going to, the mama bear is going to come out, right. You're not going to hit her being talked to, and it doesn't have to be even your daughter. It could be anybody that you were being seen wrong. Right. And so it's so weird how we.
We'll have so much more compassion for somebody else, but ourselves. And so when you do that, all of a sudden, even your three-year-old take, take your own three three-year-old picture of yourself and, and, and defend that person really. Because at the end of the day, again, You can get more bees with honey than you can with vinegar.
That's true. That's for sure.
Dr. Mitra Ayazifar: Thank you so much. I appreciate your time. Thank you so much for interviewing me.
Dr. Diana Mercado-Marmarosh: Thank you for asking all these questions, because I really think there's a lots of people out there wondering this thing. So these are perfect questions because like I said, unfortunately, and this is why we're having this conversation.
Unfortunately. Females are not given that opportunity to be screened for ADHD if they are smarter, older, educated. Right. Because they just assumed that no, that's just a shallow thing, blah, blah, blah, blah, blah. Right. And so they will spend so many years with a diagnosis of anxiety or depression. And never get to the right thing until somebody else picks it up.
Right. And so if you find yourself, like you said, Lucy, and all the keys spending, having to spend extra money on late fees or, you know, being impulsive sometimes and buying all the things or, you know, just. Watch out for that. Cause it might be something else.
Dr. Mitra Ayazifar: Thank you very much. Now I'm going to be definitely checking in with myself more often.
Dr. Diana Mercado-Marmarosh: All right. Well, thank you so much. Have a blessed day. Thanks. You too.
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About Dr. Mitra Ayazifar
Dr. Ayazifar is an Ophthalmologist practicing in CA and has been practicing for over 25 years. Her goal is to make a positive difference in the health of her patients in need. She believes that vision care goes far beyond a simple eye examination.
 
Website: capeyemed.com/
Instagram: Instagram.com/mitramd3/
Facebook: facebook.com/DrMitracapeyemed
Tiktok: tiktok.com/@drmitramd?

Beyond ADHD A Physicians Perspective Ep 21 Dr. Jia Ng (Nephrologist, Researcher, Founder of PublishedMD)

Dr. Jia Ng: Writing is very cognitively demanding. We always think that writing is only words on paper, but actually writing comes from processing. When you just go in to a session, thinking that is going to come up with it within five minutes is impossible. Academic writing is nobody's first language. Everybody has trouble when they first start, there is a structure behind it and there is a skill.
Dr. Diana Mercado-Marmarosh:  Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
 
And in the past year, I have undergone radical transformation after discovering  ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Okay. I am so excited today. I am going to talk to a dear friend of mine. This is Dr. Jia Ng, and she's a board certified nephrologist and a clinical researcher at the sector school of medicine at Foshe Scott Northwell. And she's also the founder of PublishedMD. Where she coaches clinicians on how to publish research papers and achieve their academic goals without the overwhelm., oh my God, this is such a needed thing.
You know, one of my biggest limiting beliefs is that I'm not a good writer, that I'm a slow writer that I can never publish anything. I remember it was always so painful to do, you know, any type of like project that required writing. I would rather be like, can I turn in a video? You know, but obviously you need to be able to communicate in written form and also, you know, through video or whatever form. Right?
I am so excited to have you here so that you can share it tricks and anything, but I'm very curious. How did you decide to coach other clinicians to do this? The writing part? I know a lot of us have problems with writing notes, much less something more like this, like a research paper and stuff.
Dr. Jia Ng: Thank you so much for having me. Yes. I went into this because I was struggling myself. And first I am, English is not my first language. And then I came in thinking I wanted to do research and I struggled for a whole year. Could not write, could not get first draft all my projects. I like abstract conference abstracts, but never a full paper.
And so I know the struggles and after getting, courses and coaches, because that's my path. I found certain ways. And so then habits that really helped me. And so now I see clinicians in the same pain and I know I can help you. So I decided, and I was giving workshops and saw the results like, oh, just by doing simple steps, you can improve and you can like get it.
So that's why I kind of started doing this.
Dr. Diana Mercado-Marmarosh: That's so great to hear that we all like simple, believe me, your brain wants to tell us it's no, no, it's complicated. I can't even start. So when you break it down and make it simple that at least sparkles or interest, and obviously we got through med school, right.
So we could do, we do a thing or two there, and it's interesting. English is also my second line. Primarily Spanish speaking first, up to the age of 10. And then I, I learned English. When did, what is your primary language? And then when did you learn English?
Dr. Jia Ng: So, I'm Malaysian. I went to actually a Mandarin school and we learned Malay and English as part of. Even though I speak English as Malaysian English, which is somewhat broken with a mixture of dialect can in there. So when I write my, my essay it's is usually, I've missed either grammatical errors or spelling errors. So that's, that's my issue with writing initially.
Dr. Diana Mercado-Marmarosh: Yeah for us, we call it TexMex, you know, Texas English and Spanish mixed together TexMex.
And some, we make up some words that have nothing to do with like either English or Spanish, but whatever it's fun. Right. So tell me. Have you ever worked with anybody who has ADHD or have you, what do you think would be some tips or techniques that might help somebody who has, you know, in their mind, maybe a limiting belief.
You don't have to have ADHD to think you're not a good writer, but some of us with ADHD have that belief. What kind of advice would you give them?
Dr. Jia Ng: Yes, there's this myth like you birth is you feel like you have to be a naturally good writer. That that is a big myth because it is a skill. And I would even say that academic writing or academic writing is not, is nobody's first language.
So everybody has trouble when they first start, there is a structure behind it and there is a skill. So usually first you need to know. The, the invisible structure in a paper, like what goes in, what, where, and even though like the discussion section looks like paragraphs of something, but actually if you look closely and if you know the insight part, there is a structure like paragraph one, You need to write something, paragraph two, you need to write so then wait. So, there is a structure, first know the structure, what needs to go in where, and, and once you go there, it is more like, how do you break it down? Which section needs to have only methods, which only have certain results and you don't mix them. And it's very prescriptive. It's almost prescriptive that that's why it's easier once you know, the, the prescription or the algorithm. I find it easy.
Dr. Diana Mercado-Marmarosh: You know, you bring such a good point up. Most of us, any tasks that we're trying to do, if we don't understand the rules of the game, right. Or the task, it's going to feel impossible. Right? If you are giving the 411 Hey, This goes here, this goes here, this goes here then at now it doesn't seem like such a big task or such a big thing. And so how long have you been writing or publishing papers yourself?
Dr. Jia Ng: I would say four years. No, no. I've finished my fellowship two years ago. So that means that was the time it was my biggest struggle. Couldn't get any paper out. And so truly writing it's two years more intense writing. And, you know, when you set about that structure, like HPI, you know, when we first write our notes, assessment and plan it is always just a mess, but now you've been a physician or attending for a long time. Oh, everything's easy. This goes here. This goes there. So paper is the same. You just need to know the underlying structure.
Dr. Diana Mercado-Marmarosh: Yeah, that's so good. I mean, I always tell my patients, like, if you don't even understand why I'm having you check your sugars or what is actually a carb, like, how are you going to win at this game?
It doesn't make sense for me to just tell you here, some meds. Goodbye. Right. I said, because you know, your diet is obviously going to negate. If you go and drink, you know, a whole 12 cans, right. That cost you $5 of Coke. Those $5 Cokes are going to negate your $2,000 insulin or Tresiba, right.
And so it's the same thing with our brain. If we allow one. To say, like you're not a good writer, like that might negate the whole experience. That of what, if you could have shared your findings with the world and it made a change, right? Yeah.
Dr. Jia Ng: Yeah, exactly. That's, that's why I'm doing this. Like, if I can help one clinician do it, that one paper means they can help a hundred patients. And that means I would indirectly I'm helping another a hundred patients. So, so that, that's why I want to do this.
Dr. Diana Mercado-Marmarosh: Yeah. So you're trying to help spread the word and make more of an impact for others, right? Yeah. That's, amazing. So, what do you think are one of the biggest challenges when people are trying to do the, this research papers or any writing in general?
I mean, you just said, if you don't know the structure, but what do you think are other things that can get in people's way when they're trying to do something like this?
Dr. Jia Ng: So first is the writer's block, try and put too much in, in too many hours. So writing is very cognitively demanding. So we always think that writing is only when words on paper, but actually writing comes from a processing, synthesis.
So you first need to read the words. Then needs to synthesize and transform it into an idea, then idea, go to the paper and then paper, you need to write over, over again to get a clear, beautiful message. Right? So this whole process is like five or six steps. And when you just go in to a session, thinking that is going to come up with it within five minutes is impossible.
Even for the most, the experienced person don't do that. So sometimes I think it's better to flip kind of think through, oh, at this, this time I'm actually only doing synthesizing. I'm writing is part of my writing activity, but I'm only thinking about idea. Let me form my idea. Maybe I'm just scribbling.
And so you take the pressure off of trying to write a beautiful paragraph within that session. So, so that's one like taking off the pressure. Second thing. It's better to do a short, intense focus within like 20 to 50 minutes instead of four hours. Because as I say, it takes so much energy that once you're done, and if you don't build a habit that you can't do more than 15 minutes, if it's a, if you haven't written a paper forever or any, you can't expect to do it.
So I usually coach, say, you start with. 10 minutes, get the flow. Even if nothing's coming out, you just write, oh, I can't figure out something. Or let me scribble a few things out. Just the whole thought to hand to paper, that itself is a skill, a cognitive skill that needs to be a habit that needs to be built.
Dr. Diana Mercado-Marmarosh: You know, you just describe one of the key things that I coach my clients every single time. It's that initiation state of taking off the pressure. When we have a backlog, it's almost daunting to look at that in-basket or to look at that amount of charts that you have to close. We are used to sitting there for eight hours and like, almost like quicksand.
Right? You feel like you're not productive. And so the first thing I tell him is, yeah, you're gonna do 20 minutes. Short, intense focus, no phone, no Instagram, no Tiktok, you know, NO! You're gonna work and then five minute break, 25 minute break. And I said, max, two hours. That's it. Even though I know you want to sit there for eight.
No, you're not doing that because you're going to get the same amount in the short amount of time versus the eight. I've done this before. I've done it multiple, multiple times and people have. Themselves now all my clients. And they're like, oh my God, you're a genius. I'm like, I'm not trial and error. You just do trial and error because what happens is that, like you just said, there's certain amount of executive function that is required and certain amounts of energy level that is required.
Like you have to know any of you tell yourself that you're going to. Yeah, eight hours or four hours to writing. That's intimidated for the brain sometimes. Right?
Dr. Jia Ng: Right.
Dr. Diana Mercado-Marmarosh: Exactly. You freeze up, but if you tell yourself, like you just said, well, whatever comes out in 10 minutes and then walk away, then there's like, like you said, there's no pressure, but more importantly, what you tapped into is that 1% initiation, because people with ADHD.
We can think about it like the mountain, but we don't realize that it only takes one step to start climbing the mountain. Like you don't need the whole mile up, you just need one step. Right. And just when you start, then it's easier to take the second step and the third step and the fourth step. And then you look back and you're like, oh my God, I come this far.
But then work people who want to complete tasks, we do. And so then that 1% where those 10 minutes. Are so good because they breaks through that. Well, I'll wait for the perfect time. When, when the hell is it going to be the perfect time, it's never going to be the perfect time. Right? And so sometimes you have to have a messy first draft.
And that's what I say do have messy first draft, because you're so much ahead because you started it.
Dr. Jia Ng: Right! You know, you're charting and in academic writing is exactly the theme. So would a messy first draft and sometimes, and you talk about. What often happen is, oh, you start the first sentence in, oh, I need to find out a statistics.
Then you start open the Google, Google scholar and you start looking for statistics and then, you know, like the tent article, anything. So, so instead I say you put a placeholder and you just type and you put, oh, need to find steps. Parenthesis or you find a better word, then you move on. It's like, oh, mortality. I think I need a better word, just put, need a better word and move on until you're done. And you're like, oh, maybe let me think about a better word. Find us the SAR is, you know, so, so then you, you at least have something on a paper and you can chip away, you know, you first need to have the stone. before you can start, what do you call it? Carving it.
Dr. Diana Mercado-Marmarosh: Yeah, that's perfect. You're so right. You need to, you need to just start. And like you said, you don't have to have the details. All your brain wants you to. I have to have that detail before I move on. And like you said, you can squirrel yourself. You're all of a sudden you're your tent. And then you forgot because something else was more interesting when you were reading, you forgot what's the statistic you were looking for there, right?
Like all of a sudden you have all these. Statistics and you're like, wait, was I going to, I don't think that was the point of that paragraph, but it sounded good. So now you post it in there and that was not even what you meant, yeah, so that's so good because then, like you said, Another day, you can come back.
Like maybe the first day you just did one part and then another day you come, maybe the D that's when you go and research and do all that squirreling or whatever you want to say it, you research and you find the articles that are more credible or not, or which one supports it or not. And then maybe another day you then read, was that really what I wanted to say or not?
Right. And so you can break it up.
Dr. Jia Ng: Right. Right. In fact, I, even for editing, I have a system. So I think writing comes with systems that help us everything. So when I edit, I don't edit words first I go look by. Hmm. Does the, does it overall, does the paragraph look like it flows even though that's grammatical error?
So I just go with big, big chunks. Firs I edit first round. Let me just make sure the ideas. Uh, sequence. All right. Ordered once. That's good. Then let me look at each paragraph. Is that too much extra fluff, then only I go to each sentence. Then only I go to, each individual words then wordsmithing, then, then the next round.
Okay. Let me put all of the references. Then here, I spend one whole hour looking at articles first, looking at stats and looking for this. So if you have a process, then you are not context switching and not switching from one task to another. That makes it faster. And you, because you're breaking it down, it's like, okay, I'm just going to spend 20 minutes looking at 10 articles, and that's it.
Dr. Diana Mercado-Marmarosh: Wow. That's that's genius. You know, you're pointing out stuff about task switching. That's something that I like hone in in my course, because we don't realize like, people always say, well, just batch stuff, just batch stuff. Well, when you batch stuff, we don't realize we're tasked with jeans. Sometimes if we're not careful, like it takes a different amount of executive function.
Or I call it energy level or thinking process. However you want to define it to synthesize, like you just said, and then another is just to scan, right? Like it's different areas. So sometimes when you go from like, just writing your first draft to wanting to have your final draft, like you're missing the steps in between.
And that's where you're, you might be task switching, because like you said, now you're thinking, oh, I just thought about that idea, but then I'm looking for this other journal and I'm looking for that. And so you're going back and forth. You're not, like you said, there's not a sequence that you're doing, so you are helping them set up their systems so that they do one task at a time so that they're not scaterred everywhere. And so it makes it more manageable in a stepwise approach.
Dr. Jia Ng: Right? Exactly. Exactly. Yeah.
Dr. Diana Mercado-Marmarosh: That's great. How can people like contact you and like find out ways to work with you? Because I'm pretty sure you're going to have a lot of people be like, okay, yes, I need a system. Cause I'm all over the place. And it's going to take me like six months to do something, to even choose a topic.
Dr. Jia Ng: Yes, yes. Right. Choosing a topic. It's also a big thing because we always think it has to be a sexy topic, but, but actually we, the, the topics are already in it's because, um, you see patients all the time. That's where your questions are, you know, where the problem is.
And, and research is not about just creating data, but solving a clinical problem or solving a research problem. So we have it in us. It's just that sometimes we need to know how to dig the questions, then you can answer the question. So, so that's a whole another topic, but bottom line is, it is in us. And if you know how to draw that out, you can find it.
Dr. Diana Mercado-Marmarosh: Yeah. So tell me how, like, how do you see yourself in three years? What are your goals?
Dr. Jia Ng: In three years, what really hoping is to expand how to create the system that I can replicate for many people, not just in a small group, but to more, more and more people, because it is so simple. Sometimes it's so simple that, oh, I can't believe it's so simple.
They just follow the steps. Then you can do it. And so I want to spread it to as many people as possible, hopefully institutions, because that's where the gaps are because academic clinicians, they, they need to publish papers, but never got training. And so that's a gap. How do you expect people to publish papers when you have never thought that taught them how to do it?
Like me go to medical school to see patients, but we ex we are expected to publish papers, but never got trained. So I want to fill that gap. That's where I'm going for.
Dr. Diana Mercado-Marmarosh: And in terms of your personal life, what are the next big goals of audacious goals or fun goals that you have for the next three years?
Dr. Jia Ng: Next three years, I really want to con continue coaching in a group setting.
But now I want to be going to universities and doing workshops. That's, that's where I'm really heading, because, that will be where they can get the most out of it. Like during that time period where the training, or when it up for promotion does a good time where, okay. They are motivated. It's been, I can help them and then, you know, kind of match made in heaven that way.
Dr. Diana Mercado-Marmarosh: And do you have any things that you want to do, like for fun? Like, are you, do you like to go travel? Are you, do you have any goals or something you're looking forward to now that the pandemic seems to be slowing down enough?
Dr. Jia Ng: Yes. One day we're hoping to go through Iceland to see the Northern lights.
So I think that's my next goal. We were going to go this year, but we were not sure that the COVID situation is the war. So, so we decided whole off.
Dr. Diana Mercado-Marmarosh: Well, I'm so intrigued. Yeah. It's, it's always amazing to learn from other cultures and other environments around us. Like the Northern lights. I that's in my bucket list too, one day to go and see that over there.
So tell me, I mean, you know, that sometimes we space out, right? And so if my podcast person am I on the other side, Finally started listening and paying attention. What is one piece of advice that you would give them if they just started to pay attention? And what would you do?
Dr. Jia Ng: I would say the, to repeat back, my point is make it so small chunks of writing, right?
Writing does not come naturally. So don't, don't even think it's supposed to come naturally. You actually need to build a habit, start small in small chunks and limit yourself. If you can do 20 minutes. Great. I like to put the timer. If you can, once you get a habit go to 50 minutes, but more than 50 minutes. Take a break.
And then you do a second session as like what Dr. Diana said really no more than two hours, unless you are a seasoned writer. So that's the first one. And the second thing is I can't emphasize enough. This one I did not mention earlier is you have to write during the daytime when your brain is clear, not in the middle of the night, not after your kid's asleep, not after you have finishing, finishing all your patients.
That's not the right time to do writing because. It is so cognitively demanding. So you have to however it is, you may skip a committee meeting here and there, but you're writing. You need to do it at your clearest time.
Dr. Diana Mercado-Marmarosh: Yes, that's so nice to hear that you two have tapped into the whole thing about writing.
When your head is clear when your energy level is up for today. I don't
know why physicians think that it's the writing or notes, you know, it's such an easy thing
to do and it's pajama charting right? Like. And so if you don't take that too to that level, then it just becomes harder.
Dr. Jia Ng: Yeah. Like what you said, but the word respect, you know, writing needs to get some respect from you that the true attention that it deserves. So it does need that.
Dr. Diana Mercado-Marmarosh: Yeah. So, awesome. Well, it was amazing chatting with you where can they find you, like tell us all your social media stuff.
Dr. Jia Ng: So you can find me on my website. I think it has everything. Www.publishedandb.com and I do have a YouTube channel. You can search, it's also published MD there.
I give tips and strategies on, more, more than. How do you write academically, you know, the style and how do you break it down? How do you read a paper fast? How do you like all the tips that we take for granted, but, oh, I wish I knew that then I could have, not squeeze it two hours or two months of my time.
Dr. Diana Mercado-Marmarosh: Yeah. So good. Well, there you have it. Go follow her. Don't make writing harder than it is. Bust those limiting beliefs and find an amazing coach right here. You can't get it any easier. The simple systems to support you all the way as you publish your research papers. Dr. Jia has your back. So go talk to her, break it up and get yourself published because the rest of the people need you.
Dr. Jia Ng: Thank you so much!
Dr. Diana Mercado-Marmarosh:  Someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group. Beyond ADHD, a physician's perspective so that you never missed an opportunity to create time at will do share this podcast with your friends.
I can learn to live life and stay in their own lane.
 
About Dr. Jia Hwei Ng
Dr. Jia Ng is a Nephrologist and Researcher, founder of PublishedMD and her mission is to help busy clinicians publish papers and achieve their academic goals. 
Website: https://www.publishedmd.com
Email: info@publishedmd.com
YouTube: https://www.youtube.com/c/PublishedMD/videos
Twitter: https://twitter.com/jiahweing
 
 

Beyond ADHD A Physicians Perspective Ep 20 Dr. Weili Gray (Board-certified sleep, integrative, and lifestyle medicine physician founder of Dare to Dream Physician)

Dr. Weili Gray: You know, your life is worth it. We only get to live once. So get to know yourself. What, is the life that you want to live? And what's stopping you because whatever is stopping you, there are ways to overcome that. Live the life that you want and live it now because tomorrow may not be there.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
 
And in the past year, I have undergone radical transformation after discovering  ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Oh, my goodness. I am so excited today to have a dear friend with me. It is a very, very special treat that you guys have today is Dr. Weilli Gray. She's a board certified sleep integrative and lifestyle medicine physician say that fast three times who practices in Vermont. She is also a Registered Life Planner and the founder of Dare To Dream Physician, where she offers life planning and host a weekly podcasts. So excited to have you here. I want to ask you all the things, but first, first of all, we'll start with, how did you decide to become a life planner in addition to all your other hats, all those board certifications.
Dr. Weili Gray: Yeah, well, first, thanks so much for spontaneously inviting me on your podcast. You know, we, we had like a, what two hour notice and that normally I would like run away from that, but I went with it. So I'm super excited to be on here. And, regarding the question of, you know, why am I doing a million things?
Like, you know, I already have all these board certifications. I practice. As a sleep physician at the hospital in rural Vermont. And, about a year ago was actually when I accidentally I call it like I accidentally got life planning. And in this workshop where I got life planning, I was, I had so much clarity in a short period of time on what is it that what's the life that I really want to live? What, are my dreams? And not just like, you know, like we all, I mean, both of us are physicians and, you know, at some point we had dream of becoming a physician, but, you know, once we became one, it was like, well, is this it? Is there more, you know what, that's not the end of her life right there.
And so just having that long view on my life and saying the things that, maybe I'm scared of right now or the things that are causing me distress. And, to, to really put that in perspective and say, well, this is what I want in my life. This is what I want to accomplish. This is the legacy that I want to live, you know, where do I really want to be?
And so when you look at that long-term perspective, it puts all these other things into context and the things at that point about a year ago, I was in a lot of. pain and suffering. Like, I, I felt like things were a lot of things were happening to me that, I felt like helpless and, just, I felt like I couldn't, I didn't have a grip on my life anymore and I had just turned 40 at the time.
So it was like, wow, is this what a midlife crisis? It was like, and, and so that's how life planning, transformed my life. And that's why I decided to, you know, pay it forward and become a life planner and help others, who might be suffering some, something similar, also have their transformation.
Dr. Diana Mercado-Marmarosh: Yeah. You know, that's so interesting. What you just shared, how sometimes it is through stress that we, I mean, I don't want to say we hit rock bottom, but we get to a point where we have that question. Why am I doing this? Right. Like, what is the point of all it is? When did I decide that being a physician meant X, Y, and Z.
And I think COVID really did a number on getting several of us to ask ourselves those questions and to wonder whether being a physician was just one part of it. And how could you then leverage it to do something else? That'd be enough physician didn't define you and that your interest. And ways, like you said, designing your life on purpose instead of just deciding that it happens to you.
Right? That's how I always felt. Turning off fires, not like me on control. Like that's how I felt prior to coaching. And definitely it's so interesting how we all sometimes get to that point in our lives. And sometimes, unfortunately some of us don't have that moment because we're so busy running around. But I am so glad that you had that clarity and that you found that resource, and now you are able to use it for others so that they too can have their transformation and such a breath of fresh air.
You know, most of us, when we think of planning or like, how do I run away faster? You have to have, did you think that thought at some point or no?
Dr. Weili Gray: Yeah. So, we can absolutely talk more about this later, but my brain definitely is not into planning. I like, I mean, part of me likes planning, but then the other part of me loves spontaneity and, just, you know, doing things on the fly and what, and so the, the word life planning is
it is maybe it doesn't capture all of it because in the heart of what I do as a life planner is also to help each one of us, including myself, enjoy the present moment and to live life more intentionally and more mindfully. And, you know, those are a lot of buzz words that I like I'm usually turned off by like, you know, these buzz words, like, what does that mean?
Like, what is the living, you know, in the present and, you know, living mindfully mean. But it's really just soaking everything in. So a lot of us, like, for example, you know, I'm a mom of three kids and I was, you know, if I talk to like a friend, you know, when I was in college that like, I remember telling a friend in college, You know what, like what's the legacy we want to leave behind?
And I remember telling her I'm like, I, I want kids. And like, this is like a weird thing to say, you know, for like an early 20 something year old. And I didn't want kids then, but I was like, I really, you know, I, I feel like that's part of leaving a legacy in the world that was important and important thing for me.
And, and then, you know, here I am, you know 10, 15 years later, And I have three kids. And then yet most of the day I feel like I felt like I was really struggling. Like I was struggling as a mom. I was struggling as a physician. I was just struggling as a human being, struggling as a wife, just struggling with everything.
And I just had to slow down and just look in front of you and say, You know what I had voice this 15, 20 years ago and said, this is part of what I want in life and why am I not embracing this dream that I'm living? Because so many people may not be able to have this. And, you know, I shouldn't take that for granted and just taking every moment in like, you know, when, if my daughter comes up to me and I'm trying to, you know, get some work done on the computer and she says, Hey, you know, mommy, I like look at this, you know, cause that's how kids connect.
Right? They want to show you everything. They want to tell you everything. And instead of being annoyed, be grateful, be enjoyable. It just take. The senses and like what she's showing me and the way she's talking to me. And so that's part of life planning is to really be in that moment and just enjoy what we actually have to, because oftentimes some of the reflective exercises that we do in life planning, You know, what you have, you know, 24 hours left to live and, you know, knowing that, and that the feelings that come up from that, what just reflect for a moment, you know, who did you not get to be?
What did you not get to do? And what, what did I miss? And it's so interesting because a lot of us may have these dream. Like if you ask me right now, we'll be like, wow, it'd be great if I was financially independent. So I didn't have to worry about making an income. If you know, I had a house by the beach, like of course I can name all these things I would love to have.
But if you reflect now knowing that you only have a day left to live. A lot of the things that are so valuable to us are the things that we already have. And, and so to live life in alignment with our values and the things that we do have, and not take those things for granted and not, you know, that's, that's living in the moment, that's sort of, you know, living in the present.
So, so that's, was part of my transformation was. I was just, you know, like I was working really hard. I was cranking out our reuse, you , trying to, get a bigger bonus check and all of those things, like, you know, chasing the carrot. And even though that wasn't really part of why I went into medicine, it was like easy to do.
Cause these were like metrics on paper, but yet what I was giving up was that ability to. Enjoy the dream life that I was already living. So this is part of, , part of the, what I love about, you know, going through life planning and that it's not just planning, it's actually just enjoying life. Yeah.
Dr. Diana Mercado-Marmarosh: That's, that's so good that you made that a point because maybe some of us have not heard of that term. And so we would have totally have misinterpreted. And now how you say it, it's basically. Making sure that you design your ideal day or a deal a week or the rest of your life, like you said, based on your values and your.
I had to ask myself that same exact question, because COVID forced me to, if I had 24 hours, I had a week. If I had a year, if I had five years, what would I do? What wouldn't I do? And then why am I still doing. Who said I had to do it. And from there, like you said, we quickly realized that there's different levels of wealth.
It's not just financial wealth. There is spiritual wealth, energetic wealth, right? Like how fatigued are you that you can't even enjoy that awesome thing you just bought, right? Because you can't even like get on the bike because you're tired. Right. So there's all kinds. And then you can not ignore the time, the gift of time to enjoy those around us, because we don't know.
I mean, we could die in a car accident or they could die in a car accident or somebody could, you know, you could be at the wrong place at the wrong time. Stuff happens. Right. And so I know those seems like we went deep quick, but those are things that if we don't slow down enough, we might miss it because we get so busy, so busy.
And I don't know where we got this notion of like pack more, pack, more pack more. And the more you do, the more productive you are and the more productive you are, the more self-worth you are like, who came up with that? Like, What if it means do less and less is more because all of a sudden, you know what it is that you need, you break it down to the must haves and the nice to have.
And I guess I could have. And you're right. Like most of us would definitely not go to work that day. I don't think. Right. We wouldn't. I think I would go to the beach somewhere with my family and have a nice dinner steak or whatever, eat ice cream, right. Call the people that I love and not call the people that irritate me.
Right. And so it's again, on purpose deciding. What makes sense for you and for your family and not necessarily what the world is telling you should be. So how did you decide you wanted to be a doctor?
Dr. Weili Gray: Yeah, that's a great question because I actually was really anti pre-med. When I was in high school, I was like doing group projects with some of my classmates were like really gung ho pre-med.
I don't even know how in ninth grade, you know, you want to be pre-med, but I guess they were, you know, really, you know, they were really gung ho about it. Just the way, the way that they talked about, you know, like making the grades and, you know, like, just like the whole application process to college, it was just like, none of that was on my radar.
So it was like, oh, wow, this is not really sitting well with me. And you know, if this is what pre-med is, okay, that's definitely not what I want to do with my life. So it was pretty anti. Going to medical school. Cause I'm just like, yeah, I'm really not that type of person, you know, who's gonna, you know, plow everything in my way to get, you know, to my goals.
And then I always liked the sciences. So I was an astrophysics major in college. And, junior year I went to a liberal arts college. So it was like, yeah, that was my major. But I also took classes in art and art history and, you know, the humanities. And so it was a lot of, a lot of fun. And. I went abroad junior year, and to England.
And, part of that is England is a great gateway to travel to the rest of Europe. And I also traveled around in Asia and a lot of that travel, like I was doing by myself, like, you know, I had a backpack and that's about it. This is before cell phones. I didn't have that. And it was just such an amazing experience because everywhere I went, I got to meet different people, like people from different cultures, people from different walks of life.
And, you know, even like people who spoke different languages. And it was just so much fun to connect with people. And I'm just like, wow, this is just, this is so wonderful. Like, this is like what, what it means to me to be human is to connect with others in this, you know, really genuine way. And so when I came back from my study abroad experience, You know, reality hit.
Cause I'm like, okay, I'm a senior now. You know, um, I'm graduating with an astrophysics major. I don't see myself doing the whole PhD thing cause you know, I can't focus on one topic for the rest of my life. And so I'm like, what do I, what should I do? And then I thought about it. I'm like, wow. It kind of makes sense to maybe look into
medicine, but that's like, not like I was rarely really gung ho about not doing that. So I had to reconsider doing that and I started shadowing, doctors in the community. I shadow in the emergency room. I took a year off after college and like volunteer with AmeriCorps and worked in, worked with kids in the school system.
And it was, it w it just felt right in the end. So I, I applied for a post-bac program. And then I did, to do my pre-med classes that I didn't do in my astrophysics major. And then I, and then I went to med school. So it's been, I have to say there wasn't, there's not been a moment like in my heart where I feel like.
This like working with patients, like I never felt like this was the wrong choice for me, but as most physicians have experienced, you know, in our country with the, you know, 40% or more burnout rate, there's a lot of things that sort of, that's not necessarily related to, you know, connecting with patients, helping with patients, that are really weighing, that can wave physicians down and certainly.
Been I've experienced a lot of that and including, you know, having a baby during my intern year, that was kind of, a lot of juggling, you know, work-life balance has been really challenging.
Dr. Diana Mercado-Marmarosh: Wow. That's great that you, you took that opportunity and you got to explore all those cultures and then. You had the insight that you were somebody who was not, was going to be bored if you just did one thing. Right. And so. You pick the field that was going to be ever changing right. Medicine, and you have no idea what's happening because it's ever changing. Right. And so you decided to do that in your own terms and you didn't do one, right?
You, you went into sleep and integrative and although that works right. And so that's so good. Tell me, did you ever feel like. You know, you would go down rabbit holes because you were so intrigued by different things.
Dr. Weili Gray: I always go down rabbit hole.
It's the part of the joy of living right. Is being a lifelong learner. And it's that, it's that curiosity that I remember having, you know, when I was a kid that I never outgrew, that, you know, I think that makes life interesting.
Dr. Diana Mercado-Marmarosh: Yeah. And was there ever a point in your life that you thought, Hmm, I have 10,000 interests and I'm going down rabbit holes and I'm trying to do all the things.
I wonder if I'm struggling here. I wonder if my, if I might have ADHD or was that not even in your radar?
Dr. Weili Gray: Oh my goodness. Deanna. This is where I have, like, I have to thank you so much for 'cause. I, I actually, I, I'm never. We're associated with ADHD at all. Until I signed up for your group because, although, you know, your, your podcasts, has the word ADHD and it, but you know, all your messaging as you're sort of talking about what you help physicians with is, you know, time management and, you know, getting charts done.
And although I was like, well, I don't know anything about ADHD except for, you know, like some of my patients may have it. I, I signed up because I'm like, I definitely, you know, when you, when you use the term time blindness, I was like, oh, there's a word for that.
And so, yeah, I definitely needed the help with. You know, getting my charts done because, you know, although I love the part of connecting with patients, the charts were really boring and, you know, sort of not, not the part that really killed me. And so I. I showed up to it's group coaching. So I showed up to my actually I didn't, I couldn't even make the first session, but I listened to the replay of the first session.
And as I'm sitting there listening to the replay, I'm hearing all these physicians and, talk about their struggles, you know? Yeah. They talked about charting, but then they all were very open about that they have ADHD or they just got diagnosed with ADHD. And, and not only do they talk about their struggles as a physician, but also as a mom and, you know, just like in, in general, in life.
And I'm thinking. Wow. Well, first of all, my first reaction, like maybe five minutes in, I was like, this is interesting. Like everyone's are, is ADHD but me. But you know, this will be good for me, like, cause I really need help with turning. And then as I'm listening, like maybe 30, 40 minutes, Lynn I'm like, why are they all describing me?
Other people? Like there's a group of people that struggle with this too. And so it was like, it was this light bulb moment. I'm like I'm 41 years old. You know, I, I graduated from high school. I graduated from college. I did my postdoc, I did medical school. I took all those, you know, step exams and board exams and residency and had three kids.
Wow, this, this explains so much of why I, you know, have this like lifelong struggle of feeling overwhelmed. And it's so funny because then I look back and you know, I don't have an official diagnosis of ADHD. I'm on the wait list to see somebody for this. But it's, it's just, you know, Two or three months that's passed by.
I've read, I've listened to a lot of podcasts, including yours and, I, you know, read, at least one book, if not more than one book, I'm trying to look ADHD 2.0 was the first book that I read and just, you know, read articles and just did a lot of research on this, on my own. And it's and I have to say, you know, thank you Diana, that, you are so positive about this diagnose that one, that you speak out about this, because even in the short period of time that I've, you know, associated with having an ADHD brain, I've just, you know, I've been sort of in one-on-one conversations, with other physicians, I've sort of just share them like, oh, this thing just happened.
You know, I had. Light bulb moment. And so many of them then shared with me that they have ADHD and I'm like, oh, I didn't know that. And so thank you for being transparent and being not only transparent, but just being so vocal about this because it is. It's out there and it's one of those things that if you didn't put yourself out there and didn't, you know, become vulnerable and share your struggles that, that so many people, you know, wouldn't even know including myself.
So that's one. And then the other thing that I thought was really an interesting observation was like, I was kind of proud of. Yeah. Like, I think I have an ADHD brain and this like explains all my struggles, but at the same time, you know, like I'm really excited to be identified with this. And I think that's also from you because you talk about it in such a positive way that it didn't even occur to me.
That some of the physicians, you know, who, don't openly share that they have ADHD. Actually, you know, they admitted to me that it's, it's like they have, you know, not necessarily some of them will say, you know, they have some shame around it. Others are just like, I just, you know, almost tried to dis- associate myself with it, even though I have the diagnosis. And so it's been really, really an interesting, interesting journey, but I will say that looking back, I remember as a high school. So although I don't have, you know, an official diagnosis, I'm definitely more of the inattentive type. Like I was the kid who sat in the classroom and like, I wasn't disruptive.
I didn't move a lot. I, but I would daydream or like, I wouldn't necessarily process in the same way as maybe the way the teacher was teaching it or other kids would be able to process things. And so I did struggle with low self-esteem in high school, like ninth grade. I remember there was a class physics class.
Like I felt like I was just like, I don't understand. You could describe, you know, motion with math. I like that didn't click in my brain. And because I was stuck on that, like, I couldn't move past, like learning, like memorizing the equations. And so I just remember doing really poorly on the test and in that class. And I was like, maybe I just don't need to go to college.
Dr. Diana Mercado-Marmarosh: All or nothing, our brains so good at that. Right.
Dr. Weili Gray: So, and I, I had a lot of this, you know, sort of a lot of this low self-esteem self-esteem that I just internalized cause I'm like, I don't get it. Like, I, I feel like I'm a fairly intelligent person, but there's some things that I just really struggle with.
And I even remember going to my guidance counselor in high school who was such a nice lady. And I was like, I, you know, I see some other kids getting accommodations, so, you know, take their tests. Cause it takes me a long time. Like I'm always like the last one to finish. Like I'm like I could have used a little bit more time, but I'm like, okay, I'm just going to try to finish.
And I'm like, you know, can I get something like that? And it's so interesting because I just remember, she was like, oh no, you don't need that. Like, do you really? You're you're probably okay. Like she sort of, you know, shut it down, even though she was like one of the nicest people I knew in high school and, and that was it.
And I never really like, you know, going through college and going through medical school, I, it was a struggle for sure, but it was just like, it never crossed my mind again, because. If she had answered differently, if she was like, oh, okay. Maybe like, maybe you should be tested. I think it would have just been, so, you know, the trajectory of my life would have been some difference.
Dr. Diana Mercado-Marmarosh: Yeah. So, you know, so many amazing points that you just shared and. Go through those. So first of all, I was that physician, the ones that you're describing, where they trying to mask, and they don't want to tell anybody anything. I mean, I neglected my diagnosis for 10 years after, you know, they told me that I should know better that I outgrow it.
Because I felt ashamed that how come, I didn't know better, like in how come somebody told me I didn't, this specialist just told me that I'm faking it. Basically. That's what they're just finished telling me. Right. And, and the thing was that I did, I ignored. But I didn't know that I was working harder than everybody else, because I mean, I thought I'm going to do whatever it takes to do this for my patients. Right. And I didn't know it was at the expense of my health and at the expense of my mind and all that, because I just thought I do what I want needs to get done because I love my patients. Right. And so it took me discovering life coaching and ADHD coaching to start to see it as the gifts. And, and to realize that, you know, things evolve and that emotions cause we can get very emotional, real quick, right?
Emotional dysregulation and executive function. They can come can we're overstimulated. And when you get curious, then all of a sudden you're not judging yourself all the time. And I think it was the fact like you just pointed out because they dismissed you. You never like second guess. Should I take a step and get a second opinion or whatever, and you're right.
What if I had had enough common sense to be like, you're one of like 500 doctors here in Houston. Let me go get a second opinion. Why do I need to like talk to you? You just met me for two minutes and you walked out right. But again, because of the feeling I was having and just like you, I don't want to say that it was a low self-esteem, but it could have been because we tend to have that little inner critic that says like, you're amazing.
No, you're not. Yes you are. No, you're not. It's like the little angel, and a devil, right? When you're doing it wrong is quiet. Like we Excel, we kick it out of the park. Right. But we keep like questioned ourselves along the way, every step of the way, because it doesn't come easy, but because it doesn't come easy, we don't expect it to, so we're okay.
Trying to narrow, try and error, trial and error because we don't know any other way. Right. Because that's how we have gotten to the end result. And not getting to the end result. If it's something we want is never an option. Not because we fear failure, but because that's aligned with you. And so you're going to exert all these energy that you don't even know where it comes from sometimes. Right? But then you pay for it a couple of days later, like exhausted, right. Chronic fatigue. So it's like you're in constant survival mode. Unaware, if you slow down enough, like you said, and have some aha moments, you can be like totally thrive mode. But when we get to that thrive mode, it's because we're not long, no longer judging us.
And yeah. So I kept looking around and I could not see, like you said, physicians talking about it. And so I didn't want to talk about it naturally. Right. Because I think I had told five people if that, you know, prior to two years ago, and then. I don't know. I think I posted something on ADHD for smartass women.
So that was my like shining star that got me to start thinking of it differently. And she said, Hey, let me, let me interview you. And that was February, 2021 that she interviewed me. And since then, like a lot of people, a lot of physicians throughout the world started reaching out to me and they're like, oh my God, I'm so glad you said that.
And it's, again, something that it's a little bit sad that we keep it hush, hush, because people still have that misinterpretation that you know, that you're maybe being argumentative because you're calling out BS on some systems that no longer make sense because the people that made it like are long gone.
Right. And so it there's so many things or maybe you look like you don't care because you're showing up late. But again, you're not, it's not that you're trying to show up late. You have that time blindness or you're too loud. You're like, I'm not trying to be loud. I'm just speaking my boys, what's your problem.
You're like, you're too boring, you know? And so it's just the flavors of it, right. Like you said it's sometimes because you don't know, because I didn't know I had ADHD. I think that's what got me to med school because I didn't know, I wasn't in my head. And so sometimes what you don't know is you don't know, but then when you do know then.
It all goes to what you're thinking about it. Right. Because for me, I was thinking shame, but for you, you were thinking, oh, I am proud here. Yeah. This is my super power. Right. And so it goes back to what are you thinking about it? And then how can you support yourself? Because while pills can help. They don't teach you the skills.
They don't teach you about time blindness. They don't teach you how to work with your strengths. They don't teach you how to do whatever you need to do in a way that is not inefficient for you. And that's the thing. My group coaching is not meant to be only for physicians with ADHD. You don't have to have the diagnosis, but you need to feel like time just gets away from you or like clutter, somehow magically shows up, like, you know, like for some reason the socks become like lids for your kitchen that you don't know what happened, you know?
Like, and so I think when you are able to come to a community where. You can be you and you're no longer being looked at like, oh my God, that's the doctor that needs like 5,000 reminders to like, get their charts done or to like get out of the room or to whatever. Right. Then everybody else is not the norm.
Yeah, such good points. I, and I, I would say that, you know, I love the work that you're doing in this space. And, and also, you know, even before joining your group, I, you know, even though I had no idea about this ADHD world, some of the things that helped me, which also I see you are actively, you know, working toward helping other physicians with is.
Helping them see their worth. And, and I'm not talking about that, just like in a negotiation point of view. I see, you know, the whole like time blindness and, and, you know, chronic lateness and, um, sort of, you know, like being scatterbrained and those things, I could see how that easily leads to a low self-esteem or, you know, this.
Julian like, you know, I'm just not good enough. Why is it that everyone else can do this? And I can't. And I mean, to be honest, like there's a reason why, you know, ADHD is groups and the neuro atypical category, because most people don't have brains like this. And so when the rest of the world has a norm, like social norms and especially for women, you know, like women are supposed to be the nurturers, you know, they're supposed to like keep everything together.
So when you have these norms, And the person that you are, can't meet these norms. It's natural to feel like, oh, I'm not worthy. Like I'm, you know, I'm just for whatever reason, like I'm broken and, and what coaching and, you know, life planning and this self development work can be so powerful is allowing us to see that.
Okay. We're not like the norm. But we are worthy. We have inter like intrinsic worth. And, um, and, and the word that you like to use, that, which I love is, you know, you have a zone of genius and you need to embrace that. And so, like, for example, um, also I highly recommend the book that Deanna, um, uh, talks about a lot, which is ADHD 2.0.
And in that book, um, there is like a tart, like I actually, you know, cause I'm not really good at reading books, I like to listen to books. And so, so in the, in the book, even if you get the audible version, it comes with this PDF chart and it just reframes the traits that are often associated with. Either ADHD or, you know what Dr.
Hallowell calls, um, the bass trait. And, and so it's, you know, so like for example, impulsivity, you know, that that's a negative framing and that's sort of how, like, in the, you know, in the diagnostic criteria and sort of in society, you know, they, they use that word impulse impulsive, you know, that person is impulsive, but what's the other side of impulsivity, right.
That person is a spontaneous. Is a venturous is fearless, you know? So you have, you know, you, you have one part that's impulsive, but then it's the other part, you know, it's, it's the same trait just flipped. It flipped in a positive light,
fierce
Dr. Weili Gray: that actually is. You know, changes the world and, or drives innovation.
And so it's exactly, and that's, you know, this strength based approach that you, so advocate is that, which is, I think, why I never, you know, as I'm embracing this new identity of having an ADHD brain, like, it just didn't even occur from me to me for that more than a few minutes to be ashamed of it because you, you know, if you frame it in this positive light, It's it brings value.
And so that radical, self-acceptance the, you know, the compassion, all of that you talk about, you just have to look at it and it may be, you know, it may not happen overnight because, you know, especially if you keep having these negative messages that you tell yourself that the others around your society tells you, you know, you're not going to be able to flip this overnight, but if you, if we start.
Reframe, you know, these traits that are associated with ADHD in that positive light. I think that will take away the shame because it's true. Like most of the cool stuff that happens in history, like I'm willing to bet happened, you know, of someone who's neuro atypical, you know, whether it's ADHD or something.
Yeah.
Dr. Diana Mercado-Marmarosh: Right. Yeah. Yeah. Such good point. So tell me you joined because of the charty did that improve or did that stay the same? We're all friends here. You can tell us the truth.
Dr. Weili Gray: Yeah. So I definitely has improved. So I, and I was, I told you before that I actually had one-on-one coaching that wasn't like specifically designed for ADHD or just kind of life coaching that I did with another coach.
I told her about. What I really need to work on is like my time management skills. So I had, you know, even though it was a different program, like I had already dumped, done some work in this and it, it worked like, I was like, so amazed. I'm like, wow. Like I went into that before coaching. I went into that and I remember saying to my coach, I'm like, Okay.
I'm glad that you can see that this might be fixable, but I'm like, and I would love it to be fixable, but I don't have any confidence in that. You know, I'm just chronically, you know, a procrastinator and, you know, I just struggled with. Just time. Like, I didn't know the term time awareness at that point, but I'm just like, I don't have this.
And so, but through coaching, just through little, little reframes, it, um, really helped me. And then what happened was, you know, I didn't, I did well for. A while. And then, you know, something happened in my life. I don't even remember exactly what it is. Things just started piling on and falling apart. And I'm like, I definitely need a refresher deal.
So I signed up for your program and yeah. You know, even within. Within like a few weeks, things started really coming back to me. I'm like, of course, like, yes, like, do you know, do this? This is, I applied some of the techniques that you use. And then also just kind of learning what works for us, like experimenting.
Um, it, it, it helped me. It's just even the, just the awareness, like, okay. I know I'm not usually aware of time and by the way, I love that quality of time blindness, like, so I don't say that was shame because it's the whole time I do believe time is a social construct and it's not being aware of time.
That helps us be more creative and helps us to do something amazing because if time yeah. Uh, always ticking in my head. I wouldn't necessarily be able to do that amazing thing, but when it comes to charting, it's actually really good to have time awareness. So that's where, you know, timers come in, you know, you give us a timer, um, when we sign up for a coaching with you and, and, and that little things like that are really helpful.
[00:39:18] Dr. Diana Mercado-Marmarosh: Yeah. Thank you. Thank you so much for sharing that. So what do you think has been like one of the things that you would give advice for people to do? I mean, you you've been giving us a lot of advice, but you know, As you reflecting your last year, like, what would you like to tell people, like in the last year you have a lot of growth I've been seeing, you have a lot of girls.
You're one of my classmates in one of more business coaching program. So I seeing you, like, sky's the limit with you? What would you tell people if you reflect back in your last year, what would you tell them? What advice would you give them? Yeah, I
Dr. Weili Gray: would tell them, just going back to the, finding your own words.
And when I say like first, knowing yourself, knowing your why, you know, that goes back to the life planning, like what resonates with you. What's gonna spark your soul on fire. So knowing those. Really important to you and then designing your life to go with what's actually important to you. But then also having trust that you have this intrinsic worth, that no one around you can take away from you.
And so, and that intrinsic worth is often tied to your why. It's like, why am I here? You know, I am here because. Insert, you know, your life mission. I want to make a difference. I want to help people. I want to heal people. And if you know that your why, and that's what strikes a chord with you, then, then go pursue that.
And nothing's going to get in your way. You know, these little things, like if you're struggling with like, you know, finishing charting and, and, you know, like washing dishes, right? Like my husband was like, that's not one of my favorite things to do. Those things are not that important find what's important to you and then design your life around that.
Because, you know, as physicians, most of us have the privilege to have some sort of help, right. Like, I mean, I don't have a house cleaner. I try to look for one, but we don't have, you know, we don't have someone like that in our area. But it's just like, I use the dishwasher more, you know, I told my kids to use the dishwasher more.
I'm like, even though I'm female and I'm a mom, like, it doesn't mean I have to wash all my dishes. It's it's because it's stuff that's not important to me. Like, yeah. I want my kids to like, eat off clean dishes, but like, I don't have to be the one to do it. Right. Like I rather be saving the world. And so it's, it's, it's knowing your.
Like knowing your worth, knowing your intrinsic value. And then don't let anyone take that away from you because you may hear messages from society. Right? Society's going to tell you, oh, you know, but it's the mom's responsibility to make sure, you know, the kid has clean dishes or clean clothes. You know, that is, is that really true?
Right? You quite, you start quick. Cause that is that really the most important thing to you. So, and I'm not saying that my kids have dirty clothes and all of that, but I'm just saying, like, that's not tied to my worth. Like if my kids go out and they have a dirty shirt, like I could care less, right. If someone looks at me with a dirty look, Great.
You know, like I, I just don't even respond. And so that is, you know, I think that that life like that mission driven life will, will just, it, it makes all the other stuff less important.
Dr. Diana Mercado-Marmarosh: Yeah. You like, you bring up so many good points. Like again, when you don't stop slow down, ask, is this going to matter in five minutes, five?
Is it going to matter in five weeks? Right. Do I really have to do dishes like right this second? Or is it going to matter more that I sat down and I painted with my kiddo. Right? Like you have to like ask yourself what it is. And like, like you said, question, anytime you, the w you used the word should.
Like that is usually something that somebody has told you, you should be doing and you don't want to be doing right. And. And we use that to punish ourselves or to make us feel bad. Like I should be a good mom. Well, who says you're a bad mom? I don't have XYZ. Well, who say you need XYZ? Like all this things, right?
Like I recently got coached on in my mind. I was equating having all the clothes done and put away to define a good mom that if I didn't have it a way, not that it was just clean, but it had to be a way. That if it wasn't a way than it was a hot mess. And then that, that I didn't care enough for my kids to have like a clean house.
And so it's just, your brain tells you little things, and sometimes we don't slow down and question them. Are they thoughts that are really serving you or not let them go if they're not right. And so I'm just so intrigued by everything you're doing. And I'm just curious, what are like some of your big audacious goals that you have, like in the next three years?
Dr. Weili Gray: Gosh.
Dr. Diana Mercado-Marmarosh: I know, but I know you, you're the physician who dares to dreams.
Dr. Weili Gray: I'm going to put you on this.
Ooh. Yeah. You know, I have to say, you know, as a life planner, I'm not someone who necessarily like plans, you know, this or like this number or this, but what my audacious goal is to just keep using my. Because I actually, over a year ago, I, I couldn't do an interview like this. Like I would, you know, no way even with like a month preparation, not, you know, not like two hours.
And I didn't even before I went for a run right before, right before an interview, but it's just to be keeping. Authentic, keep speaking up, keep using my voice, keep advocating all the things that why I wanted to go into medicine. Um, and one of the things that I am so passionate about, and I don't exactly know how to solve this is.
How do we keep the physician patient relationship? How do we keep that alive? Because there's so many things that are getting in the way, right? Like reimbursements and, um, you know, the, the, the way that practices are being run and, you know, administration of hospitals, and there's so many different complexities in, in this, but what's so important is when we sit, like when we close the door and we say, Across the table from a patient and they tell us, you know, whatever about their health, that's really affecting them.
And we're able to listen intently and we're able to offer some words of empathy and hope, you know, walking them through how to treat this, that like, we can't, we can't take that away from medicine because it wouldn't be medicine anymore. And, you know, even the placebo effect where like, you don't even give them like a real treatment.
You know, but, but knowing that they're participating in treatment, like there is value in that. So it's, it's, we can't take away that connection in medicine. So I don't, I don't exactly know how that's going to look, but that's like, my life mission is to somehow keep that at the front and center of healthcare.
Dr. Diana Mercado-Marmarosh: Well, you are speaking it into existence because you know, there's a lot of ADHD physicians out there who are very creative and I'm pretty sure they'll come knocking at your door to help you do that. But I think this is how physicians get to decide how they practice medicine. Right? We've seen a lot of physicians do their own practices, uh, because again, they want to do it and have that relationship with their patient without being totally.
10 minutes are up. Let's go, right. Without being told you didn't do this, or you didn't do that or order this or order that, and then fighting with the insurances because they think they know which medicine is better based on the cost. And so it's all kinds of things. Right. So one more question, before I let you go, where can people find you?
Because I'm pretty sure they're going to be like what she has. She can dream. She couldn't help me, you know, with my planning. Tell me, tell me more. So where can they find
Dr. Weili Gray: you? Yeah, so I offer one-on-one life planning and I would love to work with any physician who is thinking. Oh, I just, I feel like I'm busy and overwhelmed and I just don't feel like I'm living this fulfilled life that I, I feel I deserve.
And, um, that's exactly, you know, what I like to help physicians with through life planning so they can sign up for a discovery call on my website, dare to dream position.com. And then I also have a podcast that anybody can listen to. It's it's the same name, dear, to visit a dare to dream physician podcast.
And I put it up. Usually it's interviews with, sometimes I do solo shows. Um, and, and we just talk about what is it, you know, how do we discover what your dream life is? And then how do we help you live that as soon as possible? Because we may not have 20 years to wait to live our dream life. We can start living that now and not take life for granted.
Dr. Diana Mercado-Marmarosh: Yeah, that's such an amazing point. You just made, we can't keep deciding that we're going to be happy when XYZ happens. We need to decide today and you have that power. Of deciding what you're going to focus on. Are you gonna find all the negative things that you think, you know, having gone your way today?
Or are you gonna look at all the things that you made happen because you decided you want it to happen? Right. So how you show up really does matter. And then realizing that none of us are a hundred percent all the time, right? We all need our breasts and we all need your time off and you need to be able to protect who you're around because it makes a difference for your energy, for your money, for everything.
And so I, this is a funny question that I always ask every guest at the very, very end, because you know, we're talking to sometimes two people with ADHD and we space out. Let's say they just started frayed attention, like right this second, what is the one little last nugget that if they just listened now, they would walk away with.
Dr. Weili Gray: You know, your life is worth it. We only get to live once. So get to know yourself. What, what is the life that you want to live? And what's stopping you because whatever is stopping you. There are ways to, there are ways to overcome that. So live your live the life that you want and live it now because tomorrow may not be there.
Dr. Diana Mercado-Marmarosh: So there, you heard it, Dr. Whaley gray shared all the nuggets. She gave you all the insights, but nobody can make the decision, but yourself, you need to be willing to decide that where you're going starts with you. And don't do it for anybody else, but yourself. And again, just like she said, it's not because X, Y, C is going to make us more worthy is that you already have been worth the all along.
Just didn't realize it. So start realizing it. And thank you again, it was a pleasure having you as my guest, and we definitely need to continue the conversation. And I hope to see you in person in a few weeks is that. Not going to be there. Ah, okay. Virtual hugs. All right. Well
Dr. Weili Gray: you take care. Thank you so much and keep doing what you're doing.
Cause you you're changing the world. Deanna.
Dr. Diana Mercado-Marmarosh: Thank you. It's been a pleasure. We are get to dream stuffed into existence.
As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
 
About Dr. Weili Gray:
Dr. Weili Gray is a board-certified sleep, integrative, and lifestyle medicine physician who practices in Vermont. She is also a Registered Life Planner and the founder of Dare to Dream Physician, where she offers life planning and hosts a weekly podcast.
Dare to Dream Physician Life Planning: https://daretodreamphysician.com/
Dare to Dream Physician Podcast: https://daretodreamphysician.buzzsprout.com/
Instagram: https://www.instagram.com/dreamphysician/
Facebook: https://www.facebook.com/daretodreamphysician
LinkedIn: https://www.linkedin.com/company/dare-to-dream-physician
 
 

Beyond ADHD A Physicians Perspective Ep 19: Dr. Adam Harrison (Family Medicine, Lawyer, Bullying Coach)

Dr. Adam Harrison: Well to our colleagues, who've suffered burnout. Don't bottle it up and suffer in silence, share your feelings and worries with a partner relative place friend or trusted colleague. And I think that action alone can make us feel so much better. Just kind of offloading that before we even get any professional advice on it.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
 
And in the past year, I have undergone radical transformation after discovering  ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Good morning. I am so excited. I have Dr. Adam Harrison today. He is a physician, a lawyer, and a leadership coach who, as a result of his own personal experiences, specializes in confidence and mindset coaching for physicians and other professionals who have been on the receiving end of workplace bullying. As the former medical director, he has also worked with medical leaders on developing kind leadership cultures based on the compassionate, servant and inclusive leadership model to replace.
Workplace bullying and replace toxic cultures. He strongly believes in doing work aligned with one's own core values. His are being honest, being, just having gratitude, leading with love and humor. Most importantly, though, he is married to an incredible female surgeon and is to father to two amazing girls who encouraged him to work towards achieving that work life balance.
And so today we are so honored to have him here all the way from the UK. And I would like to start, by asking him if he could please share any circumstances surrounding why he decided to help people with such as being a burnout coach or a bullying coach.
Dr. Adam Harrison: Thank you. Thank you so much Dr. Diana. And I thank you for that lovely introduction.
And thanks so much for having me a guest on your incredible show. I'm the honored one, honestly, I'm really privileged. Thank you so much. Anyway, back to your question, so, why did I decide to become a as a burnout and trauma coach? Well, I was bullied repeatedly myself as a surgical westerns and as a newly qualified family physician.
And I was also burnt out a couple of times when I was a surgical Western, and subsequently when I was arrested in family medicine as well. I've seen my wife, over the years of her training being bullied, as a maxillofacial surgery resident. And again, as a fellow. When we were in Australia for 18 months, fairly recently, I was tutoring female indigenous medical students in Darwin, between 2019 and 2020, and two of them separately came to me and told me they would be in bullied.
One of them was being bullied by a surgical resident and one by an attending in internal medicine. And then finally, I suppose the thing that really cemented it was. Yeah, during the pandemic, will we all observed what were already very high burnout rates. And, you know, a study that I looked at recently showed that over half of us physicians experience burnout as symptoms.
 And that was, that was pre pandemic that was in 2018. So that the amount of, of burnout just kind of rocketed, I think, during the pandemic. From already really high values and several medical friends of mine have contributed to the great resignation in the last 12 months, you know, they've left left medicine.
And so it's, it's that kind of thing that I want to have a positive impact on if I can.
Dr. Diana Mercado-Marmarosh: Awesome. Yes. That's so amazing that you had already been working on this, you know, pre pandemic. I feel like pre pandemic, the term burnout was there, but it was not so obvious. And then COVID hits, and then all of a sudden, like the things that we had been doing or asked of us to do like 10 fold with like no compensation, like it just kind of expected of us.
And we don't realize that sometimes. The health care system can become a toxic environment. And while people sometimes mean well by kind of encouraging you and pushing you along, it's not always the right way that they do it. And so how do you think your burned out impacted you and like your family, your friends?
Like, how do you think you said you had gone through several periods in your life where you had burned out, how do you think it impacted you.
Dr. Adam Harrison: Yeah, well, actually, as, as you've already mentioned, you know, it's, it's only recently become a phenomenon that's in the forefront of our minds as physicians. And there's now a lot more kind of wellbeing offerings and things like that in our workplaces.
You know, some of it is tinkering around the edges for sure, but it, you know, it's only recently that it's come onto our radar, really. So. I think it's hard to say for sure is I, I don't think that I even knew that I was burnt out in 2005 and 2007, because, you know, as you said, it wasn't a recognized medical phenomenon, then the world health organization, didn't classify it as a medical condition until 2019.
So, you know, all I knew was that I was exhausted. I felt stressed. I was unmotivated and I had no empathy for or interest in some of my patients. And I don't think there's the can be any way really that a certain number of my patients didn't pick up on my disinterest in them, but thankfully they never made any complaints about me.
Cause that would have been. Made the burner even worse having to deal with that sort of stuff. I'm sure my family knew something was up. But I guess they just attributed it to me working long hours, studying for my postgraduate exams, being stressed out by all of that. And again, cause they, you know, they're lay people, they don't medics either.
They wouldn't have known about burnout. Particularly maybe they thought I could have been a bit depressed, but you know, I never saw that. Professional for, any mood issues. So it's really hard to say.
Dr. Diana Mercado-Marmarosh: Yeah, those are such good points that you make. You know, most of us don't realize we've been for burned out or walking around feeling that way.
We think it's part of the culture. Unfortunately, I remember when I first did my very first coaching thing that I got into, with Sunny Smith, she said, oh, this is to help prevent burnout. And I was like, I'm not burned out. And you know, I did the questionnaire and like complete denial. Like in my mind, I was not burned out.
I was just irritated and frustrated and stressed, and that was on normal. Right. And I didn't realize any other way. Cause it seems like we're always kind of chasing the next big goal or the next step in our career. And we don't realize that we should slow down enough or that we. Maybe being irritable that time is a sign of, I haven't slept enough or, I'm being overworked or, you know, I'm not eating.
Right. And so you bring such a great point that most of us wouldn't even tell you that we're burned out because we know that word, we will just tell you I'm tired or, you know, I'm irritable or moody, you know, Whatever. Right. So it's so good. Like you said that now, if anything out of this pandemic it's made us aware of how important mental health really is.
Dr. Adam Harrison: Yeah, no, I completely agree. You've raised a really, really good point there about the, the culture of medicine. Just normalizing those symptoms. It's like, Well, yeah, you're tired. You have a short fuse you're fed up. You don't want to do it anymore. Join the club, you know, join the, join the queue. We're we're all like it and that, and it's kind of like, if you work in medicine, you just have to put up with it. Just normalize it.
Dr. Diana Mercado-Marmarosh: Yeah. And they make it seem like you're the one with the problem. Like, well, why are you too tired? You should take care of you, like wrap that up. Right. And then it's like, well, we're all too tired. We're nobody's just saying it because you're almost kind of bullying me. Right. Or you're almost telling me that there's something wrong with me.
And then instead of saying, well, you look tired. Get tested, make sure it's not a thyroid issue or something else. They, all of a sudden are like, you're just going to skip out on work and not helping others and make everybody else more tired. So it's
Dr. Adam Harrison: You go to your doctor's appointment.
Dr. Diana Mercado-Marmarosh: Exactly. Right. So it's so funny about that.
So tell me, what do you think is the biggest challenge that can lead people? Like what I was just describing to burnout? Would it be this like people just normalizing. You know, this toxic environments normal, or what do you think are the biggest challenges that can lead people to the burnout?
Dr. Adam Harrison: Yeah, no, that's, that's a really good point.
I think that normalization of the toxic culture definitely, it's a work related phenomenon. We know that from the who definition. I think there were multiple work related challenges that contribute to becoming burnt out. Interesting recently did a group coaching session with some physicians and they were kind of talking about the things that made them feel like this.
And one of the biggest was actually lack of autonomy, a feeling of a lack of autonomy as a physician in a corporate and insurance led system. The fear of litigation, I think weighs heavily on physician's minds. For, from my perspective, workplace bullying is definitely a contributory factor, to burn out.
I think the, the biggest thing has been really the. Recently hasn't said, I think that the, the pandemic has magnified the problems that were already there and they were already really considerable, but it's just really, you know, as you say, shine, the light on them. So lots of things around the pandemic.
So our personal fears as humans. Worrying about getting ill from COVID, especially pre vaccine, you know, going into work and having all these, these patients who have COVID. So that, that obviously is kind of preying on your mind. Our patient's fears, ratings COVID so. Just your everyday patients are kind of coming through the door.
Not necessarily those who are on ICU, but those who are coming in very anxious and paranoid about it. The reduced workforce due to colleagues leaving their jobs, I've mentioned it before the great resignation, you know, for some people. The pandemic was just the final nail in the coffin. And it's like, that's it, I'm done with medicine now.
And obviously that puts pressure on, on the remaining doctors and then the sort of workload increases again, due to our colleagues leaving also due to how very, very unwell some of the patients were, you know, in the complex their illnesses have been. And the, the kind of, You know, the second victim staff and the, and the moral injury stuff, and kind of seeing so many patients kind of die and them not being able to say goodbye to their family and having to do things through, you know, iPdds and things like that.
I mean, it's just absolutely distressing and demoralizing. And then I think there's a. You know, our, our colleagues being ill as well from COVID, which is again, leading to gaps in the rotor. So I think the pandemic has basically conspired in a way to, you know, exacerbate, everything that was already there.
Dr. Diana Mercado-Marmarosh: Yeah. Like you make such a big, big point. Like, you know, when I decided I was going to become a physician, like I remember doing. The signing the oath, right? Like first do no harm. And then you wonder, like, does that apply to me? Like, do I do no harm to myself? Like, why do I have to walk into the line of fire, carrying a fork instead of like a protective gear, right.
Like, why am I going to the war with like a mask that's like cloth and. Like this doesn't make any sense, like what, we're just going to pray about it. Like, I remember being so mad and thinking, well, I mean, why can't they make masks? Like, I'm pretty sure that mass production, the cost of making that mass production versus replacing me and all my years of training, it doesn't make sense.
I am the limiting asset, not the damn mask. Like I was so mad. And then not like you just said, like, okay so fine. If somehow I'm supposed to sacrifice myself and I'm going to die because I've seen some colleagues dying of this. Why do I have to bring it to my family? I never knew I was going to put my family at risk in that sense.
I mean, I know that we drive and sometimes you can say, well, you're driving, you're putting them at risk every day. Cause you're driving. Right. But it's different. You hoping that, yeah, it's a choice. You're hoping that everybody on the road has a license and they know what they're doing. Right. And you're not hoping to walk into like a possible death sentence. Right. And then, and so it was like you said so many things that got you to question, like, who am I, why am I doing this? Why me? Like, I have what if I have predisposing conditions and I can't make it out alive. Or then seeing young, young physicians dying.
They're 30. Why did they die? They have nothing going on. Like, it was just such a place that all of a sudden you're like, well, wait a minute. Am I even sleeping? Because if I'm not even sleeping, like how am I going to have my immune system be up enough to even cover this? Like question your self-care and question everything about it.
And so, yes, I think it finally, like you said, boiled, brought it to like, What am I doing? What am I not doing? What needs to change? What does it have to change, and sometimes you don't realize that you do have a work environment that they mean well, but at the end of the day, they're like, well, we got to see them.
And I'm like, well, for who, like for you to get paid, or like, why do we have to see them at the same time, cost us to get creative. Right? Like you said, it was a double-edged sword because yes, you're using an iPad so that you're not in the room for such a long period of time so that you're not exposing yourself.
But like you said, who's comforting that patient, when a family cannot even come in or have a choice to come in, if they chose to put that risk on themselves in the last few hours of life of that person that they love, like, you know, coming into this world and leaving this world obviously are the most intimate moments in a person's life that some of us have the privilege of being right.
And then when you're not able to do that, like, oh my God, that's kind of. It stabs you, right. It pulls at you. And like you said, it adds further injury of like dehumanizing the whole process, right?
Dr. Adam Harrison: Yeah, yeah, no, I completely agree. Yeah, it's true.
Dr. Diana Mercado-Marmarosh: So what do you think are some of like the best resources that you think have helped you or your clients to like recognize how to decrease this bullying or how to prevent this burnout that, you know, it's finally being talked about.
Dr. Adam Harrison: So I think, firstly with respect to, recognition, of burnout, honestly, and I think it's just about, for me now having a more acute awareness of the clinical features of burnout. And if I began to experience anything like that, again, I now think about whether it's being caused by stress, anxiety, depression, or burnout itself.
 And so obviously clinicians, although they have all this knowledge, they, you know, we do revert to kind of patient mode. So it's good to just kind of remind yourself there are resources you can look up, and you can, you know, you can go and see a health professional to get an objective. Opinion. You can also check yourselves with these questionnaires that I mentioned before.
We know the questionnaires, like the Maslach burnout inventory or the Mayo clinics, wellbeing index, which are both validated tools. So you can literally just say. Like you said you were in a denial, you did the question. I was like, oh my God, you know, almost a hundred percent of the day, the only test that you don't want to get a hundred percent on sort of thing. Yeah.
I was in denial , but yeah, it's, it's good things that people can do that. I think with regard to prevention again, it's back to recognition. I think for me, that's the first step. So having that insight or self-awareness to know that something just isn't right within yourself and then to acknowledge that and not be afraid to admit it.
I think that's the beginning of the journey to diagnosis, recovery and prevention for me. Recovery and prevention involves taking a step. I think looking at my work life and my non-work life reflecting and then taking back some control. So for example, I decided I didn't want to work full time back in 2008.
By which stage I was eight years post qualifying as a doc, I'd finally paid off my student debt by that stage. So I could afford to. Maybe what? Four days instead of five days a week. And then I, I personally went about acquiring other skills so that I didn't have to do purely clinical work and I could spend some of my working time being an educator and some of my time in leadership roles.
And obviously this isn't the right thing for every physician to do. There may be other things you want us to, you may want to carry on working. Full-time have a side hustle that kind of reenergizes some people or, start working part-time clinically and start doing some of the entrepreneurial as well.
But I think you've got to discover your passion or assignments in it puts it, find your one. And really forensically examine your personal values and beliefs, and then act in alignment with all of those things, because that's the only way you're going to achieve some sort of harmony in your life I think.
Dr. Diana Mercado-Marmarosh: Yes. I think everything you just said, like resonates a hundred percent. It was not, you know, in this last year and a half, it's been a journey back to myself. Like, like you just said, asking myself, like, why am I doing this? What's the point of this? Why am I saying yes to things I don't want. And then resentful to doing that, or like, why had I said no to things that I've always wanted to do?
Just because I thought that's not what a physician does or that's not what a mom does or that's not what a wife does, right? Like we have all this should or should not like manuals like that somewhere. We learn them and we pick them up. Yet, they're not really allowing us to step into the who, why, where you know what we want to be doing. Right. And when we slowly ignore those pieces, they lead us really south and we get in trouble because other sudden we wake up and you're like, is this what my life is supposed to be? And then not until you start getting quiet and like ask yourself if time and money was not really. An issue here, what would I really be doing?
And then you can spend a few minutes and all of a sudden the answers come to you, but you, you might feel afraid because you been ignoring those kind of all along. Right. And the thing is being afraid is norm, like, it's not like you were like, Ooh, I can't wait to do that spinal tap. Like nobody was like, let me walk into something.
I don't know how to do, right. Like, well, maybe a few were, but I think most of us, are always feeling nauseated at the sign of doing something new, but it shouldn't keep us from discovering who we should be. And so you're so right of talking about setting things that are aligned with you, because then they really allow you to come and work.
You don't have to work because it feels fun, right? Because it lights you up and I'm so glad that you discovered, you know, how to do it your own way and how to then empower other physicians and other professionals to be able to also do it their own way. Like how validating is it for a physician who can say, Hey, I've gone through this, but it doesn't have to be this way.
And so I'm so curious for you to tell me a little bit more about how you, you do set up this work. You said you do work place, you help, set up better environments. How do you do that? Do you do it like a group organizations or do you teach a leader and then they go and implement, like, I I'm so drawn to all the work that you're doing.
Dr. Adam Harrison: Yeah. It's, generally targeted at physician leaders. The thing is, you know, the C-suite, you know, they kind of, they kind of have their own agenda. I don't, I don't necessarily understand the non medical executives. But I get, I get physicians and they, you know, they kind of see something within myself as a fellow physician that they can kind of tune into as well.
So, yeah, it's, it is unfortunate that a lot of. Physician leaders are not very good leaders. And the simple reason for that is we're just not taught any leadership skills at medical school, or anywhere else for that matter. you know, any graduate is not taught to any leadership skills on their course, generally, you know, be their geography graduate or French language graduate.
You know, it's a. It's a, it's a real shame. And then something that's really needed. I think moving, moving into the future to have lots of better, better leaders. But yeah, doctors are not, they're just kind of thrust into the role. And I always say the all doctors are leaders because people are always looking to a doctor, even, even an intern, you know, the, a junior nurse, when, when something's, when a patient's going off, they're going to be looking at.
Intern for a stare as the doctor, right? So we're all leaders to an extent, but you know, you want these leaders to exude kindness and compassion so that people who are looking at them and, modeling on them, you know, the junior doctors who are looking to them for an example, are going to model themselves on like that kind of kindness and Rob, rather than, you know, aggression and, you know, command and control leadership and, and that kind of stuff, you know, so yeah.
I tend to work with them, go through, you know, their values go through their, their leadership styles are, and, you know, can do it one-to-one or as part of workshops. And group sessions. And that's this, I suppose it's a kind of a top-down approach. The people who are on the receiving end of unkind or even toxic.
Who are the junior doctors really? If they'd been on, you know, kind of recipients of that kind of bad behavior, then I want to work with them on their confidence and their mindset and how to manage the stress and the fear of those sorts of interactions. So, you know, I suppose it's a sort of a two-pronged approach really within the.
So toxic workplace culture, you know, teaching the, and training the leaders to be just much more kind and calm and considerate, and just basic things that people don't think about. Just common courtesy and civility. This incivility in the workplace is that is another thing. Another thing there's a paper in the Harvard business review by poor Athen Pearson about the effects of incivility in the workplace.
So it's, it's all important. It tends to be my approach.
Dr. Diana Mercado-Marmarosh: Thank you. That's so helpful. And so useful. You know, I feel like as you know, this is an ADHD podcast and this is obviously where I'm going to ask you this question, which of course I have my own opinion about it. You know, sometimes I feel like people with ADHD and sometimes physicians who have, are not even aware that they have ADHD because they don't even, like it's not talked about or they don't want to be labeled or whatever.
Right. And so. Most of us think, or now I've learned a lot more, but most of us when we're going through med school and going through residency, like they tell us that ADHD is something that people are just impulsive and people just can't focus long enough, but sometimes it feels like a misnomer with that because it's kind of like the spectrum.
You will focus on things that maybe you don't need to be focused on. And here we are like a three hour, like a history and physical. And you're like, what happened to all the other people, right? Because you don't prioritize. Not because we don't want to, but because we get so drawn into like that patient and we're so excited and we go down rabbit holes.
But then we don't complete all the tasks and we are labeled as lazy and we are labeled as, you know, not professional and not in showing up late and all kinds of things. And it's not. Because we're trying to put more work on you or do more things. It's just, we really are so intrigued and want to learn all kinds of things.
And so I feel like, and what is your thought on this? Would it be that people with ADHD sometimes might be at risk for bullying or might be at risk for feeling like they can burn themselves out because they're trying to do too many things in a way that maybe we're expected to do. And they're not giving themselves the opportunity to do it their own way.
Dr. Adam Harrison: Yeah. Okay. I'll yeah, I'll just sort of, address them separately, but a hundred percent. Yes. To both. So first little caveat. I'm not, I'm not an ADHD expert like yourself. I'm a family physician by training. But I've reviewed, The suggested diagnostic features of ADHD and adults from the national health service, a website in the UK.
And I can, I can see how some of the symptoms could very much lend themselves to people with ADHD becoming burnt out more readily than those without ADHD. So for example, this whole list, I'm not going to go through them all, but, You know, including, for example, some of these features are carelessness, lack of attention to detail, continually starting new tasks before finishing old ones, poor organizational skills, inability to focus or prioritize continually losing or misplacing things forgetfulness.
And I think all of those things, as you say, could be perceived by. Other people as, you know, laziness or, you know, just kind of carelessness or whatever, or disinterest or something like that. I think bringing it back to physicians. When you add to this, the perfectionist and people, pleasing traits that you see in the vast majority of us, the difficulties we have in saying no to requests by patients, colleagues, the administration, and the subsequent guilt we feel.
If we do say no, you've got a perfect burnout storm brewing in physicians with ADHD. And in terms of being bullied, we were talking before, you started recording about whether people with ADHD, whether it's classed as a disability in the states, and you said that it is, and I mentioned a study that was done in the UK and about 2018, I think it was a survey that was done essentially.
Workplace bullying. And then people with protected characteristics. So gender ethnicity, disability, sexuality, religion, you know, various things, whether these different categories of people. We're at a higher risk of workplace bullying. And interestingly of all of those, you know, at-risk groups, those with disability were reported the highest rates of workplace bullying.
So certainly someone who is neurodivergent. Would be, would be within that group. So they will be more likely to report high rates of workplace bullying. I think because of, some of the, you know, the symptomatology within ADHD. If, if you've got someone who's particularly unpleasant in your team or wider, working environment, Who thinks your, I said lazy or they think you're a bit peculiar or something like that.
You know, they have the kind of preconceptions basing, basing it on your behavioral traits, then that could definitely lend itself to being. So, yeah, it's very, very sad. But yeah, I think
Dr. Diana Mercado-Marmarosh: But I think it's so good that you're talking about this because you're bringing awareness, right? Because once you bring awareness, you can't unsee what you now have seen.
And then you can take steps towards getting help, either going to a therapist, going to a physician, going to a site, you know, to a coach. And in more specifically, you know, then you decide if you go to an ADHD coach or if you go to a trauma coach, or if you go to a bullying coach like yourself, like then you start to find the resources to heal, whatever it is that you're going through.
And realize that you don't have to normalize what has happened to you, right? And that every day could be a different way towards becoming who you need to become and showing up and practicing medicine in your own way. If you decide to continue that. Or you decide to do a different entrepreneurship or together you have now tools to help you, because it's not just as easy as well.
Let me remove them from that environment as is, as in you put them in another environment and everything's gone because while things might lessen. They're not going to completely be a hundred percent better until you have done the work in your own self. Right? And so it's so important that you, you bring all this up because sometimes ignoring things like this, unfortunately, you can see how that can lead to depression and hopelessness and shame and all of a sudden, it could even lead to suicide. I mean, you, you know, that some professionals such as lawyers and, physicians, you know, are up there dentists too, like up there with the risk of suicide, you know? We don't talk about this things because somehow we've been told all throughout, we'll just suck it up.
Like it would be okay, you're the one who's weak. You shouldn't be weak. You shouldn't be asking for help, but like, we also have seen how amazing it is to take care of a patient in a team approach. Everybody's working in their zone of genius. Like why can't we do that same approach to ourselves to take care of us?
Like we are worthy to have that team approach. We are worthy to have, you know, a physician who cares, who knows what you're on a therapist, a coach. Why not. You also just like you treat your patients, treat yourself with the same, like resources and why not us? Like we have no, like, excuse, like we literally have experts at our fingertips just because you're a physician like.
Are able to get into more spaces and then you can use and leverage that to help your patients and your community at large. Right. So I am so curious how your next three years look for you. What are you up for? Like, what are your goals? How are you going to continue to make an impact for us?
Dr. Adam Harrison: I absolutely love this question. Dr. Diana, so thank you so much for asking you you're a wonderful podcast host, what prep actually preparing for this podcast and having the questions in advance really forced me to think about this. So thank you for that because it's kind of focused me on that a little bit. So. I'd like to in the next three years I'd like to set up and run a retreat for physicians.
Who've experienced workplace bullying by the end of the three years that, that you mentioned within that time as well, maybe within two years, but two to three years. So now I'd like to have published a book on, you know, kind of my way of how I suggest people manage mindset, problems, and confidence, problems that have arisen out of workplace.
Within 18 months, I'd like to set up and hosted a conference on mindset, confidence, workplace bullying. And they're looking a bit bit closer by the end of quarter three of this year, I'd like to have completed my ICF accreditation. That's just kind of hanging over me. So it was one of those things that you just kind of defer, you know, it's important, but it's like, oh, something else has come up, you know, and deprioritize it by the end of June.
So by the end of quarter two, I'd like to have started my own podcast and have at least one group coaching program up and running. Certainly one for victims of workplace bullying and one for those interested in kind leadership. So yeah. Yeah. Within the next three months, podcasts and group programs are my aim fingers crossed.
Dr. Diana Mercado-Marmarosh: That's amazing. Now give us the insight. What are you going to do for fun? And the next three years?
Dr. Adam Harrison: So funny, my wife works very, very hard, but we, we do like our holidays and I suppose that's our main, our main family time, because you know what it's like the working week just goes by so fast, doesn't it?
And there's all sorts of stuff. And even the evenings, you know, the kids go home from school and we have a five and an eight year old daughter. And, you know, our eight year old is slight, right? Come on. You know, you've got homework to do. You've got to have your food, you got to have a shower. You've got piano practice.
And she started playing the guitar recently as well. It's like, well, you know, you wanted to play it. So you've got to do it. And you know, these evenings with all these things to do over in a flash, are they, so the week times. You know, the best kind of quality family time. So, so lots of holidays, I think. Well, as many as we can get in.
Yeah. Especially with the world opening up a bit more. That would be great. Yeah.
Dr. Diana Mercado-Marmarosh: What are your, like, places that you want to visit? Are you wanting to like visit any specific part of Europe or maybe come to the states?
Dr. Adam Harrison: Yeah, we love the states. My wife, and I've been to the states many, many times, would definitely like to come up to this. I've got in the last year or 18 months, I've, you know, accumulated so many good friends in the states like yourself and you know, it'd be, it'd be so great to come and have some. Well, it's not a reunion, is it? Cause like we've not met in person before, you know what I mean? Like I have a gathering of people, so, yeah, definitely, the states and back to New Zealand to see our friends there. So, yeah, they're probably the main.
Dr. Diana Mercado-Marmarosh: You know, I'm pretty sure you can tell all of us, Hey, we're going to have this like trauma conference and you see Lynn's and you want to come be a speaker and you know, we'll be like business expense. Let's go, you know, we're going to be like, well, a little bit. Fun and a little bit of play and a little bit of learning, like perfect, right?
Tiny bit of work. So I'm pretty sure if you also decided to come do a conference. And Vegas or somewhere, you'll get all physicians to come out to. So you, you would just give dreaming and you you'll make it happen. We'll show up.
Tell me where can our listeners get in touch with you so they can learn more. The amazing and great work that you're doing. Maybe they want to work with you and maybe they just gonna to tell you how amazing this was and you know, where can they get in touch with you? I know you're a social butterfly. Tell us all the things.
Dr. Adam Harrison: Yeah. Social media, butterfly. Thank you. That's good. So my, my website is, fairly, fairly new. It's still a work in progress, but it's, it's out there. That's just, www.DrAdamharrison.com. So Dr. Adam Harrison, all this one word and I can be contacted through the contact form on the website.
The website has web pages on how I can help individual physicians or their organizations through. My coaching, training workshops, workplace bullying, and kind leadership development work. So yeah, that's, that's the main thing. Everything is pretty much through my what is it? In your course at your HQ. That's my, that's my HQ now.
Dr. Diana Mercado-Marmarosh: And I understand you have a YouTube channel and Instagram and you have all kinds of stuff.
Dr. Adam Harrison: Yeah. I have all the, all the shiny objects. I think my, my LinkedIn and YouTube are my favorites. Hopefully you can put links to those in. But, but Instagram and Twitter are just like, yeah, I'm struggling with them.
Maybe I'll get some traction one day who knows, but they're, they're a bit of an enigma to me, but anyway,
Dr. Diana Mercado-Marmarosh: Well find him on LinkedIn. And if you want to work with him, please do reach out. And if you're considering my course is actually. One of my amazing, expert guests in there. So please join my course and have access to him or work with him directly.
Either way find the resources you need, because you're definitely worth the investment. Our brain is the most powerful asset that we have. And how much money did we put down to become a physician and how much money do we put down to buy our cars and buyer houses? Like there's nothing. Money that you can invest in you becoming who you want to and showing up for yourself, showing up for your family.
Right. And of course, for your patients. And so one last question, anything else you would like to share that maybe I forgot to ask? Or if people finally like woke up, they were asleep this whole time and they just now said, okay, what do I need to take away? What is one last thing that you would like to leave us with?
Dr. Adam Harrison: Okay. Okay. I think, well, can I have, can I be cheeky and have two things? Well, thank you. Thank you. So I think from , a burnout on bullying perspective, my, my kind of take home message is, I have, I have a mantra that I use for my victims of workplace bullying clients, which is you're not alone. It's not your fault.
And you have no reason to feel ashamed. And I think this is equally applicable to our colleagues. Who've suffered. As well, essentially don't bottle it up and suffer in silence, share your feelings and worries with a partner relative close friend or trusted colleague. And I think that action alone can make us feel so much better.
Just kind of offloading that before we even get any professional advice on it. So that, that would be my kind of, um, professional take home message and, um, yeah, and just. Finally, just going back to the contact details thing. I just it'd be, it'd be great. If people could follow me, keep an eye on my website for the release of my podcasts and group coaching programs in the next two to three months.
 I think I'm particularly excited about my podcast show, which will be all about inspiring women leading. And, I've literally heard in the last few days that Dr. Una has very kindly agreed to be my first guest, so yeah, yeah. Really, really chuffed. But, yeah, I just want to say thank you so, so much for having me as a guest on your brilliant show.
I've loved it, and I'm really grateful. Genuinely.
Dr. Diana Mercado-Marmarosh: Thank you again. You know, being the source of inspiration and speaking up when nobody was, you know, like you'd start a pandemic. So you're definitely a pioneer doing this and, and doing it at the right time and continuing to do it and showing up. Right. So that's so important.
So. Guys listen up. Like even if you think that whatever your message is, is not important, know that there's somebody out there that's going to be so glad that you decided to share, and it's not gonna be as embarrassing as using ink or as shameful as it is. If anything, you choosing to be brave to speak up and to empower everybody else to do the same.
As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
 
 
About Dr. Adam Harrison:
I'm a physician, lawyer and leadership coach who, as a result of my personal experiences, specialises in confidence and mindset coaching for physicians and other professionals who have been on the receiving end of workplace bullying.
As a former medical director, I also work with medical leaders on developing kind leadership cultures based on the compassionate, servant and inclusive leadership model paradigms.
The underpinning philosophy to both my workplace bullying and replacing toxic cultures with kind leadership work, is mental and physical wellbeing, so I do a lot of work in that arena too.
I strongly believe in doing work aligned with my core values (honesty, justice, gratitude, love and humour) and I believe that shines through in my work.
I am a fan of social media, hanging out on LinkedIn (as 'Dr Adam Harrison'), Facebook, Twitter, YouTube (I have my own channel for which I create content) and Clubhouse, where I have co-founded a club.
I am also a budding podcaster (by mid-2022 hopefully) and future author of a book on how those who have experienced workplace bullying can change their mindset and restore and reinforce their confidence so they can stop dreading and start enjoying and thriving at work.
Most importantly though, I am husband to an incredible female surgeon and father to two amazing girls who changed my career trajectory to help me better work towards achieving that often elusive work-life balance.
Email: dr.adam@coachingmentoringdoctors.comLinkedIn: www.linkedin.com/in/dradamharrisonFacebook: @coachingmentoringdoctorsInstagram: @dradamharrisonYouTube: Dr Adam, Physician-CoachClubhouse: @dradamharrison | High-Performing PhysicianTwitter: @FutureExecCoach
 

Beyond ADHD A Physicians Perspective Ep 18: Dr. Jessica Daigle (Board Certified Pediatrician, ICU Doc, Founder of Mom and Me By Jess Daigle MD)

Dr. Jessica Daigle: Having that sense of control and order is what allows you to be able to move forward. Like you need to .
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
 
And in the past year, I have undergone radical transformation after discovering  ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Dr. Diana Mercado-Marmarosh: Well, hello? Hello. I am so excited today to have one of my good friends. Dr. Jess Daigle. She's a board certified Pediatrician. She's an ICU doctor and founder of mom and me. By Jess Daigle MD and upcoming in-home virtual postpartum care service. This may, that will provide medical care to newborns and education to the mamas, along with emotional and practical support during their fourth trimester.
Her heart is towards mamas and their little ones. She loves to educate console and reassure families. She's on a mission to help moms ditch, overwhelm, and feel competent in their new lives so that they can reconnect with themselves and embraced motherhood with confidence and joy. So I am so excited. I want to her to tell us how she ended up being able to do all these things.
Dr. Jessica Daigle: Well, thank you so much, Diana, for having me. I'm so grateful to be here today and to share my story with moms, because I've really been there. I always wanted to be a pediatrician, which I think that was just a God given quality, but it became, it started to have more meaning after I had my own kids. Because essentially you have to go through something to kind of really understand someone else's experience. It's not enough just to have the education, the experience lends more meaning to how you can help. And so my first, baby it was a miscarriage, so that was hard, definitely for a lot of reasons.
It was my first clue into like grief dealing with grief and guilt and shame when it comes to losing a baby. Thinking about what if and what could have been. And then, God blessed me to have my second child. But he was all preterm. So he was born at 31 weeks and I actually was on bed rest with him for nine weeks in the hospital just to have him at 31 weeks.
And so, he had only been a later at first, but then he did fine acquire a feeding tube and things like that, which is typical for a new, preterm infant in the NICU. And then when he came home, I thought, you know, okay, But exhale, we can just kind of get on him growing and then he had to go back on tube feedings.
And so that was emotional because I was still finishing the last part of my training. And that was hard. And then, my third child ended up being a premature infant as well. So I've definitely had the experience of, of new mom and NICU mom actually at the same time. So my first baby that I brought home ended up being a NICU baby.
So, you know, on top of the newness of taking care of a baby, now you have a baby that has medical challenges. And so, that was definitely stressful and overwhelming, but by, you know, creating systems and understanding how to assess my knees and, and how to get what I needed, allowed me to get through it.
And so, but that foundation alone, coupled with the work that I do in the hospital, taking care of preterm infants and, just even normal newborns and seeing moms go through the concern and worry about being able to. Take care of your babies. You know, it is scary as new and unless you babysat babies before, you know, it really, you really don't know a lot about what you're doing and you kind of learning on the job training is what I call it.
And so just want to be able to be that guide for them, that mentor, that advisor, consultant, strategist, all of that, is what moms need to be able to set the right tone for their postpartum journey and their motherhood journey as well.
Dr. Diana Mercado-Marmarosh: That's amazing. So like you just said, you live this experience yourself, where you're already on track to becoming like a pediatrician and a NICU physician?
Dr. Jessica Daigle: Yes, I was actually, cause I, I read this book when I was younger. And my mom was like, why are you reading such a heavy book? But it was called The Long Dying of Baby Andrew. And it was about this family, Robert and Peggy Stinson who had this really extremely preterm infant. He was under 25 weeks gestation.
And like the heroic step, the doctors were, you know, medicine was changing at that time. Being able to allow babies that young to live longer. And, but we were right on the cusp of. You know, new technologies and medications and things, and they wanted to just be able to let their baby die dignity.
They didn't want all the heroics and all the procedures and things, you know? And so it kind of taught me that young about quality of life too. Like, cause I, I wonder what what's the, what is the right decision in those instances? So I said, I want to save the babies. Like I want to be. The person to help families navigate those harder, difficult times that young, I was 10 years old.
I wanted to do that. And so, as I grew towards it, and then I had my own kids, it became even more real to me. How important of a process that is.
Dr. Diana Mercado-Marmarosh: So, did you have your kids during residency or like,
Dr. Jessica Daigle: Yeah, my first one, my loss, my miscarriage, and then my son Liam, who's eight now who was 31 weeks. I had him right at the end and I was actually accepted to me in etology fellowship.
Right. When ever I was kind of going into, having him and having to, I was interviewed. I'm sorry, excuse me for fellowship at that time. And then my daughter, I was already working out as a physician in the NICU.
Dr. Diana Mercado-Marmarosh: Yeah. It's so interesting how sometimes whatever we're drawn towards, it's like, we've almost been preparing to walk in that step, right?
Like, it's so weird how your. Experiences like mesh with who you're going to be and what your zone of genius is going to be. Right. Provide that support for the families and you went through it. Right. So it's so crazy how sometimes you're able to blend them both together for the good of the humanity.
Dr. Jessica Daigle: I think the so special.
Dr. Diana Mercado-Marmarosh: Yeah. And you know, you and I have had this conversation multiple times, how females sometimes are diagnosed. With ADHD later in life. And probably because whatever things we were systems we were using were okay when it's just ourselves. But then when we all of a sudden have a baby or we end up like getting promoted and now we're managing other people, not just yourself.
All of a sudden, like, its ugly head comes up where you like your executive function, juggling of things is not like you, you meet kind of like, I want to say you get oversaturated. Like it doesn't matter how much you try you working harder is not going to help. Like you have to do something different in order to.
Then just figure out a different way. And so moms become diagnosed with postpartum depression or with ADHD sometimes after the birth of a child. And I can only imagine, like you're saying, when now you have. A newborn that's in, in the NICU that is requiring all those extra special attention to detail that needs to be there.
How that could be a little bit overwhelming as well. And so how would a mom who has ADHD or a new mom that it works, you know, that has a NICU baby. How do you think you could help?
Dr. Jessica Daigle: I think that the, it comes down to cleaning and I'm, I just posted a post cause I'm doing a workshop March 29th-31st about having a postpartum plan because I see a lot of moms come in with a birth plan, but they haven't taken time to think about how their life is going to be adjusted after having a baby.
And to be fair, no one can really a hundred percent plan for that. Because a lot of times it's not until you're in a thing that. How you feel about it, you may think based on some other values you have, or what you know about yourself currently, that you may want to do this and that. But I do think you can at least consider it and, and ride down an ideal situation.
Cause that's like if like life in general, we have goals and we work toward them, but something may come along the way in life and kind of shift you or you have to navigate or turn down a different path. But you still know where you're trying to go. And so, I encourage moms. If they are working with me, we would look at the, what I consider the five pillars of things that are impacted when you have a baby. You yourself is impacted you as a person. You have your identity. What you think about yourself as a woman, and then what kind of mom you want to be? A lot of times, you're just now starting to think about that. You know, I know, I didn't think about what kind of parent I want it to be.
I didn't compare it to my own childhood or anything like that until I had kids. I started to look back and think, yeah, I want to do that. And no, I don't think I want to do that. You know? So thinking about you as a woman what your goals are for yourselves feel even while having this baby. And it could be short term, like, I'm definitely about self care.
So having planned for taking care of yourself, making sure that you're all right as well, and then the babies. So learning what you can to take care of your baby, like where, where do you feel afraid or what are you worried about? Then okay. Who can help me, like having those systems in place for support that could be from the pediatrician like me, that's what I wanna do.
Help moms in the home. I would do go through newborn education. Cause some of them don't even know, well, what's the good way to change the diaper? How should I be feeding them are, you know, breastfeeding and or formula education is necessary. How do I even make the bottles and things like that. So I would even, I'm gonna do even those basics.
But knowing, like, what's your plan for the baby? Like, do you, what's your childcare plan? Like, do you want to, are you that person. Knows. You're going to have to go back to work in six to eight, 12 weeks, depending on your financial situation or your household. Okay. Well, who is going to be watching my baby?
That's a real concern and a big one. , I know that stresses me out still. And look, they're 83, but, but I have a system now. I have a mom, my mom and I have two of my family members and they come in rotation. And now that I know that I planned that. It doesn't change the fact that it is needed. Right.
And so that's the, one of the big things that you have to realize, like it has to be dealt with. They can't, you can't bury your head in the sand and it just magically gets better, you know, but by having the strategy, then you say, okay, I've already thought about how I feel about this. This is what I'm going to do to make myself feel like I'm in control of it. Cause that's what it comes down to at the end of the day, having that sense of control and order is what allows you to be able to move forward. Like you need to. And so you, the baby thing, your relationship with your spouse, right? So, you know, our partner, our, even if you not with somebody, like what is it that you're doing just to make sure you have support in place?
It could be. I say, mom and me, plus village equals three. Yeah. I said, no, you need to know what your village is. That threefold cord, like we hear people talk about that triangle that, that, you know, that that system of flow is important. So you may not be, the daddy may not be a partner. It might be your mom or an aunt or a best friend, but somebody else that is there that you can rely on and lean on because you do need community.
And then the fourth thing is your house. So when you have a baby. Nothing changes like every, your life as it was still, you still have a light bill. You still have a cable bill or Netflix bill or whatever you want to call it. Like the bills are still the same. The things that you need to do in your life are still the same.
But now you have to factor in. A baby. Like I remember the first time I was getting ready to go somewhere like, oh wait, no, I have to think about like, wait, it's not, it's just, you know, just pick up and go no more. It has to have a main looser has extra change of clothes and some milk. And then do they have some wipes?
Do you have, you know, some nameless, normal saline case, they knows, got little buggers, you know, like it's not just pick up and go with it. Or if you are trying to go by yourself, who's coming to the house to wash them. Do they know what they're doing? You know, it's so much that you have to think about.
And then lastly, return to work. So like I'm alluded to already, you know, some people don't are, they'll have the situation where, so if they have the baby, they either gonna to stay at home. More, they are taken off for a whole year or like in other cultures is they are supported that way. You know, a lot of people overseas have different, a lot different cultures are able to support their moms a little bit more in this way, which is something I think we can work on all over here in the U S.
Which is part of what my business is going to aim to do, to, to provide that personalized care, to help moms during this transition, because she's going through a lot, like, you know, every other procedure like surgeries or anything else, you have a recovery period that people are expecting you not to be having the hustle.
Well, we have babies, people were just kind of like, all right, you did that. You to be showing up next week to work. And you're like, no, like my body's recovering, like why are you having this expectation of me that you don't have with anybody else that under a major transition in life, you know? And so those are the pillars you, the baby, your home environment, community and your work career. These are the areas that, that you need to think about. What do I want my life to look like? So when it comes to a mom, ADHD or not, you know, what do, what do I envision for myself or what is ideally gonna make me happy and know that you have to be fluid and know that it can change.
So what I thought I wanted for myself was very different. Once I had my kids, like my priority shifted, my values, we're the same. I would say I, you know, I've always been loving and caring and wanting good will towards others and things like that. But when my kids came in, I was like, all right, I want to be my best self because now I realize they are relying on me.
They are watching me. So I view my world and even my life differently now, like even with my business, I'm like, I don't want to give up. My son is watching me too, you know, he's, he's going to need to know, Hey, I gotta push through when things are hard sometimes to get the good in it. And so that's what I would tell a family is really knowing.
And that's why, if someone like me is good, because I'm going to help them realize these things and we can work through it together about what is important to them now, what do they want to see in their life and how to best use them.
Dr. Diana Mercado-Marmarosh: Thank you so much. That's amazing. You know, again, I know when I had my first baby, like, luckily my mom came and she helped me with him, but not everybody has that support.
And you need to create that support. Like you said, like it does take a village and you do have to know, okay, who can come watch them so that I can sleep or I can shower or I can eat because like you said, You just delivered a baby. So isn't it all of a sudden what you're supposed to feed them on demand every two hours.
Like if you decide you're breastfeeding and like, when are you sleeping? Are you doing that every two hours? Right. And so there's so much stuff that can happen. Like. It can build resentment and all kinds of stuff. If you don't have conversations beforehand of what it is like, or let's say things already happened.
Okay, what can I learn from this experience? That didn't seem just right. And I correct it, right? So that we are not all making assumptions of. Things should be or not be. And then you modify that. And, and sometimes with ADHD, like it's kind of hard because we interpret things. To mean a lot more than they, they mean, and it's that emotional dysregulation that can happen.
And then you throw in lack of sleep in there, forget it. It's like a hot mess waiting to happen. Right. And so it's why this, you know, I joke around and I say, self care is not just you getting your nails done. Like. It actually means you putting your oxygen on yourself first so that you can be able to drive places with your kiddo.
Cause you're not sleep deprived and not going to crash somewhere. Right. And so we have to let go of this idea. Like I can do it all myself. Like you have to ask for help. And, and most of us have been taught that if you don't do it yourself, you're doing it wrong. But like you just pointed out, like in some cultures, like family moves in to help you, you know, it's a village is not just, okay, good luck.
You know, we'll pray for you. It's like, okay. Pray and send the food. Like, don't be just praying, you know, send me cooked food.
Dr. Jessica Daigle: I mean some extra behind that work..
Dr. Diana Mercado-Marmarosh: It's so important that you're pointing all that out and like what better than to work with somebody who this is what they do. Day in and day out and has to personally experience as well and can guide you for all those things. Because like the thing is, you don't know what you don't know, like you think, you know, and yeah, reading it somewhere 3:00 AM. This is not the same as being able to talk to somebody who lives. This is their zone of genius, right? Like this is what, how they can help you. And, you don't have to sit in overwhelm, like you could get the help. And so, yeah, this is so good that you're sharingthese things, because I think part of us with ADHD, we feel like we always trying to prove ourselves and we, and like, why can't I just human?
Why can't I just be a mom? Why can't I just, and that type of thing is not helpful. Instead you have to ask a different question. How can I help me to, you know, those are different questions versus you thinking there's something wrong with. And so tell me, what, what does it look like in your next three years for you?
What are your big plans that are going to be stretching you?
Dr. Jessica Daigle: So I am launching my own in-home care practice in May, where I will start to take a, it will be a cash based practice, but I'll be able to see, moms, and the home and I'll be doing like the newborn Sam and also provide a, and when I say the emotional, support is because, like you said, the moms, they're worried about the baby that they do often neglect themselves. And so you're right. Like self care is caring for someone it's assessing needs and then how those needs to be met. So in order to care for yourself, you need to see what are my needs and how can they best be met. And that's true.
And it does not mean that it has to come from you. It could be whoever. You know, if you say you need a massage right now, you're not beating yourself up because you can't give yourself a massage. You say, Hmm, that place down the street. Sure. Looks nice. Let me go check them out and you go and get what you need.
So, it's changing the narrative, normalizing the fact that itwas not right for anybody to expect, you know, nobody can be everything for anybody all the time. You can be everything for yourself all the time, you know, that's why we have community, you know? And, so take that pressure off yourself first.
And then, then you'll be able to open. It's kind of like opening up a fist. Like if you hold a tight fist, you can't put nothing in there, but if it's open, you can give as well as receive. Right. And so that's how we should be living our lives. So I'm starting with that in home practice, but I envisioned a center, um, for moms, that, will, you know, like holistically cater to them during this period.
Giving them everything that they need because as I've explored my own business, my mind has expanded into everything like moms are impacted in so many ways from this physically to mentally. So learning mindfulness, learning, life planning, learning, what, what kind of pair do you want to be?
You know, dealing with postpartum, depression and anxiety. Life skills, like almost like a little mom vocational center. That's like the, my center and lessons, amazing mom that you want to be yoga therapy. We got somebody that can help you with that too. You know, just that, just that kind of thought because you know, everybody's having to run everywhere for everything and. Like, you know, she, I want her to have a place, like when, like, when people go to a spot, I can get a facial in a males and a massage, you know, like, okay, that's aesthetic.
I want something like that for mind, body and spirit. So.
Dr. Diana Mercado-Marmarosh: And, what are your fun? Goals that you have for the next 3 years, are you going to be traveling anywhere?
Dr. Jessica Daigle: Yes, my son wants to go to Hawaii. So trying to do that, I, I want me and my husband we've neglected to hang out with each other just by ourselves with all of our.
Aspirations me getting this business off the ground, him with his real estate. So we used to go and cruise all the time. And so I want, us, you know, but then COVID happened too. So you know how that is, but once we feel, you know, ship ready again, I would love us to go on a cruise. Because we always had fun that way.
And that's definitely where Liam was created.
Dr. Diana Mercado-Marmarosh: So careful, Ms. Jess, you're going to come back with a souvenir.
Dr. Jessica Daigle: Oh no, no, no. I took care of that. You know how people say they got their tide? I had the bridge demolished, my uterus and my ovaries. United States of America apart.
My ovaries are California. My uterus is Georgia, they have no way to get there.
Dr. Diana Mercado-Marmarosh: Oh, funny. So, cruises, what else do you see in your fun to do things?
Dr. Jessica Daigle: I wouldn't mind. Thinking of driving cross the U S I love driving. And, we've done like Georgia. Towards like New York for like a thing, but I would love to do like a cross country type of road trip. I think that would be fun, like just stopping at different like sites and, you know, and then singing in the car and snacks and stopping, sleeping off different places. I think that would be fun.
Dr. Diana Mercado-Marmarosh: Yeah, that sounds like a good adventure. I'm also wanting to do at some point, I want to get in one of those railroads, those cross country railroads, like that sounds cool. Yeah. Where you just like, get it, you just get in there and you just, you know, they bring you the food, you just chill
and we can plan something together.
Awesome. Well, this has been so amazing. Tell us where they can find you and tell us where they can register for that webinar, that masterclass that you're going to be having soon.
Dr. Jessica Daigle: So. My workshop, Adjusting to Motherhood, Developing Your Post-Partum Plan is March 29th through the 31st at 8:00 PM Eastern time.
So that is three days. We'll talk about, all the different parts of some of what I talked about here today. And, kind of worked through it real time. So moms can start playing, especially are expecting moms. And then for those who already have a baby, maybe hadn't thought about it, but you know, it's no, it's never better late than never.
Like they say, because it's really something that you'll continue to revamp, like thinking reassessing those parts of your life now that you have had. But now that you have. So that workshop is, can be found. The link is on my landing page, www.momandmemd.com/stop overwhelm because that's my mission.
And we, we, that we don't want to live in overwhelm. We want to live in power. Okay. And so, my social media handles, I know that you're going to include there too, but. @momandme_MD on Instagram and Jess Daigle on Facebook. And I haven't new Tik TOK. That's at @momandme_MD.
But yeah, so like on my landing page is information about the business to come like the what I'll actually be doing. Also a flyer with the registration link to my workshop and just a little bit more about me.
Dr. Diana Mercado-Marmarosh: Awesome! Well, this has been so fun, but before I let you go, one more tip that you want to share with the people that maybe I haven't asked you about. If they just started listening, if they hadn't paid attention to anything else, they just woke up. They sold, what do you want them to walk away with, today?
Dr. Jessica Daigle: I want them to know that motherhood is on the job training. There, is no real manual for how to do it is a process. Okay. And, but you can plan and think about the areas of your.
Now and how they might be impacted when you have a baby and what you want it to look like, but just be willing to be flexible, that will serve you well, as a mom, because many things are not often what you think, and then what you desire over time may change and being, being willing to be flexible will help you to move forward in your motherhood journey with confidence and joy.
Instead of living stressed, we don't want to do stress. We want to do confidence and joy!
Dr. Diana Mercado-Marmarosh: Awesome. Well, thank you. This has been awesome delight. So much fun to talk with you. Every time I learn more tools that I can go and implement, I'm gonna put all your links on the podcast stuff so that they can come and find your workshop and they can follow you on Facebook and Instagram and Tiktok and everywhere, so they can learn how to empower themselves and stop
overwhelmed.
Dr. Jessica Daigle: That's right. We don't want to do overwhelm , it can happen, you know, in any moment we all can be stuck, but the goal is to get unstuck.
Dr. Diana Mercado-Marmarosh: Awesome. Well, thank you so much again, and this has been a pleasure.
Dr. Jessica Daigle: Alright, you too dear.
Dr. Diana Mercado-Marmarosh: As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
 
Dr. Jess Daigle is a Board Certified Pediatrician. She's an ICU doctor and founder of Mom and Me, By Jess Daigle MD. 
Stay connected with Dr. Jess through the following channels:
Webpage: https://www.momandmemd.com/stopoverwhelm
Facebook: facebook.com/jessica.daigle.1422
Instagram: instagram.com/momandme_md/
Tiktok: @momandme_md
Twitter: @drjessdaigle
LinkedIn: https://www.linkedin.com/in/jess-daigle-md-faap-67ab7b117
YouTube: https://www.youtube.com/channel/UC2iYUOQyQRNEG1RD2iVu2Gg
 
 

Beyond ADHD A Physicians Perspective Ep 17: Dr. Andrea Bustamante (Functional Medicine Specialist)

Dr. Andrea Bustamante: If they're struggling with any mental health issue or they think they may be struggling with something that they're okay, that they have the power to make the steps to move forward and to take it day by day and never compare your past journey.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering  ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
I am so excited today. I have a very special guest with me, Dr. Andrea Bustamante , she's a functional medicine specialist and, she is going to talk to us about medicine because she's also a behavior therapist, pharmacists. So it's such a unique trait to have her here. What she does is she helps people achieve their best mental and physical health beyond the medications, through functional medicine.
So we are in for an amazing treat. And so Andrea actually also has ADHD. So she knows all the ins and outs, but first of all, let me just welcome her. And Andrea, can you tell us a little bit about yourself?
Dr. Andrea Bustamante: Thank you so much. Yeah. So, I work in the behavioral health fields and also have dealt with ADHD, anxiety, all of those issues myself.
I wasn't diagnosed until a little bit later on into college when it got severe, where I couldn't do the normal things that I saw my peers doing, and then went through a journey of medications and seeing my other patients going through journeys of medications and finding another route, which is functional medicine that looks from the inside out and through that, I just fell in love with it and learned how to turn ADHD more into a superpower, versus something that is dreadful.
Dr. Diana Mercado-Marmarosh: Awesome. And can you explain to me a little bit about how you came to realize that you might be a little bit different with, from somebody else? Or did somebody pointed out to you? Like what happened?
Dr. Andrea Bustamante: So I, throughout school, I always had issues of not paying attention. Even in kindergarten, they made me go get a hearing test because they thought, I couldn't hear my mom.
She's like, she can hear just fine. I'm telling you she talks nonstop. And they didn't, you know, I always had difficulties in school with paying attention and, you know, not being present, but so that went on and my grades were okay. Nothing spectacular, nothing, you know, not an "A" student, but not a terrible student.
And then I, you know, went through certain anxiety and depression things, and I didn't understand where they were coming from because then no one in my family really had that. And I ended up going to college and all of these things. And my nephew actually was diagnosed with ADHD. And my sister will going through this process with him.
That was learning a lot about it. And I was on the phone with her, just talking about my struggles with school and how it was hard for me to clean my house, like simple tasks. And I didn't know why it was so hard and like, am I lazy? I'm no, I'm not lazy, but maybe I am. And she said, well, maybe you should talk to someone that you're very similar to my son. And so I went ahead and talked to someone and we went through everything and it was just like a light bulb went off and he was like, do you do this? Do you do this? And I'm like, yeah, I do that all the time. And I kind of explained to him what a week looks like. And, sure enough, it was great. We worked through things and he gave me the diagnosis and walked me through it.
And what that. And it was, it was a big light bulb and it made me relieved because I finally had a name to what was going on with all of these symptoms. And I met all of the marks cause they say women with ADHD are more prone to. Like teenage pregnancy. I had a teenage pregnancy. I had those behaviors.
I had those impulsivity is, you know, I had all, all of that too. So it just, it, it made me feel comfort, but then it also was like, whoa. Okay. So now what do I do?
Dr. Diana Mercado-Marmarosh: Awesome. So tell me, once you had that diagnosis, how did you end up with where you're here today with being this functional medicine specialist? Like how did you arrive there?
Dr. Andrea Bustamante: Yeah, so at first, you know, we went through, I guess, tools that could help. And, I was seeing not only a psychiatrist, but also a therapist. And so. Different rounds of medications. And then, the therapist was super sweet and gave me all of these great tools, but I wasn't going to read all of them too many steps.
Like it, it just, I tried to implement them, but I mean, you know how it is or they don't read directions, you kind of glance at it. And you're like, all right. And then with the medication. They, they helped a little bit, but there was trials of, um, you know, when your doctor changes or your insurance changes or that type of thing.
So there was those struggles and then finding the right one. And I ended up finding a regimen that somewhat helps, but I was on three different medications and I didn't like the side effects. And I was just thinking there has to be another way, like there has to be something. That I'm missing here. And so I just started diving a little bit deeper and I met some wonderful functional medicine doctors and they taught me a lot about nutrition and toxins and sounds, and lights and all these things that are, were affecting me that I didn't even realize.
So once I started. Listening more to that and diving into that. I said, okay, I think I can do this. And I just started making little implementations here and there. And I mean, it's still a work in progress, but I felt a lot better doing that. And then I actually came off my medications and I just. A lot better that being said, medications still have a great place.
They are still awesome. Like all the time. If I took them, when I was at my peak state of going through school and everything. And I can't imagine not having that tool, but there's a lot more out there that we can do for ADHD. Isn't talked about.
Dr. Diana Mercado-Marmarosh: Yeah . And, thank you so much for pointing that out. You know, like you said, there is 10 to 20% of people who do not tolerate medicines, you know, an 80%, you know, 80 to 90% do.
That they do. Sometimes you wonder if they're even optimized because they start to work and then sometimes people feel embarrassed or they don't want to say that it's not working that well. And they feel, you know, and so you don't really know me as a family medicine doctor, you know, the more I've got an educated, like every time they come in, I asked them the questionnaire and I don't just ask him to adult self questionnaire.
Make sure. I screen for anxiety and depression, like all three at once. They laugh at me because if they're an exciting patient, I'm testing them for depression and ADHD. If they're an ADHD patient, I'm screening them for anxiety and depression. Like it doesn't matter where they're coming from.
They're getting the three questionnaires, every single visit because to me, I really think you need to objectivize it. Because you're not going to remember what you answered the first time versus the next time we just don't. Right. And just like I asked my people with diabetes and high blood pressure to bring me their sugars, to bring me their blood pressure.
Like this is. The thing that I do for them, like I tell them to sometimes bring me their ADHD, like scale or like ADHD diary. And, and they laugh at me, but I'm like, no, there's certain times in the day where your medicine's going to wear off. If you don't even have awareness, how can I change it? How do I know?
You know? And so while some medications, like you said, could work or might work sometimes they're not even ideal. Like you said some of the side effects. Oh my God. Like the side effects, it's like, you could almost tolerate them, but I mean, are you going to have really have Tachycardia from it, like all day?
Probably not. Right. Are you really going to have a massive headache where you can't even move because you're withdrawing from it? Probably not. And so if it does work. It works to some extent, but they're not going to regulate like the emotional component, the emotional dysregulation from it. Right. And not only that, but they don't provide the tools.
Like you said, they don't, it's one of the many tools in your toolbox, but you need to understand all the other pieces. Now, can you share me some of the big insights that you have had as you're understanding all the other cool pieces?
Dr. Andrea Bustamante: Yeah. So, there's just so much in it. So like one of the biggest ones is nutrition.
Whether you're on meds or off meds. If you have ADHD, it's so different on how you view food, eat food, all of those things. And that was one thing where some days I, you know, you don't eat, you get busy, you get hyper-focused on something. And I, remember, I used to get stressed out because I would see people on social media making these beautiful, healthy meals.
And I was like, I don't, I can't. There's a block. There's a wall. I can't cook dinner right now. And then I would feel guilty. Will do I eat this like packaged food because it's not technically healthy, but I'm starving. And so it was this whole cycle and I had to almost, you almost have to like allow yourself to be like, Hey, this is what I'm doing today.
And this is a great step. And I think making sure, even setting alarms to check in with myself of, did you, have you eaten yet? Have you had water, those little things have helped so much with focus with mood. Oh my goodness. Because it's, I think it's a common thing and people don't talk about it. Sure. You talked about, if you're on stimulants, it can decrease your appetite, but on or off you you're distracted. You're not going to eat.
Dr. Diana Mercado-Marmarosh: I wish people could see that I will be here laughing because it's so true. Like I have some reminders, like at 2:00 PM. What are you doing? Are you doing something interesting or something that you're avoiding? Like, I'm I on Facebook? Like, you know, or am I actually being productive and the same thing, like you said, like checking in with yourself.
Why am I overreacting? Did I forget to eat? Did I not drink all day? Like what's going on? Right. And so that's so insightful that you're saying that. And it's funny because yes, like you say, some people always just talk about like, not eating, but sometimes we do eat because like that's, the sugar is part of the dopamine that like trigger us to like find more sugar or find more energy somewhere. So tell me about the lights. What were you wanting to say about that earlier?
Dr. Andrea Bustamante: Yeah, so even things with lights and stimulation in that aspect, making sure that, for example, like sleeping. It's hard, right? It's hard to turn your mind off. It's hard to sleep. It's hard to stay asleep, but making sure that, for example, like blue lights or anything like that, like I have my blue light glasses on at nighttime.
I try not to look at anything with light. You know, of course you have lights on in your house, but I try to stay away from that. And that really helps and getting into a nighttime routine of something very minimal, whether it's my glass of tea, I'm going to, you know, Not look at my phone for at least an hour before bed, things like that, which at first I was like, oh, that's silly.
But it actually helps in getting into that routine and getting sleep has helped tremendously too. So. Paying attention to all of those things, as well as even what we're seeing on our phone with social media, all of those things, too, that plays a huge role with anxiety. Like I always tell my patients and clients, I give them a news diet.
So if someone's watching the news all the time, I'm like, all right, try to minimize that because you're putting all of that into you and it's in your subconscious. And I think it's important to monitor what we're feeding ourselves, you know, with social media, with our mind.
Dr. Diana Mercado-Marmarosh: Yeah, you're so right. Like, you know, whatever you focus your attention to, like that's where you're going to go. Right. And I think most of us with ADHD, we tend to be like curious and learners and, we all of a sudden, we feel like sleep, oh my God, that's boring. Like, you mean I'm not going to be doing anything. And so it's almost like revenge, like against sleep and then guess what we pay for it the next day.
Right? Like, we're not whatever we were enjoying right there as we were doing it. It's not like it was amazing. Like the next day you're just like, oh my God. And then you forgot because you were half reading, half this half, whatever. Right. Or you went down a rabbit hole that you didn't even know how you ended up there.
Right. And so you're right. Like focusing on like, okay, let me put my phone away. Like making it invisible for the last hour or charging it in the other room or like, you know, so. It's not right there. And you have to take a few steps to like, get yourself to touch the phone. You know, it can make, make a difference when you separate that.
So when your clients come to you, like how do they usually find you? Like, because I hadn't heard about functional medicine being used for ADHD, so I'm so curious.
Dr. Andrea Bustamante: Yeah. So a lot of it, is through right now is word of mouth. A lot of people, it's word of mouth, social media. So Instagram, I have Facebook groups and, a lot of it is awesome there.
Cause you have community of just like hear other people supporting other people with these conditions because it's not, it's not like you can cure ADHD. Right. But you can learn how to live with it. And chances are, if you have it and you have children, they're going to have it too. And you can all, it's always like you're teaching.
But, so most of it's through word of mouth and just through internet meeting, other people that have this especially professionals that have ADHD or anxiety. That it's now starting to be talked about, but before it wasn't, and, I was even hesitant at first to come out with this and everything, but I love it now.
And it's, it's amazing. It's so, so amazing.
Dr. Diana Mercado-Marmarosh: So tell me. What do you think was like one of the pivoting points for you to be able to now, because you, you were kind of sharing with me that sometimes, you know, uh, prior to starting the podcast, you, you were saying that sometimes you weren't sure whether just to share.
I mean, I was there too. The first time I shared about it was about a year ago, actually. And then Tracy Otsuka's podcasts. Like that was the first time I talked about ADHD. I had told like five people prior to that, because in my mind, oh my God, I was broken. Like, that was what my brain was telling me.
And I didn't realize that, you know, it's whatever. Make it mean. And like you said, like she teaches you that it could be a superpower if you know how to share it. But what do you think was the defining moment for you where you're like, okay, I need to talk about this. I need to help other people.
Dr. Andrea Bustamante: I think it was the fact of getting out of myself and realizing it's not about me, it's who I'm going to help.
And once I did that and I said, imagine if I was struggling, if I had someone say. It's it's okay. And like you said, you feel broken, you feel like something's wrong with you. There are days, even still now where I'm like, I wish my brain would just be a normal brain. So I think it just came to that point of, I need to help others.
And it's not about me. It's about these other people. And when I would see patients at the hospital and they're getting these treatments and getting all of this. Yes, it can be helpful, but when you have something you can relate to someone on a whole different level. You know, like my best friend has type one diabetes.
She can relate to people on a whole nother level. She knows what it's like to stick herself every day to go through all her meds. When you have ADHD, you will and understand how the brain is, how everything is different. And I think that's what made me get out is like, Don't make it about you. Like this is about them and I think it should be talked about it.
Shouldn't be something to be ashamed of at all.
Dr. Diana Mercado-Marmarosh: Yes. You're so right about that. I think people with ADHD, you know, I don't know if you knew this, but I'm pretty sure you do. Like, we tend to think outside the box and we tend to be the risk takers and the, and because of that entrepreneurs.
Right. And like, we tend to. Say things before we even realized we already said it out loud, which can be good and bad. Right. But at the most part, I feel like we wear our hearts on the sleeve. And like you said, we tend to be brave when we realize it's not about us. Right. When we realized that sharing my story could make a difference in that person. So like, you know, when people get diagnosed, when I diagnosed him with ADHD or anxiety or depression, I think like you said, the first step is awareness and then normalizing it, like making sure that, Hey, you know, it can be genetic. It is genetic. And then like your whatever happens to us, you know, it, it might mean.
We might get diagnosed sooner or later or way later, you know, and then, and sometimes you don't realize that. And so it doesn't matter where you are. If you finally have gotten the diagnosis, become curious and figure out. What can I use? Can I use meditation? Can I use stretching? Can I use running? Can I use sleep?
Can I use low carb diet? Like what can I use to help compliment how I manage my ADHD? Like you said, it's never going to go away, but can you make it be? And like you said, sometimes the brain offers, like, why can't I just be normal? But I'm like, well, normal is boring. Like nobody ever made history by being normal, you know?
Dr. Andrea Bustamante: Oh yeah, absolutely. Absolutely. And I think too, There's so much where people say, oh, ADHD moment. You know, when people throw around the word, and I remember when I met my now partner, I told him, I said, I just want to let you know upfront. I have ADHD. And you know, he knew a little about it. Maybe. Maybe can't pay attention a little hyper, but now he knows it on a whole another level.
And it's that excitement that, you know, all of the, the enthusiasm and motivation and positivity, and let's go, let's do this type of thing. And it's funny, but it's great. And he's like, yeah, it's a whole, it's never boring.
Dr. Diana Mercado-Marmarosh: It's never boring. And you know, the other thing I wanted to point out, or what you said is that.
When we get out of our heads when we know why the why it's when it's so important, like you said, you are out here doing things that for most people might be uncomfortable, which is like, interacted in different social groups and in different Instagrams and in different things. But you're doing it again from a place of service to like empower others to then go and live their best lives. And so as physicians, I'm used to like always trying to have everything right. Because of obviously, we feel like if we don't have it right, we're gonna. You know, mess up stuff. And I'm not saying that, that puts us at risk, but I'm just saying medicine comes to us at a place where you always have to a hundred percent certainty know things.
The thing is life is never a hundred percent certain. And if we really wait to think that way we can like miss so much. And if we start to understand. You don't have to know everything that every single person in front of us, like we don't have one minute, like in the board exam, just one minute to figure it out.
Like you can keep bringing them up back and try different things. Try Eastern medicine, Western medicine, a mixture of stuff, and like, You're so much better for being a better listener and not jumping to conclusions. And so I think it's so nice to be able to have a conversation with somebody who can have an open mind.
Dr. Andrea Bustamante: Yeah, absolutely. And just like, like with a lot of psychiatric, even medications and things like there isn't one that fits everyone. I mean, it's so different and our bodies are made different and everybody is so uniquely and wonderfully made inside and out. And so I think it's just so important to do it.
So individualized, all of the options and if it doesn't work, that's okay. We can try something else.
Dr. Diana Mercado-Marmarosh: So tell me, what do you have? Like, what are your big goals in the next, like five, 10 years? What is your, what are you working towards that you're so excited that it's like lighting you up?
Dr. Andrea Bustamante: Yeah. So I'm hoping to transition my business to, full-time just me seeing my clients with my functional medicine business and doing group programs and diving in, and I just really want to help men and women who are frustrated and just tired and just want answers and don't want this run around. They're there ready? And I'm just looking to, to build that community with them and to, to change lives and to just continue learning, because there's so much that I've just learned in the past couple of years. I can't imagine the next five years what's going to happen.
And I think the COVID was rough, but it was also beautiful because I mean, look at me. Virtually interacting and making wonderful friends. And I think it's the next couple of years, it's going to be awesome. Just like that. To have a big community.
Dr. Diana Mercado-Marmarosh: Yeah, like you never in a million years would I had thought I'm just going to talk to people out there and be like, Hey, so what are you up to, you know, like never did I think that that was possible. And to be able to have, like you said, a new way of having friendships all over the world and not make it mean anything that we're just talking through the computer. Right. Like, and to understand that one day we might meet in person, out of conference somewhere and it's going to be amazing. And because you get to create that because all of a sudden, from the place of like, where do we go from here?
That's where COVID kind of put everybody at right to really. On themselves to realize like what was going on for them, because sometimes we live our lives. Like whether, you know, what did they say, blinders on? So you're not, you're just going through the motions. Right. And you don't realize that a week has gone by a year, has gone by whatever your kids, all of a sudden, a little older.
And you're like, what happened? Like when did this happen? And so I think COVID kind of makes. Everybody kind of like stop and reset and like figure out what's important. What is not, what do I let go of and how can I make a difference in this world? You know? And I think, I think like you said, it was hard, but it was also a beautiful thing.
What do you spend so much time on that you maybe want to let go a little bit?
Dr. Andrea Bustamante: Oh gosh. I think worrying honestly, I've I don't think I worry as much as I do, but when I confront it and I stay present and I realized, why am I worrying about this? You know, and even little worries, big worries. All of it. And I think letting go of that makes more room to being present and enjoying the moment.
And enjoying family friends like anything. So that's my number one thing to, to let go of for sure.
Dr. Diana Mercado-Marmarosh: Yeah. And so that's the thing, right? With human brain. Like it tries to trick us sometimes like it's main mechanism is to keep us alive. Right. It wants to keep us alive. And so by making you feel worry, it's telling you, Hey, you gotta think about situation a, B, and C and D.
When that comes along, you got it. Cause you're already worried about it. But the, but the thing is that when situation arises. Thank you are going to figure it out because it doesn't matter how much you worried about it beforehand. It can never prepare you for whatever is going to come, whatever curve, ball, life throws at you.
Right. But meanwhile, if you are stuck in that, What if, what if, what if situation like you have the adrenaline going, you have the cortisol levels going. So you're like an always high state of like fight or flight type of thing. And it does not let you, like you said, step back and then actually enjoy the people who are right here with you present.
Right. And so that's why it's so important to, like you said, become intentional. Who's in the room. What am I doing in with the people in the room? Let me come back to what's going on right now.
Dr. Andrea Bustamante: Absolutely. Yes. And it's, I mean, we people with ADHD already have, you know, higher levels of cortisol. So. Worrying only stresses that. And, and I've even tried to, like, I carry a notebook, one notebook I've learned to just one, but in this notebook I have, I can take notes. I can do whatever I want, but sometimes even if I'm in a meeting or watching something or say, my son said something to me, I'll write it down.
And that really helps me, even if I don't look at it again to actually absorb it and be present. And I think stuff like that help. That's what you remember. You don't remember, you know, worrying is never going to solve anything but memories. Those are the things that, that I really cherished.
Dr. Diana Mercado-Marmarosh: That's so good that you have that insight. And that's a really smart, trick and tool. You know, I had a patient today, actually today. She told me she's like, you know, Did she say she couldn't sleep well. And she says, she's going to sleep. She said, do you think it's because I'm taking my medication at 7:00 PM. She's on, on, an, a medication twice a day.
And I'm like, well, what time do you take the first one? She's like, well, I get up like at nine or 10:00 AM, but usually 11:00 AM. And so by that time I take the first one and I'm like, in what time are you sleeping? She's like, well, usually two or 3:00 AM. And I'm like, well, I'm like both, but what are you doing before that?
Nothing. And I'm like, but what are you really doing before that - worrying. That's what she told me. And so it goes back to worrying, right? And like the thing is that meds can help some, but if you don't take that moment to come back, But what am I doing? What's going on? Am I really in trouble right now? Or is my brain just telling me I'm in trouble?
Like, you know, just, you can't be like examining your brain and being your brain at the same time. So, so it just might give you that two second pause to just ask yourself, like, why. Angry. Why am I sad? Why am I mad? Like, just asking, but not judging. Just asking. It sounds silly, but it can bring you back and it can help you to be more present.
So yes, let's, let's let go of worry for you. We got to keep right. So how can my listeners get into. You, if they would like to find out more about you and your future coaching opportunities and all those things.
Dr. Andrea Bustamante: Yeah. So, Instagram is one way, so it's dr.andrea.bustamante, or I also have a website, it's avenahealth.online so event a v e n a, and then health.online. And you can see a whole list of ways to get in touch there too.
Dr. Diana Mercado-Marmarosh: How exciting. So one more question, before we let you go, if there was anything that. You could, let's say people just woke up and they just finally started paying attention.
What else would you like to share with them? What is like the one single takeaway point that you want them to have? Like if they just first started listening.
Dr. Andrea Bustamante: That if they're struggling with any mental health issue or they think they may be struggling with something. They're okay. That they have the power to make the steps to move forward and to take it day by day and never compare your past journey to.
Dr. Diana Mercado-Marmarosh: Awesome. Thank you. I mean, that was a beautiful wrap-up. Yeah. It's like your past does not have to define your future. Your past can be, you know, it's not good or bad. It's just things happened. What did you learn from that? And what steps can you do to become the person you're trying to become? Right. And so it's never about who you finally become. It's about. How much fun you had becoming who you wanted to become, right?
Dr. Andrea Bustamante: Yes. Yes. Yes, absolutely.
Dr. Diana Mercado-Marmarosh: Yeah. Well, thank you so much. It was a pleasure to have you, and I'm pretty sure we'll continue this conversation.
Dr. Andrea Bustamante: Absolutely. It was a pleasure to be here. Thank you so much
Dr. Diana Mercado-Marmarosh: As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
 
Stay connected with Dr. Andrea Bustamante:
www.instagram.com/dr.andrea.bustamante/
https://www.avenahealth.online/
 
 

Beyond ADHD A Physicians Perspective Ep 16: Dr. Michelle Quirk (Board Certified Pediatrician, Running Coach Certified by Road Runners Club of America, Founder of Mindful Marathon)

Dr. Michelle Quirk: No matter what sport you're going to do, right. With exercise. Start low, go slow. You have to go into it, you know, almost with a marathon mindset. Like this will not happen overnight, especially if we have been on the couch for a while, or even if we do a different sport.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering  ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Okay. So this week I am super excited cause we have a very special guest.
One of my really cool friends. This is Dr. Michelle Quirk and she's a board certified pediatrician and a certified running coach. You heard it right. Running coach. And she is with the Road Runners Club of America, and she founded mindful marathon to help make running easy. Did you hear that? Easy and fun for busy professionals.
And so today she's going to show us how to be informed, how to, make this enjoyable and how to have a very effective approach as she, this is what she teaches her clients. And she coaches them to become athletes not just, you know, a shift of mindset, but go into it into a lifelong love for the running.
So she was going to teach us about how to be very informed and make this fun. So super excited to talk to Dr. Michelle, tell us, tell us all the thing.
Dr. Michelle Quirk: Oh, thanks so much for having me, Dr. Diane, I'm very happy to be here. Yeah, so, where should we start? Should we start with, the fact that maybe I wasn't always a runner?
Dr. Diana Mercado-Marmarosh: Yes, please do tell us, because probably everybody's thinking, well, she's probably like an athlete, like where she has 10,000 medals or something.
Dr. Michelle Quirk: No, no. I mean, I have quite a metal accumulation now, but that that's only within the last like 10 years or so, but yeah, I, I was not always a runner. I was not much of an athlete as a kid.
My sport growing up was dance. Like I did ballet and stuff like that, but, yeah, I struggled through the mile run. Never thought that, I would ever be a runner. I thought that they were made of something different than I was. And so, yeah, I found running about 10 years ago. I had tried it a bunch of times and quit a bunch of times for all of the reasons you can think of, you know, it hurts.
It wasn't fun. I was feeling tired. I was afraid to get injured. And about 10 years ago, I, decided to lace my running sneakers on again, and really give it a go because I was in this time in my life where I was going through, lots of difficulties. So it was, you know, I finished my residency, started a new job, moved to a new place, was newly married, like all of these stressors.
And my dad was diagnosed with cancer at that time. And so I found myself telling my patients and families like, Hey, you know, you need to exercise and eat well. And sleep. Well, and all of these things and here I was not doing it myself and I thought, you know, what better thing can I do then try to lace these sneakers up and at least just try again.
And this time. I'll just go five or 10 minutes around the block. See what happens because all of the previous times didn't work and I failed. And so this time
Dr. Diana Mercado-Marmarosh: You we're probably trying to do like the marathon every time that you started. Right?
Dr. Michelle Quirk: Pretty much. Yeah. I think not a marathon, but you know, you think that yeah.
That I would be able to go out and just run a couple of miles. Because this is what I would hear. My friends who were runners say, like, I just did my easy three miles, so why can't I do that? But if you're not trained to do that, it's very hard to go from zero to that first 5k, if you don't go about it in the right way.
So anyway, long story short is that I ran my first official 5k, like about a year after I started really consistently running and I've been running ever since. So it's it stuck this time?
Dr. Diana Mercado-Marmarosh: Good. So, you know, you're talking to an audience who can't concentrate at all sometimes right. With ADHD and, some people obviously do use running as a tool to help them focus.
Like actually I shared with you before that, I had no idea that I had ADHD till I was in my first year in medical school and, I was kind of surprised, but looking back now that I put the puzzle together, it makes sense that in high school, I had no idea because I was running like 10 miles a day, like with my cross country team or with my track team or whatever.
And so even during track, like, you know, I would do the two mile or like, you know, the long thing, right. You, it could make sense why that's where I was getting my dopamine from.
Dr. Michelle Quirk: Yeah, for sure. And I think when I started running, you know, like a lot of people, I would listen to music or really try to tune out, to what I was doing.
But as I went along. You know, really fell in love with the sport. Now I really, I try to go without any headphones and without any music. And I think that taking away all of that stimulus actually has helped me to focus more and I can get into, it's a clarity of mind, really. Like sometimes I don't think about anything and sometimes I get very, creative ideas for mindful marathons.
Where I'm taking things with my athletes, but for sure, you know, plenty of studies on running and, and dopamine. And I don't think I appreciated that, you know, at the time, but now, during periods where I have not been running due to injury or rest or whatever it is. I noticed the difference.
Dr. Diana Mercado-Marmarosh: Yeah. And so it's interesting you say that, that it gives you clarity. I don't know if it's just, everybody has a different thing of what they consider like peaceful and boring. And so I remember that the things that were boring. Listening to pathology for me during medical school, like I would put it on like, I would hear the lectures and I would run because I was looking at the trees.
I was looking at everything else. And I guess the stimulus of doing something, what like penetrated and make, make the information a little bit more easily to digest. When you sat down, you kind of primed your brain, but at the same time, like you said, you were getting oxygen into the brain because, and some days, yeah, you just turned it off because he didn't matter. Like you just needed that break.
Dr. Michelle Quirk: And there's not much out there, right? Like, yes, you're paying attention to nature or the cars if you're in the city, but, but there's not much else, but you and your foot falls. So if you are, yeah. If you're listening to a lecture, I could see how it would yeah. It, how you would pay better attention and how it would stick. I used to do that too.
Dr. Diana Mercado-Marmarosh: Yeah. It's so weird. How, you know, when you're listening to the lecture, you're just thinking, no, I just have to listen to the lecture. I just have to keep running through the lecture. Once the lecture is done, I'm done. Or even if you were not listening to the lecture, you would be like, okay, I just have to get to that street over there and then like you get to the street, you're like, okay, maybe I can do a little bit more. And so it's like a mindful challenge at the same time, then that nice sweat that happens afterwards. It's like that soreness, but you're like, okay, it's a good type of thing.
Dr. Michelle Quirk: Yeah. The sense of accomplishment, I think.
Right. And then you did two things, you exercise and you studied.
Dr. Diana Mercado-Marmarosh: Yeah. So what do you think is the key to getting started with running?
Dr. Michelle Quirk: I think the best advice I could give would be to start low and go slow, which is not hard for us. Because we all want very quick results. And so you have to go into it, you know, almost with a marathon mindset.
Like this will not happen overnight, especially if we have been on the couch for a while or even if we do a different sport, like I have a lot of athletes who do a lot of cycling or they have a spin bike and they're used to that workout, but running is it's a little bit different. So it's still a great aerobic cardiovascular exercise, but you use different muscles and it's just different takes time to adapt.
So, but I always suggest is really taking it easy setting aside, maybe, you know, two or three days a week when you, when you first start for just five or 10 minutes and maybe tack it on, if you already do some other kind of exercise, add it on. So if you like to cycle or you like to do yoga or you're more into weights or HIIT training or something. You can tack it onto the beginning or end of one of your other workouts to work it in gradually and not do what I did, which is go out and try to run three or five miles when you haven't done it before.
Dr. Diana Mercado-Marmarosh: Yeah. So, I mean, it seems like such common sense thing. Right. But the things that seem simple, like you said, you have to make sure you schedule it in, right.
Because. If you wait too, like you, when you feel like it, like, you're never going to quote unquote, magically feel like it. Right. But it's like everything, like once you start, like the motion will keep you going, like you just have to get over that 1%, just start something. And then the object emotion keeps going right.
Stays in motion. And the thing is like having realistic goals, like you said, I have a friend, oh my God, she, I love her to death, but. Like she has this mindset. Like, I can do anything, which is good, but sometimes it can get us in trouble. Right? Like she, again, signed herself up for a marathon. She trained here and there and then she just magically thought she was going to do this marathon.
Of course she did it. But what happened? She ended up with rhabdo, like for the next few days at the hospital. Right. So like, that's the thing, like, you can't just like reel your brain into like doing things. I mean, maybe you could, but then you pay for it, right?. The, the body keeps the score. And so it's so important to make sure that your mind and your heart and your body kind of match up with your goals so that you don't like overdo it.
And so we don't think that something like that would happen until it does. Right. So you just gotta make sure that if you're going to do something like this, that you do talk to a coach, like talk to you so we could make sure we're doing it safely.
Dr. Michelle Quirk: Yeah, you don't want to wing it for a marathon for sure.
But you know, one thing that has helped I work with a lot of, you know, high high-achievers, very busy, busy professionals. Right. But one thing that seems to work well with the training plan is like one is just to have something in writing. And two is to look at. The week ahead. So I usually sit with my calendar on the weekend and look at all of the things I have to do that are written in the calendar for the week.
You know, my work shifts, um, doctor's appointments, whatever it is, have to bring, you know, kids here, their family obligations. So you look at all of that and you say, okay, I have my three days for my. Workouts. Where am I going to put that, you know, morning, evening, like you have to figure out what works for you and where in your schedule.
It makes sense, but doing it ahead of time is really the key. And then you schedule your workouts in the same way you schedule other things. So if it's on the calendar with the time, you are much more likely to do it than if you leave it up to, you know, first thing in the morning, the alarm goes off and it's like, oh, Coach Michelle says I have to go for a run, I don't know.
Dr. Diana Mercado-Marmarosh: You hit exactly the point that I always teach my clients as well. Like you need to plan. Otherwise, it's not going to happen like out of sight, out of mind. Right. And the thing is, if you wait until you feel like it, you're just not going to feel like it like your body and your brain are going to tell you like all the excuses, why you shouldn't go do it.
Right? And it's the same thing. Like whenever we have to close some notes, That might seem like the painful or boring task. And you might be like, well, I don't want to do that. Like, I'll wait till I feel like it. And again, you're never going to feel like it. And so, but if you schedule it, like you just said, you don't make it mean anything.
You're more likely to make it happen because you already took away the decision of trying to even decide if you want to do it or not. It's in your calendar. It's Sarah, of course life happens and things come up, but if you at least have it on your calendar, the likelihood of it actually happening goes way up because no, no longer.
Is it just an idea in your brain? Like now it feels like a product it's it's in the open it's in the calendar. People can see that you have committed, you know, especially if you're sharing with your husband or your significant other or your girlfriends, and you're telling them, Hey, we're going at this time at this place.
Then it's more likely. Right. And, and like, I recently heard somebody saying like, you know, you have to show up for you. And sometimes we don't do that. Like, you know, you tell your friend, Hey, we're going to start running at 10:00 AM and then like nine 50 comes and like, your friend's not there.
And then it happens again. You're like, you're really mad at your friend, but your, your friend, you know, you're the one who's like not showing up for you. And so you have to decide the why. Do you talk to your clients about like, why they're running or why they're doing anything they're doing?
Dr. Michelle Quirk: Yeah, that's I actually, in my questionnaire, when I work with, my one-on-one clients, like one of the questions on the questionnaire is why do you want to run?
And sometimes we have to go beyond like the first one or two or three things, even that come to mind. But when you can really get into, um, you know, the deep reason for why you're doing it, I also encourage people to set, um, you know, Some goals for the near future and then some for the distance. So maybe you have a, you know, you want to run your first 5k, let's say, um, but you know, like your friend, like maybe you have an idea that you want to run a marathon, but that might be one or two or five years down the road.
So, you know, it's important to have those short-term goals that you can work towards. Right as stepping
Dr. Diana Mercado-Marmarosh: Not three months, like she did it and then like went to practice like five times. Right. She's like what? I run at the Navy all the time. I'm like, yeah, that time.
Dr. Michelle Quirk: Yeah. A marathon training cycle can be like 16 to 20 weeks.
So if you're, you know, and that's, you know, 3, 4, 5, 6 days a week of running, but it's a long time. It's half a year. So. Yeah, you don't want to just wake up and decide to do that.
Dr. Diana Mercado-Marmarosh: And you can, and, and obviously she was able to, but then she paid dearly for
Dr. Michelle Quirk: it. I'm sure it's right. And we don't want to get anyone injured.
We want them to enjoy the experience so that she wants to do another one. Yes, exactly.
Dr. Diana Mercado-Marmarosh: So it, so that it doesn't become something that was so exciting, all of a sudden at shore or a task, right. Because you are being unreasonable sometimes. Right. So, yeah.
Oh my goodness. Yeah. So you've been running for the last 10 years. Can you tell us some of your struggles with that? How did you overcome them?
Dr. Michelle Quirk: Yeah, but I think one, one struggle is what you alluded to. So just because I love running and I'm a coach does not mean that I am above the excuses either. Like I still sometimes wake up in the morning, the alarm goes off and I'm, you know, I don't want to get out, but I think what I try to remember is how good I feel.
While I'm out there. And it's really just the act of getting outside. Especially here I live in Pennsylvania, winter is a little bit of a rough time to be a runner. Like there's not that many hours of daylight and it's cold and you have to dodge the snow and the ice. So winter is always a little bit harder, but once I'm out there, I feel good.
And of course afterward, I feel great. So it's not as difficult anymore as it used to be to get out the door. But I still struggle with that. That's important to know everyone, I think assumes like, oh, you never have that trouble, but I do. I do. I just, I just go. And sometimes I don't write, like some days it just doesn't work and you have to rearrange things, but you know, I've learned how to be a little bit more flexible with myself, not to the point of laying on the couch.
Flexible in terms of shifting schedules as the needs come up.
Dr. Diana Mercado-Marmarosh: Yeah. And I think that's really important, like understanding what you value and what you think is important for you and then making time for it. And then again, like you said, staying flexible enough to not make it be like all or nothing.
Right. And then like, that's, it, it didn't work out the rest of the week is not going to work out. Right. Like you throw your hands and you're like Gord, so dramatic or brings like. No, everything went south, you know? And so understanding that that's just part of your brain and that your body easily forgets that you were just doing this last week and all of a sudden, like if you let go of it for a couple of weeks, it's like, you never did it.
Right. You're a sore all over again. But again, like getting back into. I think is so important. And, and sometimes even like taking a picture before and after, like can motivate you because it actually happened. Right. And, and yeah, like, so I hadn't ran since like high school. And then like, I don't know, I went through lots of shifts, like last year with like life coaching and discovering myself and all kinds of stuff.
And then I started running for a while there and it was so amazing. And I was like, oh my God, I can't be by just ran like a mile or two. And then I did it. 10 minutes, which is very slow, of course. But then you're comparing yourself to like, when you were to high school, you could do like a seven or eight minute a mile. Right. And, but I'm like, Hey, when you haven't done it in like, almost like 20, 30 years, like, it feels like crazy, right. And then of course, I had my injury with my, I dropped the 50 pound bag of cement on my foot and broke it in July. And then after that, I was like, I think I'll wait. And so I haven't gotten back to it, but I definitely want to, because it felt great.
Like you said, it's just you and the road and then just measuring each post or each house that you're passing it is just gives you that like competitive spirit of like, okay, I can keep going.
Dr. Michelle Quirk: Yeah, I think, I think that's probably. You know, talking about injury, that's probably the other biggest struggle are periods of time away from running.
Due to injuries. And, you know, like the first time after I had really, you know, run for, I don't know, five or six years without having any trouble and then had an injury, it was something like ridiculous. Like I was weeding the garden. Stepped off of the step into the garden, twisted my ankle. And I was out for two months, three months.
And so I remember just feeling very like defeated, how I was going to lose all of this fitness and it was going to take me. In my mind, I thought it was going to take me five years to get back to where, where I was by taking three months off. So that was, that was tough. But I think, you know, coming up with ways to just adjust your goalposts.
And during that time, I found that I liked swimming, you know, I was allowed to swim and I found that I liked that. And I ended up doing a triathlon after all of that. Done. So you can, you can turn the lemons into lemonade.
Dr. Diana Mercado-Marmarosh: Yeah. And like, not being afraid to go get a massage, if you are sore, if you just went for a round, you know, because, that's a good way to get all that lactic acid out.
And then you just feel so much better. I really think that doing my massages during the time of the injury was so helpful because you know, you're trying to be. The whole thing, and then they're like, they're working it out so that you still are getting back on track, you know? Yeah. So, yeah. So, um, so tell us, what are you up to like these days?
What are your current, big activities that you have going on? Or how can people find you.
Dr. Michelle Quirk: Yeah. So I, I always have, at least a couple of one-on-one clients. And I just started a group program, which is called ReadySet run. So that's going to run for 10 weeks and I'll probably offer that again in the fall.
We'll see. But I am actively planning our spring virtual 5k. So that's what is on deck next. So look out for that and you can. Find out all the information on my website, which is mindful-marathon.com. And if you are, you know, if you're a beginner, let's say you're on the couch. If you're on the couch, there is a walk plan.
So you can really like dip your toe into it. There's a walkway on the website. And then if you want to, you know, kind of get started with running, and make it stick. There is a workshop. So you can find those both on the website, just scroll to the bottom and you can get them for free.
Dr. Diana Mercado-Marmarosh: How exciting. So tell me, where do you see yourself in the next like five years what's coming up?
Dr. Michelle Quirk: Ooh, that's a great question. I would really like to help more runners. And I think that that may be in the form of races. I don't know if it will be virtual. I have visions of in-person races, and hopefully helping to bring this maybe to doctors, healthcare organizations like to help the problem with burnout.
So we'll see. It's, it's a little cloudy, a little fuzzy that vision, but it's. So I'm hoping to grow that portion of mindful marathon, like the race portion.
Dr. Diana Mercado-Marmarosh: Awesome. Okay. So one last question. So let's say my, you know, ADHD, people come and go in or attention comes and goes. So let's say that they just started listening.
Like what is the one takeaway point you want them to take away?
Dr. Michelle Quirk: No matter what sport you're going to do, right. With exercise. Start low, go slow. Just don't overdo it. Good. Awesome advice.
Dr. Diana Mercado-Marmarosh: You heard it. You just got to start, even if it's slow, don't be trying to do the whole marathon at once, right? It doesn't matter where you are.
You can keep improving if that's what you desire. Right? You want to do things that light you up and be willing to try things that you haven't tried before, because you don't know what if that's your thing and you didn't know that was your zone of genius, right? So you just gotta be willing. So willing gets us, gets us places.
Dr. Michelle Quirk: Exactly.
Dr. Diana Mercado-Marmarosh: Well, thank you so much for coming today, Dr. Michelle, you're basing. I think I'm going to go in and look at that website myself, because I think I need to get back into that. Okay. Thank you for the motivation.
Dr. Michelle Quirk: Thank you for having me. It's always a pleasure to talk. Bye-bye
Dr. Diana Mercado-Marmarosh: As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
 
Stay connected with Dr. Michelle Quirk:
Website: www.mindful-marathon.com
Facebook: http://www.facebook.com/mindfulmarathon
Instagram: http://www.instagram.com/mindful.marathon
YouTube: https://www.youtube.com/c/mindfulmarathon
 

Beyond ADHD A Physicians Perspective Ep 15: Dr. Rashmi Schramm (Board Certified Family Medicine Physician, National Board Certified Integrative Ayurveda Health Coach)

Dr. Rashmi Schramm: Let's just define meditation and mindfulness, because even that can be kind of muddy sometimes, right? Meditation is simply moving from activity into stillness, mindful. It is a formal way. It is a way to practice mindfulness and mindfulness. Most people would agree that definition is the awareness that arises when we are paying attention to this present moment without judgment and with curiosity.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering  ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back. Like I have.
 
Hello? Hello. I am so excited. I have an incredible guest today. One of my dear friends and colleague and amazing guest coach in my group. And of course I am very biased. Right? Because I have outstanding people that I bring to you. So this is Dr. Rashmi Schramm, and she's a board certified family medicine physician, and she is. In her 21st year of practice. Oh my goodness. Isn't that amazing? She's a National Board Certified Integrative Health Coach with a specialized interests. And I'm going to mess that up. Can you help me pronounce that?
Dr. Rashmi Schramm: Yeah, Ayurveda.
Dr. Diana Mercado-Marmarosh: Ayurveda, and meditation and she teaches two easy types of meditation, which is mantra and yoga nidra. Okay. So she is a founder of Optimal Wellness where she incorporates evidence-based medicine techniques into individual and group coaching. And she helps busy women to ditch that guilt and tap into the inner peace and power so that they can live more energetic and. Purposeful lives. She regularly hosts live weekly meditations for those interested in easy and effortless way to dip into this type of meditation or to go deeper into their practice.
And so please welcome this amazing treat that we have for you today. So tell us a little bit, how did you get into this amazing practice? People probably don't know this yet, but yoga nidra, she introduced me to it and she of course has changed the way I see meditation because I used to think that I was doing it wrong.
 And I, my brain just kept saying what you have to sit still. This is no way, but the way that she taught it to me, it was very relaxing. I even felt like more energized. So, which was weird. Please share with me about how you got started on meditation specifically. And how are you like able to share this gift with others through coaching.
Dr. Rashmi Schramm: Yeah. Thank you so much for having me, Dr. Diana, you know that I am so honored to be here with you and for, with all your listeners. So I actually was born in India and I grew up there. I was there until I was almost 12. And so I was exposed to meditation spirituality. That's sort of thing. Not that I was like a meditative kid or anything, but it was very normal.
It felt like home for me. And then we immigrated to the United States. We, I actually, my entire adolescence was in a very small coal mining town, where there weren't really very many other ethnicities other than, you know, Caucasians there. And so I kind of, at that point, like had abandoned all of my Indian essence.
As an adolescent growing up, trying to just fit in. And then when I went off to college, I really like, I found a group of people that were meditating. So it was like this on and off kind of love for me. And I was like a secret meditator. I was like a closet meditator because I was afraid people would think that, you know, like I was whatever, I didn't, I dunno what I thought.
Right. But it was my brain in college. I really loved meditating then. And then I went to medical school, completely abandoned meditation again. And then was like a very intermittent meditator until about 10 years ago. And I, you know, it was in my thirties, I had young kids, um, my husband and I had started this practice that was growing by leaps and bounds.
And it was all going very well from the outside world. I had these two beautiful girls, you know, they were like, they were, you know, I mean, it was, it looked perfect from the outside and it's not that it wasn't perfect on the inside, but inside my brain, things were not that great. I was really experiencing a great deal of, you know, now we call it burnout.
I didn't even have any language I wasn't on social media. Didn't really know a lot of other people. That was, they were openly talking about being in this really like, kind of like irritable state. I mean, I was just like this long burning, like, oh, somebody presses my buttons, it's going to cover it, you know?
And I would press my own buttons and it was like this ongoing. And I was, you know, I was like fixing all the things on the outside to make sure everything was perfect. Right. Like I was taking more and more exotic vacations. I was like, it's that hedonic treadmill that I, now I recognize it. Right? Like I cannot find that kind of content meant outside of myself, it doesn't exist.
And also that perfect life doesn't exist. And so, , I really began to question a lot of things in my life and I sorta just one day. Remembered my meditation practice and just kind of dipped right back into it. And I was, you know, I should mention that while I was feeling these, issues within my emotional mental states, I was, it was then translating into lots of physical illnesses too, for me.
So I was having digestive issues. I was having chronic daily migraines. Wouldn't talk. I wasn't tolerating medications. So all of that stuff was going on. So I kind of almost waited way too late. Right. Until I had a whole, a bunch of physical symptoms, then I was like, I gotta do something. And so, you know, I initially went to meditation because I was reading some things about how much it helped with migraines.
And so. And with insomnia. And so that's, and then I started to dip in and out of meditation for a while for a couple of years, actually. And, you know, I would meditate, my migraines would go away. It would sleep great. Then I forget about it. And then another few months would go by all of the same stuff.
What happened? It was like this, you know, like I called myself a crisis meditator back then, you know? So it wasn't like I grew up in an Ostrom and all of a sudden here, here I am teaching meditation. I, it was a really messy. Ugly start to meditation for me. But once it really took hold, it was like, whoa, it was like this massive personal growth, this space that opened up this evolution that began to happen for me.
And where I noticed that I could find contentment and live. In a different space and in a way that I dealt with my, you know, whatever emotions that were going on with me, not as like a fight kind of thing, but it just became a different way of being, and living it spread to my kids, you know, people were noticing.
And then I was, I wasn't really qualified to teach for a while. Obviously I didn't go to teacher training, but I was like, Every day, like I was grabbing my office staff, I was grabbing anybody that would, that would like to meditate with me. Like, come on, let's do this two minute meditation. So it started like that actually just with me, like being like, come on, I got to get you to come on.
You know, we'll do this lunchtime meditation and then it became kind of a thing with my staff. And then people will start to hear about. And then, they started asking me to go teach at different places. And I was like, I don't, I don't know. And I, then I started to look at how I can teach, you know, I wanted to have the deep knowledge.
So over the last several years, I've developed the ability and the certifications to be able to teach, those different kinds of meditations I was telling you about. So that's the long story.
Dr. Diana Mercado-Marmarosh: You know, it's so interesting. How exactly what you said like last year when I discovered coaching and stuff. When I, I remember I did the first program that I did, they asked us to do like a burnout questionnaire and I was like, why are we even doing that? I'm not burned out. There's no way I'm burned out. Like, I didn't even know what that meant, but. I laughed when you said you were irritable, because that was me.
Like they would ask me to do different things and I would get overwhelmed. And instead of say like, no, I need help. Or, or let me do that a little later, I would just kind of blow up and I didn't even know what was happening or I would come home. And I was so drained that I didn't feel like I could function or have extra energy to cook or do anything like that.
And it's funny how now you said they have words, at least to help you identify with what's going on, but you know, sometimes we're so oblivious to what is going on, that we are reacting to things that are happening, but we're not even aware that we're reacting, we think is just happening to us. And that we don't realize that through meditation, it could be.
Step into that little bit of a window that maybe I could control it maybe a little bit. And we don't realize that that could be the case. If you don't realize what mindfulness is. I know that when I talked to you, I was telling you about my ADHD. And I was in a journey of trying to discover how to focus and things like that.
And you shared with me that that meditation can be a way to help people who had problems with concentration or with procrastination, or even with like task initiation. Have you noticed that to be the case for people that have ADHD or no ADHD, like does that type of method, can they, can it help anyone?
Dr. Rashmi Schramm: Yeah, absolutely. And we've got now hundreds and hundreds of studies that have been done and in adolescents and in adults as well. That show that practices of meditation, mindfulness practices, all of those things can definitely strengthen those neural pathways that require more focus that require more concentration.
And so before we get too far, let's just define meditation and mindfulness, because even that can be kind of muddy sometimes, right? So meditation is simply moving from activity into stillness and mindful. It is a formal way. It is a way to practice mindful. And mindfulness, most people would agree that definition is the awareness that arises when we are paying attention to this present moment without judgment and with curiosity.
So it sounds really simple, right. And it actually is the way that we all were as children. So I think you've got a four-year-old right. And so, or she's three or four. She's always mindful. You don't have to teach her mindfulness. In fact, she's going to teach you how to be mindful. She's going to teach you how to be in this present moment and not be as judgy as our brains are, you know, I'm 47. And so like, I've had that many years of conditioning of me going like, this is good. This is bad. I like this. I don't like this, all of these things, but if we free ourselves from that amount of judgment, for even short periods of time and just stay curious instead like a three-year-old would then magical, wonderful things begin to happen.
Really, truly. I know it sounds that way. But there's more openings. There's more, there's more freedom, in that mindfulness. And so it doesn't mean you have to always sit down to meditate. So for example, you can have a mindfulness practice then, you know, you're, you're either just doing breathing cause I've had, you know, when I work with one-on-one folks, there are some that are coming in 15 out of 10 anxiety.
Right. And that's all right. That's okay. What we do then is we just work within the breath. That's all we do. We do some breath work for a week or so, and then we can move into some kind of meditative practice. So there's so many different ways to go about that, you know, kind of changing those neuropathways.
But to answer your question, the way really. Neuro, you know, kind of physiologically that, you can imagine that meditation would help, whether it's concentration or focus is that during meditation, let's say it's five minutes of meditation and we'll take, for example, a yoga nidra, because we mentioned that already, which is fully guided, right?
So all you're doing is you're listening to a guidance and sometimes, it's the guidance is saying breathe a different way. Sometimes the guidance is saying, put your attention on different parts of your body. There's different, you know, there's different parts of the guidance. There's guided imagery, there's all kinds of different things.
And so what's the brain going to do when, when you're, when you've decided, okay, I'm going to spend 25 minutes inside this guided meditation. Your brain is going to be like, no way. I don't have time for this. Oh my God. This woman has no idea how busy I am. Listen here. I got two young kids. I work full-time, I'm a coach.
I have a podcast. I also have this other program. I got deadlines coming up. She didn't know what she's talking about. So all those things are going to happen. Right. And that's okay. They're supposed to happen. So your only job once you've decided I'm going to just do this. Nidra is then to notice all those thoughts and come back to the guidance.
And then there's going to be something else that shows up. Oh, crap. I forgot to email that person. Yeah. That's a thought you come right back to the guidance, then it's going to be like, oh my God, I forgot about the form. I think it's due today for my kid's school. That's all right. That's a thought you come back.
Right. And so. Each time you do that, where you notice that you're in the middle of a thought or a thought train, they're usually trains because they sweep us along, and your job isn't to be like, oh, this sucks. I'm not doing this right. Your job is really simple. You just come right back to the guidance.
And the more times you do that, the faster you can do that the next time. And so think about how that can be useful if you're trying to chart. I mean, how many people need you the minute that you need? We're going to finish a chart. It's going to be 15, maybe 20. Right. Everybody needs you all the time. And so your ability then if you've been sharpening it and training your mind to come back to the task at hand is literally you're rewiring the brain to do so.
And so. In a, in kind of a fun way, because those nitrous have all kinds of other, and same for the mantra too. They have all kinds of other, you know, benefits, like as far as neuropeptides and all these other things go in kind of a fun way. You can train your mind to really come back to the focus and use our ability for the concentration that we already have.
Dr. Diana Mercado-Marmarosh: Yeah. You know, one of the short sentences have been very helpful for me is just thinking right here right now. Like when my mind is like in a thousand places and the patient's right in front of me, I have to just tell myself right here right now, like right here right now. The patient is the most important thing right here right now, or if the kid's having the meltdown, right.
It's like right here right now, I have to validate their feelings. Or I have to ask the question that is not, instead of me screaming back at them as. Uh, or, or awarded in the way where I'm like, okay, um, you know, you're a great kid having a hard time. How can I help you? Right. Like, so it's about their behavior and not them.
Right. But the human instinct is to screen back. Right. And so just the right here right now. Like if my husband's mad at me or if I'm mad at me or whatever right here right now, Bringing it back that I'm not, it's not really that bad. Like I'm not in the middle of the street, naked in the car is running over me, even though the brain wants to tell me that.
Right. And so I think because of the yoga nidra that you have helped personalize for me, I've been able to realize that I can focus at will or that, I think part of it says just. Let it go, let the universe take care of it, which sounds nice. And it makes you feel supported, but our brain doesn't want to let go of anything.
Dr. Rashmi Schramm: Yeah, we have that. And I love that. It's kind of a mantra that you use, right, right here. Right now. I might start using that too. Sometimes I'll use, I'm like, oh man, I have this ability to really go back in the past. Like I made kind of a large mistake. I mean, it's not a mistake if you learn from it last week and who as you know, like for a while, uh, you know, like the next day I was like, I could recognize what I was doing.
I wasn't spending that much time on it, but it was still happening for me. Cause it was thoughts still kept showing up. So I started to just go to past past, or what's done is done or, you know, it's just good to be able to remind ourselves what's done is done. What's done is done. Um, I mean it wasn't like horrible, terrible.
I didn't hurt anyone. I just made a mistake in a purchase and that's okay. Because we all make mistakes. That's okay. And so it's like, all right. And what's done is done. Let's, let's be right here right now, like you said. And so the more we practice that, the better we get at it. And if we have those precepts, like the kind you're talking about, where you can just come right back to it, where you don't have to explain a whole, you know, series of events, then your training is like, you know, of your mind is even more powerful.
Dr. Diana Mercado-Marmarosh: Yeah. And it took a while because the brain wants to tell us all kinds of things. Like obviously when we're doing our notes, right. Or we're trying to close the encounter, it's telling us that we're so slow. Like we're like really, really slow. Right. And it's probably not the case, but our brain is telling us that.
So like, I've learned to acknowledge that. But at the same time, I tell myself I hurry slowly. So it tells me that I knew move on with it, but not so much to where I'm going to make a mistake and put the order on the wrong patient, or I might miss a big thing. Right. So it's enough to tell my. Okay, let's go, but not get outta here. And then we missed the whole bowl.
Dr. Rashmi Schramm: I know. And that's the danger, right? Is there, there are so many opportunities for the wrong click and the wrong chart. And, and we are really tasked as physicians. We are tasked. Something that I think is nearly impossible, for the brain to sometimes do where sometimes most of the time doing the job with three or four people.
And on top of that, all of the emotional and, the complexity, the, of the social aspects of all the things that we're dealing with our patients, and then what's happening with our staff, let alone whatever hospital system or clinic you're in. I mean, it's a lot, it's a lot to manage for sure. And be. That way of just reminding yourself and then, like having your own back and reminding yourself of that self compassion that can, that can take us a long way.
Dr. Diana Mercado-Marmarosh: And you know, people with ADHD, we even though in the U S it's not recognized as emotional dysregulation to be a thing that is used to diagnose ADH T in Europe. It is. And so it makes you wonder whether people having society or depression. Along with ADHD or if it's just part of their ADHD, because they're so irritable that they can't accomplish a task because they, you know, their brain has 25 tabs open and can't prioritize which one it is whenever things are gonna happen throughout the day.
You seen as mom meditation, a two or three minute meditation, when you feel like you're about to lose your shit. Right? Like I, excuse myself, I go to the restroom and I do a little micro meditation and it's my way of telling myself I can't. Sit and overwhelmed the whole rest of the day. Or I can sit in this uncomfortable overwhelm for two or three minutes and try to rewire how I'm going to see the rest of the day.
So maybe this encounter went to shit, but I still have five other patients that I would want to show up at a better place. I'm still a human being. I'm not a robot, but acknowledging that, how I show up in how I'm choosing to show up. Sometimes you can control it. And sometimes you can't because there's so many things where we're human, right.
We might be dealing with the worry of a family member who is sick or a neighbor who is dying, or you don't know. Right. Or you're going through a divorce, things happen. Right. And so. That's the beauty of understanding that we're human and understanding that meditation can be a tool for us to regulate us.
Right. And to support us because to me it's a very strong, self care form because, nobody's going to be like, oh my God, you look tired, good. Sit down. Like you have to be aware of how you're feeling so that you can. Recharge yourself, right? Because I keep saying this, you cannot give what you don't have.
Like, you can try to pour from an empty glass, but nothing comes out, you know? So you gotta make sure you fill that cup up. And that way you do give from a place of abundance, not from like, you know, a feeling of having to do things.
Dr. Rashmi Schramm: For sure. And that minute that we start to do that, we start to get resentful and that's like a big red flag for me.
Like when I noticed it was that meant showing up, I'm like, whoa, what is, what is happening here? Just slow down for a second and notice what's going on. It doesn't have to be that, you know how to fix the situation, but just bringing awareness to something can be really powerful in and of itself.
Dr. Diana Mercado-Marmarosh: So tell me, what are you goals for the next year or two?
I'm so excited to hear. I know you're a trailblazer and you're everywhere. So just share with me.
Dr. Rashmi Schramm: Within Optimal Wellness, I've got a whole bunch of things in the works right now. So. We've got a small group program, which is almost full. It starts on the 31st and that goes for 12 weeks. That's going to be amazing.
You're actually going to be coming on as a productivity coach, Dr. Diana, and I'm so excited about that. And so were all the women that are registered already and all the ones who are going to register from now until then, and then. So have my one-on-one program and that is actually full with a wait list. Right now I have two retreats that are coming up here locally, where we're going to do meditation, some yoga we're going to do like some workshops. It's going to be a whole lot of fun. Really my bigger goals are to do more in-person retreats. That's my goal. We all know that that is not under your controller, my control that is under the COVID control.
So, I have big dreams and big goals, and I know where I want to host these things. But, I'm working cautiously. So right now the retreats that I have in person are all outdoor and they're one full day retreats. So which we can still do and require vaccinations and all that. But once you start to get into the multi-day retreats, then it can be a little bit tricky.
So that's definitely on my mind. The, you know, sort of offering to help, really burned out and not even if they're not even burned out, but just in general, women who need community who are ready for personal growth, who are looking for personal or a spiritual journey. That's what I want to be able to, provide in a larger scale.
Dr. Diana Mercado-Marmarosh: Yeah. Like at some point in my future, of course, you and I have talked about this doing retreats, like all over the world. I love to travel with. So I'm like, Hey, we got to go hang out in Croatia or Spain or Italy, you know, how amazing would it be for people to come and like figure out their systems, figure out their way of taking care of themselves.
And then we can offer CME and they can be a business expense or a medical. Professional developer expense. Right? And then again, like you taking care of you, it's the ripple effect, how amazing you show up as a parent, as a daughter, as a physician, right. As a neighbor, right? All of a sudden. Have you're functioning from a place of peace and embodying it, not just like, you know, having the thought about it, but actually living it.
Right. So it's very different. Tell me, if our listeners are wanting to get in touch with you, how can they find you? Where can they find? Yeah,
Dr. Rashmi Schramm: I'd love that. So I'm on Instagram and Facebook and, the handle, there is just doctors, Dr., and then my name, which is Rashmi Schram. And then, my website is optimalwellnessmd.org, and I'm on LinkedIn.
I'm also on. Ah, clubhouse. So wherever people are, come hang out with me and, we'll have a lot of fun together.
Dr. Diana Mercado-Marmarosh: Awesome. So if there's anything like one final takeaway point that you want the listeners to hear, what advice would you give?
Dr. Rashmi Schramm: Yeah. You know, I think it's that normalizing the idea that whether you've been identified as somebody with an ICD 10 diagnosis or DSM-5, you know, meet the criteria for ADHD or not.
Every human being in 2022 has ADHD tendencies, period. If somebody doesn't recognize that they're not living in our world, we live in a distracted distractable world. And so to normalize. This notion that it is really hard to focus and concentrate because we carry a computer around in our pockets. We then we, we have so many ways of dings and beings and all this other things that, to like, have that sense of self-compassion that, that nobody is alone and that nobody is just born.
I think with just this like laser focus and that we can all get there and the systems that you provide, you know, there's so many different tools that are out there that to just continue to, you know, again, just a curious and bring back, come back into that self-compassion and just keep growing. That's what I would say.
Dr. Diana Mercado-Marmarosh: Awesome. Well, thank you so much for those that are obviously my clients and have worked with Rashmi already. It's I mean, what do they say other than life-changing and she teaches him how to do breath work and she teaches them how to meditate, but. I am only bringing you people that I trust and people that I myself have worked with.
And of course I am her client. So I want you to know that I'm not just here making a podcast about XYZ. I am giving you the tools that have helped me to be able to function. You know, tapping has been one of the tools that was helpful for me. And that in combination with yoga nidra have been really supportive for me, because like I mentioned, if you guys don't know what that is, you can go to YouTube or you can find Dr.
Rashmi's information and try some of her meditations. And then you'll see that you're going to come out of it. Refreshed. Energized. That's what we want. We want you to feel refreshed and energized alive, right? Not numb. So please give, give it a try. If you have never tried something, you can't, you don't know if it's gonna work or not until you try it.
So give it a go.
Dr. Rashmi Schramm: Yeah, I love that. Thank you for reminding me about YouTube. I actually have several, I have a, I have a meditation for focus on YouTube. That's perfectly free. So you can just go to YouTube, Google my name. And that would be a great one to try.
Dr. Diana Mercado-Marmarosh: Don't worry, guys. I'll get the links and I'll put in the comments.
Okay, thank you again. I know that time is your most valuable asset and I am so grateful that you gifted that with us today. And so thank you.
Dr. Rashmi Schramm: It's my pleasure. Thank you for having me.
Dr. Diana Mercado-Marmarosh: As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
 
Connect with Dr. Rashmi Schramm
Website: https://www.optimalwellnessmd.org/
Social Media Handles:
facebook.com/Dr.RashmiSchramm
instagram.com/dr.rashmischramm/
youtube.com/c/DrRashmiSchrammOptimalWellness
linkedin.com/in/rashmi-schramm-md