Imagine being lost and searching for deeper meaning in the world, only to find it in the faces of the sick and dying. If it sounds like a journey worth hearing, join us to explore the personal and professional life of Dr. Michael Fratkin, a respected doctor in Humboldt County. We chart his course from a nerdy teenager to a leading player in the realm of palliative care. You'll learn about his initial explorations at the Open Door Clinic, his dedication to Hospice of Humboldt, and his passionate commitment to helping those grappling with mortality.
Navigating healthcare for seriously ill patients often feels like traversing a labyrinth, but Dr. Fratkin provides us with a guiding light. We delve into the poignant realities of patients battling complex medical illnesses and the essential role of advocacy and information exchange in their journey. The anecdotes of Michael's own medical school classmates, who had to face their own medical illnesses, drug overdoses, and other tragedies, serve as a testament to the power of shared experiences in forming lasting bonds.
But this isn't just a story about medicine and healthcare. It's also a tale of innovation and embracing new ways of healing. We touch upon telemedicine, and the push for a more human and soulful approach to it. We also venture into the intriguing world of psychedelic medicine and Michael's ongoing work that combines palliative care and psychedelic science research. As we wind down, we discuss the idea of legacy and the profound wisdom of investing not in material possessions, but in relationships. It's an episode that promises a blend of personal narrative, professional insights, and societal challenge discussions. So, are you ready for a journey unlike any other?
Find us on Facebook at 100% Humboldt.
Imagine being lost and searching for deeper meaning in the world, only to find it in the faces of the sick and dying. If it sounds like a journey worth hearing, join us to explore the personal and professional life of Dr. Michael Fratkin, a respected doctor in Humboldt County. We chart his course from a nerdy teenager to a leading player in the realm of palliative care. You'll learn about his initial explorations at the Open Door Clinic, his dedication to Hospice of Humboldt, and his passionate commitment to helping those grappling with mortality.
Navigating healthcare for seriously ill patients often feels like traversing a labyrinth, but Dr. Fratkin provides us with a guiding light. We delve into the poignant realities of patients battling complex medical illnesses and the essential role of advocacy and information exchange in their journey. The anecdotes of Michael's own medical school classmates, who had to face their own medical illnesses, drug overdoses, and other tragedies, serve as a testament to the power of shared experiences in forming lasting bonds.
But this isn't just a story about medicine and healthcare. It's also a tale of innovation and embracing new ways of healing. We touch upon telemedicine, and the push for a more human and soulful approach to it. We also venture into the intriguing world of psychedelic medicine and Michael's ongoing work that combines palliative care and psychedelic science research. As we wind down, we discuss the idea of legacy and the profound wisdom of investing not in material possessions, but in relationships. It's an episode that promises a blend of personal narrative, professional insights, and societal challenge discussions. So, are you ready for a journey unlike any other?
Find us on Facebook at 100% Humboldt.
Hey folks, welcome to my guest, the special, the man, the myth, the legend, dr Michael Frackin. Good to see you, nice to see you too.
Speaker 2:Scott, How's everything? Everything is complicated, interesting and overall pretty darn good Nice.
Speaker 1:We have a lot to be grateful for. Always we do. It's funny. I was thinking about you coming over and I'm going. I feel like I know Michael, but I haven't hung out. It's like you're somebody I know but I haven't seen. You know between COVID and just life and your business and the arc, and we'll get to all that. So I always start with two questions who is Michael? Who?
Speaker 2:is me who?
Speaker 1:are you, who are you and what do you want?
Speaker 2:I'm a father and a husband and a brother and a friend and a son, and I'm also a Humboldt County resident for nearly 30 years. Wow, once I settled, this is where I came. I'm a doctor.
Speaker 1:Saw you went to school at Irvine.
Speaker 2:No, oh, no, oh no. I went to school with Irving, irving, but no, no, no.
Speaker 1:Irvine AI has it wrong folks, they totally have it wrong.
Speaker 2:No, I went to medical school at the University of Utah where I just had my 30th medical school reunion. Yeah, we can put a pit in that if you want to come back to it. Wow, boy, that was interesting. I bet that was fun, and then, yeah, so what do I want? I want to experience life every day such that I'm infused with a sense of meaning, purpose, and then just for my own spectacular enjoyment. Awe, I'm totally an awe junkie.
Speaker 1:Wow, how do we get some of that?
Speaker 2:It's everywhere, everywhere, everywhere you look if you want it, everywhere it's there.
Speaker 1:So tell us the Michael story. How did you? You were born somewhere and then you went to school and then here you are. So give us that time, mark.
Speaker 2:Yeah, yeah, yeah. I was born in upstate New York, in one of the most difficult towns to spell Schenectady, New York.
Speaker 2:Just outside of Albany, new York, I think you say Oneata. And then, as I entered high school, my family started to shake and shudder and we ended up relocating a number of times, once to Florida, and then where else do we go For Florida? To Austin, texas. So I went to like three different high schools, which is kind of related to the whole reunion thing. I'd never been to any kind of a reunion because I never really had been connected to my high school class or college class or anything like that.
Speaker 2:So anyways, I finished high school in Austin and Texas, went to school for a year or two at the University of Texas, but then, before my grades tanked, I wasn't happy and I didn't know what I wanted to do. So I shuddered everything up and hit the road and I moved to Park City, utah, where I worked as a ski lift operator. And then I traveled to Lake Tahoe where I lived outside and climbed rocks for about a year and I returned and skied at the Russell Lodge in Alta. If anybody knows that place, it's a pretty amazing place, alta.
Speaker 1:Utah.
Speaker 2:And stayed there for a couple of years and I went to Alaska and fished on a salmon boat, which taught me that I really wanted to go back to school. I am not that kind of a physical specimen where I thought that I wanted to work that hard with my body and my brain works pretty good. So I decided to go back to school. I studied marine biology for a while, studied political science for a while In Utah, well, in Florida and in Texas, and then ultimately I finished back in Utah. Once I decided I wanted to go to medical school. I went back to Utah and finished there Because I had a whole community of friends and people there. Sure Well, what an adventure. Yeah, it was like nine years to get an undergraduate degree.
Speaker 1:Kind of like the backside of Benjamin Button when he went and did all that stuff at the end of his backward.
Speaker 2:Are you comparing me to Brad Pitt?
Speaker 1:A little bit. Oh, my goodness, I'm a lucky man, glad you caught that. Yeah, you and Brad. So who were you at 15? What were you all about? The nerdy teenage boy, oh god the worst hair anywhere.
Speaker 2:I. Do you have a fro or was it long? It's like a Jew fro. I had like a Jew fro. It's kind of like it was like it flopped over to one side, nice, I didn't know that was a thing.
Speaker 1:That's a thing.
Speaker 2:Oh, it's a thing, it's totally a thing, totally a thing. And I was stoned like all the time. Yeah, I barely graduated high school who wasn't? Yeah, I watched a lot of TV, drank a lot of like I think Mountain Dew Gross Early.
Speaker 1:And I know about that.
Speaker 2:With nine kids, they, they'll my teenage years were years of kind of involution, of like collapsing inside of myself and feeling so insecure that I just put out no risk at Autic, no risk and anything that's a well said occurrence.
Speaker 1:I think that is a thing.
Speaker 2:People do that.
Speaker 1:Involution.
Speaker 2:Yeah, involution. It turned inward and somewhere along the line I caught the idea that maybe there was more to life. I mean, it was a time when environmental pressures like reinforced my own sense of kind of hopelessness. It was a time when there were books being written about nuclear winter, where the nuclear freeze campaign was falling on its face, where the idea that we had mutually assured destruction with gajillions of ICBMs pointed at ourselves and each other such that a button gets pushed and it's all gonna be over. I remember, like hearing a car backfire or some kind of a sound in the environment, I was like that's where I went to immediately Like this is it's all gonna end in a bunch of mushroom clouds and scattered subatomic particles. Yeah, because that's what it was, that's what it felt like.
Speaker 1:And so I was super down.
Speaker 2:I mean it caused an effect Like I was probably super down anyways, but the sort of relationship between that kind of externalized sense of social hopelessness and my own feelings inside just made for smoking lots of bomb rips.
Speaker 1:Yeah, I wonder if that relates to today, to our kids. I see some quiet desperation that is similar and I kind of wonder sometimes that they have a harder, a little harder time in some ways.
Speaker 2:Well, now you gotta put some articulate kid behind the microphone and talk to them, cause I don't really know. I mean, I look at my incredible daughter. She's almost 18, my son 13. They're going through stuff, but they seem to have a certain does Jenny say, a certain kind of sense of less catastrophism than I can remember when I was a teenager. That's good, they're both pretty.
Speaker 1:That's a good. I put a pin at that. Let's get a good teenager on the show. A good teenager. I don't know what that looks like.
Speaker 2:I won't volunteer my daughter, cause she'd kill me.
Speaker 1:Yeah, I know she would, but I'll ask her. Yeah, never know. So tell us the story about how you got to Humboldt then. What brought you here? How did you arrive? What did you do when you got here?
Speaker 2:There's a part A and a part B. Sure, the part A is when I was living in Lake Tahoe climbing on rock with a friend of mine living in a tent. We had a friend who was going to South Lake Tahoe Community College and he needed a ride home to Humboldt to see his parents over, like some break, winter break, I think it was. So we gave him a ride, and people who know Arcada Bayside will appreciate this. But his parents, who worked with Caltrans at the time, in like 1985 or no, 1981 or two, they lived in that incredible building right across from the Bayside Grange, which is now the hot yoga building. And so I came with my buddy Billy and Chris and we hung out in Humboldt County for about a week or so.
Speaker 1:That's a historical site. That building was amazing. It was a school or something.
Speaker 2:I don't know, but staying inside of it and driving in through the fog and the mist and the amazing forests around here totally left a mark in me. And then a whole bunch of life unfolded and as I finished my training I had to decide where do I wanna go and be, where do I wanna have my life unfold? And I wanted a place that was in the Pacific Northwest, had beautiful forests, rivers, ocean and was far away from everything else. So it wouldn't change so rapidly.
Speaker 2:The population was stable, maybe a little bit economically a low average in terms of all the typical growth that you see in groovy towns Checking all those boxes.
Speaker 1:Exactly, it's not Santa Cruz, yeah.
Speaker 2:No, not exploding, not changing, homogenizing like everybody else. Sure, left leading politics check that box, double check 25, 50,000 people check check University, check check check, check, siblings, all that stuff had me recognize this place as home immediately. So when I got finished with my training I went knock, knock, knocking on the door of the Open Door Clinic and Herman Spetzler and his wife Cheyenne, her and the legend, yeah, and I made them hire me. Was he a full guy?
Speaker 1:Herman Spetzler.
Speaker 2:Yeah, herman Spetzler was an extraordinary human being super brilliant, incredibly strategic, started a big clinic called the Open Door Clinic, was the only reason the Open Door Clinic has proliferated and now is really the backbone of healthcare for our community. Primary care, specialty care, behavioral health, all of that, All of that for people who may or may not have a bunch of resources.
Speaker 1:Yeah, they were out at Ferndale Fairgrounds for the veterans. Stand down today where they take care of veterans and the Open Door dentist van is there. And yeah, quite a guy. And I remember as a college student being broke getting care downtown Arcada, the old store.
Speaker 2:Yeah, it started I don't know how many millions of years ago, during the sort of late stages of the Vietnam War. He and a bunch of other docs basically opened up in what is now the Tin Can mailman, right next to the Open Door Clinic. Sure, they had a few cuts and they did draft counseling and that sort of thing for folks, and then they just did the next thing and the next thing and the next thing, and now they're in Crescent City, ukiah, maybe.
Speaker 1:No, not in Ukiah.
Speaker 2:Crescent City, mckinleyville. The North Country Clinic in Arcada. The Cata Clinic in Arcada. Eureka the big one, the Eureka Community Health Center, the Telehealth Center also in Eureka, the Fortuna Clinic, the Mobile Medical Clinic, Dental Clinic. They are the backbone of primary care.
Speaker 1:I have to agree with that yeah, so what I met you which was not meeting you? I saw you on TV 15 years ago.
Speaker 2:Seriously.
Speaker 1:Yeah, you were telling your story on access TV about being a palliative care guy and you kind of gave the highlights in what you did and you attended a lot of deaths. And can we do that? Can we talk about that?
Speaker 2:Yeah, yeah, yeah.
Speaker 1:I mean coming up to Resolution Care, and then we'll talk about that.
Speaker 2:Yeah, well, I came to town as a primary care internal medicine doctor, which just means that my focus in primary care was on adults with complicated illness. I spent a lot of time staying current and capable as an HIV specialist when I first got here, but my heart was always, always in the care of people who were really, really sick and I ended up, not too long after I got here, stepping into the medical directorship over at Hospice of Humboldt. Hospice and palliative care have just always drawn my attention. It's the kind of thing where I'm drawn towards situations where people are confronted by their mortality, where the shit is really going down. I'm drawn to move towards those things, while, quite naturally, a lot of folks are drawn to go the other direction, to run, to run. Yeah, fight or flight. That doesn't make me any better. Maybe it makes me more into tension and conflict and drama.
Speaker 2:I don't know the reason is, but I've always been drawn towards it. I worked as a emergency room tech in Florida Tampa General Hospital and one of my jobs was to gather information from people who got brought in by stretchers and trauma situations and all the rest. So they'd be cutting off their clothes, they'd be intubating them, doing x-rays, putting in lines and IV infusion sites and all the rest of it, and the only place you could go to talk to these people if they were able to talk was over their head, so behind their head while they're lying that way.
Speaker 1:Upside down.
Speaker 2:Upside out and I would talk to these people and ask what's your name? Where are you from? What's going on? How are you feeling? Are you okay? It's going to be okay. And I would talk to these people upside down and it kind of anchored this concept that there's everything that's going on with people. There's their broken leg, their pulmonary contusion, their intra-abdominal bleeding, their surgical problem, and then there's the person inside of all that. Wow, and that was sort of critical for me to decide that I would go into the field of medicine, that I would ultimately train as a doctor so fast forward. I always had my interest in people who were living at the sort of edge of mortality and when I got here I ended up working at the open door clinic but my responsibilities were for all of the folks.
Speaker 2:That were some of the most complicated people, people with incomplete diagnoses, people that were progressively moving towards their death as a result of neurologic disease or heart disease or lung disease or cancer, and I got less and less interested in what was wrong with them than how they were navigating the natural human process of finishing a life, and so that became more and more my area of interest, and all the whizz-bang technical medical stuff became less and less of an interest. Palliative care is this beautiful, unique neighborhood inside of the modern healthcare system where the first, second and third things that matter is who the person is and how they're relating to what's happening to them.
Speaker 1:Wow.
Speaker 2:So I describe that in kind of three ways. Number one we don't take care of any patients, we only take care of people. We do that with other people in a fully staffed palliative care program that includes a doctor, a nurse, a social worker, a chaplain, maybe a community health worker, but a team of people with differing perspectives, that kind of wrap around and provide a sort of 360 degree view of what's happening to the person with the cancer, the heart disease, the whatever, whatever. So number one people, not patients.
Speaker 2:Number two because the quality of the lived experience, the quality of life for people who are dealing with serious illness or life limiting illness or terminal illness or diseases or illnesses that are gonna kill them, since their quality of life and their lived experience is so important to us, turns out we're also technical experts in optimal symptom control. So the things that make you miserable when you're sick pain, breathlessness, nausea, fatigue or just the sort of psycho-spiritual challenge and grappling with the fact that life is not an infinite experience. So number two symptom control. We're damn good at it. We take good care of people and their symptoms so that they feel as good as they can feel.
Speaker 1:Right, not afraid to give meds if they need meds. Not afraid to give them meds, yeah.
Speaker 2:And not afraid to adjust those meds and trial it with this and trial it with that and finesse it so that they can balance out, based on their own goals, how much medicine versus how much clarity, and they get to be empowered to kind of drive the nuances of their symptom control.
Speaker 1:Pretty powerful, empowering, very empowering. I like it. Yeah, that's the idea.
Speaker 2:So people have patients symptoms. And then third, I don't know if I'm allowed to say this, but I'm gonna say our healthcare system is kind of fucked up. Oh, yeah, yeah.
Speaker 1:And call it a medical desert is what we've.
Speaker 2:Unbelievable. I mean that means that we don't have enough of some really fucked up healthcare structures In other cities, where there's tons of that. Let me promise you it's fucked up.
Speaker 1:There too Our system is terrible.
Speaker 2:Our healthcare system does not prioritize individual human beings. It does not prioritize smooth processes and operations for the experience of the person with illness who's under stress. It's optimized for the economic structures that drive it. I don't wanna go off on a soapbox, but it really is problematic. So the third thing that I say we focus on is when people have very complicated medical illnesses. They always have really difficult human circumstances. We don't take care of people with a bump on their knee and a rash on their nose. The people that we take care of in panache are seriously ill. They're confronted by either mortality or other kinds of significant losses and disability. Sure, and we help them to navigate through this crazy healthcare system.
Speaker 1:I think money or relationships or vocation Could be anything.
Speaker 2:Usually it's a lot of information exchange and then it's a lot of advocacy and making it easier for them to get from step one to step two to step three so they can benefit from the amazing technological advances that are out there and caring for their particular underlying disease state. But yeah, we focused for many, many years. I focused on people who don't have a lot of resources, who are burdened by being poor, by being mentally ill by being substance abusers by being whatever.
Speaker 1:We're all about that. So, to make your point, joni, my wife, I haven't shared this with you because thanks for finally hanging out with me.
Speaker 2:Yeah, yeah.
Speaker 1:You're welcome. Thanks for being my friend. Finally, joni had a stroke five months ago, so you know maybe a little bit. Joni's a runner and a hiker and a competitive cyclist and a mom.
Speaker 2:Times how many kids you have.
Speaker 1:We have nine. I'm number 10.
Speaker 2:Oh, my God.
Speaker 1:Yeah, so to be 10 grandkids, which is cool.
Speaker 1:So we haven't seen each other for a while your 18 year old was like three, so navigate this stroke that she had one morning in McKinleyville and I had to go get her, take her to Med River Hospital and fortunately we had a good, a slow ER morning and a doc that was decent. But the care there and then the care after has just been night and day. It's just terrible and just ambivalence and obfuscation. And you know we don't have your file and oh shit, really, are you serious? Either A, you don't have a problem, or B, you have a big problem, because people were just from one person to another, from one shift to another.
Speaker 2:There's no coherence.
Speaker 1:The handoff and no one's answering a phone, and primary care it's anyway. So she's got a green light. She's started to walk and run and she was given four miles a day to walk and now she cheated it, she got up to 10 and anyway she just got the green light to finally run Nice.
Speaker 2:Oh man, I'll just give you a five case. I'm glad that the story direct pointed towards her. The therapy's back, yeah, excellent recovery.
Speaker 1:But the point is that to me is that she's the last person maybe in the county or the planet that could have had, should have had, a stroke. It'd be all the fat asses like you and me that maybe don't all together healthy.
Speaker 2:Yeah.
Speaker 1:And so it could happen to anybody. But yeah, terrible experience.
Speaker 2:It's so hard to make your way, Even if you just have a sniffy nose or anxiety about maybe it's COVID and you want some advice about whether you should take PaxLivette or shouldn't. Getting access to wise guidance in healthcare, even for the most simple things, is hard, and when things get more complicated and more grave and the decisions become more critical and pivotal most often the support for those choices that are yours to make is not there.
Speaker 2:So that's a big part of what palliaries. So number one, people, not patients. Number two, symptom control is super important. And number three, navigational assistance to be able to get the most out of the healthcare system, but also to do it on your own terms.
Speaker 1:In a timely manner. You just highlighted what it's critical.
Speaker 2:Yeah, a lot of people perceive me as a pain in the ass because I advocate, and have advocated for decades, that if the person in front of me would be in less distress by getting something done now rather than two weeks and waiting for the cue to do. I jumped the cue, I cut the velvet rope, I call people and bug them, and there's some people who don't really like that.
Speaker 2:I don't like that, but the people in the families that I take care of. They recognize that that's real value. They don't have to be super smart, but I have to be willing to butt heads and push hard to get them what they need, we'll get the great, exactly so.
Speaker 1:You've attended how many deaths and actually been, oh God, I don't know, have you ever? That's what floored me and I realized we had a friend last night who lost her aunt up in Grants Pass. She passed as Anyway. So, and it hit me hard to go, you've experienced this not dozens, not even hundreds of times.
Speaker 2:I guess I would say, although these last few years I've been kind of less directly involved, but over the years in this community I've been a part of teams that have cared for probably 5,000 people who've died, which means that I've had something to do with maybe 3.5 other family members in association with that.
Speaker 1:So maybe 20,000 people.
Speaker 2:Maybe 20,000 people have some direct contact with the work that I've done, some touch from the work that I've done in the community. How does that feel? It makes me feel like I'm a part of the fabric of this place. Yeah 100% Humboldt, if you will. You might say that.
Speaker 1:Yeah, well, yeah.
Speaker 2:No, it makes me feel like. You know, I drive through town. I made tons of home visits over many years and as I drive through this neighborhood even this neighborhood actually around the corner I drive past the house that I serve somebody in the last part of their life and while I go to the supermarket, I'm in Wildberries and there's two categories of people. There's people who come up to me in the produce section saying thank you and they want to give me a hug.
Speaker 2:And then there's the other bunch of people that are triggered by my presence and they're rushing and hiding in the pet food aisle to stay away from me. Either way, I know that I've had some substantial or meaningful impact in the community.
Speaker 1:Any regrets in that practice? And what is it? 20 years here, 30., 30.
Speaker 2:No, I mean, there's lessons I wished I'd learned the second or third time rather than the fourth time yeah.
Speaker 1:So say we all yeah.
Speaker 2:There's definitely choices that I made that I'd like to back to the future and reverse them If we could. Yeah, but no. I think I've been pretty earnest about picking myself up and being honest with myself and figuring out the things that life and these circumstances and the privilege of stepping into the bedside in those situations has wanted to teach me.
Speaker 1:I think I've been pretty good about it. I like the word earnest, that's a good word. So I just got back from my fourth I'm sorry, I'm good of 30 years at a reunion. I just got back from my 45th reunion of we weren't doctors, we were knuckleheads. This is Sweetwater High School in.
Speaker 2:National.
Speaker 1:City California. And I was voted prettiest hair. You were not. Oh yeah, I had beautiful locks.
Speaker 2:Did you throw?
Speaker 1:No throw. Long hair long and with blonde streaks, I was all, yeah, no you throw. My friend had a, philip had a nice shoe throw, but going back there and going with all the overweight folks that are all 63 years old and it was really heartwarming, it was wonderful. They were so wonderful friends and people that you lose track with and you see them every five years. I want to hear your 30 year. So these are docs. So medical school.
Speaker 2:Because I moved around so much as a kid and because I came in and out and in and out of college, changing my majors and everything else, there was never really a cohort of students that I felt a part of until we always were. In high school we all walked in on day one of medical school, our 100 and whatever 102 or three of us, and we started and we finished together, plus or minus a few. How?
Speaker 1:many dropped out.
Speaker 2:Oh, I don't know too many dropped out. There were one or two of them got injured along the way and ended up taking an extra year. A couple of them did drop out. This is the University of Utah. University of Utah School of Medicine, top of the hill.
Speaker 1:Wow.
Speaker 2:So I'd never been to a reunion of any sort. Utah is an interesting place, heavy Barman, you may have heard about that. Our medical school class was about 80% married male Mormon missionaries with kids.
Speaker 1:And then there's men.
Speaker 2:Yeah, a lot of ebbs are there and there was a crew of us that were everything else.
Speaker 1:You're the token guy with the fro.
Speaker 2:Didn't really have a fro by that point. I was cooler by medical school time. But yeah, the rest of us were sort of this eclectic mix of older students or students with different kind of unusual background and not a uniform sort of spiritual and religious kind of identity. So we hung out. So I've been in touch with that little crew of five or six or seven of us. On and off we have a little ongoing funny text thread with each other. But I'd never gone back to the reunions so I went this time and it was under attended. There was only about nine of us that came in person to the rubber chicken dinner at the hotel.
Speaker 2:Sure, and then we got a little VRBO. Our little crew of people Did your wife come with you. No, no, she didn't. She stayed home and it was intimate. So, out of a hundred or so students in our class, we had the opportunity to actually pull off the. They said there's a tendency to wanna put your best foot forward and be impressive and talk about how happy you are.
Speaker 1:And how great life is my chance.
Speaker 2:Well, we pulled the bandaid off of that one Good and we started talking to each other, and while my source of information is only this handful, what I can tell you is that two of us took their own lives somewhere along the line in the last 30 years. One of them I discovered by reading about him as an example in a story in what's called stat news and medical journalism piece. I was reading along about the distress and difficulties that COVID has placed on physicians. Wow, and they're describing this guy and his devastating kind of psychic experience being an emergency room physician through 2020 and 2021. They described how he asked for relief from his supervisors. He asked for a change in his schedule. He asked for this. He asked for this, he asked for support, he asked for time off. He didn't get much of any of that until he tried to kill himself and he ended up in his own ER. They admitted him for a couple of weeks, started him on medicines, he had left and then, three days later, he had taken his own life.
Speaker 1:Wow, sad.
Speaker 2:And this was just a beautiful guy. And then discovered there was another one. At this event, discovered that there were three or four others that died of medical illness, like so what are you gonna do? Roll the dice this one had cancer, that one had this, that one had that. Those were surprising sadnesses, right. And then discovered that at least a couple of spouses died of drug overdoses. The guy who was sitting next to was telling me about his 24 year old son who died of an overdose fentanyl inside, of crazy meth addiction and such Crazy. A couple of three people that I heard about left medicine to go do something else, and so it had us all in this kind of deeper reflective state in thinking about what has been the nature of this life. Oh, and one of them had this amazing story about delivering two orangutans at the zoo by cesarean section when he was on call for obstetrics. Good story, so that was your regular vet story.
Speaker 2:They called him from the hospital and told them they needed help down there. Come on down quick, so he delivered a couple of orangutan babies by cesarean section crazy.
Speaker 1:There's some movie like that where the couples get back together and they reflect on life.
Speaker 2:It's complicated.
Speaker 1:Yeah, it's real complicated. They all had drama and different things that happened and somebody knows the name of that movie. It's like 10, 20 years ago, but they come back together and obviously I've watched the movie a lot, but it's all that, it's life. I really see that anymore.
Speaker 2:So that was what was great about my 33 years that we actually really dropped in. That was the funniest thing. When I look in the mirror, I have this sort of internal algorithm kind of software system that makes me feel like I pretty much look the same as I always did, you do you look great, but I thought I know that's what it looks like when I look in the mirror. I got it all worked out.
Speaker 1:That's how I got it.
Speaker 2:But then I looked at all of these other people and they've all gotten so old. It's crazy. My algorithm doesn't really help them. What happened to you, brie? It's so gross, so yeah, so it had me come home and I was like I'm a little bit more viscerally thinking about aging. I'm 61 years old. I feel great. I got a lot of juice left in me, nice, but it's a thing.
Speaker 1:This getting older thing and this sort of yeah, the more concrete reality of aging and mortality is real Overall around San Diego, to all the old landmarks, the hood, the restaurants, the beach this place where we smoked weed to the beaches, to Balboa Park, and all of it had significance. And I purpose not to get too reminiscent but to really kind of be in the moment and enjoy it with Joni and it was fun, but yeah, I think it all. But there's a little something like it comes to some realization of aging and it's real.
Speaker 1:No one gets out of here alive, it turns out so.
Speaker 2:Turns out that's a throwaway line and it turns out it's actually a description of the kind of semi-hidden and plain sight reality we all live our lives, and probably ought to, as if it goes on forever. Yeah, but there's something profoundly appropriate that we don't go on forever.
Speaker 1:Right, yeah, so I have a bank president friend that prays for people and he's a great guy and he doesn't pray for healing anymore, he prays for quality days. May your days be amazing and just live in that minute, that moment, that day. And I thought, jon, that's a cool prayer man, I'm gonna pray that prayer cause. That's so powerful. And so let's go there. What are your top three takeaways? We're there. What are your three takeaways for living in the moment? What works for you when you have that awe? You mentioned the awe earlier. I just let it in, let it in.
Speaker 2:It's everywhere. It's in the grain of this table, it's in the sweetness of this water, it's in the empty Dixie cup Dixie cup that I've had here. You used to have a little bit of cactus juice in it. It's in your eyes and mine, and it's right here in this present moment presence. So that's, I guess, number one. I have to come up with two more.
Speaker 1:Yeah, that's one. I'm feeling the table, I'm just I'm getting into the table.
Speaker 2:You're feeling it, yeah.
Speaker 1:Nick did a really nice table here. Somebody commented that on the last podcast. Hey, this is a great. This is really I can smell it's really fresh table. So he was. Whoever that was was in the moment.
Speaker 2:So, number two, oh, the love that you can gather in your life, true and deep and honest and authentic in all the many different ways that love can be exchanged, between beings and laughter, and love and sex and friendship Touch.
Speaker 1:All of it, thank you, all of it.
Speaker 2:I'm anticipating fully in the economy and exchange of love for other human beings. Well said, presence, love, play, play. Have a blast as much as possible.
Speaker 1:That's fun. Yeah, have some bloody fun. Yeah, yeah.
Speaker 2:I mean be respectful of the other people around you. Sure, I want to like step on their toes and splash mud in their face while you're having fun. Not necessary, but it's not really necessary. Yeah, you can actually call them and you can combine presence, love and mud together and have fun with people.
Speaker 1:We're going to go get muddy.
Speaker 2:Apparently that happened a few weeks ago out in the Black Rock Desert.
Speaker 1:Oh really, they got muddy.
Speaker 2:They got muddy. I bet they did?
Speaker 1:Who does it? Well, it's part of that show. What?
Speaker 2:That's the bell, that one let's see.
Speaker 1:What did I win? Oh, there's a prize in here for you.
Speaker 2:Oh my goodness.
Speaker 1:So this is the Humboldt Quiz. Let's see how you do. I'm going to take a look because there's a fabulous prize in my box here In that Dick Taylor bag.
Speaker 2:Maybe what could possibly be in there.
Speaker 1:Well, maybe a sticker Could be, a sticker you could put on your car Lollipop, maybe Lollipop Balloon, some crackerjack. So when you get to go out to dinner tonight and I hit you with a credit card, whatever money, where would you take your sweetheart? Where do you guys go to dinner? If you could go anywhere in Humboldt?
Speaker 2:I'm going to dinner, are you really? Yeah, with my sweetheart and with two of our best friends, nice, and so that's what comes to mind. Where are you going? I usually go to Jaffies and I go to like Fa, fa, Fa in Arcada. Are they still good? Those are like my two. They're probably more than anywhere else. They're awesome. They're awesome, totally reliable and consistent. But tonight we're going to 511, right down the street Sweet yeah, nice.
Speaker 1:What do you have at 511? What do you think sounds good?
Speaker 2:Don't they have like Calamari, they should have Calamari.
Speaker 1:They have like Calamari.
Speaker 2:Do they have Casamigos Repasado Tequila? Almost certainly for you Good Repasado.
Speaker 1:Mucho gusto, amigo. So number two you get to go for a hike tomorrow, anywhere you get the day off Bull Creek, wolf Creek, Bull Creek, bull Creek, okay, bull Creek blows my mind.
Speaker 2:That's so hum, yeah, let me show you where it is.
Speaker 1:Okay For you folks that are not familiar with Humble Over there, and this never gets old. Nick loves this part. It's down in here and so hum Bull Creek it's, you're looking right at it.
Speaker 2:I'm looking right at it actually, I see it.
Speaker 1:Yeah, Joni's ran out there. They do the albany of the giants down there right.
Speaker 2:So beautiful. It's a beautiful mature stable.
Speaker 1:And that road is all jacked up.
Speaker 2:Yeah, because the trees came down and everything else. But they've got it all figured out and Bull Creek is a special place, so don't go there.
Speaker 1:Yeah, because I like it when there's nobody there. The weather here is horrible. Folks, it's snowing today. It's awful, it's funny. It's funny One of the most magic days in Humble, it's like 80.
Speaker 2:Oh my God, I'm sweating in here. It's crazy. Do you know? It's hot in here.
Speaker 1:I actually I dressed for it so Well, you heard two layers, it's pretty, yeah. Well, the others are more of a t-shirt. Is that a Mormon t-shirt?
Speaker 2:No, no, my God. I mean, what is the deal? Well, who wears t-shirts? Nick, do you wear a t-shirt?
Speaker 1:Yeah, I mean, what's the?
Speaker 2:t-shirt. Yeah, but I mean, and then another shirt.
Speaker 1:Oh, I didn't want to wear one. That's a redundant.
Speaker 2:I never really understood that.
Speaker 1:Well, if you're a hairy beast like you and I, it's kind of. I mean, I've never worn an under shirt.
Speaker 2:An under shirt. It's not my shirt, okay, it just seems overkill. Like same thing with underwear. Oh, you're flying free? No, I'm not. Actually, that's a lie, I actually do wear it.
Speaker 1:I think Remember the science episode with Kramer. That's nothing between us and him and a thin layer of gabardine. Good one. So Did I win? Not yet. Okay. Yeah, there's still more quiz questions coming. So what's a magic day at Humboldt? What would you do besides Bull Creek? How would you spend your day? Just a day, a Michael day?
Speaker 2:Oh gosh, a Michael day.
Speaker 1:Self-care day.
Speaker 2:Occurs essentially in my beautiful home. I mean I bought a piece of property on the way up to Neeland, Nice, Greenwood Heights. It's five acres, Beautiful area. I was married in that home. My children were born In that home. I buried a couple of other friends on the property. I've had amazing music, spectacular parties over the years. So my perfect day is I wake up before everybody else, like an hour and a half before everybody else, crank up the coffee, go out to my little man cave which is away from the house where nobody can bother me, make some coffee, have at least one cup, maybe get into the second cup before I go in and jump aboard the whole train to get everybody in school and to work and everything else. Then I get rid of them all.
Speaker 2:They all go to work and they all go to school. Then I go back to my man cave door, open cats on my lap and I love my forest, so working in the yard is your hot tub in this? No hot tub. Like every time I had a hot tub, it turns green and I did it annoys me. Yeah, our rats eat the wires or whatever the fuck. But I've had it like it goes green ones.
Speaker 1:It goes green. Yeah, I don't think it's green.
Speaker 2:Yeah, I'm not, I'm not like a maintenance Guy it's over water testing what's it?
Speaker 1:put oil in a car.
Speaker 2:I'm just not really into it. That's why you gotta like your car. No, well, that's right.
Speaker 1:Don't forget to charge.
Speaker 2:That I don't do.
Speaker 1:Yeah, I understand did I win, you did, you did great, I won. Let's see, oh, there is a small price involved. It's a sticker. Look at that, would you? Are you?
Speaker 2:kidding, just a sticker.
Speaker 1:Yeah, it's good for something oh.
Speaker 2:I'll just give you a slide. That over to you.
Speaker 1:Definitely there. You can wear that with pro. Yeah, great, great chocolate. Oh, there's no chocolate in that bag. Well, it remains to be seen. Let's hit the bell again. Let's see how you do. Oh my god, what's left? There should be some chocolate. I gotta bring the chocolate.
Speaker 2:My wife. It's her favorite.
Speaker 1:They're up in Seattle right now competing for the first time since before COVID and the, the chocolate, chocolate championship of the world. They're gonna be great, they're gonna win gold. They're amazing, Just good guys and really cool. So we didn't talk about resolution care. So you all this career and then you'd start resolution care and tell us about what. What was that you could? Could you? That was it's remote. It's doing what you do remotely right.
Speaker 2:So in 2014, on the strength of burnout and frustration and indignation and complaining and whining and ranting and raving about everything Everything is so broken and screwed up and what's needed is so simple Mm-hmm I Took my one step up to the plate and Built the business. Wow. And so resolution care was a team-based, comprehensive palliative care program giving care to human beings in their homes. Using whatever means for communication worked, sure, including video conferencing zooming today what we call zooming today. Yeah, sure, and I was the first to do it.
Speaker 1:Nobody else around the country had really Figured out that all telemedicine is a fall under a telemedicine umbrella. Sure should be the phone, it could be the internet, it could be.
Speaker 2:We call that telehealth, which is FaceTime broadly includes all the other different mechanisms of synchronous and asynchronous communication. So texting is asynchronous, or sending messages or emails, that's asynchronous, okay. Using voice messaging and sending those off, that's asynchronous to communication happening at two different times. So what? But it's phone calls and video conferencing Okay, those are synchronous. Those things are happening in real time.
Speaker 2:Yeah, and so I. I pioneered the use of video conferencing based communication to provide care for super, to predict people in their homes right, and so we started. That Timing was excellent. Society thought that palliative care ought to grow. There were a number of legislative and policy Opportunities on.
Speaker 2:The state of California mandated palliative care for all Medical recipients in the state at about the same time, perfect, and we happen to have, I Think it's pretty safe to say, the absolute best Medicaid managed care Organization working to care for low-income folks in our community. The partnership health plan is a fantastic Health plan, a non-profit health plan focused on the care people Depending on Medicaid.
Speaker 1:Are they right over here in Sacred Heart? Or they said where they? Well, they're here, they're there, they have offices everywhere.
Speaker 2:They. They now have 14 counties down north humble Mendocino, the other ones yeah, the other in the north in the 101 corridor, lake County. But in January I think of this next year there's an additional 10 counties that are being given to them so they can manage the Medicaid lives in those counties. So they have about 750 1000 members so our son Gabriel's Medicare Medi-Kel.
Speaker 1:He's got downs and autism, so yeah, he's part of partnership.
Speaker 2:Yeah, and you know, say what you want about, you know, governor, on healthcare. But partnership shows up and they innovate and they work together with their provider partners we're a provider partner to develop programs that deliver For the people on your care, for the health plan and for the providers. And you got to balance it out. For it to be sustainable, everybody's got to get their needs met in a Balanced and reciprocal fashion. Right, shout out to partnership, shout out the partnership right on.
Speaker 1:So a question then. So did resolution care then Replicate its model for other places? And well, I mean they were one of our universe and partners.
Speaker 2:They were our most important one. They were Working together with the California Health Care Foundation to develop Payor provider partnerships and some grant funded things that got us started. So the model was replicable, the model we proved that it was replicable and To do that it took about five, five and a half years to figure out how to do it right, so that I wasn't sure spending more money than I Took in right right so when you're spending more money than you take in, it's not good.
Speaker 2:You need to either have a ton of money of your own or you need to borrow.
Speaker 2:Or get some money from other people, yeah, so, in order to make it work over those years and I borrowed about a million and a half dollars from people who love me, people A couple of them were related to me, not many of them, but but people that love the work that we were doing who pretty much figured that they flushed their money down the toilet, oh no, but coming into the pandemic in the middle of 2021, yeah, what's the pandemic to?
Speaker 1:to the model.
Speaker 2:Well, I mean, it proved the model right. I mean, yeah, it would we. We were on May 19th of March 19th 2020. We were about 40% video conferencing for all of our encounters. On March 20th 2020, we were a hundred percent.
Speaker 1:Wow.
Speaker 2:And our team, our staff, are amazing, incredible people. They they were, no, they had to adjust to it for a second and for the first few months they were kind of Complaining oh how can we possibly care for these people without ever laying our hands on them? How will they know that we really are there for them? And then, after about three months, they stopped talking about that over proved the model.
Speaker 2:Yeah so, and all around the country people were asking us how do you do it? How do you do it? So I did a lot of teaching during the first couple of years the pandemic throughout the state of California and nationally about how do you make this kind of telemedicine model right human, personal, soulful, relational, how do you take advantage of the advantages that are within it.
Speaker 1:So I talked a lot about people put it in package and then Sell it. Give it away.
Speaker 2:Well, I model it because I owed a billion and a half dollars, including my daughter's college fund. I wasn't going to give it away. I had to like sell it and in the pandemic, a couple of potential buyers for the enterprise came our way nice and I made a deal and I sold it to the company that changed its name from resolution care and Was able to call up all those People who are dumb enough to lend me money and say hey, guess what? Friday afternoon at 2 o'clock. Check your account.
Speaker 2:It's coming in with all the interest. I promise you payback, and so I took a job with them for about a year and a half and I'm. We parted ways at the end of last year, so I am free.
Speaker 1:Does that mean, you're working or not working?
Speaker 2:Yes, it does.
Speaker 1:It means I'm doing both.
Speaker 2:You do a little bit of both. Well, for a minute I really wasn't. I had a little identity crisis like, oh my goodness, I miss all these people. I miss this particular project, I miss the role of leader.
Speaker 1:Who am I? What do I want? Leader.
Speaker 2:But then I started to look around and kind of went back to the things that I've been most fascinated, in awe inspired by, and for the last 20, 25 years I've been trying to build a bridge between the palliative medicine community and the brave souls that were pioneering psychedelic science research, Kedamine.
Speaker 2:Well prior to that in NYU and Johns Hopkins and in UCLA there were these early trials looking at the classical psychedelics like mushrooms or psilocybin, LSD, MDMA, the map studies were maturing around MDMA or the drug that the kids call MOLLE or ecstasy for the treatment of post-traumatic stress disorder and all of those.
Speaker 2:All that science and clinical research was very slow to start but once it got ahead of steam, really it has established an enormous amount of momentum and interest because it's safe, it's more effective than anything we've ever seen. They say it works, it works. So I was trying to bring those researchers together with the world of palliative care, and the world of palliative care and just about everything in medicine is incredibly conservative, so it took a long time. But with Michael Pollan's book how to Change your Mind and the Netflix series how to Change your Mind by Michael Pollan and a lot of generational transformation, the minds of the American populace are open to answers that can respond to the mental health challenges that we all face and the pain and suffering that people have, and they're not naturally or viscerally afraid of the idea of how we might be able to use extraordinary states of consciousness, non-ordinary states of consciousness, as an opportunity to heal.
Speaker 1:I think of early medical marijuana, and the same process had to happen.
Speaker 2:Similar process. Similar process it helps people.
Speaker 2:But these are even more mysterious compounds. Correct, yeah, the experiences occasioned by these compounds, the ultra person's perception and experience of reality, of life, of the world. It's a big deal. I think that people who are approaching the end of their life and struggling inside of that should have access to these medicines. I think people who are well, who wanna get more well, should have access to these medicines in different ways. So right now there's a radical change in how healthcare is perceiving psychedelics and I'm involved in that Locally. I'm working at the Center for New Growth, a practice kind of organically grown by Dr Carrie Griffin.
Speaker 1:You should have on the show. I think I talked to her. You did yeah here. No, I called her.
Speaker 2:Oh yeah, we should talk to her here with the microphones and the headphones, With these Everything yeah, maybe I'd have a chocolate bar for her yeah maybe A sticker.
Speaker 1:There is a sticker, it's a sticker in, there isn't it.
Speaker 2:That's all there is. It's just stickers.
Speaker 1:It's hard to say right now.
Speaker 2:No, but she can talk more and open up. She opened up that center, though she opened it up and, in fact, we have a ribbon cutting tomorrow afternoon, although this is gonna be a delay for people, sure, but we have a new office that we're sharing with spa social or social spa in Arcada, much groovier environment. Social spa and we're working in collaboration with a number of local agencies Hospice of Humboldt, the Open Door Clinic, the PACE program, the VA Medical Clinic to try and create ways to give access to ketamine-assisted psychotherapy.
Speaker 1:This is ketamine-focussed, for that.
Speaker 2:Only because that's all that's legal at the moment.
Speaker 1:How's ketamine work in your view?
Speaker 2:It's such a complicated. We could talk for an hour about this.
Speaker 1:But the trials of the studies are pretty conclusive, right, it's so compelling. In England, joni was listening to a podcast.
Speaker 2:Ketabine, in combination with a strong therapeutic alliance and a psychotherapeutic model that places the healing over there in the person, is a powerful intervention. That surprised me. I thought that it wasn't really a psychedelic or it wasn't really in the same category as a catalyst for healing as some of these other medicines that I'm more familiar with. But it is, and, used well and thoughtfully, inside of a container that sets intention and works to integrate the experience, it's an amazing breakthrough, powerful healing, learned a little bit about it Sounds amazing.
Speaker 1:It is it is yeah, had a couple of friends, hey, before we go. Yeah, which means we're going. What do you want your tombstone to say? What are we going to say at your, at your memorial? What are you envision, what would you like? First of all, what are the words on the tombstone?
Speaker 2:Ah, I don't know how you spell it?
Speaker 1:How do you spell? I think it's A at a bunch A. Maybe I have to put a little speaker up.
Speaker 2:Yeah, but no, I just want to get to the end of my life and feel like my tanks on E. But I got exactly where I needed to be. I just want to be able to just go. Ah, I have lived my life.
Speaker 1:Left it on the field. Good word, good one. I love it. And I hate to talk about legacy because it's over an overworked term, but so when we think of you, this podcast, this is my legacy.
Speaker 2:This will last forever in digital perpetuity, Thanks to.
Speaker 1:Nick, it'll be on YouTube.
Speaker 2:If Nick has anything to do with this, it's gonna be on YouTube for a long time Now my legacy is in all of the people I've cared for, all the people I've taught my children, my wife, my garden.
Speaker 1:Connection relationships.
Speaker 2:All of what I've left behind that resonates in other beings when I no longer am a being. Good word, that's how it works. That actually is how it works.
Speaker 2:That's how it works and whatever's created and hard stuff like concrete and buildings and stories that I captured in some kind of Word document or whatever I don't know. Yeah, the ideas that I had are not so special is to merit a great book that changes the world. I'd write a book if I thought I could write a book that hasn't been written before, but I'm living a life that's never been lived before and that's gonna have an impact on people.
Speaker 1:Good one. I like it. So the idea of a relationship investment versus a printed word or a how-to video.
Speaker 2:Yeah, yeah, it doesn't mean much to me actually I like it Well.
Speaker 1:Thanks for coming. Man Pleasure, it's great to see you again.
Speaker 2:Thanks for having me. I really do. Is there a chocolate in that chocolate bag?
Speaker 1:We're gonna see here in a minute when we're off camera, off camera.
Speaker 2:You don't want people to expect that there's a chocolate in it you want people to stay in mysterious about the whole thing.
Speaker 1:Yeah, I'll surprise you in a minute. Thank you, Scott.
Speaker 2:Thank you, Nick.