One Small Step. The Body Remembers. The Soul Decides. with Dr. Mike Meaney

I welcome my childhood friend Dr. Mike Meaney back on the show where we discuss how pain changes how a life moves. It sharpens every edge, tests every bond, and forces you to decide what you believe when there are no easy choices left. That’s where our conversation begins: a candid account of failed orthopedic surgeries, a system that too often rewards the cut over the cure, and the daily reality of living inside a body that won’t stop hurting. We examine how fee-for-service medicine, device royalties, and surgical center ownership can bend decisions, why second and third opinions matter, and what patients can do to avoid becoming a statistic in a volume-driven industry.

From there, we turn toward the inner struggle—resentment, justice, and the long road to healing. We talk openly about opioids as a seductive solution to the human problem of physical pain, and the devastation they leave behind. We sit with the hardest question: when harm is done under anesthesia, what does forgiveness mean? Faith enters not as a slogan but as a practice. We return to the simple Catholic teachings we learned as kids—tell the truth, avoid violence, treat others as you wish to be treated, care for the marginal—and measure them against adult complexity. We explore the mystical claims of Christianity with clear eyes, and why daily sobriety can feel like proof enough for belief.

Then we build forward. Our guest shares One Small Step, a platform delivering certified peer support on nights and weekends for people on Medicaid—exactly when the rest of the system is closed or the ER is the only option. We walk through how human-in-the-loop AI can safely triage, detect pre-crisis signals, and route people to real peers with lived experience, reducing avoidable ER visits and giving support that actually meets people where they are. It’s a practical blueprint for reform: dignified care, data-informed decisions, and a focus on outcomes that matter.

If this conversation resonates—about pain, faith, accountability, or access to real help—share it with someone who needs it. And if you appreciate these deep, unfiltered talks, tap follow, leave a quick review, and tell us: where do you draw the line between justice and mercy?

To learn more about One Small Step head over to https://onesmallstep.io/

Transcript

New Venture And Episode Overview

Host’s Surgery Journey And Orthopedics’ Incentives

SPEAKER_00 0:25

What is up, y'all? Welcome back. I have a very special guest rejoining me for his second time on the show, Dr. Michael Meany. Mike and I grew up together down in Tucson, Arizona. We went to Catholic school together. We played a ton of different sports. We were both freshman athletes at the same high school. Um, went to the same high school until I transferred uh my junior year to a different one. Um we had a great conversation the last time he came on and then we we discussed how long ago that was. Man, time flies. It's it was 2021 when that episode launched, and now Mike is down a completely different venture um working in sort of a startup capacity, starting his own company in the mental health sort of um uh online healthcare industry, and we we talk about it in the show. But anytime I I have time with Mike, he's always just uh very well spoken, um holds a lot of balance for different topics, and this show is is nothing short of that. We talk about so many things from uh my chronic pain going through all these surgeries, orthopedic surgery industry, um, him going through recovery again and then starting this company um that he's putting all of his time and effort into now. We talk about um the healthcare industry at large, uh the Luigi Mangioni case and him murdering the uh United Healthcare executive, um and just uh living life as a good person, but moral morally and ethically. We a lot of different things. We get into spirituality, we get into Catholicism, into speaking about Jesus, speaking about God. Um so yeah, I mean hold your horse for this one. It's it's almost a couple hours a couple hours long, excuse me. Uh I hope you can listen to it in sections. I hope you listen to it all. Um honestly, there's some really good parts of the conversation on various uh stages of the podcast. So um stick with me, stick with us and and listen to the whole thing. Um and then as always, you know, please leave the show a five-star written review. We're back, we're recording again, we're here. It really does help get the podcast in front of more eyes and ears around the world. I think I checked last episode and again we haven't launched one since August. And I recorded one after the Super Bowl talking about sort of the bad bunny drama. And I'm gonna launch that um the day after this one, even though it was supposed to be last week. I just got a little lazy. Sorry guys. Um, I've been struggling with the with the arm and with pain, and I had just a lot of other stuff going on. Um but rest assured, I'm gonna launch that one out because I think that was an important little solo episode I recorded. Um but yeah, please please consider leaving the show a five-star written review on Apple and Spotify. Uh, it's a free, easy way you can give back. Please consider sharing this episode. If a part of it resonates with you, um send it to a friend, send it to a family member, you know, send it to someone else who might benefit from it. Um yeah, if you have any feedback, you can always email me at coaching at nicobarassa.com. Um, I am still working with people in a one-on-one capacity, although very limited these days. Um so if you are interested in working with me, I usually do uh late afternoons um on the weekdays if I can fit you in or the weekends. But you can always go to www.nicobarassa.com to find out more. And my last name is Bia Zembravo, A-R-R-A-Z-A, for those that can't understand it because I'm rolling my arse. Um yeah, hopefully you guys enjoy this show. A huge thank you again to Mike. Um, brother, I appreciate your conversations with you all the time. Uh it's great to share space with you. I'm so proud of what you're doing. Always proud of the young men and women I grew up with, um, who I've called friends and family, that they're doing good things, making a difference in the world, making beautiful families, and living happy, joyous lives while helping others. So thank you, brother, for coming on the show again. And I hope you all enjoy. Uh I don't know.

SPEAKER_02 4:13

Anyway, it's uh it's wild, man. It was a long time ago. Jeez, dude. Yeah.

SPEAKER_00 4:20

That's uh what's going on in there, man.

SPEAKER_02 4:22

So you're back in flag or are you in SD?

Ethical Gray Areas And Chronic Pain Fallout

SPEAKER_00 4:26

Yeah, we can um we'll we'll just start, we'll just start from here, dude. Well, we can catch up on the show because I think it'd be good for it anyways. But um I I'm back in Flagstaff, yeah. And uh yeah, dude, it's been a whirlwind. I mean, I've been like my health with all the surgeries, my last surgery in Vale, Colorado. I was really keep my fingers crossed. Whoops, sorry, I just popped up. Listen to podcasts. Um I uh I was really hopeful that it would be, you know, the thing that was gonna solve it. This guy is, you know, nationally reclaimed surgeon. And what I've come to find out now is that the orthopedic industry just has a ton of like very intrinsic problems within it. Um, particularly how surgeons make money and how they're incentivized to operate more, um, and how they're really incentivized to kind of convince you that you know, whatever they're gonna do is gonna help out. Um, so you know, I went in anesthesia. I wrote we had a lot of conversations. I flew out to Vale three times before my surgery, uh, very methodical, very scientific about how I was communicating with the gentleman. Told him, you know, I I didn't want any of my native anatomy cut unless it was gonna be absolutely necessary from his point of view. I didn't my shorthead of my biceps was tenid in my second surgery because my core cord is fractured, and I told him I did not want my long head mess with it all. It was totally healthy. Woke up from anesthesia, he cut my long head, reattached that, drilled a hole in my arm, reattached uh the tendon to that. Um he didn't uh take out any of the stuff that was put into the first surgery, which is what I've kind of been asking this whole time. And then uh I had a a chondral defect in my humeral head from all like the just biomechanics being off that it basically a two-centimeter chunk of my humeral head had popped out or just dislodged. So he cleaned that up, which is what's called a microfracture technique. It's pretty old and archaic. Um, there's a couple newer ones he chose to do that one. So, you know, I try to be positive, went to rehab again. This is my fifth time. I think I've spent like almost two and a half years total rehabbing surgeries now in the past six years of my life, which is crazy. It's just like key key parts of your life, right? In your early 30s. And um, you know, to to not my surprise, my arm was worse. Like my my biceps are way weaker, my stability is way weaker. Now I have a biceps issue, not just a shoulder issue and a neck issue. Um, and then so I went back to the guy, you know, complained to him. He's like, oh, well, I'll I'll punch you off to this guy in Boston at Mass General, um, who I just went to go see in December, who has his own ideas, you know. But to make a long story short, you know, I basically started to write a book on the experience where I've interviewed a lot of people who have had failed orthopedic surgeries, and not not to like I don't have anything against the necessity for orthos. The issue is that uh it's one, if not the highest growing conglomerate within healthcare now, and it it's sort of become something that it's not supposed to be. It's like it's like the pharma industry, it's really just there to make money now. And so you have a lot of physicians sort of saying, well, you know surgery could make this better. And and at the end of the day, like a lot of times it won't. And a lot of times we should just leave the body alone and suggest PT. And some surgeons still do that, but unfortunately, you know, we have this system now where surgeons are basically they have a stake in the surgery center, they have a stake in the practice, and they have their own paycheck, and so they're getting paid three times. They're also getting royalties from different medical implant companies and medical device companies, which I personally think should be illegal. I don't think we should incentivize surgery at all, right? You're already going to make more money in the OR. It's like$400 a freaking minute or something in the OR for most ORs, right? Um, but I think if we look at what a physician's job is and when they say the when they take the Hippocratic Oath and all these sort of ethical things and moral things, there's just a lot of gray area within the orthopedic industry. And what happens is if someone is left in chronic pain, um, the surgeon will usually just pump them off to another surgeon, and then once it's not their patient anymore, they're sort of legally not liable anymore, right? Someone else gets to deal with the problem. And I also have a problem with that. I have a problem with the how the legal system sort of addresses orthopedic surgeries too, because the issue is if you kill someone in surgery, something's gonna happen to you. But in orthopedic surgery, you could put someone in chronic pain for the rest of their life and you're essentially untouchable, right? And I understand the reasoning behind that because people could lie and say, Oh, I'm in pain, try to sue someone for millions of dollars. But uh the antithesis is true too, is that someone can be left in a body that feels like a jail cell and suffer for the rest of their life, and the person that is responsible for it is never held accountable. And I relate it to this way, right? Uh I'm training to be a pilot now. I'm like any commercial pilot when they take off, if the plane lands and they land funky and someone like hurts their leg, that they're probably never gonna fly again, to be honest. Like, like the the requirements for being a pilot is incredibly like up there because you're dealing with people's lives. I don't understand how we can make any more excuses for people in surgery. Like surgery is really stressful, it's very hard, you have to be very good at it, but you're getting paid a lot of money, right? It's like don't play in the NBA if you can't shoot the shot, you know? And so I hear surgeons saying, like, well, then there's a lot, there's all this malpractice and a lot of stress. I'm like, I get all that, guys. Don't do the job then, right? Someone else will step up, right? At the end of the day, a lot of people do it for money or for status. And I understand that, right? It's like being a lawyer in our society. And I'm not to say that like there aren't plenty of surgeons that do it for the right reasons. I just think the industry's built to kind of like uh corrupt them in a way after a certain amount of years. You know, you got to pay off these incredible loans, right? All these other things, and you become this get in this community. And one of the things I also notice is that when surgeons look at my shoulder and they see that something has been done wrong by other surgeons and they acknowledge it in clinic, they definitely won't go and testify. They definitely won't talk to a lawyer about it because it's also like this unspoken fraternity where like if someone were to speak up about someone else's decision making or someone else's uh practice, um, you know, they they sort of will be looked upon in the industry to be this person that's not trustworthy. Right. So then there's just a lot of facets of this. And you know, as I've experienced it, it's just been it's been interesting. Yeah. So I mean, again, like I don't this this show's not gonna be about my my experience about this, but uh, I feel like a lot of times it's interwe woven in my interviews now because it's just such a huge part of my life, dude. You know, like I wake up every day, I'm in pain, I can't do half the things I used to be able to do. You know, I still have a functional body, but for all intents and purposes, like my arm is severely different and changed, you know? And it really shouldn't be, you know, because it was okay before my first surgery, and now I've had five, spent thousands, hundreds of thousands of dollars, tons of time. It's put my ability to get in a relationship back, it's put my ability to have children back because I've been so focused on this, and now I'm having to sort of being 36 catch up on those years, you know, and really rectify and come to peace with like what what's wrong with me, you know? Um which is interesting. It's an interesting thing.

Mental Health Lens On Trauma And Recovery

SPEAKER_03 11:16

Yeah, no, dude. Well, thanks for sharing all that. And um, you know, like we've messaged about, I just like it's a really, really difficult thing to experience and like it's a trauma, like it's a deep trauma, I think. Um, and like I I think and I hope you're um you know pursuing healing through the lens of like an intense traumatic event that's sort of been sustained and long term. Um and I think everything that you're saying like resonates with me in terms of you know, having navigated the healthcare world most of my life, now actually building a company in the healthcare world, uh, we we have not we have not figured out the right incentives to make this an optimal system. And I think that um it's really hard to identify where the fall point is because as you noted, there are these multiple stakeholders that are all uh variously incentivized to make money and protect themselves and try to help others, but through this kind of convoluted system that the legal and medical and hospital and financial industries have foisted upon our healthcare system. Um and and and the result of that is um, on the one hand, you know, we we're the envy of the world in in terms of our healthcare, in terms of the quality, the outcomes that we drive. Um, but in other ways, we are you know the laughing stock of the uh developed world in in terms of how patients are less protected than a lot of the other um stakeholders. And so I um I don't know a ton about what you're experiencing and what you have been through. And like I guess through my own lens as your friend and as someone who now runs a mental health company, like I think there's a lot of ways that I would think about it and approach it because ultimately, you know, this is a a trauma that you've experienced and it's shitty and the outcomes are unclear, and it's already robbed you of so much freedom. And I think like it's really challenging, but I think the challenge is like how do you constructively move forward, maximizing your freedom and your health, and not letting this be a blocker to your flourishing as much as you can, you know.

SPEAKER_00 13:55

Yeah, I mean, that's pretty much my focus every day, you know. And I relate it this way because I appreciate you bringing up it is a mental struggle. The thing is, is like when people like I never knew really what deep chronic pain was. You know, I was like, oh, you can just sort of ice bath your way out of it, right? You can just therapy, you can do CBT, all these things. And those things help for sure, I'll be honest. Um, and even as somebody's practiced counseling for for so long, I do understand how that implicates chronic pain. The issue though is if you go out and you stub your toe or you just drive a nail through your hand, your brain's like perception of that pain in that instantaneous moment is like survival, right? And that's what it's supposed to do. And the issue is like with my arm, even when like I take sheets off my bed, when I put my pants on, when I put a shirt off, I get like severe, sharp pain in so many different areas, right? And so the thing is, is like I trust me, I'm optimized as much as I can. I'm always open to new things and I'm always, you know, trying to do like all these different things, right? Whether it's energetic or spiritual, whatever. But the thing that I think a lot of folks can't understand until you're in that much pain or until you experience that, it's like it's like acute pain that's chronic. It's like it's just debilitating. It just it's yeah, it's debilitating. And and that's why when I look at people and like I can see it now. I didn't I couldn't I couldn't see it before this happened. Like I can see people who are suffering on a way where like the they can't escape. The only escape is like to end life, right? Which is unfortunately what a lot of people choose. And I hope people don't choose that, but I also now have this weird, like uh deep empathy for folks that choose that in a state of chronic pain because I know what it's like to feel so trapped in your body that you're just like, you know, especially when like it's done to you by someone that's supposed to help, right? I think it could it would be a little bit more palatable to me if I was in an accident or if something happened, you know, and I'm like, like it's just you know, but the fact that like this all this happened from surgeries is what sort of it's what's sort of the thing that's really hard to um like just get on a level of like grieving where it's where it's just kind of passive and not active, you know, to talk about the mental health part because yeah, there's always sort of this yeah, this like resentment there that's like yo, these guys made tons of money off of this, right? You know, were not accountable, punted me off, you know, made excuses. And I'm I'm not gonna get in the details, but it's it's just like egregious, like how I was treated. And and and it's like it's not one person, it's a theme in the industry. Right. And that's why I was like, sort of my the way to harness that energy for me now, besides like just trying to live my life, is like to write a book, not to like you know, demonize the industry, but to shed light to the public of other people that hasn't experienced. So if you have a kid that's 10 or 14 and they're about to get surgery, like read this and just take some time to think about it, you know, take some time to consider who your surgeon is, if surgery is necessary, get multiple opinions, don't just go with the local person, you know, like these things, right? Um that's kind of how I'm I'm reshaping that energy. And um, you know, to be honest, like what you said, it's like, and I appreciate what you said is you know, I've lost just some some life in there, and now being 36 and being solo still, I'm like, I want to have a family, I want to have a partner, you know, and though those things I'd put on the back burner for six years because I've just I was just stuck. I was like, I'm waiting another year, I'll get better, I'll get back on the horse, and then boom. And then it never happened, you know?

Opioids, Pain, And The Limits Of Resentment

SPEAKER_03 17:23

And so yeah, no, well, so let me just ask, because I think um like I think this is a really pertinent and like poignant theme for both of our lives in in different ways. And so if it's helpful, I think we can unpack this area a little bit. Um let me know. Uh so I'm happy to share a number of different thoughts. Um, I think there's like these things are like really the hardest thing about these things is that when I encounter them in like my own life, um, versions of them, right? Like actually nothing that is really analogous to this, because this is a long-term sustained pain that is financially implicated you on and and all sorts of things. But it's so hard to keep the variables straight in our head, right? Like of where certain blame should be allocated for certain outcomes and where and and and and so what happens to me is that I end up sort of conflating all of it. And a healing process for me is actually just doing the work of trying to untangle all of those things because you you you know, at each instance there are actors and incentives, and everyone's typically acting based on those incentives, right? But then the emergent outcome is this like horrific, shitty set of experiences that you've had. Um, and and and and it's hard to sort of disentangle and and like make sense of all of the causal factors in that. And and so I think like one thing I'm always inclined to do during these conversations is like, how can we bucket certain things, right? There's like the tactical things you can actually do, right? Like writing a book and you know, speaking with lawyers and and sort of and then there's like the practical things that you have to do for your health, and then there's kind of like the long-term spiritual journey that this all has an impact on, right? And like I actually think those two things are separate, and like conflating them can actually rob rob clarity from each bucket. Um for sure. And so I think there's like there's that's my like initial reflection, but then there's two more, and like, yeah, like let me know which which direction you want me to go. So on the one hand, as a recovering alcoholic and drug addict, um, and in the mental health space and substance abuse space myself now, the opioid um crisis is is is is really prominently in my face all the time now, right? Yep. And on the one hand, it's tragic, and we know that there was explicit bad actors that were sort of incentivized to just make money regardless of the impact on people. But on the other hand, to your point, is that why this was such a profound discovery early on is that the problem of pain is like the most core problem of human experience, right? Like the most common part of being a human is like suffering, and pain is at the root of suffering, and there was this drug that literally made pain go away, right? And this is like a yeah, excuse me, physical pain. Yeah, yeah, yeah.

SPEAKER_00 20:58

Yeah, I just want to be clear I just want to be clear with that because like there's emotional pain, there's other types of pain.

SPEAKER_03 21:02

It's a very good point.

SPEAKER_00 21:03

And those things don't really affect that. Yeah, yeah, yeah.

Accountability, Systemic Failure, And Justice

SPEAKER_03 21:06

Exactly. No, no, but but but I'm sorry, but yeah, absolutely. But like to your point that you are now in this chronic physical pain and it's like inexplicable to people who are not, right? Like people who are not in severe chronic pain don't know what that's like. Um, and that's why this drug was just such a remarkable discovery, because it took people that were in chronic long-term pain and it made it go away, uh, which is a remarkable thing, but then it created all this distortion around that thing, right? And and I'm seeing and I'm sort of like living the outcomes of that every day in the work I do, but also in like friends that I've lost um from overdoses, um, and and just sort of like the lives destroyed. So that's one thing also that we we could talk about. And then the third and last thing that I just want to Note because you know, for like a lot of different like reasons, like I I I heard you use the word resentment, and like I think that that is a really powerful emotion. And as we talked about last time, like for me to recover from being a drug act and alcoholic and you know, all this stuff, it was like even though I'm still those things, right? Like, like I cannot drink or use drugs safely at all, and haven't been able to my entire life. And by the grace of God, thankfully, I haven't in over 12 years. Um but like I am still like beset by this in this particular area of my life, this like very what some people could perceive to be an unfair set of circumstances, right? Because everyone can have a beer, a glass of wine with impunity. For me, every time I do that, I'm like risking the brink of death, right? And that's a very unusual like reaction, right? Um, and that's a mix of biology and you know, environment and sort of all of that stuff. But the only way through that was through confronting resentments and letting go of resentments, because I think resentment is the most toxic thing in life, and it just destroys people. And so I think, yeah, and and then also like um you know, I do think that you've said some heavy and deep stuff like uh around having sympathy for for folks that choose to like end things when they're in chronic pain. And and I just want to acknowledge that like yeah, like that's a heavy topic, and obviously, like you know, whether you in include this on the show or not, like I just want you to know that like I'm always here for you, and I've also and I'm sure that's in the especially now in the work that I do, there's a lot of self-harm, like motivation that we have to talk through in in the work that I do. Um and like I feel much closer to it, and I think way more people experience that ideation than we appreciate. Um, and there's a whole set of things to talk about there. So, anyways, I I appreciate your opening and like happy to go any direction.

Violence, Responsibility, And System Change

SPEAKER_00 24:23

So we're we're alive now, so don't like we're don't even yeah, we're we're we're on it. Um let's no, I appreciate all that, Mike. I think let's start at resent me because I think I want to provide just some perspective about I'm totally on board with everything you said about resentment. I I do believe it's a very toxic thing. I do think it exists for a reason. Um we can choose to do with what we will, and that usually shapes you know our present or our future. The difference with resentment in terms of physical chronic pain when someone has done something to you is that you're consistently reminded of it. So until you can get out of that pain, it it's uh it's so so, for instance, having an addiction. Right. If you become sober, there's a separation you can have. Now you still have the memories of the pain you put yourself through the decisions you made, but you're you're technically sober, so you can detach yourself from the resentment and it's no longer your worst to hold, right? Uh it still exists, right? The energy is not just doesn't leave, but it's gone. With pain, it's like I I wake up in pain every day because of what these surgeons did. And it's not a conflated thing, it's very matter of fact. It's decisions multiple men made and that they got paid to do that uh they did when I was in anesthesia when I was defenseless, you know. So I think uh the the the difference is now is that uh like I have to live in my body for the rest of my life. These gentlemen get to go home to their family, get to put food on their table, all these other things live in their bodies, right? Now I wish no ill will on them. What I do believe in is justice, right? And I do believe in um the system needs to change, not for my benefit because the damage has been done for the benefit of future people that exist, don't even might not even exist yet for my kids, for your kids, for anyone's kids, right? Um so I think the resentment that I have is is not so much like focused on an individual as it m uh as it is much an internal motivator to help leave something behind that might uh influence the system in some small way, you know, or influence the money flowing into the system in some small way. Because the the only way to change, as we've if we've really learned, is the system's not gonna change. It's that uh consumers have to be the the the spear. They have to choose not to get surgery, they have to choose not to go to surgeons, they have to choose to say, I'm not you're not, you're not the person that has my best interest, I'm gonna go to physical therapist, I'm gonna go to OT, I'm gonna do everything I can before I go to a surgeon because a surgeon's job, and I'm talking about orthopedics, just to be clear, not not cancer, not cardiovascular, a whole different ballgame. But orthopedics, you go to orthopedic surgeon, and that's what they're gonna want to do. They're gonna want to cut your body up and that's what they do. Surgeons surge. Um and you know, I think that that's really where my resent lies. And I wish I didn't have it. I mean, really, I wish it wasn't there. The issue is I I've gone into all these surgeries with the intent on leaving that behind me, right? Turning a chapter, right? I know I'll never be the same again, but I just want to be able to paint, I want to have a functional arm, I want to be able to do the things I want to do. And even sitting in this chair right now, it's severely uncomfortable for me. You know, that's just how bad it is. Um and it sucks. It's just it's terrible, dude. So I think that that that's the difference. Is that if if it was something I could attach myself for, like a breakup, right? Get my heart broken, or I lose a family member to death, or a dog dies, or something like that. Those are things where you can process that grief. I think it's very hard to process grieving chronic chronic pain when you don't have a method to soothe it. Right. And I refuse to take opioids for the very reason of that industry primarily made a lot of money because a lot of failed surgeries, you know, um, tons of failed surgeries of people were left in chronic pain and they became opioid addicts, um, you know, or they had some sort of disease that, you know, like fibromyalgia or you know, some sort of thing that was basically killing them from the inside and no one could treat it. So they you know became addicted. And obviously there's other people that got addicted to it for other reasons, but a lot of folks were suffering from the medical industry, one hurting them, causing pain, and then abandoning them, right? And then with no hope, with loss of relationships, it doesn't matter how much love you have in your life, if you're suffering and in pain all the time physically, it's really hard to even be able to absorb that love, you know, because your presence, if we talk about what is the essence of presence, it's the ability to be in your body, be in your soul, be in your psyche in one moment. And if someone is punching you in the side of the face, it's impossible to be present, right? You're in defensive mode. You're like, okay, if someone is like hits you with some sharp object, and that's how I try to explain to people that aren't in the physical pain like that badly, it like sucks out your ability to somewhat be fully present because your brain is always trying to like hush down this pain to try to like normalize it, right? Your nervous system is trying to like play these tricks to just make you be able to survive. That's what the brain's job is to do, it's to survive. Um, so that's that's really how I view resentment in that way. Now, I I've had resentment in so many other parts of my life, you know, and I've always been able to process it and forgive and stuff like that. In this particular area, it feels nearly impossible because the decisions that were made without my approval, but also like the end results, you know, it's that the fact that I'm I I literally have been like stripped of these things. And and I'm not even talking about my ability to be a pro athlete, it's like my ability to like sit at a coffee table and not like have to move my fidget my shoulder around because it never is in the right place and it's it's just sending pain signals to my brain, you know. And also the fact that whenever I've gotten back into these offices, not one of these surgeons has ever said, I'm I'm sorry, I shouldn't have done that, or I was just trying to help, or whatever. It's never been that kind of honesty because they know they incriminate themselves. So they'll just be like, Well, just I'll send you to the next guy, you know, hopefully he can help. And I just I feel like there's so there's something inhumane about that experience in America, right? Severely inhumane that you cut enough bodies open, like the soldier that goes to war, you keep you forget you're killing humans, you forget you're cutting humans, like they have to go home to a family, to things that love them, to stress, to all these other things. And it's just that there's there's something missing there within that part of the healthcare system. And and and you're right, it's very multifaceted, it has to do with the insurance companies, has to do with it goes all the way up to how political campaigns are funding all and you know, and you're a very intelligent human being. There's all these different nuances that contribute to this. But at the end of the day, we are participating in the system, right? And I think the book is really about we need to consider what we're participating in. I mean, is that you know, young gentleman who um, you know, killed that guy uh that was the United Healthcare CEO, right? I mean, I think not that I'm for that murder at all, but I think that that that was a message to a greater issue in our society that so many of us have been touched by, which is people getting denied life-saving healthcare in the US. You know, we talk about having the best technology. I we really don't in a lot of ways. There's a lot of places that have better tech than us that are more developed in many areas. Um, in some areas we do, right? But in a lot of areas we're lagging behind. And I wonder why, I've often wondered why, and really it's because it's making enough money, so there's no incentive to innovate. And that's another part of the book that I'm writing, is like the incentive to create new orthopedic surgeries is very small. A lot of the surgeries we all get right now are from the 1960s or 70s, and we wonder why it's a regulation it's not. It's really the fact that these companies, device companies, surgery, surgical sort of manufacturer companies, they don't have incentive to create a new surgery, nor do surgeons, because everyone's getting these old ones. And if 70% of people turn out okay if we have 60 years older, right? But 30% of people end up in chronic pain, for them, they're still making the money, right? It hasn't really flipped the bill where it's like, you know, gonna be gonna be that big of a problem. So and I want to bring this back around to this resentment. It's because it's because of those things. That's why I think about so many people suffering that don't have the um platform I have that don't come from, you know, when I walked into the the clinic in Vale, you know, the dude's loading screen. I'm I'm on a photo on his loading screen as I was running a race in France, and I'm like, that's me on your computer, you know, and he has all these photos of Tiger Woods and freaking uh uh Andre Agassi and um Brett Favre and Dan Marina, all these people he's operating, all these famous athletes, right? Very, very famous athletes. And you feel very confident, right, when you go in there. But I think the thing is, is like the end result was the same, even with the guy that I had my first surgery with in Flagstaff, whereas this callous detachment and sort of overlooking uh like uh just the deep uh sort of uh power they have over someone's life. And I think that that that's really that's really the uh the thing where it's it's hard for me to listen, you know, and I know you mean this in in all good faith, is like talk people talk about resentment when like I'm like I I almost think of like Jesus, you know, in a way, and and I'm like, yo, I I'm I'm not Christian really anymore, but I I do very much follow his teachings on a human level. And I I think to myself, like, you know, if someone was staked to a cross and then we asked them to like let go of resentment, that guy might have been able to do it, but all the rest of us, there's no way. There's no way because that physical pain that your brain's sending you, it's like you can't think of anything else. You know, and there there are there are millions of people suffering like that that you know it's hard for them to have relationships, it's hard for them, like the amount of energy it takes just to do like the the most minimal thing, you know, just process a regular thing. You know, it's you're you you you process everything so differently, yeah, you know, and I and and the amount of work I've had to do already as a man to get myself to a place where like I'm not the same, but like where I can be compassionate, where I can be patient, where I can be someone who's gonna be a good father, who's gonna be a good partner in a relationship, those things are really important to me. And it's taken so much more energy to like get to a level where I'm like, yeah, I'm good. I'm ready to do this, you know? Um, because of the amount of suffering my body is in, you know, which is wild to think to think about. It's just like it's just a wild, it's a very weird experience. It feels like I'm on this like mushroom trip that just doesn't end, you know. Um which is interesting.

SPEAKER_03 34:20

Well, I mean, look, again, like I yeah, I I certainly don't live in in chronic physical pain. Um, and so I yeah, and like I th I it we we should come back to the Jesus analogy because I because I think that's a profound thing that that you note. Um, and like ever so one, I think you should absolutely write this book with a huge target on the healthcare industry and the super corrupt incentives. Like I think that's incredibly important, and I know that um people uh would find that resonant like with their own experiences. Um and then I think yeah, and and we we again we can process this in like whatever direction you want. Um I think there is like I think that I think exploring resentment is is quite interesting because I I think resentment is always a self-own in some ways. Like I don't think resentment can be constructive in any way. I think a pursuit of justice can, a pursuit of accountability can, but resentment is drinking poison and hoping that the other person is impacted, right? And and and and so I think like I'm really interested, I'm interested in in talking about that, if that is useful.

SPEAKER_00 35:59

Um no, sure. I don't disagree with that statement at all. I think that's I think that's spot on.

Personal Duty Versus Societal Rules

SPEAKER_03 36:03

And then but well, uh and then also I just I mean, full disclos disclosure, as you know, like my dad's an orthopedic surgeon, um, and I have uh you know the utmost admiration and respect for him, but also saw him um, you know, reject the trends of the industry. He got offers to join groups and get bought out his whole life uh because he's excellent and high volume and high quality. Um and he always rejected it because he felt like the incentives that that would attach himself to were corrosive. Um and so he maintained as a solo practitioner his his his whole career, um, which I have a lot of admiration and respect for. Um and but like I also know that you know there's a ton of incentives to like not end up doing that. And and and and so I really know in some ways, just as an observer, some of what you're talking about. And I think that the financialization of the healthcare industry has imposed a lot of like corrupt incentives on a lot of people. Um and yeah, like I'm very proud of my dad and like uh honored that that he never made those choices. Um and it's a good lesson for me, as like I do my own career, right? But um, you know, I think he saw a ton of his friends get swept up in like all of this, and uh, you know, the three or four ways you can make money off of one surgery with stakes in the group and stakes in the facility, and you know, stakes in the the instruments and and like all of that is really so I just I should I should just disclose that I'm not fully like unbiased, I guess. Um, and that a lot of what you're saying resonates with the shape of the industry as I've known it and seen it. Um but then the other thing I I I would say that I that I think one thing, and like whether this is helpful or not, I I guess I can just share it as um a reaction to like the physical pain distinction that I don't experience, right? I I I would say that the only corollary that I would maybe clarify about the addict is that um the emotional pain that caused me to drink is still a constant part of my life. Um and it's it's it's not physical. And so, as you know, emotional and physical pain are very distinct. Um but like for me, there has been a way, and like the pain has like lessened over time, but like the reason that I sought ease and comfort and soothing through substances is because I have an incredibly sensitive soul that encounters a very harsh world. Um, and that's you know a euphemism that covers a lot of shit that's happened in my life, right? Um and and just have chronic emotional pain and still do to this day, uh, for a lot of reasons, um, that are some of which are in my control, many of which are not. Um but for myself personally, I think, I mean, again, this is not my own innovative idea, but like in the big book of Alcoholics Anonymous, it talks about resentment being the number one offender. It kills more alcoholics than anything else. Because when we have resentment, we drink, and for us to drink is to die. Right. And and and so I think righteous anger and seeking out accountability and all those sorts of things are healthy and good. Um, but I think the United Healthcare example is as poignant as the example of Jesus, because one is an illustration of what to do, which is what Christ did, and which is why that's the ultimate ideal. That's the distilled, that is the the distillation of what the ideal is to be human, is to is to forgive those who unjustly persecuted you, right? Like, and and the the Mangioni and United Healthcare is is a perfect example of a failure like to do that, right? And and and and this heinous outcome that that like results from. Um yeah, so I think um, man, like my heart is with you, and I'm I'm so glad that this is where we started because I because I think this is a really powerful and like palpable topic, and um yeah, interested in in going any direction from there that that that you feel moved.

SPEAKER_00 40:54

Dude, absolutely. No, it's it's great. And I I do appreciate you saying that your emotional pain in terms of addiction because it is very different, right? Like I have plenty of emotional pain throughout childhood, throughout life, throughout all these surgeries that I have dealt with. But it's very different. It's just it's it's really hard, it's really hard to comprehend, you know. Um and uh I would not wish it on anybody, honestly, even the gentleman that put me in this position, you know. Yeah um, and I think that is forgiveness because I don't I don't wish suffering on those folks. I I do think like the the Mangioni thing is interesting because you know, I I hear what you're saying with with the Christ reference, but I do also think we live in a world that there there will always be inherent fighting, unfortunately. That's a very human thing. I've battled with that in most of my 20s and early 30s. I'm like, you know, are we always gonna be in wars? There's always gonna be death, there are always gonna be this stuff, this and I know we can get better for sure. Do I think we're ever not gonna have um fight? I think it's innate in humans, you know, and I think that from what I understand is that gentleman felt that you know he had been so wrong by this healthcare system, nothing's changing, he needed to make a statement. And for for all intents and purposes, a lot of people paid attention. A lot of people started to talk about healthcare, a lot of people started to talk about United Healthcare denying cancer treatments, denying all these other things, you know. And so to be fair, I think he actually did make a little bit of a difference with that. I don't agree with his decision um and how he did it. Could he have done it other ways? Sure. Would it have been as big of an impact? I don't know if it would have. You know, people tend to not pay attention unless the fire is burning them these days. Unfortunately, you know, climate change has been happening for a long time. And really, we still have plenty of deniers. And, you know, it's like it's gonna be until we run out of water, until they're like, yeah, actually, you know, it's getting hot, you know? Um that's that's just an unfortunate, I think, like just archetype of just human. I mean, I know you you you're a forward thinker. I know many people are, but the majority of the species, like, just is sort of stuck in their own little thing. I mean, even with how much pain I'm in, I'm I'm very much like you. I'm can I'm such an empathic man that I'm always like looking out for people around me. Like if they're suffering, I will go serve it, right? If there's a homeless person on the street, I will go talk to them. Like I'm this is always how I was raised, how I always will be. Unfortunately, that's just not common. It's just not a common thing. People like would rather take a selfie and post it on TikTok or Instagram or you know, do these things, which is nothing's wrong with those things, but the shallowness to our society really sort of our our attention is on these like very like just insignificant things that we deem important, right? Now, this young man did something that was uh I agree egregious, but people started to pay attention, right? People started to talk about it. It it was it was a legitimate thing in the room. Um, you know, and I I wonder if we we can, you know, if we can get to those points without stuff like that, unfortunately. You know, I think that I hope the answer is no, no, we can get there, you know, by talking about it. But I mean, we've we've spoken about these things, you know, people go and spike speak in front of Congress and have hearings and all these other things, and nothing changes. Yeah you know. You know, it's it's it's that's just like how I look at it.

SPEAKER_03 44:05

So so so let me ask you two things on that because it sure because I think it's it's actually a really illustrative example of pain and resentment and suffering and action, right? And um it got people talking about it in some ways, but has anything constructively changed? I I I would actually argue no, right?

SPEAKER_01 44:30

No, yeah.

Building Self-Awareness In A Noisy Culture

SPEAKER_03 44:30

And so um it was actually ineffective in that it got people talking about an argument between whether or not it was just or not, rather than looking at the root cause that provoked it, right? So like I actually think it undermines the case, is my perspective, which violence like typically always does, right? Like there is just war, right? And and in in certain circumstances, right? But violence often undermines cases. Um, and then the other thing is actually like attribution. Like, who is actually the locus of responsibility and accountability and blame? Um, was it the CEO of United Healthcare? I'm not sure that there's salient analysis that points a direct cause from that guy to his pain. I think what what most of the time we're dealing with is complex systems that have a lot of like multi-stakeholder actors with a lot of different incentives. And and so um sort of the low resolution version of who who is to blame oftentimes, again, I think moves us further from where we want to be rather than toward where we should be. Um, and I think this is a great example of that because yeah, that guy inherited a company and a healthcare system uh and a set of incentives that way preceded him, right? And um, like I think that like you noted, even with like the selfies and the shallowness of of like the culture. And you know, I saw a meme actually the other day that that exemplified this. So, like, have you seen Ing um Inglorious Bastards? And you know Christopher Waltz's character, oh yeah, who's like the the like the evil Nazi general, right?

SPEAKER_00 46:42

Yeah, he's like the head of the SS.

SPEAKER_03 46:46

Um, so someone asked him how he was able to distill the persona of evil so well, and his response was I didn't. That guy thought he was doing good, and that's how deep the question of how to interpret human behavior goes, is that a lot of people who are committing heinous acts and crimes because of their incentives, because of their access to information, because of all sorts of things, are unaware that they are causing that much harm. Now, I don't think the Nazis fit that description, but I think Christopher Waltz's answer is really, really profound. Um, and like I think it begs the question of like the shallowness of our culture, the corruption of our healthcare system. My belief, and I'm curious to hear your like reaction on this, is that you know, there's a fraction of the population, maybe 5%, that are psychopathic, that like have no human empathy, that have no emotion. But the vast majority of people are trying to trying to do the best they can under the incentives in which they find themselves, with like most of the time, like the best faith possible. Um, and yeah, like our culture and our systems have optimized that to look a certain very selfish and shallow way, and I think that's a tragedy. Um but I think like the question of human agency in all of that um isn't important, but I think it's rarely the solely attributable like cause, in my view.

SPEAKER_00 48:36

Yeah. Yeah, no, I I agree with some of that. I think uh I think the uh the thing with Mangioni is that uh I would I would push back and say, well, how else do we change the system? And I agree, I don't think it uh like changed anything, but nothing anyone's been doing has been changing anything. And and I do think we often say, well, it's the it's the system, it's these corporate entities. And I actually disagree with that now. I think it's a people that we create these things, right? And so uh yes, he assumed the CEO role and he assumed plenty of uh things that came with United Healthcare long before him, but he assumed that role and he knew the company he's in, right? Does that mean he should have his life taken from him? Absolutely not. But I think that there's a bigger thing there where it's like there's hundreds of thousands of people that have come out and been like, yeah, my child was denied cancer life-saving healthcare, my wife was denied healthcare. I think if you had one of those experiences, I think you might have viewed his murder differently. You know, I haven't had one of those experiences.

Radical Responsibility And The Path Inward

SPEAKER_03 49:32

Yeah, right. So I I so and like I think that's an interesting point, and I have no sympathy for like the challenges of running insurance companies. I I think they clearly have messed up um incentives. Um and I've not had a denial of care like happen to me or or anything like that. Um but I do know that retributive justice does not heal. And and like as a as a like as some and and like this is like you you know, my like one of my best friends in the world died of an opioid overdose, right? And and and like I think that is really fucked up, and like I think the pharmaceutical companies and the insurance industries have some degree of blame for all of that, but like that it is is a that's a like seeking retributive justice on them for the outcome that happened to my friend, I think is is is one uh I don't think it's a an accurate reflection of the full set of causal factors that drove that outcome. And so like that's one part of it. The other part of it is whether it actually like moves the goalpost toward like solving the problem, and I think it actually undermines it. And so I would, if this happens to me, which you know, God forbid, I hope it has not. Um but like I've also been, I mean, I was a PhD student that was dead broke, I was on Medicaid for a long time myself, right? Like I've I've experienced some of the the bowels of this like really fucked up system. Um and I don't think that murdering the CEO of the health insurance company that is at the helm of those decisions is either an accurate reflection of like the causal attribution or helpful toward the end outcome. And like, yeah, I mean, and like I I think if someone presented analysis that either of my reflections are inaccurate, that like there is a direct causal attribution to that guy, or it did advance the ball in some ways, I think I would have to update my prior on that. But yeah, because I think there is actually evidence that it has been counterproductive, that like I I feel quite quite strongly.

SPEAKER_00 52:26

Yeah, I I even think if there was evidence, I would still disagree with the murder. Like, I I don't think that's the right way forward. I do think uh I do feel like there is evidence that the entire conglomerate of United Healthcare has been absolute diabolical in so many of their denials. And as the CEO of that company, I mean Totally. I mean, I I don't know how much other proof we need, Mike. I mean, I feel like you know, if you if you're if you're steering the ship, and I know that there's a board director and a lot of shit that goes on with that.

SPEAKER_03 52:57

Just to be clear, like, I mean I have no love loss for United Healthcare or insurance companies. I mean, like I they are the bane of my existence daily, uh, in some ways, right? Yep. I'm saying specifically murdering him. Like, I don't think that there's not accountability and justice that should be uh like pursued for a lot of insurance companies. Um but I I just think like particularly that outcome is is counterproductive to all of those people who have been denied.

SPEAKER_00 53:40

Yeah, I don't disagree. I would ask, what do you think would have been more productive? Like it feasibly actually worked, you know, because we talk about community organizing, protesting, all this shit, and it seems like nothing changes from any of that.

Faith, Hypocrisy, And Practical Morality

SPEAKER_03 53:51

Yeah, so I don't think um I actually agree with you that like I think community organizing and like protesting um is often more effective as like a virtue signal like mechanism than operative um like changing. Um and like uh I think what is effective um or what would be more effective, and and like I I think there are two parts to this answer. So the first is our whole healthcare system is completely fucked up, right? And our whole agriculture system and our whole pharmaceutical industry and our whole school system, right? Like there's so many layers to look at that have contributed to America becoming a fat, unhealthy, diabetic, obese, dying country that isn't having kids, that's not productive, and sort of all of these sorts of things, right? There's a ton of blame. Right now, what's the simplest way to solve this problem? It's to look at the most local unit and think about what these most local units can do. So like it truly starts at the family, right? Like, are people eating like reasonably healthy food? And if they are like low income and on SNAP, um, is our benefit structure contributing to people buying and becoming accustomed to healthy food? I mean, the food pyramid, right? Like, which was not updated until very recently, was completely contrary to what it should have been for a long time, right? Um, there's so many things that start with like how individuals can think about working out more, eating, eating more healthy, sleeping head, taking care of their mental health. The most powerful and profound way to protest is to design your own life as best you can to not have to be fucked over by the system. Right now, that's not a satisfactory answer for dealing with the systemic injustice, but I do think like the most constructive way to do it is to the best that you can. I mean, look at you, Nick. You're skinnier and more fit than I am, and I'm not in chronic pain. Like, you actually are an embodiment of like the way to maintain peace, health, stability in the face of something really shitty happening to you. And so I think like that's actually the most profound way to operate. I think the second thing to think about is like given that, and given our system, people have to really identify what lever in the system they are most adequately poised to influence. They're not gonna solve a complex system in their lifetime. You can't, right? But like, could you write a book that, oh, look at that, Google uh meets uh a riverside. Uh um, like, could you write a book that like moves the needle like uh constructively? Could you become an insurance executive? Could you become a doctor? Could you become a naturopath? Could you have a podcast that is focused on health and like wellness and well-being? Uh, you know, I think the right w way to think about influencing systems is for us to identify the single node that we can have the highest ROI impact on and really focus on that. And so I don't think though, in my identification of any singular node that, like, and I'm not suggesting that using this either, but like murdering someone is not a node on that map for me. Like Luigi Mangioni came from a very wealthy family, right? He could have run for Congress, he could have started a healthcare company, he could have done a lot more to have a higher ROI impact than killing that guy. I mean, and and and so that that may be an inadequate answer, but like unfortunately, I think the complexity of insurance-mediated healthcare, where probability distributions determine how a lot of these financial decisions are made, and they're attached to a provider system that is incentivized to get paid per intervention rather than overall wellness outcomes. Like, I think you have to look at that complicated picture, find the node that you're you're best able to influence, and try as best you can. Um, but that isn't even something that everyone is interested or like well disposed to do. So the true way to have the most profound impact is to, as you are an embodiment of, try to be healthy, try to be countercultural in how you live your personal life and in your family life, and join communities like like churches and nonprofits that uh hold each other accountable and and have webs of mutual enrichment and betterment that do not that like minimize their exposure to overdependence on a fucked up system.

SPEAKER_00 59:22

Yeah. I I don't I don't disagree, Mike. I think you make a lot of good points. I this is why I love talking about you because you are a very well-thought-out human being. Like you take time to think about things, you're very methodical, almost like chess, with how you're explaining things. I do think I want to point out that in Luigi's case, uh, I don't know if you ever saw x-rays of his back, but he had a massive, massive uh spine surgery, right? Spine surgery in the orthopedic world is one of the highest problems of leading to chronic pain, highest failure rates, and one of the least successful uh uh types of surgery you can get. I'm adamantly like opposed to so many spine surgeries unless your back is literally so shattered you can't even stand up straight. Um I'm not gonna assume what kind of pain he was in, but given my thing, I imagine that he was probably experiencing some sort of pain where he might not have been thinking about uh, you know, trying to use his family's net worth to, you know, find the node. And I don't think that's an excuse. I just want to also have compassion for his state of existence, just like I have compassion for the man who's not alive anymore whose family doesn't get to see their father. You know, so I think that like I I I I try to like understand because I look at it this way. There's so many times in American history where we've sent the tip of the spear soldiers, whether it be a green bray or a steel, in some country and they murder somebody, right? That's happening probably right now. And then we make excuses for it. We say, well, that's a bad person. That's a bad guy, right? Or a terrorist or doing something, you know. And I'm like, it's interesting to me how we uh how we can so easily detach uh that person from being human. But then here in America, where we have so many other people contributing to the massive suffering on a level of many, many people, but yet when something happens to them, we're just like, well, that wasn't their fault. And I'm like, yeah, might not have been that guy's fault either that we just killed. Right. So and the reason I'm bringing that up is I I think it's like it's a situational way we like sort of uh try to have convenient morality in certain uh scenarios, you know. Uh and uh I I try to tell myself, I'm like, I don't believe anyone should ever be murdered, but then I'm also like there are times in human history where it has been clear that someone is doing something that's so bad that uh and there nothing's gonna happen but fighting, right? We look at the world wars. I'm not saying that this is like that. But I think that like in his mind, uh I think what he was trying to do was to do something. I mean, the guy knew he was gonna get caught, right? I mean, he just shot the guy in cold blood in the middle of the cameras everywhere, you know. It's not like he was he wrote a manifesto about it, right? I I think in his mind he thought that he was going to uh create enough of a conversation around it where maybe something would change, you know. And you're right, it hasn't yet. It might in 10 years. But I I do feel like this this thing has has spurred more conversation about it. You know, it is exp it it's it's empowered people, and and again, I don't think that it was the right way to go about it, but I do think that like there there has been some things that have resulted from the actions that have empowered people to speak up more about like how shitty United Healthcare is, how much they denied coverage on critical life-saving care.

Wrestling With The Mystical In Christianity

SPEAKER_03 1:02:27

Yeah, so and and like again, I just want to underscore I think insurance executives are often the villain. And like I think the system that they orchestrate and operate is insane and fucked up and hurts a lot of people. I mean, I see this in my own work that like we have this platform that can help people stay in rehab longer, and a lot of rehab executives won't pay for it because insurers don't reimburse them like directly for it. And and and so I mean, what's fucking crazy is that all these rehabs, that is like a seven billion dollar industry in the United States, up to 50% of people leave against medical advice. They leave treatment, which is heartbreaking for them and their recovery, and it breaks the banks of these places. If they were responsible fiscal managers, they would invest in closing their leaky funnel, right? Because they're it's like money walking out of the door. But people don't have short-term incentives to solve that problem because of the insurance industry. So like I think it's disgusting, I think it's cruel, I think it's inhumane, all sorts of things, right? Um at the same time, like I do try to hold my principles consistently. I'm generally anti-war. Like, not um one like in in every sort of situation, I do believe in like just war, and there is you know deep Catholic theology around that that um I subscribe to. Um you know, uh, but in general, I am I'm I'm anti-war and I'm against the death penalty. And like back to your example of Jesus, like an eye for an eye, like um, you know, uh that that is that is old testament justice. Um and and and that's not what I think we're subscribed called to do. Now, like let me just also underscore if something ever happened to my family or or me where someone was harmed or something like that, like I'll kill a motherfucker. Like, like that's fine. And like I will accept the consequences of that, and I will go to jail for the rest of my life, and I will feel righteous, and I will, but like, you know, and like maybe in in some ways I'd I pray that I uh I would have better judgment, but like there is there is like whether we can externalize and generalize that, I I think is like uh an important question for all of us. And like I oppose the death penalty because I think it's an egregious in incursion of the state. I also think it's against my own like Catholic um uh like faith, and like I generally think killing people um is wrong and like injustice does not like correct injustice. I think that's true in war, I think that's true in our interpersonal lives, and and like whether I can hold up that I ideal is also different if I were. As as I mentioned, like if if something happened to my family, like that's it's it's different, but like I don't know that like that's very separate from looking at how to change the system. Because like if I fucking like killed someone that hurt my family, I probably wouldn't be doing that thinking that it was gonna change the outcome. I would be doing that out of pure malice and and anger and like retribution and resentment, and like I would have to live with the torture of that right for the rest of my life.

SPEAKER_00 1:06:38

You would.

SPEAKER_03 1:06:39

And and and yeah, so like I think there are things that we can do that are wrong but understandable, which I actually that's what I hear you saying, because like I actually agree with you that like the insurance companies are incredibly egregious perpetrators of injustice, and we should do a lot to hold the like account. But the only the only distinction I would make is is is that especially on the left, Manioni was like lionized, right? As like this is a constructive reaction to a systemic problem, and I think that is a crock of shit. I think maybe if I were in his choose, cut forbid, like who am I to judge? Like uh uh like butt for God, there go I, like totally. But as someone who is not involved in that particular thing, and as a sovereign member of society, like can I push back against people who are now lionizing that as a constructive template? Because I think it it's it's absolutely not.

unknown 1:07:54

Right.

SPEAKER_00 1:07:55

I guess that's my No, I dude, I agree. I I'm laughing because you know I think there's something to say where we grew up. You know, I obviously I grew up in the West Side Body as you grew up in a little bit different town, a little bit inside of town than me in Tucson, but all the guys I know that grew up with us, they all have this dog in them, you know, which I really appreciate because it is kind of like a fuck around and find out. You know, and I know some of the nicest dudes I grew up with, but everyone they won't hesitate. And I think that that's how I sort of rectify it to myself too. It's like, and I'm glad you brought the death penalty because that's a really interesting thing we do into we have in certain states. And like I think about this way if I had a if I had a child and someone broke into my house, right? I'm I'm not even kidding, I'm not even asking questions. You're not laying my house, right? You know, you're not laying my house. And and I and I'm gonna feel something about it, but I guarantee you, I'm gonna feel less bad about killing someone that's coming in with the intent to harm someone I love versus me allowing someone to harm someone I love, right? And I think about it this way, because when I think about the death penalty, because I I agree with you, I'm also for the most part against it, but then I try to put myself in the shoes of a father or mother whose child was murdered by somebody, and then that person gets caught, and they don't have the ability to, you know, hurt that person because and so I'm like, oh, if I put myself in their shoes, like is it justifiable? Like, you know, right in the religion, the religion in me, how I was brought, how I was brought up, says no, but the father, the human in me, says yeah.

SPEAKER_03 1:09:25

Well, so you know so I think this is a really you and I are 100% aligned on that.

SPEAKER_01 1:09:31

Yeah.

SPEAKER_03 1:09:32

And I think they are different questions, right? And like actually, like the Jesus, and man, I mean, who knew that we were gonna have talking about Jesus and Luigi Wongioni, right? But like, hey, um, it's actually not a bad thing to like reflect on given our cultural state, right? And like how to disentangle these things. So I would say this like on this note in particular, um you know, the the example of Jesus is so like I think there are there are different questions here. There's like one, what is my personal duty in any given moment, and what can I aspire to do in that personal like duty in that moment? And what would I actually end up doing, right? So, like as a father, or not not as a father yet, as hopefully a father, but as a husband, right? As a family member, if someone ever entered my house and hurt my family, like I would probably react in a rageful way, damn the consequences, right? Now, I don't know if you've ever seen this, but the most powerful thing for me to feel like to actually see what Jesus is like on earth today are the people who show up at the court hearings of people that have murdered their family members, and they write letters of forgiveness to them and they read them out loud in the court.

SPEAKER_01 1:11:11

Yeah.

Why The Simple Teachings Still Work

SPEAKER_03 1:11:12

And that is like the message of Jesus. And my God, I wish I could be like that. I have no idea if I could, but that's actually the ideal, right? Like these people that are facing this horrific strain and they still forgive. And I think about so many recent examples of all these horrific murders, and like you can go and listen to the family testimonies that are brimming with Jesus Christ's essence himself of like forgiveness and love and compassion. I probably would not act like that, but but that is what we are called to act like, right? And and and but like I I think here's here's the thing. That is separate from thinking about how to build a society, right? And and and the thing that I would argue is that if I was rageful and like vengeful and I fucking killed someone, I would accept the consequences and I would accept that that's what I did in my rage, but I would not then try to extrapolate that and say our society should sanctify that behavior. And that is a big fucking problem that a lot of people on the right and left right now are doing. They're saying they're watching these fringe motherfuckers like do shit and they have some sympathy, and they're trying to extract some principle that can then govern our society based on that principle rather than just saying, like, that was really fucked up, there but for the grace of God go I. But we cannot sanctify that in our fucking society because then we cease to be a society, we cease to be civilization, right? And and so there are two different questions here of how to interpret and think about our personal conduct, and then how to think about the the society that we all want to build, right? And like I think that's where the conflation has happened. And that's something that I try to hold myself to because as I've shared, if it were my own family, there before the grace of God go I. I'm I'm I'm killing a motherfucker. But like after I do, I'm not writing a manifesto trying to inspire a bunch of other people to do the same thing. I'm and you're not right.

SPEAKER_00 1:13:41

You're not trying to justify your behavior. You you're you but that's that there's a degree of consciousness you're speaking to, Mike. I just don't think a lot of people have. And I've asked myself this a lot where it's like, I don't, I don't think it's like a better than it's just like people aren't looking for the they're not looking to look at their own self-biased, right? They're not looking to be more self-aware. Like the the narrative you're speaking to is like, is Lord of the Flies the book in the movie where all the little kids are on the thing and they have like the freaking shell and the con, right? That's what it reminds me of. It's like, it's like there's just like trying to control someone's deepest, darkest fears and emotions and commodifying their attention and these these like you know, martyrs that are existing, and then politicians or you know, uh business people using them, whether it's on the right or the left, to sort of construe these very skewed narratives to control people's thoughts and feelings and really trigger their deepest, darkest fears and securities and pull those out. But you don't get that as much because you've you really you look at yourself first. When you have an emotion or a feeling or when you're angry, if you were to you know hurt someone that's trying to hurt your family, you would still have an unreasonable conversation, right? You'd be like, I I'd hope to never do that again. But like you're not you're probably not gonna regret doing it because you save someone's life that you care about, but you're gonna have this feeling that you're like, you know, you're not gonna, you're not gonna all of a sudden be like, oh, this is what we should all be doing, right? Right. And and I feel very similar to that. I don't think very many men and women think like that though. And and and I think that the the the let's take this conversation another step further. Like, uh how do we get people to like because we can talk about education and sort of defining public education, all these other issues, like how do we get people to start to think, I wouldn't say more like us, but just think like be more self-aware to where they can hold more balance of the opposites? Because we're just having this very like nuanced, rich conversation of all these things we just randomly got in. But you and I talk like this all the time. I know your brain works like that. I know you can't, and so does mine, you know? And for like for better or for worse, we're stuck with it. Yeah, but like a lot of people don't they don't do that, like they don't think about that shit. They're just like, yeah, Fox is right, or yeah, CNN's right, or whatever, you know, and this person I'm just gonna iconify and I'm gonna get angry at something, yeah, and then therefore I'm gonna behave.

Service As Healing And Being Seen

SPEAKER_03 1:15:54

Yeah. Uh it's such a good question. And again, I uh I like I just I so admire and like honor that you make space to have these conversations about this stuff because because it is is interesting. I mean, and like shit, man. I don't know if I like have all of the answers. I can't, I mean, I can just give you what I think what's worked for me as someone who because I like have a lot of energy about trying to effect positive change in the world. Yep. Um and I for a for a decent chunk of my life, I I didn't have the same energy in rectifying the shortcomings within myself. And the only way that I was forced to do that was through the journey of sobriety, which again like is not generalizable. Like most people aren't fucking alcoholics like I am, you know. Like, and I and I don't wish that upon them, certainly, because it's it's it's real torture, right? But like at some point, um I had to take radical acceptance of the fact that the world is a fucked up place, the world's also a beautiful place, um, and that there's a bunch of shit that's out of my control, and there's a bunch of shit that is in my control, and my pain and trauma, which is, you know, in the grand scheme of things, relatively minimal as someone who grew up in quite a privileged life, but then in other ways had to navigate certain pains that a lot that that I definitely wouldn't wish on anyone. Like, I do not wish upon anyone the self-consciousness of someone who has a stutter. Because like the the bruising of that on like imprinting on your soul as a child is so difficult. And and like that's as someone who has largely been able to be unencumbered, uh, you know, despite having a stutter my whole life. But now encountering other people in the stuttering community and spending a lot of time there, it reaffirmed just how deep and hard and painful that is, right? And so even though I was really privileged and all this stuff, I carried emotional pain from that. And that ultimately, I mean, of course, this is the paradox of life, and this is why I ultimately rejoined the Catholic Church and I've doubled down on being a Christian because I actually think the story of Christ is the only thing that helps make sense of this, because it's the inversion of everything. Um, yeah, and and and so um for me it it it it I had to accept that um it might not be my fault, yeah, but it's my responsibility. Yeah, like my pain might not be my fault, but it's my responsibility. And again, I'm not in physical pain, and I don't want to overextend my own emotional pain in an analogous way, because like God forbid that I have that uh pain, but like in general, our pain is often not our fault, but like it is ultimately our responsibility for how we deal with it, right? And and and so that was but but I came to that only through having to confront literally death. Like I my first day of sobriety in a jail cell, not a burning bush, but a fucking empty jail cell, like toilet. Uh, I just have this vivid memory of just in the depth of my soul for the for the first time, which is shocking because my last day of sobriety was not my worst bottom. I had fallen down a flight of stairs and shattered my jaw and this horrible set of experiences. But that morning, in the depth of my soul, I was just like, oh my god, I'm going to fucking die.

unknown 1:20:20

Yeah.

SPEAKER_03 1:20:21

And like I have to uh fucking, no holds barreds, no matter the cause, no matter who's responsible, I don't want to die. What am I gonna do to like survive? Because I don't want to put my family through that pain. Right. And and so I had to totally give up and say, I can do one right thing, one moment at a time. And that was how I like rebuilt. And it isn't like perfect. I still struggle with emotional pain and like all sorts of things, but that for me was the moment where I was able to sort of develop that. And and and and so I guess I'm sharing that because you asked, like, how can we generalize this kind of approach? And I think it is hard, and I think the screens make it hard and stuff, but like I think everyone has a deep down longing for meaning, right? And I think the hardest thing is that we grow up into the world, and because of the flashing lights and external influences and experiences we have and other people and other things, and cars, and sports, and music, and grades, and all this stuff, we think that meaning will come externally. But the only truth, the only reality that I know is that peace and tranquility comes from looking inward. And it took me, you you, you know, there's this incredible poem. Um, and of course I'm blanking on the name, maybe it's T.S. Elliott, but it's like, and at the end of our adventure, we will come back to where we began and we will know it for the first time. And like the path to peace is inward. Um, and like I think that if there's anything I hope other people and as like running a mental health like tech platform, if if there's one message that we try to help others through sharing our own experience come to, is that uh the pathway to peace is through ourselves. Um and I think that that is that that's how I do it. And and like questions of how to construct society are are kind of different and separate, right? Um, and and and and that we just have to draw those distinctions and like disentangle those things.

SPEAKER_00 1:22:53

Uh no, I can't I couldn't agree more, buddy. I think like you saying that you know the pathway to peace is internal, absolutely, but also that you know the pain might not have been my cause, but it's my responsibility. And that's what I've seen my whole life, even with these injuries and with heartbreak, separations. And that's why you know I continue to to fight for better for better things. I wanted to bring up because I do want to talk about the Jesus and God thing with you. Yeah, I do think that's a really important. And and I want to I want to know from your perspective, because I I I struggle with that even recently. Like I try so much to to go back to my roots. I was raised Catholic, just like you and we went to Catholic school together. We've known each other since we were kids. And um but I want to bring up a uh a thing that brought me to tears the past couple weeks. Like I I have a a really I'm close with a really close coworker of mine and a very, very deep human being, and she is she's younger, and we we have these deep conversations about religion, about theology, about uh loss. Um, you know, she lost her father uh recently um and he was still very young. And uh and she she said this like comment to me because we gotten to know each other uh over talking for a while. Um and it was just over text, but literally it made me start to cry because because a lot of people don't see how much pain I'm in. Um because one, it's not that I'm hiding it, it's just that like I I I exist in service of others. So like I try to make everyone's day better that comes in contact with me. I don't always succeed. I have moods, I have you know, shit that comes out of my mouth that I shouldn't, just like everyone else. But but genuinely, whether I uh am religious or not, I believe like my moral compass is to help others, and that's the only sort of uh way I can process life uh where where it still has a meaning of me being in existence, finding purpose, finding meaning. That's that's where I find it helping others, right? Even if I'm suffering. And she said this thing and it was very quick. It was just like you know, because we were talking about surgeries and and just like my plan for the next one if I'm gonna get it or not. And she's like, she said something to the effect of like I see like how much uh pain uh you've been in and how it affects your life. And she's like, the fact that you can uh treat so many people and and hold space for so many people and be there for like complete strangers. She just said she just said that like she said something to the effect of that, right? I can't, I can't I'm kind of paraphrasing that. But it was like so uh so meaningful to me that someone said that, that they they noticed those things that it made I started to cry. You know, and uh and I think that not that I'm like I cry a good amount, I'm I'm a pretty big cry, honestly, but like I think that like it just brought brought this thing out of me where it's like wow, someone actually sees uh me doing that, and it's not because I'm overly like look at me, look at me, right? Like I hey if I've if it's no one sees it, it's not happening. It's that if she like uh understood what my experience was on a base level, and she sees the type of human I'm still choosing to be, regardless of what's being done to me. And that was it was just like a beautiful gift I was given in that recognition.

SPEAKER_02 1:25:40

Wow.

One Small Step: Mission And Model

SPEAKER_03 1:25:40

Well, yeah, I mean, and I think I just I want to strongly affirm that. Um, and and like I I I think that is deeply profound, and I think she's correct. Um, and I think that and again, you know, physical versus emotional like pain are distinct, but as you may know, like like the 12th step of um it in in the 12 steps is is about giving it away and like being of service like to others, and that's not like a a nice thing that we have to do um to like that that is the whole the whole program is like sharing the message, and and and so I think that like you have found potentially part of your healing is in making space for others and in sharing your own experiences, and I think that is so profound and so beautiful and like beneficial for like the world. Um, and so I'm personally very grateful like to you for doing that. Um, and I think like that's probably really like good motivation for like your book and the podcast and and like whatever you do is how many other people you you can help through this, you know. Um yeah, and then I think like the other thing that I would just say, and um and like is our video clear and then and like everything good? Yeah, okay, I'm just making sure because you're like a little bit dark on my screen.

SPEAKER_00 1:27:20

Oh, it's probably it's probably here. I'll I'll turn mine up. You can keep talking, but it's probably because my uh the sun's setting. I was just using natural light today.

SPEAKER_03 1:27:25

No, and then I was just seeing um that uh the the photo uh okay there you go. Um now you're even darker. Okay, yeah, there you go. Um there we go. Sorry for that interlude. I was just making sure.

SPEAKER_00 1:27:44

Um now it's all good.

SPEAKER_03 1:27:46

Um so then the other thing, dude, and like I'm sure that you've been exhaustive here, but just so like what what what my platform does is like we do certified peer support, right? So like we're we have people. That have serious mental illness or substance abuse, we're online on nights and weekends when like the rest of the care system is shut down, and you talk about an incentives problem. Like mental health care is structured around business hours and credentials, it's not structured around like when people are in pain, right? And and so our big innovation is to be there when people need it, which is 70% of the week that doesn't have coverage. Um I I'm I was the first certified peer on the platform. I take a lot of these calls still. And like the first thing to always that that I always ask people is is like what are the like exhaustive set of things that people can do to like be helping themselves through their pain. And like I'm sure that you've thought through all this, and like I'm definitely not a proponent of like opioids and stuff, but like if you are in chronic pain, you know, short of having more surgery, I would like there's Tylenol 3, there's there's there's there's non-opioid strong handlers, right? There's there's cortisone, there's there's all sorts of things that I don't know about, obviously, but like I just I hope that that you are fully embracing all of those things because like you you you know living in in chronic pain is like horrible, and and and and I also admire that you don't want to take opioids, but like I can also just give you this example, right? I got my tonsils out when I was one month sober, which is like kind of scary, right? Because it's like what do they give you like when you get your tonsils out? Oxycon uh oxycodon, right? And my sponsor was like taking taking medicine as prescribed is not breaking your sobriety, um, it's not like a violation, and if you're in extreme pain, take it. And he said, the only thing that matters is if you find yourself wanting to take it when you no longer need it. And he said, if that ever happens, then you basically relapsed. And so I took it for three days and then I flushed the rest of them down the toilet. And again, chronic pain is very different, and all that stuff. And I'm not advocating people taking opioids. I'm a fucking alcoholic and addict, right? So it's that's scary shit. Um, but I think it's like, are there ways to in the interim find other like ways to support yourself and your pain? I don't know, but I would like I don't know, I'd probably ask you like about that if like we were talking about this, because I would I would just be curious and say, like, if your shoulder is in chronic pain, like are there things um yeah.

Scaling Through Medicaid And Partnerships

SPEAKER_00 1:30:54

I have I have left no turn on stone uh or stone unturned here, Mikey. I promise you, my man. I've had I flew to Mexico and had sixty thousand dollars worth of stem cells put in my shoulder. I've had multiple plately rich plasma injections. Yeah. Um, you know, the things you mentioned, like Tylenol and steroids, I'm way beyond that, right? Like those are those are things for, you know, you got a little bit of an ache. Um, you know, my things is I've tried, you know, stem cells and and they help for a little bit, right? And so I think that yes, there are ways acupuncture, dry needling, massage, but these all these things cost resources, right? They're not covered by insurance. Or that's the that's that's the system we live in, and that's why you know these conversations are so important. It's like, look, and until we get insurance to play by the rules, and then maybe if insurances get involved, maybe it'll corrupt those systems, and that's what worries me too, right? Maybe they'll, you know, and those uh that those are the things that I think about. But I appreciate you uh asking those things, but you know, rest assured, absolutely I'm happy to talk about off-air on this because I don't want to make the show just about my treatment and all that stuff. But I've literally almost everything from red light therapy to the most arcade, like weird shit out there, you know, I've tried it. Um but I I wanted to get back to to the Jesus and got there because I think you brought it up and I really I love your perspective on it, and I just want to ask you. So for me, it's you know, studying the teachings and teachings of Jesus is like a human who was born on a certain day, died on a certain day, and sort of practiced these spiritual, sort of moral, ethical teachings and was very sort of anti the current establishment that he was going on because of the oppression that they were experiencing, you know, and he was a minority sort of immigrant or brown minority human being, right? Um like it it's it's easy for me to get behind the teachings. Where where I find it hard, and again, like we we went to the same, I went to St. Ambrose, you know, to St. Pete's, we we went to we had very similar sort of upbringings, right? Um and then I was raised in a very Roman Catholic, you know, Chicano, Hispanic family, and most of my family are still Catholic. Um and the thing that I battle with now is like almost the the metaphysical parts of Jesus and the mysticism, you know, like the the the the fact that he is the son of God and that he is what was born, you know, via Maria, via sort of immaculate conception, like like that is the stuff that it's uh it's it's hard for me to get on board with it, you know. It's hard because it it just seems like uh it just seems like uh we're just making it up because it just like this uh whimsical fairy tale, just like I bought astrology tarot cards and it's sort of filling a void where it's got to be something like amazing because uh we need we need something to believe in versus like uh just a really good uh dude that had some good values and he like stuck to those values. Like what what is your take on the on the mystical part of of Christianity and just like you know the the Holy Trinity, you know, being a Catholic and and those things? Because I I I I grapple with it. Like I really, I really want to believe in that again. And this it's sort of like Santa Claus to me in a way, where it's like I lost that when I was a kid and I was like, you know, you know, like now I'm just like now that there's just like a bit of my spirituality that is sort of like it's sort of like detached, you know, it feels like it's a moon and my planet is here, and it's I'm just like I don't even know if I want it to get closer anymore. Like it's still there, but like do I really believe in that, you know? Um so I I just want to start with that question.

SPEAKER_03 1:34:05

No, I mean it's it's a beautiful question, and like it's it's also a propos, because I'm gonna have about I've got like 30 more minutes because I have to go to math. So this is you know next on my list, right? So I think my approach, um what's the most succinct way to say this? I think like the only reality of faith is approaching components of having it that you do not fully understand and that you do not fully believe and taking the jump anyway, like almost definitionally, right? So like the mysticism, the holy trinity, things like this, I can give you as far as my intellectual like capacity has taken me in like understanding those things, which is like quite far. Like, I mean, I'm not a biblical or theological scholar, but like I've got decent answers for all of these things at least. But like, are they foolproof? Are they the physics of like religion? No, certainly not. Um, but what I can say is that in general, um the mysteries of life have only grown more profound as I've gotten older. Like it kind of happened on this curve, right? Where like I don't know, you're like young and you like want to figure out life, and then you hit your like late teens, early 20s, and you think you have like some decent framework and mental model of how life works, and then your late 20s and 30s hit you, and they sort of just like obliterate you, and like you kind of realize that everything you learned through your teens and early 20s was like somewhat accurate, but like also not like it had low recall of over what it could explain and like predict about life, right? Um and like I think that for me, and again, it's that uh that T. S. Elliott poem, like, and at the end of our journey, we will come back to where we began and we will know it um like completely new. Um like these teachings that we learned at St. Ambrose and St. Cyril in my case. Um, you're St.

SPEAKER_00 1:36:40

Cyril, sorry. No, no, no.

Human-In-The-Loop AI For Mental Health

SPEAKER_03 1:36:42

No, it's okay. Just I'd I'd have to clarify and wrap um Cyril of Alexandria when I can. Um uh in Tucson, Arizona. Um, you know, what did we learn in kindergarten and first grade in Catholic school? We learn things like don't lie, we learn things like don't choose violence, we learn things like treat people how you would want to be treated, and we learn things like care about those who are marginalized and less fortunate than you. And the profundity of those lessons, insofar as those basically four rules that I just laid out, like doing all of those things to the maximum ability that you can as an adult is actually way harder than most people will be honest about. But if you guide your life toward those four things, for based on my experience, I have found myself to be happier, more joyful, and more free. And so for me, so much of my own faith is just sort of a pragmatic acceptance that like these fundamental truths that have been distilled over centuries that I challenged and ruthlessly rejected in some ways in my youth are actually like the best framework and guide that we have for how to be a full, complete human. Um, and like for me, that ended up being enough to take the plunge because I spent my life searching for like the answers, the framework of like how to make meaning and how to be like joyful and free. And the crazy thing, Nick, is that the answers that I got when I was six years old are the answers. Um, and and and so like my hat is off to the Catholic Church. I'm like, holy shit, you guys are right. Um, you know, and then for me, the this of course, because I'm dense and stubborn, and you know, I say God made me an alcoholic and he made me a scientist. And it was because I needed to have sort of like falsified proof of God's existence in my life in order to believe in him. Every day I get to experience a miracle of not drinking and not wanting to drink or use. And that's been going on now over 4,200 days or something. I don't know. I was just looking at this yesterday. Um, and so I get to experience a daily miracle that I get to now sort of experience as like the greatest justification for for my belief in God. Now, of course, that is not generalizable. Not everyone's an alcoholic who's in recovery that that has experienced this. And I'll just I heard this the other day. Someone said, um, if you want to learn about God, like go to the first floor of the church. But if you want to see God, go to the basement where the alcoholics are having a 12-step meeting. And like that is my experience. Um, and so I don't know how satisfying that is. The actual metaphysical stuff, I think, is very tricky. I guess the only thing I would say, and Ross Duthat out of the New York Times wrote a book about this recently that I'd encourage you and others to read, is that there's a lot of the metaphysical stuff that is unresolved on the Christian theological side. There's also a lot of metaphysical stuff that is unresolved on the quantum physics and uh uh you know, unified theory side as well. And and and and so at some point at the depth of our understanding, we we have it it ri resolution. And so this is why I kind of said at some point definitionally, faith is looking at things that that are unresolved and jumping anyway. And I've taken that jump in part because I realized the things that I was taught like when I was six years old are actually the right things and they save my life. Um yeah.

SPEAKER_00 1:41:17

Dude, I I really appreciate you taking a stab at it. I know it's not easy, I know you do have to go. The thing that comes to mind with that is like I hear you on the faith and the jump, but it also there's plenty of people that that are of a religious practice that don't follow the morality in the religion. Like, I mean, we can look at the US. There's so many Christians here that aren't anywhere close to living in the teachings of Jesus, but they go to church every Saturday or Sunday, you know, they kneel, they pray to something, um, but they're in favor of innocent people getting murdered and oppression happening, right? And they and the the the thing that reminds me is like, well, well, the faith jump, it's like, well, can't we even wrap that into like just ignorantly saying, Well, I'm right. I know that's not what you mean, but I think that that's how a lot of people sort of take that and run with it. Yeah, it's like well, that then they'll just be like, Yeah, well, well, my my feeling is right, and therefore, like, you know, me praying to Jesus and this God is what is like the right one, and so whatever is happening here is justified because the people in my circle say that like you know that was justifiable.

Safety, Triage, And Pre-Crisis Signals

SPEAKER_03 1:42:17

Yeah, I mean, and and so again, like I guess there is part of me that I'm I'm wary of oversimplifying uh everything into this kind of binary between like the personal versus the externalizable, but like I really do think, and like sort of the beautiful thing about Jesus is that you know he had commentary on other parts of social order and like how to orchestrate our society, but the vast majority of it was direct instructions for us personally, right? And and and so for me, it's like a lot of people get this wrong because they conflate their personal experience and their personal like journey with how to externalize that onto the rest of society. And like I think that's where there's a lot of gaps and there's a lot of friction and a lot of contradiction and tension. But I sort of just um I don't actually view that as any evidence to the believability of the church or of faith. I view that as evidence of the sociology of man, right? That we are deeply conflicted and contradictory, um and and that uh, you know, we try to externalize our own beliefs, and that can actually like reject more people from accepting Jesus. And and and and so again, like similarly to the healthcare thing, it's like, what's the best way? It's like before we determine whether other people are practicing right or whether other people should have claims over how other people practice, let's just concede that those questions are not answered, they're unsatisfactory, people are fucked up, hypocrites, all that stuff. But like, is there a lot of personal stuff that I could do to follow Jesus more? And will that give me a more happy, joyful, and free life? My experience has been yes. And then like the rest of stuff is questions about how we act in society, right? And so I'm not an evangelical, I'm not out there trying to convert uh people. Um, but my way of supporting others on their journey is talking openly about it, right? And like, I'm grateful that you give me this platform to do it, and and hopefully I've I've done it justice. Um but yeah, there's a lot of hypocritical Christians, there's a lot of uh people who are hypocritical atheists. I mean, like hypocrites um is is just deeply part of being human, I think, right? Um, and so yeah, again, I think I I try to not let that stuff influence my personal belief system and like how I'm approaching the pathway to peace internally.

SPEAKER_00 1:45:13

I I hear you, man. I'm with there. I'm there with you. I appreciate you, you know, answering that as eloquently as you could, because I know it's not an easy question, but you know, when you were going on there, it just kind of made me think more and more about that stuff. And you know, you and I could talk for hours, but I do want to give you a little bit of space to talk about sort of the project you're working on. I think it's it's really interesting because I want to know a little bit about it before you leave, if you don't mind.

SPEAKER_02 1:45:33

Yeah.

SPEAKER_00 1:45:34

Um, and then you know, like what what's the goal with it and you know what kind of brought you into it? Um, because I don't know a ton about it. You know, you've been working on this for a while now. Yeah, you know, um and and it's it's your thing, like it's your full time. You you left your last position. Um, you know, and so you g give me like the lay of the land. What's going on?

SPEAKER_03 1:45:52

Yeah, yeah, thanks. So uh my company is called One Small Step. Uh, we're a platform for certified peer support on nights and weekends. Uh, we support people with substance abuse and serious mental illness, predominantly who are on Medicaid. Um, and we work with their provider organizations uh for their mental health care, and we augment those services. So all these provider entities help these people during the week with therapy, counseling, psychiatry, case management, all of these sorts of things. Um, but then on nights and weekends, people have the emergency room or the crisis line, uh, which is a very inefficient utilization of resources. Most people shouldn't end up there. Um, everyone who ends up there at some point didn't have to end up there if they had the right intervention that they needed. Um and so that's the people that we support uh with our platform. And then on the other side of our platform, we have certified peers who are in mental health recovery or substance abuse recovery themselves, like myself. They're certified by the state of Arizona or whatever state they're operating in. Um and they uh work on nights and weekends as kind of like an Uber-like job, but instead of driving Uber, they can get paid to support people who are having mental health difficulties uh in a like remote way that supports their own mental health recovery, right? And so um that's kind of the high level of what we're doing. I've been at it for like a year and a half. We launched the product a year ago. Um our utilization grew 9x over the the second half of last year. Um we uh kind of grew the potential revenue that we can earn from doing this uh 20x last year through like forming more partnerships with providers that want to provide their patients with this kind of service that that like don't currently have access to it. Um and then we're a technology company, and so one of my co-founders is an AI uh PhD focused on mental health and looking at how we can make both sides of this kind of platform more efficient through utilizing AI. Um in the most safe, user-friendly way possible. Um and so uh yeah, man, that's what I and I can talk about this for hours, but uh dude, we I gotta heavy back on them because we gotta talk about this more.

SPEAKER_00 1:48:30

I love this idea. I I already have like tons of ideas. You know how we work, dude. It's just like that, it's beautiful, dude. I I I I feel like what a what a great space for you to be in, to be honest, because you know you've always been entrepreneur, entrepreneurly minded minded, but you've always been a deeply caring human being, even when we were young, you know. I think I've always seen that in your eyes as you care about other people. Not everyone has that. You know, some people just want to make money because they think that's gonna make them happy and they want to you want to get theirs and support theirs. And that's never really been why you exist. It certainly is not why I exist. Like I want to make wealth so I can give it away and help other people, and of course, take care of people I love, but hopefully help alleviate suffering because I know what it's like to suffer. I know what it's like to not have anyone there. Right. You know, and I think that that this this thing that you're building is is sort of treating an unmet need in society at large. Um how like how do people get involved? Like, what if someone wants to become a peer? Yeah, you know, what what do you guys need as far as support? Are you looking for for more like primary care sort of healthcare organizations to reach out that might want to partner with you? Yeah. Like is that is that what you're looking at right now?

SPEAKER_03 1:49:31

Yeah. So um so if you go to one smallstep.io, that is uh where you can learn more information about our company. Um I guess if anyone's interested and and they want to email me. I mean, I'm I'm just Mike at oncemallstep.io. Um or you can connect with me on LinkedIn or uh wherever.

SPEAKER_00 1:49:51

Um are you guys in any state or are there only certain states?

Closing Gratitude And How To Get Involved

SPEAKER_03 1:49:54

So yeah, so so this is where all of my frustrations with the healthcare system have. Have been informed, right? So, like we know this is massively in demand, right? Because there are 90 million Americans struggling with substance abuse or any mental illness. Um, but in order to grow sustainably, so that I don't have to be dependent on grants and external philanthropy and stuff, because I think those are powerful and good models, but I think that they are long-term, often not scalable. Um, and to build a technology platform and recruit and attract sort of the best engineers in a sustainable way, um we we we formed the entity as a private company that is a part of the medical world that is that that has a reimbursable service. So right now we are reimbursable through Medicaid in Arizona. Um we are signing um up new providers in Arizona on a monthly basis. Um and so if there are any large behavioral health provider organizations that have large Medicaid populations, um, we would welcome connecting with them. Our first big partner was in Flagstaff, the Guidance Center. Um, they're a great organization doing incredible work. Um and they're like one of our best uh partners. Um, we also work with the Easter Seals Blake Foundation in Tucson, Arizona, uh, that has been an incredible partner and helped pioneer our outpatient model. Um and and so if there are entities in Arizona that serve Medicaid patients, we would love to partner with them. One day I want this to be open to anyone and everyone, but um like commercial insurance is just now starting to reimburse for certified peer support. So a few states like Michigan, which is where we're expanding to next, uh, the uh commercial insurers are starting to like cover this. Um and ultimately I have a lot of faith that this will be popular among insurers because we help lower overall costs, which is the one thing that they really do care about. Because people ending up in the emergency room is is a really thousands. Yeah, and it's a huge tax on the system. And it yeah, and like it's not how it's an easy sell, Mike. It's not helpful. It's an easy sell. Yeah, so so this is how my brain has thought about this. Um but uh we love working with people that are interested and and like motivated by what we are doing. Um, and and and so anybody is uh welcome to uh reach out.

SPEAKER_00 1:52:43

Dude, I love it. I I know I gotta let you go. Um, I do want to talk eventually when we can speak again about the AI thing because so many people use AI for advice, relationship advice. I know I have it's very interesting. But I mean the thing, it's like the degree of empathy you get from it is like mind-blowing, right? If you just chat GPT something, especially if it knows your story and it knows things that have been going on, it has like a history. I mean, I'm just like, wow, this thing's giving me advice that uh seasoned therapists might not see. So yeah, we can we can crack that out.

SPEAKER_03 1:53:09

Another 10. So I'm okay.

SPEAKER_00 1:53:12

So let's well let's talk about the AI, how do you how you guys are integrating it? Um, I also want to talk about a couple things off air right before you go, because I I I want to let you know kind of what I've been working on in the medical system outside of my day-to-day job. But um yeah, so like AI, dude, it's it's so interesting. Like now, you know, loneliness, mental health, like all these things, we talk about these struggles, and these are so innate human, and they're even more prevalent today because even though we're so connected, we're we're so dis we're so disconnected, right? Like very rarely do people look each other in the eyes or they say hi, do they have a conversation? And I think if we get back to more and more of that, we're gonna have less like feeling of alone. I know when I have conversations like this, I feel better. I just feel better, you know? Like, how are you guys because you're saying like using AI in a thoughtful way, which like one bravo for for considering that, but I almost think like the way I've seen Chat GBT work with people has even been like safer than them working with some people that have professional degrees because it has less of a bias.

SPEAKER_03 1:54:10

Yeah.

SPEAKER_00 1:54:11

You know, like like therapists are like, oh, don't go to AI for for healing. I'm like, guys, uh, as someone who was a counselor for five years, like I type it in and AI's giving me pretty solid advice emotionally for relationships. You know, it's pretty unbiased. Yeah.

SPEAKER_03 1:54:24

Like, yeah, so uh I like most of the answers I uh I guess in my life, like I see it as as kind of both and like like rather than and or, right? So companionship and mental health support is the number one use case of AI, uh, like among uh consumers, right? Like, which is astonishing, but that is the number one use case, and it's not a question of whether people should or shouldn't, like they are, uh, by the hundreds of millions of users every month, yeah, using it for companionship and mental health. This is the cat's out of the bag. So the question is how do we like design a system that drives maximum effectiveness, like given that fact? And so my belief is that we have to have human in the loop mental health AI. So we are building our own AI system that our members can directly engage with. And we haven't released this broadly yet, but over time, uh that AI will support triage and allocation of members to real humans when that is needed. Um, and we will build identification systems um that identify when someone is escalated and like needs to talk to a person, versus having their question adequately dealt with by an AI, right? And there are millions of Americans using AI for mental health support who can't afford access to counseling and psychiatry, psychology, and who are getting great answers. Um, then there's the edge cases, right? And and like I shared with some of the insurance questions, this is all on a probability distribution, right? And so there are tail cases where things are not going well, where the AI system is not recognizing someone's in need, or they end up helping them in a self-harming way. Um and that is really tricky, and we have to like develop way better LLM science, basically, to identify that. And so one thing that we are working on with some researchers um in the Bay Area uh is like the systems are getting pretty good at identifying crisis and suicide um signals, right? Um, but what they're not good at is the large taxonomy of like pre-crisis emotional stress that ends up as a acute self-harm incident. Um, so we are working with researchers, and again, my my co-founder has a PhD in this themselves, and we are developing a taxonomy and our own benchmarks and evals around what pre-crisis engagement looks like. Um, and that's to make sure our own system is safe and to make sure that we're routing people to humans when they need it. Um, but then it's also something that we can work with the larger AI labs on to uh work with them on like what we learn and and how that that can inform their own models. Um so yeah, that's that's a little high level. I mean, and then there's all the efficiency stuff on the peer side. So when people apply to be a peer, we can quality assure um their answers, right? We can after they they do sessions, we can have a quality assurance AI kind of look at the answers and like help them in real time with certain tricky cases. Uh there's there's all sorts of things we can do to make that side of our platform more efficient as well.

SPEAKER_00 1:58:26

Yeah, I I love it. I I I I view this as from the counselor perspective, like there are things that people will ask AI that they won't even bring up in therapy, right? That there are things they'll talk about suicide auditation, they'll talk about a love that they lost. And not to say the therapist isn't good, it's just the fact that they don't they know there's gonna be zero judgment on this stuff. Yeah, they know there's things, you know, yeah, and and and I and I understand that. Like there's a reason and and for again, there's positive, there's for better and for worse. There's some positive things that will happen from that, and some severely negative things that can happen from that. And thoughtful design of the architecture of the thing is what's ultimately gonna predict that outcome, like you're speaking to. Right. Right. Because I mean it could do wonders, it could also not, you know. Right. Um but but I do think there's less, like I am concerned with AI for a multitude of reasons um outside of the healthcare space, right? When we talk about like defense and wars and all these other things. But speaking of this specifically, like I I almost feel like it's safer for some people to talk to AI than it is to some therapists, because therapists, like not everyone that has an MS or a Psy D is honestly a great therapist. You know, like that they're they're just like not every surgeon is a great surgeon, you know, like they're they're more fallible in that way. Whereas AI, like, I feel like, and I've asked it tons of questions about Jesus, about spirituality, about and it gives you like very methodical. That that don't it doesn't, it doesn't try to it doesn't it doesn't try to like feed it to your bias. It's like, well, good question, Nico. Yeah, but let's think of it this way, right? And right, and I and I really appreciate my fear is that some human part of it will become nefarious and they will manipulate the output of the information because they want to sell a certain narrative, right?

SPEAKER_03 2:00:11

Yeah, so what's interesting, and so like we're working with partners on this across the country, really. There's uh there's AI labs um that we're working with on making our models and products safe. There's frontier research that that like we're doing. Um and the the problem of sycophancy uh is is like the technical problem. Like that is real. So the systems are optimized for engagement and they want you to keep engaging, basically, right? And so they do they sort of infuse kind of like mild flattery and sort of all these, it's like, wow, that's such a great question. Like that's such deep insight. And like sometimes it is that, but like other times it's not, and and and so there's these like sycophantic tendencies um that we have to think about, especially in the mental health case, right? Um but like in general, I totally agree with you that like the reason that this is all revolutionary is because and we've known this for a long time, with a lot of predictive analytics, um, are more accurate than humans, right? And like we we we saw this in radiology, uh, we'll see this in mental health through AIs.

SPEAKER_00 2:01:24

Um we'll see it in surgery soon, too.

SPEAKER_03 2:01:26

We'll see it in surgery, right? So, like um, yeah, machines have a generally lower error rate than humans. Um now, to your point about systems, um how we attribute blame and agency to a machine versus a human is a very tricky thing. And in some ways, we have to be like careful because we already struggle with that. And if now we have this like third actor that we can start shunting a lot of like blame onto, right? I mean, yeah, anyway, I think there's a lot of ethical quandaries. Um, but I I think these technologies are absolutely astonishingly amazing. Um, and it's it is a great gift and blessing to be alive um when they have been sort of discovered and pioneered. And like for me personally, like to be a founder building in the space using them is like really the most exciting thing I could possibly imagine.

SPEAKER_00 2:02:29

Yeah, dude. You know, absolutely, my man. I love it for that. I love you, I love that for you. Yeah, I think it's just such a yeah, I have so many things I want to talk about, but I know we gotta, we gotta, we gotta close this one out. Um, but I dude, we I gotta get you back on like soon. You know, let's we you and I we can talk about anything and everything, and I love that. Um, and it we can always interject our own personal experience, but also become esoteric and talk about it. Dude, I love this.

SPEAKER_03 2:02:54

Who knew that it was it was Jesus versus uh Man Joni was gonna be like the central theme. But I actually think it's really profound, dude. I think it's really profound.

SPEAKER_00 2:03:03

Agreed, my man. Agreed. I I I I expect nothing less, and that's why I've loved this show is that people ask me, oh, what are we gonna talk about? I'm like, just just show up. You know, I'm just like, we'll we'll find it. It's there somewhere. You know, I rarely have pre-I mean, with you and I, it's different. We're we're close friends who grew up together, but even with people I don't know who are you know have millions of followers and they're only they always want some like pre-call thing. And I'm like, we'll talk about some aspect of your life. I just asked them what's off limits, and if they give me some, then I won't touch those things. Other than that, we're just gonna have a conversation.

SPEAKER_03 2:03:32

Yeah, I love it, man. Well, it's awesome. So yeah, um let me know. Uh, I think you said that that you want to close out with a few uh off-camera things. So happy to do that too.

SPEAKER_00 2:03:45

Yeah, yeah, yeah, for sure. No, just before I just want to end this and say again, thank you, dude, for coming on the show and talking to you and Mike. And um, I'll throw a link to to the company, uh, to your company down low. And if anyone wants to reach out or get involved or maybe become a peer, you know, just yeah, yeah, yeah.

SPEAKER_03 2:03:59

Sorry, that that the other thing is that you so all states have their own peer certification system. There's a lot of agencies and educational institutions that will help you become a peer. So look it up certified peer support. Um every state has it. Uh um, you know, the guidance center and flagstaff is like a great place to start. Um, and um yeah, yeah, uh reach out.

SPEAKER_00 2:04:25

Awesome. Well, thank you, Mike. And uh yeah, everyone, I'll throw links down in the description to that. And yeah, we'll we'll have you back on soon, brother.

SPEAKER_03 2:04:31

I mean, hey Nick, thank you so much. I Nico, Nick, I knew him as Nick from you.

SPEAKER_00 2:04:37

You can call me, you can call me Nick. I actually went through this how I changed my name to serve a pit tape homage to my Hispanic heritage when I was 23. So Nico.

SPEAKER_03 2:04:46

Uh yeah. It it it it is an honor and uh I'm a privilege just uh being able to speak my mind on your platform. So thanks for having me. Absolutely, my man.