Finding Balance and Overcoming Addiction: A Certified Anesthesiologist Assistant's Journey ft. Kelsey Koehler

Kelsey Koehler, CAA bravely shares the darker moments of her life, including a personal struggle with alcohol that led to 2 DUIs a week apart.  Her story is a beacon for CAAs, illuminating the stark reality of substance misuse in our community. Her proactive approach to recovery and commitment to transparency with the Missouri state medical board and her own support circle exemplify the profound strength it takes to rebuild a life.

In our candid discussion, we move beyond Kelsey's individual story to address mental health in healthcare, unraveling the critical need for empathy and connection among CAA colleagues. This episode stands as an invitation to the medical community, especially our fellow CAAs, to embrace vulnerability, foster a culture of openness, and extend a hand to those silently battling personal demons. Kelsey's story will resonate deeply with anyone who has ever faced—or could face—the daunting intersection of personal hardship and professional responsibility. Join us as we lay bare the struggles that unite us and the strength we can find in each other.

Connect with Kelsey @Kelsey.jantsch@yahoo.com
IG @kelseyjo333

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Find AA meeting near you (Alcoholics Anonymous)
Find NA meeting near you (Narcotics Anonymous)

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Transcript

Mary Jeanne: 0:00

My life is either going to get really bad or I've got to change just about everything in it. Welcome to the Awakened Anesthetist Podcast, the first podcast to highlight the CAA experience. I'm your host, mary Jean, and I've been a certified anesthesiologist assistant for close to two decades. Throughout my journey and struggles, I've searched for guidance that includes my unique perspective as a CAA. At one of my lowest points, I decided to turn my passion for storytelling and my belief that the CAA profession is uniquely able to create a life by design into a podcast. If you are a practicing CAA, current AA student or someone who hopes to be one, I encourage you to stick around and experience the power of being in a community filled with voices who sound like yours, sharing experiences you never believed possible. I know you will find yourself here at the Awakened Anesthetist Podcast. Welcome in. Hello all my fellow CAAs and AA students. Welcome to the podcast and welcome to this really special episode.

Mary Jeanne: 1:17

Honestly, I'm really proud of this episode. I'm proud of Kelsey and I'm proud that she trusted me enough to share her story with me. It's really a big moment for our profession, I think, in the history of us to have someone come forward and share the full spectrum of what it means to be a CAA and what it means to be a full spectrum human being while being a CAA. It's the first time I know of that a CAA has really gone on record to share so much, and I hope that it inspires us all to share more of ourselves and knowing that there's so much community and connection and way forward through life's hard things when you reach out for help, when you share that you're struggling, and that we as a profession could move forward in that direction, really supporting and helping each other, that certainly might take away from this episode and I'm really interested to hear how it resonates with all of you.

Mary Jeanne: 2:25

So I do want to give you just a little bit of background on Kelsey Koehler. She graduated from the University of Missouri, kansas City AA program in 2017. She currently practices in St Louis, missouri, for a private group. She works PRN. She said she mostly works weekends and she tries to work as many hours as she can each weekend because she's still commuting from Kansas City. That's about a three and a half hour drive to St Louis every weekend to work and she shares in her process how she ended up living in Kansas City but working in St Louis and her journey moving through the lowest points in her life, and I think you all are going to get what you need from this episode, and so I just want to have us get into it and share Kelsey Koehler's story with all of you. Okay, how are you feeling nervous, or yes, yeah, I know, I know.

Mary Jeanne: 3:24

Totally normal. I mean, especially, obviously you're sharing something so vulnerable. But also, everyone else has always been nervous and by the end they're like, okay, we got into it, like yeah, I'm really grateful to have you, and I think it will come out through the episode how we know each other. But yeah, this is sort of we haven't seen each other for a number of years, so this is a little bit of a reunion, so it's good to see you and I think I would like everyone to get to know you through the rapid fire round. I really enjoy these. I hope everyone else is enjoying them. I just think it's interesting to hear about the person and just sort of everyone's little quirks and oddities and sort of what makes them unique to start us off. So if you're game for that, I would love to start there. Yeah, okay. So this may not be super short, but I would love for you to describe, if you can, your perfect day. Oh, that's a hard one.

Mary Jeanne: 4:25

Pax and I love I don't know, we love going on adventures soon. So Pax is my son turning seven today. Actually, it's his birthday. Oh, wow, yeah, so I don't know. We wake up, chill. I like. There's about five restaurants. I like Get something to eat from there, and then all the neighborhood kids play football and Matt and I always go out there and play with them. Yeah.

Mary Jeanne: 4:50

Just that and you know. Just beautiful weather, some sunshine, like we had the other day. But Yep, now, listening to that, would you qualify yourself as an extrovert or an introvert, because that sounds a little like a homebody which I can get behind. Oh, 100%, yeah, introvert I am. Yeah, I have forced myself to be an extrovert for my son, but no, I would. I'd rather be home. Anything home it's great. Yeah, yeah, you're one of the few people I think you might be the first person that has said I am 100% an introvert. Yeah, I mainly do 12s plus at work and yeah, by the end of the day, I've talked myself out. Yeah, you're tapped out, yeah.

Mary Jeanne: 5:35

Okay, what about this one? What would you be if you were not a CAA? Money was no issue, everything was set and you could do anything you wanted. What would you do for work?

Mary Jeanne: 5:45

Ride horses teach kids how to ride horses. Yeah, I would still be competing. Yeah, you did that. Okay, so I'm just going to like not bury the lead. Kelsey was one of my students. She went to UMKC, which is the AA school here in Kansas City, missouri, and she was one of my students. Remind me your history with horses. I have forgotten, but you've told me before I grew up riding them competed in 100 jumper competitions I actually went to I'll preface this with.

Mary Jeanne: 6:17

I started wanting to be an anesthesiologist, specifically cardiac. Very young. One of my dad's friends that he went to high school with was one, and I often went to like, take your diet or work day with him to go see, because that was when there was less hip hop and things like that, and so I could go see cardiac surgeries. He's the one that got me into this. But when I was originally going away to college, I got a scholarship to continue competing and riding horses. So I went out there and was like this is what I want to do with my life. I'm spending my day with horses, brushing horses, riding horses. So I took those classes mainly when I was out in North Carolina and then was like oh, wait, a second, you have to make money to do this and you don't make money. So, yeah, that's when I came back and kind of got back on the path that I had wanted to for a long time. But just, you know, life takes us different ways. Okay, that's what I now I'm remembering that you had a college scholarship to ride horses and then found your way back to CA. And also, mind you, this is how conversations with Kelsey and I go, is that I'll ask her one question and then we do. You know, it's oh which one quick question and then we get off onto something. So, yes, I remember many a good conversation with you in the OR. Okay, well, we heard a little bit about how you found out about the CA profession.

Mary Jeanne: 7:43

I want to hear more details, but let's even go back before that and I would love for you just to share about your upbringing, your family life, your childhood, just anything that stands out about you know who you were as a kid, how you were raised. Uh, was raised now where I'm raising my son, but very like good, what do you call it? Suburb area? It's a time when money was really good to. Everyone was doing well, my parents own their own business. They built homes. My mom did some of the office work, my dad did the other part. They were always around. They built their schedule around what we needed. I've got two sisters Really good childhood, like I said, I rode horses, I worked. We all got jobs very early but, yeah, we just had a lot of. That's how, like I said, I met the anesthesiologist that ended up shadowing a lot. Just there was. There's a lot of opportunities around here. So even our high schools, I mean that's why one of my son going to these schools is they've got shadowing programs. They've. They just have all these career oriented. They try and lead you in a good path. Yeah, I had a great childhood.

Mary Jeanne: 8:56

Are you in the same suburb of Kansas City now like living right now that you grew up in? Is that what you're saying? I'm like three blocks from it. Yeah, oh, I didn't know that. Yeah, and we live a block from my dad, like, and his whole family. He's one of 10. My mom's one of eight majority are somewhere right here. Wow, yeah, okay. So really important to you to be around family.

Mary Jeanne: 9:19

And you've mentioned a little bit about now that cardiac anesthesiologist with which we both know. He's one of the cardiac anesthesiologists who's really big in the CAA community in Missouri. He's one of the people right who was really instrumental in getting our legislation passed. Is that? Am I right in saying that? I think so. Yeah, boots on the ground, kind of important to CAAs? Yeah, yeah, absolutely Okay. And he was friends with your dad. And tell me about how you transition then from cardiac anesthesiologist dreams to CAA dreams and kind of leaving behind maybe some of the other options, which I think is interesting that we can be good and right for a lot of things, but one thing kind of calls to us and give us a little bit of those details.

Mary Jeanne: 10:05

Oh, like I said, I shadowed him a lot growing up multiple times. Love, that that's absolutely what I wanted to do. When it came time to I was premed and I was taking the MCAT, he was the one that kept being like I'm telling you, you've said you want to family, you've said you want to like this is the other path to go. He kept pushing like do CAA. And I'm not going to lie to you, even it probably took till the end of first year where I kept being like I don't know, maybe I will go to med school, like I think it was just something that had been in there so long, um, and I hadn't gotten far enough into knowing what we did and everything that it just kept sticking there, like maybe I'm still going to do it, I don't know. But yeah, then you get into clinicals and you get in. Just, I had the opportunity to be like the first day at a couple of hospitals new rotations and stuff and it became very clear I'm I'm very happy with the path I took.

Mary Jeanne: 11:09

Very happy. Interesting, because I think you have kind of that old story where did you know about the profession when you're an undergrad? No, okay, I feel like that is the old story, which is you kind of find out about it a little bit later and everyone's thinking they're going to medical school, and then it appears as this diversion or different opportunity away from the medical school dream, and then we're all kind of grappling with oh gee, I thought it was going to be a doctor, not because I have to be a doctor, but because I thought that was the only way. And I just feel like the new version of that is I want to be a CAA. I knew about it in high school and I also think it feels really different to get into an AA school program these days.

Mary Jeanne: 11:52

I certainly am like I'm glad I got in in 2006, because I think it's a lot more work to get into a program now and you really have to be super, super sure going in that that's what you want. You know what I mean. I just think it's different. Yeah, yeah.

Mary Jeanne: 12:07

Yeah. Yeah, I remember you as a new student because I think one of your other passions correct me if I'm wrong at that point was like fitness and bodybuilding. Yes, yeah, I did my last competition that that was December of 15. And that was right when. Or I mean December of 14. And I started January 15.

Mary Jeanne: 12:31

Yeah, and I just remember you telling me oh yeah, I get up at three and I work out and I eat, you know, get all ready and I study, and then I come to the OR and then this girl like blows me away in the OR and I just remember thinking like she's got it, like she can do, you can do anything you want. Like I just was, like I can barely get up in time to get to work on time. I just was really inspired by that level of commitment. I just think that's interesting. Was that normal for you? Like are you just kind of a go hard, go all in person? Yeah, if I make my mind up to something that's going to happen, but I mean I can do both that I also have a list of things I'm procrastinating, so let's not get it wrong here.

Mary Jeanne: 13:11

But yeah, now, if I, if I decide I'm going to do something, that's, that's pretty much it and you graduate from UMKC a program in 2017. And then tell us about taking your first job. I was one of the first in my class to start working. I had decided I really want to start working. Well, okay, I got pregnant and in my second year, had my son a week after our boards. I had worked weekends to build up maternity time because I wanted time off with him, so I took four weeks off right after boards, and then my son got RSV and was in the hospital for a week. So I actually I ended up taking five weeks off. So we wanted to. I wanted to fast track, I want to start working as soon as possible, but which even that amount of time?

Mary Jeanne: 14:00

it's hard taking a break until you like get into our job and know what you're doing for this but even at the end, you know, I thought I'm a pretty confident student, like I think I'm doing, and it still was like, oh, but now I'm alone, alone, Like I'm all the way alone now, yeah, you were, you were a pretty confident student. I would say like I think what we hope for is by the end, the students feel like I could totally do this and then the only bridge that's left is actually leaning into that, totally alone, alone, and then seeing what you do in that, and for the prospective AAs or the AAs students who are listening, it can be tempting to be like I'm going to take four months off between school and work and while, okay, also just know that the further you get away from like implementing those skills in real life, you're just kind of delaying the anxiety and also delaying a little bit of the momentum that you have, right when you come out of school, and so you know, not totally wrong, but also just to know that's what it's going to feel like. Yeah, and I worked a lot with students at the previous job and then now this is my second and I just try and tell them all there's times for breaks and I do, like you said, I wanted to celebrate after I graduated too. You've worked hard, it's been sucky at times, but yeah, we like where I work now has you immediately start. We have a transitional program and I'm like, just do it, get in there.

Mary Jeanne: 15:32

And like you have to see some hard things, especially right then when your knowledge is so fresh, because I don't remember I saw very few hard situations when I was in school that you would have to handle on your own. Yeah, and then you get out and you do have to handle them on your own, and now you're solely relying on that book knowledge and you haven't done it. So I tell everyone I'm like, just dive in, be poor for a little bit. Yeah, do the transitional If you can find somewhere that'll get you on fast and then take that dream vacation. Just delay it a little bit. Like, just get in that knowledge you can while you also have the book knowledge to like back it up. Yes, yeah, you're never as smart as the day you graduate AA school. It goes down from there for me, at least, for me, okay, yeah.

Mary Jeanne: 16:27

I forgot that you got pregnant with Paxton again, your son, who's seven. You got pregnant your second year of school, which is a whole other thing to discuss how to navigate. And you know why I think I forgot is because you just, for better or for worse, powered through like you just didn't. It wasn't a thing which I don't know. That I love that either. You know what I mean. Like I don't love that our profession doesn't allow for some flexibility, because if you miss time, you know you have to make it up, but also it the money starts accruing. You know what I mean. Like the debt is accruing. It's not like, oh, I can just not pay for a while. At least that's how UMKC functioned at that time. But room to improve for profession, okay.

Mary Jeanne: 17:11

So how did it feel? How did it feel? How did your first job feel? Once you kind of got into it and got in the in the OR alone, alone, I loved it. I never felt more dumb than that first day. I've loved our profession, the two places I've worked since I started. It's a stressful dog and I try and talk to my students about this. That school was stressful, our job is more stressful and it doesn't go away. So there is. I do think that's an area to improve for everybody. Kind of what you're working on is making sure you have the outside life, making sure you have the support. It's not. It's not an easy job. It is what it is. Yeah.

Mary Jeanne: 18:02

Totally, yeah, like emotionally, spiritually, physically, it demands everything from you. Yeah, yeah, also not to bear the lead. Kelsey worked at my hospital, so we worked together. She was a student for me and then your first job was at one of the main rotation hospitals for UMKC and I would say we didn't take all the students like the good part about being a student and taking a job at one of the main hospitals that you know exactly what you're getting into. And then on the hospital end we were pretty picky about what students we wanted to work with us, just because we saw all sides of every student you know. So, yeah, we welcome Kelsey with open arms.

Mary Jeanne: 18:43

And then, how many years were you working, would you say, before things started to get like significantly harder or more overwhelming In life or the job? I would say, tell me both. Like, how did they interact with each other or was it very separate for you? That's kind of I was going to touch on that a second ago talking about the stressful, how stressful our job is is that life also doesn't stop at all and we can't you kind of have to be, able to separate the two.

Mary Jeanne: 19:17

Not kind of you do. They can't co-function. There's not a way that you can be falling apart at work and do our job. It's just not possible. So I think that's a good thing.

Mary Jeanne: 19:29

And so my life was getting harder, right when I had our son, or shortly there after is what I should say probably about two months after. And then work started getting harder. We had it was a small group, less people taking call, and I don't even know what week this was. I know it was towards the when I put in my three months. I think it was about a month or two after I started getting my job, towards the when I put in my three months notice. But I just remember looking at my time card and I was like I've been here 78 hours this week and I have a little child at home and, granted, when I was on call I either most of the time had a friend, but either my friend or my husband brought him up to the call room so I at least could see him the few times we went in there at night.

Mary Jeanne: 20:21

But that's just not. That's not the family I wanted. That's not the life I wanted. I didn't want to be working 70 plus hours a week with my child at home? Yeah, yeah, and what was the thought on how to remedy that? Or did you feel trapped, like this is just what this job is. There's no way out? Um, I wanted to go part time. I think you and I had talked about it, but there were some other people that like split position stuff, like that. So I wanted to go part time and then you know, when the time comes, you can pick up more. Great, you can pick up more. But at least while my son was young, I wanted to be home with them. Yes.

Mary Jeanne: 21:04

I can sympathize with that and, as Kelsey just said, um, we were both working at the same time at the same place and both wanting to work part time and the group we worked for. It was very wild to consider that anyone could work part time. And this was what like 2018 ish maybe and Kelsey just started, not a year before that and that sort of push and pull of wanting more time, more family time, took you and I both in separate directions. I left to go to a part time job that I'm still at now and you left to find a different solution. And just tell us a little bit about that transition for you and where you thought you were going to go and how it ended up.

Mary Jeanne: 21:45

Um, so one of the certain things that I wanted to do was I was a surgeon that had been at that hospital was moving to a different hospital that, only at the time, had two ORs, only had one functioning, uh, with the name of a cesiologist. Every day, like three o'clock was late for them to work. You were out before three, that was. They said we want to bring AA's cause. He was going over there. He did a lot of cases in one day, so it would be mainly working for him. There was a couple of others that went there, but it would largely be working for him.

Mary Jeanne: 22:18

Did all the credentialing, did all that stuff? I mean, I was fully credentialed at the hospital. I had put in my three months notice Um, that was the requirement on my contract and it got down to like three weeks before that three months was up and they were like ooh, the hospital board decided that we need to build more ORs to make this financially a smart decision, which I was like yeah, I could have told you that two months ago, like I didn't see how this was working. But so now my job had been filled, because obviously you know they needed to fill it in that time and I was without a job. And then the story continues where we're going. Yeah, yeah.

Mary Jeanne: 23:07

Yeah, I mean just a really tumultuous time. I mean I, it was a tumultuous time to be a CAA in, kind of our little area. I do think CAA is kind of you kind of only know what's real for, like the people right around you, because CAAs are kind of in pockets. I feel like and yeah, it was just a really stressful time. One of the main hospitals that hires CAAs and is also our main training site, it was just a huge transition period. There was a bunch of CAAs there. We wanted different things. People were leaving, like CRNAs who had been there forever were leaving. Like it was just a time when people were trying to find a better fit for themselves. But I would say I didn't know any of this, so it felt like the rug probably was getting pulled out from underneath you, I'm assuming, Kind of. I mean, like I said, from the beginning I had kind of been like I just don't understand how this is making sense for them. But I went with it. You wanted it to work. Yeah, we were kind of we wanted these like things that could be different to work out.

Mary Jeanne: 24:11

Yeah, and talk to me a little bit about the state that you were in when you lost that job and personally, your life was getting harder. You said talk to me about, like, what was going on for you behind the scenes at that time. So I'm going to leave a lot of the background alone. I'm going to describe the overall situation and it's not something. None of this is secret, None of this is. I'm happy to talk to anyone individually, but I'm just not going to like throw it all out there.

Mary Jeanne: 24:48

But my marriage was getting harder from the second we not the second but shortly after I had my son, you know, we had a stress of a new baby. We bought a house. I'm graduating school for this new stressful job. So I was drinking a lot. I was drinking most nights and spring of 19 is when I just didn't want to go home anymore. That's not even the right way to put it. My son is my everything, Always wanted to be there with him, Didn't want to go to go home to the husband. So, yeah, he, we both had a problem and I never, never drank at work, never went to work hungover.

Mary Jeanne: 25:40

It wasn't, you know, getting drunk every night, but it was absolutely using it as medication to stop what was going in my going on in my head from work and imagining going home. Yeah, Do you? I think a lot of people listening to you right now are like, well, I drink every night when I come home from work too. Can you share how it felt different, and were you drinking before this, more casually, and you kind of felt yourself drinking more and more to disconnect? Yeah, absolutely I mean. Yeah, I drink before you know, have people over, have some drinks. Or yeah, you go to a chiefs game, have some drinks.

Mary Jeanne: 26:39

This was not. This was literally leaving work being like I'm um, God, it's a hard feeling to describe, but literally that's just looming doom. That I felt like I was being choked and what was going to fix it was drinking and like, not, you know, there's better ways to cope, there's other things to do, and it wasn't in my head at that moment. That's all. That was my only option that was going to fix it. Were you aware of this at the time where you're like gosh, you just I'm using alcohol to cope, or was this something only in hindsight that you now can see the? You know the track of it? I think it was.

Mary Jeanne: 27:35

So I saw a therapist personally and then we saw a couple of marriage counselors together and I think it was. I think it was January of 19. So, like I said, I didn't. This was before my drinking was where it got and before I had put in my notice and everything. I think it was January of 19 that I told him. I was like I think I have a drinking problem and we talked about it, talked about setting up more sessions, we talked about I was going to get on a little something for sleep, because I wasn't sleeping at all. My son woke up five times a night until 11 months old. I remember that. Yeah, I remember you telling me that. Yeah, oh my God. And then slept through the night at 11 months old and I was like, is he dead? Like oh gosh. Yeah.

Mary Jeanne: 28:25

But I remember that session so vividly. I just threw it out there. I was like I think I have a problem. So I started working with them. Before it got to the point it did, did this all come to a head? Like all the storms kind of coalesced at the same time, like was that the lowest point? Oh, I took the little campfire and poured gasoline on it. So I filed the final divorce spring of 19, right when I was applying for the other job quitting, my first job was taking care of our son.

Mary Jeanne: 29:10

We had a large house, three dogs, a bunny, the 74 hours a week of work, to say it in the best way possible, I was absolutely burning the candle at both ends, exhausted, dying, not communicating with anyone, just putting on a smile every day and everything was fine and nothing was fine. None of it was working. So it was end of June, just about my last day at my first job, came home from work we were on like a peel system that day. I got off like really early I was in early numbers, so I got off like one, two o'clock I think, picked up my son from daycare, we went to the park, the water park splash pad thing. We stocked a quick trip. On the way home he got a nosebleed. I remember just losing it over this nosebleed, something like totally fine and it was like a dry air nosebleed and I just really like losing it. And our house was right down the street taking there start making dinner. Call his dad I'm like you got to come over here. We got to figure out the divorce terms. I'm exhausted. He came over, some alcohol was had and things got physical. I leave and I get a DUI. Was leaving to go to my dad's. But, like I said, I may leave.

Mary Jeanne: 30:52

Some of those details of that story I'm happy to talk to him that anyone that wants to but leaving get a DUI. So now I'm like cool, now I am jobless because they had just decided, literally like the week prior, that they need to build more hours. Can't go back to that one because my pre the one with you because they had hired people and let's get a brand new DUI. Husband takes my son, my mental falling apart gets even worse and I get a second DUI in a week. So I wake up the next morning from that one and I'm like okay, my life is either gonna get really bad or I've got to change just about everything in it. And luckily I have an amazing support system, because I don't think it's possible without that. I decided to change every single thing in my life but it very easily, very easily, could have gone the other way.

Mary Jeanne: 32:11

I just feel. I just feel that terrible, terrible place you were in. If I want to go back there, I still can and I can remember like very specific days exactly how I felt and stuff like that, and I don't want anyone to ever feel like that alone. I'm very fortunate, even with the number of people I had around, there were still days that I was like I'm the only one that's ever done this and like it just it takes you down bad places. I just. I could go on about that forever, but I don't want anyone to feel like that alone because it's not it's a horrible place.

Mary Jeanne: 33:01

It takes a lot of bravery to share that story and I really want to acknowledge truly how grateful I am that you are willing to share your story, and we had talked before this and you had said that that you had felt so alone and so alone within our profession that, like you, must be the only one this has ever happened to, and I would love for us right now to kind of help others feel less alone, and I think the way to do that is to share some of the story of you coming out on the other side and to where you are now and I know it's like the worst moment of your life, being right at the point where you have two fresh DUIs, you don't have a job, you're, you feel completely alone. What do you do? How do you move forward? What did you do or maybe wish you did? There were good choices in bed. I hope others reach out or like know that they have resources to go and check into things, because I feel like I was a little bit of a tester. Some things worked well and then some things, you know they didn't hurt me, but that next morning definitely I was like clearly an issue. People without issues don't get two DUIs in a week and a half Immediately enrolled and outpatient started like I think the next day or something.

Mary Jeanne: 34:40

Can you say a little bit more just what outpatient is for the people who are listening, who are like wait what? Yeah, so obviously there's inpatient versus outpatient. Like alcohol rehab, outpatient was three hours a day, three times a week, basically a group. They do little lessons and stuff, but a lot of it was also talking. It's building a community, it's checking in, it's a lot about that and they kind of pick your timeline. I didn't end up saying I think theirs was like 16 weeks, I think, and something at like 12 weeks. They told me like you're good, I also was doing a lot of other things, so I didn't stay the whole time and then and you chose, you elected to go voluntarily into outpatient.

Mary Jeanne: 35:25

Yeah, there were several things I did just automatically by choice, and that was one of them was outpatient. I immediately called my counselor and was like we need to start talking a lot more Obviously, immediately got attorneys for my choices and then started reaching out. I actually reached out to kind of a large amount of medical professionals I think majority were doctors that I knew and was very honest. I always here's what happened, what do I do now? And one of them was and this is a really good resource and I don't want to say like, don't go do this or do this One of them was I did go up to there's the Missouri Health. I should have looked this up before the podcast. It was the Physician Health program. Yeah, yeah.

Mary Jeanne: 36:15

Up in Chicago and I did go up there because one of the docs had suggested, like, go up there, get an evaluation from them and see Normally, like that's something that's mandated. Like once you were, if I had a hearing with the Missouri Board of Arts, like they could have decided, hey, you need to go up there and do it inpatient, hey, you need it, or go up there and get an eval and whatever they say, that's what you do. I chose to go up there, like immediately, and I think I should have just taken a few days to think. So, yeah, I did that outpatient, started seeing my therapist all the time. Obviously, court dates and such started happening.

Mary Jeanne: 36:57

Oh, the other voluntary was I started taking a breathalyzer four times a day, every day. Mainly. A lot of these things were at the time I was focusing on getting my son back because my husband was not letting me see him, but this is also what ended up helping me keep my license, because I had two years of proof, a year and a half by the time. I had to reapply for my license and I had to come back for everything of here. I got sober, I've been sober. You know, I have a commitment to stay sober and you guys are welcome to follow me however you want. And they looked at all my stuff. We had a hearing at one point and they said you know we're really proud of you. We hope you know to support you in toward and that's yeah. Yeah.

Mary Jeanne: 38:04

Because we talked about beforehand sort of what we wanted the outcome of this episode. I really wanted to draw attention to that timeline and to some of these moving pieces, because there is so much nuance to Kelsey's story and to everyone's story. But there's also some big pieces and some governing bodies that I think I've never heard a CAA discuss before, especially in this way, like when it comes to our license, especially if you're disputing some sort of claims made against you or you have like an outpractice claim or some of these really hard to talk about topics, because if we don't ever hear someone who sounds like us and is in our situation talk about it, it's really hard to know what to do, which I don't want to put words into your mouth, but it feels like that you, unfortunately you said it you're the tester. You're almost like the test subject, not that this is the first person that's ever happened to, but it's the first person you knew about, because we're not talking about this and that's what Kelsey and I really wanted to do in this episode. So I just wanted to draw a little bit of attention.

Mary Jeanne: 39:07

Kelsey had said that she went up to Chicago to get an assessment and oftentimes that assessment can come in if there's an infraction from a hospital. If there's some sort of legal issue, like a DUI, that your hospital or your private anesthesia group or whoever finds out about, like the, your licensing body, you can, as part of the process of like, okay, what do we do, what's the treatment, and also to show that there's progress being made, because we are such in a profession that you need to be your healthiest to be delivering anesthesia. They'll say, you know, go get this assessment and the assessment's going to tell all of us okay, the best thing for you is to go to inpatient recovery or outpatient recovery, or you don't need recovery or there is a problem, and kind of gets just some language and some like validity behind the situation. That was the first thing I wanted to just point out. And then Kelsey is also talking about here several layers of people who need to know that that Kelsey was in recovery and that Kelsey had DUIs.

Mary Jeanne: 40:08

And one of the people she mentioned are the healing arts, which is referring to the Missouri Board of Healing Arts, which is in Missouri, kelsey said, the particular governing body, a state institution that grants CAAs the licensure in Missouri. It's not called that in every state, which is how you know, the language can be sometimes confusing. And that's the governing body that Kelsey was saying she, her license came due in the state of Missouri in 2021. And that on that questionnaire where they say have you had any? What's the language? Like a felonies or it says one of them specifically states a substance abuse. Okay.

Mary Jeanne: 40:52

Yeah, okay, and that's where you stated yes.

Mary Jeanne: 40:57

And then I assume they asked for a whole bunch more details. And then they take the Missouri Board of Healing Arts takes all of this in consideration to grant the CAA, CAA their license for that two year period. That's how it runs in Missouri. Very similar situation in every other state. It just might not be called the Missouri Board of Healing Arts, but it's usually whoever gives the licensure to the physicians that governing agency is who gives it to CAAs. And I will say, like on that one, when I did that in 2021, like I said then, at that point I had, you know, almost two years, year and a half, two years of four times a day alcohol tests Actually another topic we'll get on at some point there was a time period I had an alcohol monitoring bracelet on. I sent all that with. So it was like sending in that packet with my licensure stuff and I actually was immediately granted that the hearing was not from that. Thank you, yeah, okay, everyone has told me, like you absolutely would have had a hearing probably if I didn't have that stuff, but it's kind of like making those changes is what kept my license, I think.

Mary Jeanne: 42:18

Tell me the other question in my head was how did you know where to get a breathalyzer? Was that some of that physician colleagues that you were calling in for resources and like asking questions where they saying, hey, this thing you could do is get a breathalyzer, this thing you could do is get an alcohol monitoring? How did you know what to do? That would be called desperation and Google. That's all it was. It was trial and error and I ended up very fortunate with the choices I made. Again, I'm happy to give some of this information or talk to anyone about it. It literally was just desperation. In Google, I was determined that I was gonna get my son back immediately from this and it was driven by that motherhood thing first, and then yeah, and then keeping. I mean, now we haven't even gotten to either. Now I'm too Fresh.

Mary Jeanne: 43:17

Duis and no job yeah, let's get into that, because it this is a two-year almost period, or you know year and some change between the DUIs and the Missouri Board of Healing Arts in 2021, which I'm assuming was like kind of a big relief that they granted your licensure. And then there was, of course, some follow-up issue with them with what's the term? The, the infraction, anonymous complaint. Yeah, yeah, the anonymous complaint, yes, which is kind of a whole separate thing, so we can kind of leave that lie, although I'm sure it obviously was not just some little thing for you.

Mary Jeanne: 43:48

But in that period, how are you working? How did you get a job? Were you nervous about that? How to talk to me about that, because that seems very overwhelming. Yeah, it was more than overwhelming.

Mary Jeanne: 44:01

It, like I said, everything was imploding at the same moment and it was just. It is exactly I it's. This is gonna sound so cliche, but it literally was like one foot in front of the other and like that's all I could do was like just make one choice. And then, because if I thought about everything, it was exhausting, every it was exhausting.

Mary Jeanne: 44:24

But I Remembered that my current job remembered from school I had rotated there in school that they had transition Oles and they had Temporary and they had Pira and like just large company that has a wide variety of Shifts, and I knew I was gonna have a lot of things coming up. There was gonna be court dates and the war states and Things that I had to do. So I called the doctor that I knew, that worked there and that Did a lot of the recruiting and stuff. He was involved in it and laid it all out there. I just said it. I said everything because that's what the few docs I had talked to about where to go next had told me. Like Honestly, if you get caught in any lies in any of this, you're now, you're done. But so just honestly, like, even on all those, every hospital form, I still have to read them very specifically Because some say, like in the last five years, or some say you know felonies, none of mine were felonies.

Mary Jeanne: 45:34

You just have to like you need to pay attention. And I called him, I laid it all out there, everything I said, the situation surrounding what happened, said you know why I was jobless, like I hadn't gotten fired or anything. And they were like absolutely come on out. Obviously I had interviewing and we still did all the things. They several remembered me as soon, not all them, they have a lot of students but coupled in and I started working there because my license was still good with Missouri. But I didn't even know Until it was about three months, might have been six months. Three to six months after I was working there I got a letter in my mailbox. I was like, hey, your temporary privileges have been granted to full hmm, I.

Mary Jeanne: 46:27

Don't know if it was because the DUIs, because I'm sure, like the transitions, I'm sure everyone, with how fast they do credentialing, has some temporary time period. But I just remember getting that letter and being like I didn't even think about that's, probably like they had been watching, yeah, which rightfully so. But I Just I was up front and honest and I worked hard and just did the things I was supposed to do. And then now my little Temporary job. I just took it just to get through like, oh, I'll just get through a little bit of coordinates and stuff. I've been there five years now and yeah of it, yeah, there was some something there that made them say yes, I Assume you know some sort of resonance there.

Mary Jeanne: 47:14

I also think you were a kick-ass student, so that helps and having good relationships with people while you're in school. You never know where those relationships are gonna then step in and be your bridge to safety, especially when you're at one of the lowest points of your life, and so I just think a lot of lessons to learn there and Also interesting, that is still the place that feels like where you're supposed to be. I'm I'm curious how life settled down or when you're at now with your health and your well-being, and like that relationship with being a CAA, like where Do you feel like the last five years have taken you, that I Like to say like, oh, I would do it all over again to get to the same spot. Um, I'm not sure about that. I was not, uh, no, but it was a lot of things that needed to happen and I know that sounds so weird, but like I Wouldn't have left my marriage if it wasn't I had forced Um, and that needed to happen and I needed to talk to someone a lot about a lot of things. I think everyone should talk to a counselor, but I needed, like more, and this gave me that intense. You know, I was in the outpatient so three times a week for three hours and then also seeing a Psychologist and like there was a lot of talking and my family didn't grow up talking, like my parents were very loving I'm not saying that but like you didn't talk about feelings.

Mary Jeanne: 48:53

So just some of that, just it needed to happen and I think it's made me into the mom I am today and the you know, employee I am today, because I just think more that needs to happen, a lot more talking, mmm, and I'm just thinking also like the CAA profession was like Part of the problem. You know, like it added to the stress and to the to the drama in terms of like the jobs and being stressed about the job, but it was also the thing that, like where else can you work PRN here and there around court dates and things and make enough money to still live? You know, nehmeen, like I just think the CAA profession we just have a gift in front of us with it, and I just think that more of this type of conversation and more communication about the hard parts Allow all of the good parts of it to really thrive for us and be used by us. And I just wonder what you would say about, like, how the CAA profession could improve or what's, what's the takeaway, what's something we work towards as a profession after this experience, I could go on about that for a long time, especially, though, um, I have told I mean probably not the entire company, but several people where I work now Like I would not have a job if it was not for this company.

Mary Jeanne: 50:18

So at the time, there was only about four people. There had to be a couple, because I actually At one point like had to leave work sometimes during the day, and so a couple of the board right now. I had to know why I'm leaving work.

Mary Jeanne: 50:33

Mm-hmm, like to do some of the things that were required of you during this process, you had to kind of be able to have supreme flexibility. Yeah, yeah and.

Mary Jeanne: 50:44

You know, not talking down at all about where we were working together, but there was what nine of us there a day, like there's not extra people and I'm not saying our company always has extra people right now, like this was an extreme circumstance, obviously, so you can't do this for 110 people. But I do think more of a conversation needs to be had about Because I looked at a ton of jobs and, let's be honest, I think a lot of us look all the time. I look just to see what there is. I'm not, let's just say well informed.

Mary Jeanne: 51:20

Yeah, I, there's not another job I could have taken, even like Other PRN ones. They'd be like, yeah sure, give us your Schedule three months in advance. I can barely tell you next week, not now. Now I can, but, but then I was like I can barely tell you what's happening next week, like I can't tell you three months in advance.

Mary Jeanne: 51:43

They were supremely Forgiving and kind and but in this, like I don't want to make this sound either I mean I know they were watching me, I know you know there was safeguards in place. There was. It can be an and both. You don't just because you're kind and trusting and forgiving doesn't mean you also don't have high standards and your whole. You're watching and your care. You know what I mean. Like I just think that that that Separation doesn't have to be there, yeah, and I just think more needs to be talked about. But how we can find supporting mental health and what's going on in people's lives while Making healthcare still function, yeah, yeah, because I mean that was one thing like I was talking about where you know our profession doesn't really allow for things to coexist as like.

Mary Jeanne: 52:39

This is my job and the rest of life is over here, so there would be time for me to go back and talk about my health. So there would be times I'm like Falling apart, dying inside, probably crying in the bathroom, and then coming out and like smiling and talking to patients, taking care of them, and I think that's a lot of what doesn't work in healthcare. Yes, is I. I think that's where people start feeling alone, that's where people start having troubles after work. That's where and I think that's where it starts.

Mary Jeanne: 53:09

Hmm it's, then we have to figure out, like, how you can separate it and function at work, but also how you get help you need before you're here. And when do you think that bridge is? Is there any insight? I have my own ideas about that bridge, but Anything that you feel like if we just had this or if it was just this way, because one of the Privileges I think about being a CAA and one of our strengths, which many see as a weakness, but I'm like there's only 3500 of us. We could almost, when you go to the quad a, you're you're talking to almost a Quarter of all CAA's ever and so we can make change. You know, we could say this is what it feels like and looks like and this is how CAA's communicate, and you could get that message out far easier than for CERNAs or docs or, you know, nurses. Any insights I'm looking for? I just I would love a magic pill answer or a conversation about it. I know, I Know. That's why now I'm like man. I mean, I think our company does a really great job. They have a whole wellness board. They send out that. You know, they send out that stuff. That's just.

Mary Jeanne: 54:19

That's gonna be a really hard question because overall I think it's just my thing, I think is healthcare in general and just the mental health crisis in general. I think that has to get destigmatized. But then, especially in our profession, like I don't know if I would have gone and said like I'm starting to have a drinking problem, would there have been like repercussions, what they have started watching me at work. Would they start out where, like, like I said I never drink at work, I never. But Would they be supportive if you came and said I think I'm starting to have a problem? Yeah, yeah, I don't know you. So you so tapped on where I feel like we could Improve, which is we could, just we could say we could do the really hard work and say what it means to be a CAA is that you can always go to the other CAA's and say I feel like I'm having a problem with alcohol, like something's wrong, I'm overwhelmed. You know you could have those conversations because our profession Encourages that on all the levels. When you're a student, the you know the quad a, does the program directors Like I think that is the opportunity for change. And then you also said something about Communication and feeling like you have a community. I just feel like we could really lean into our small size as a way to like. Let's bring us all in, let's get it real tight up in here. You know what I mean? Yeah, because health care is broken. I mean there's no way around it. Everyone understands the health care system is broken and being a CAA inside a broken system Will only make your health worse unless you are your best, healthiest, most resource, more, most supported. And I do think that's our professions and that's one of the things we could do is we could say that's what our profession, you know, holds as a value.

Mary Jeanne: 56:10

Well, and I even wanted to expand it out we keep talking about alcohol, obviously, because that's what I was dealing with, but you know, we have those lectures in school and stories keep coming up about. There is the you know, narcotic abuse, absolutely, and that's what we're around all the time. And I think, same thing like how, how do we stop it before you're at the point of getting to you eyes or Getting caught stealing from work, like how do you stop it at the beginning? And I think that's gonna be an ongoing conversation. But, like you said, I Do think we have an awesome opportunity to just support each other, and I think that's the big part is supporting each other and kind of coming in and like finding out the real of how do we help you, yeah, and investing our time and energy at that spot, knowing there's this whole anecdote, I like, about upstream problems versus downstream problems, and like putting your effort into the upstream solutions and so you're putting your effort into what feels like soft skills, communication and empathy and connection. But really, if you're strong there, then the downstream problems become minimized or you reach out for help earlier, and so I mean there's just so many more things to say, but I just what you're doing today with me is the answer.

Mary Jeanne: 57:35

This is the answer, I think, and I just I just am incredibly grateful for your bravery and you reached out to me and I think also I didn't ask you this, but you had kind of said that like no one really knew that you were going through all of this and I was really close to you and I didn't know. I knew life was hard. I knew life was hard, but I did not know the depths of this, and there's something to be improved there as well, on my own relationships with people and just, of course, then it gets bigger and bigger. The eccentric circles get bigger and bigger. That we could improve. Yeah, I'm just really grateful for you, kelsey, and I just I'm just in awe of you and I'm so proud to be getting this story and being able to send it out to our community.

Mary Jeanne: 58:22

Is there anything else that we didn't touch on, any parting words that you feel like you want to have left said here? I guess this has been it was trusting me out a lot, not. I, like I said, I'm very, very open and I'm happy to talk to anyone, and I really do hope that anyone that sees this like happy to talk to you about anything, whether you want to hear more of my story, whether you need help, whether you need to talk about something else, perfectly fine, I'm happy to, and that's why I wanted to do this, because it's not only helping me just kind of move on and keep growing past this. But I want other people to know like you've got choices. It can go really bad. I'm not saying it can't, it can. But you can keep your job, turn it around, you can be happy in your profession, happy in your life, and get past these hard parts that go on. Yes, and normalizing the hard that's going to happen. Yeah.

Mary Jeanne: 59:25

How could people get in contact with you? If they do want to follow up with you Email phone any way they want, maybe we don't give your phone number out to the internet?

Mary Jeanne: 59:37

Maybe, not by phone. You're welcome to put my email at the bottom or, if you want to say it either way, which I'm fine with that, are you on social media much? I feel like we communicate occasionally over there. Yeah, no, I'm on Instagram. Facebook, I'm on everything. Okay, would that be okay if people kind of reach out there? Okay, absolutely, of course. Good, I'll put that all in the show notes, all right, kelsey? Well, what are you doing the rest of your day? I'm getting ready to. I am a big stickler about I make Paxton's cake every year. This year, I finally chose sleep over baking all night, so I bought the cake. Yes, I'm decorating it.

Mary Jeanne: 1:00:15

So I'm going to go decorate the cake. Good, awesome. Well, that sounds like a wonderful thing to do after this really hard thing. That you did is celebrate. You celebrate him and kind of the life that you're enjoying now. So I really appreciate you, kelsey, and we'll talk soon. Thank you so much for listening to this episode.

Mary Jeanne: 1:00:38

If this is the first time you're hearing of a CAA discuss their struggle with substance use disorder, you are likely not alone. I don't think it's a topic we talk about much, but it is a topic that CAAs struggle with. The disease of substance use disorder is rampant in the anesthesia profession, which includes CAAs, but it's been more highly documented in our CRNA colleagues and our anesthesiologist colleagues. So not hearing about it can sometimes feel like this isn't happening to us, but after hearing Kelsey's story and possibly other stories that you've heard just kind of through the grapevine or through people at work, you know that Kelsey is not alone in her struggle and Kelsey's bravery in sharing her story, I hope, reminds us all that there's so much value in connection and sharing ourselves and reaching out when you feel like you want to crawl inside yourself, and I'm just so grateful again to Kelsey If you would like to follow up with her and connect with her. She's allowed me to share her email, which is kelseyjanceyahoocom, and I talked to Kelsey some on Instagram so she said she's pretty active there. Her handle is at K-E-L-S-E-Y-J-O-333. And, of course, kelsey Jance at yahoocom and Kelsey Joe 333. That contact information is going to be in the show notes.

Mary Jeanne: 1:02:14

Like Kelsey so eloquently said, she's wondering how we help each other, how we help ourselves in substance use disorder and navigating a stressful career like being a CAA, like giving anesthesia, and how we intertwine our personal and professional lives. I'm wondering the same thing and, if you like, kelsey and I are wondering where do we go from here, I would love to connect with you. This is certainly something I am passionate about and so if you are a CAA or AA student, or even a prospective AA who knows you're going to get into AA school and you want to be really boots on the ground of this movement that I'm trying to start within our profession, you can contact me at awakenedanesthetistcom. Another great resource, to say, connected to myself and anything that may be going on in this wellness, well-being, preventative, mental health arena is by getting on my email list, which is also a link that you can find in the show notes. And I've also started a new connections group. It's called Making Connections. We meet once monthly on Zoom for an hour and it's my first attempt at creating an opportunity for CAAs to get together outside of work, outside of school, outside of the Quad A just a place where CAAs can feel safe, in community with each other, talking about some deeper topics, really meeting each other where we are. And it's called Making Connections because I'm wanting us to create a deeper connection with ourselves and with each other. So I invite you to that monthly group and you can find more information once you sign up for my email newsletter and tell me that you're interested in making connections.

Mary Jeanne: 1:04:05

If you loved this episode and feel like it's important to share, like I feel like it's important to share, I would be really grateful if you would just send this off to another AA student or fellow CAA in your life. Tell them why the story impacted you, tell them why you like this podcast and have them listen to this episode. And that's really how our community is going to spread in the way we want it to spread, which is keeping CAAs in this community connected and growing together. That happens so much easier when it's a direct conversation from CAA to CAA. So I really appreciate your help in supporting the podcast and the message and mission of this podcast. I think that's it for me If you are going to the Quad A, so if you're listening in real time, I will see you April 12th and I'm excited to share more on this topic.

Mary Jeanne: 1:04:59

It was all just happenstance that this topic was what we discussed in my March Process episode. You may have picked up that Kelsey reached out to me and the timing was really perfect because I will be speaking on substance use disorder and looking to solve those upstream problems within our CAA profession at the Quad A and it's really a workshop and a brainstorm and us talking and listening deeply to each other. So we're going to be practicing all those wonderful things with each other and trying to move forward, because it's an opportunity that can't be passed up, having so many CAAs and students in the room together. So I hope to see you at the Quad A 2024. If you're listening in real time and if this is sometime in the future, I hope you share this episode with another CAA in your life. Alright, let's talk soon, y'all.