S2E13 - I need a doctor....Stat! Ask a Doctor (w. Tyler)

On our latest installment of the Stale Bread Podcast...

Our favorite Army doctor stops by! Tyler talks candidly about his path through medical school, his experience practicing medicine in the military, and how he eventually found his way into aerospace medicine. Along the way, he shares memorable and unusual cases, reflects on how AI is changing healthcare, and offers practical (but unofficial) health advice listeners can actually use. Tyler also speaks honestly about the demands of medical training, stressing the value of hard work and persistence for anyone considering a career in medicine.

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Transcript

speaker-0 (00:00.438)
Well, we're lucky today. Tyler, Keller is sick on the show, so We need a diagnosis.

Please don't be herpes.

speaker-0 (00:34.126)
I don't know I told him 847 we were starting so

you

speaker-1 (00:41.962)
This isn't a good sign on a doctor that's not on time

No, he's got to be five minutes late. You know, we're sitting in the waiting room and you know, your appointment's at eight and he comes up in eight oh five. Hey, how's it go?

Who's your diagnosis? He doesn't even see you.

This is what I was talking about, Keller. This one blade, it's awesome.

I've been looking for a new one. Does it have a lot of guards? Different sizes?

speaker-0 (01:09.122)
This one is this one I use it I could use it in the shower works really well.

Is it safe on balls?

No.

God damn it, that's what I need. Something safe for the balls besides... Nair.

Yeah, the Manscaped stuff apparently is the one to go to.

speaker-1 (01:31.606)
I haven't tried it, but I've tried all the others and there's always a nick. And a bleed. There he is.

What's up, Slick?

you hear me okay? Yes.

Yeah. Yeah. Can you hear us?

I can't. I would like to have a disclaimer that these are all my personal opinions, not that of the United States Army. This is not medical advice if anyone's ever having any issues to see their doctor for a true consultation. know, all the legal mama-jamma.

speaker-0 (02:06.52)
So Tyler, how do you shave your balls?

Back to front.

back to front. You get real in that bussy, huh?

word every time.

Sorry man.

speaker-0 (02:22.136)
Well, we got lucky today, Tyler Keller sick. Yeah.

is he? Why?

Well, he's just a sick human being.

Tell her you're muted. Do you know that?

did not know. I've been talking this whole time about how I have AIDS and that shit.

speaker-3 (02:42.894)
I just have one.

Yeah, one aid. I have aid.

You don't have USAID.

Student aid.

Still able.

speaker-1 (02:52.974)
that's the worst one. The one that keeps on our wording. Maybe I could do JFK voice this episode since I'm sick. I have a brain or where

JFK.

You mean RFK?

Yeah, it's early and I'm sick.

Robert Downey Jr.

speaker-1 (03:20.268)
Robert Downey Jr. I'm sure he's had a brain worm. Right?

RDJ. He fought a brain worm in space. That's Iron Man.

Ready?

I don't fucking know man, I'm just rolling with it.

No.

speaker-0 (03:36.27)
Tyler, give us a introduction of your background, how you got into army medical, things like that.

Yeah, so my name is Richard Tyler Williamson. Tyler is my middle name. I was born in, you know, early 90s in Northeast Florida, Jacksonville, Florida, had at that time just my mom and my older brother and my older sister. My mom then remarried and we stayed there. I stayed there all through like high school and then I went to Florida State.

And I skipped the birth of my younger brother, but you know, he doesn't matter. So went to Florida State for undergraduate and then did got two degrees while there. I got a bachelor's in exercise physiology. So it's bachelor of science. And then I got a bachelor's in arts and French. And my minors were physics and chemistry. And then from there, I worked for a little bit while I was trying to prepare for applying to medical schools.

I worked a couple jobs. I worked at a physical therapy clinic and I worked for a neuro-optimologist. And then went to the bar one day with my buddy. He's like, hey man, I thought you were applying to medical school. I was like, yeah, you know, I'll get around to it. He's like, nah, you need to. He's like, you're being a little, you know, assert expletive here.

Thank

speaker-3 (05:09.442)
Fucking stupid.

Exactly, both.

I was like, yeah, you're right. The next, um, that was a, like a Friday night, the next Monday, I went into work and I put in my two week notice and then I moved back to Jacksonville to focus on applying so I could have, uh, like less, uh, bills and stuff. So moved back in with my folks for, I think it was a year. And during that time I worked even more because applying to medical school is expensive and, um, and got in my applications.

I applied to all DO schools, which DO and MD, we can have that conversation if you want later. But I applied to all DO schools throughout the United States. And I got into one in Lake Erie College of Osteopathic Medicine, which is Northwest Pennsylvania. And I also got one into one in like Mississippi, I think, I don't remember. But by that time, you have to like put in a down payment deposit, whatever.

to save your seat. So I did that. So then I went to Lake Erie College of Osteopathic Medicine for medical school from 2019 to 2023. And 2022 and 2023, you do your clinical years. Your first two years are like didactic, sit down in a classroom, listen to people lecture for hours on end, and then your last two are clinical. So you go to a bunch of different hospitals.

speaker-2 (06:42.862)
You work under doctors, they teach you and then at the end of that month or whatever you take an exam to show your proficiency in that field. And then you graduate medical school after taking two of your board exams. I graduated medical school and I was still in Jacksonville at the time. But by this time I had already joined the Army and so I applied to Army Residency Programs.

And also by this time I have had two of my children.

and got buried.

Yeah, well obviously, yeah. I guess that's not obvious.

Got me.

speaker-1 (07:27.244)
When you went into the army, you are already a doctor.

No, no. So I commissioned 2019. It's coming up my what is that six years I guess.

Happy birthday!

That's the same day I started my job. I didn't know that. Cool.

really? Yeah. So.

speaker-1 (07:47.294)
One's way more prestigious.

Yeah. But I was doing applications for the army simultaneously to the applications for medical school. And I guess they were inundated with applications because I was originally denied getting into the army. And then when these people who were going to be prospective physicians saw the requirements and the necessary payback time and all that stuff, they're like, I think I'm going to

I'll say.

speaker-2 (08:19.34)
you know, take my hat out of the ring for getting the app or the scholarship.

What are some of those requirements?

Yeah.

Yeah, so there's physical fitness requirements, Part of the application has like, how well did you do in school? How was your pre-medical school examination test like the MCAT? How was you do a fitness test? And then there's a bunch of other stuff. You give them like your whole list of your family, list of your friends, list of everywhere you've lived. And they do it

investigation on you because you will eventually get like a secret clearance as a physician. But then the requirements for staying like to pay back time and stuff after you get accepted to the military for this specific program, I was a specific program I was applying to. You you sign a contract, so everyone's contract could be different if they edit it or if they have lawyers help them or whatever. But the boilerplate

speaker-2 (09:25.006)
contract is basically you will. They'll pay for medical school and they'll give you a stipend monthly and then after medical school you'll do a residency in the army with some asterisk caveats. There's like a couple of of residencies that you can do elsewhere and then after your residency when your board certified physician you will owe us this number of years. To pay us back usually it's for.

If you take their signing bonus, it's four. If you don't, it's usually like a one to one timeframe with like residency to payback time. So residency is three years, you owe three years. And then there was another caveat that I can't remember, but that's generally what it is.

So as pay goes with the military, it, pretty on board with, being a doctor outside of the army as far as pay goes, is it kind of equal in that way or, or one pay more than other.

Right now I get paid more than my civilian counterparts. But that changes, right? So, because we don't get paid, or rather we get paid primarily based upon your rank. So I'm an 03 captain. You know, when I make 04, my pay will increase. But even then, you know, as you progress in your career in the military, you will not get paid as well as attendings on the civilian side.

Attendings being fully board certified. They've already gone through residency because right now I'm being in the residency I get paid more than other residents in the United States

speaker-1 (11:06.262)
Cool, lunch is on you.

That's right. That's right. What are we getting? So kind going back after medical school applying to residencies, had gotten married in 2020, had a ransom in 2021, my oldest, and then Fulton in 2023. And remember I was in medical school 2019 to 2023. So

Right about the time I was applying to residency programs, I had my second child and I was originally applying for to do obstetrics and gynecology, which I think is now called gynecologic services, surgery and obstetrics. But I was not accepted in that application process and my second son has Down syndrome. So was kind of both together were kind of a

forcing function and me re-evaluating priorities. And so I went and did what they call a transitional year. So I had basically a standalone intern year without like progression towards a board specialty. And I did that in 23 or 24 in San Antonio. And then from there I applied to the aerospace medicine residency in Fort, well,

was Nova Sela is now Rucker Alabama. It's just like southeast corner and Dothan Alabama area about hour and 45.

speaker-1 (12:45.664)
We know a guy from Dothan

I've

So on that note, is there any chance you can get an STD from a ghost?

No. I've heard this story. So someone, I was talking to someone the other day and they were like, man, why don't you like psych? You know, was like, because people come to you and they're, you know, they have, you know, delusions. Sometimes they have all these like psychosis and they come and they start telling crazy stories and I'm inclined to believe them. They're like, yeah, the CIA is after me. I'm like, that's crazy. What did you do? Like, why are they after you? You know, I believe them.

And then like every other doc will be like, no, they're like actively psychotic.

speaker-1 (13:31.374)
could be telling the truth.

They could be!

There is a percentage of people out there who that is probably, it would be a truth, right? But that is one, I will say that is one. I don't think if someone came to me like, hey, I have an STD because of Ghost, I'd be like, I don't know about that one.

I think they're after me.

speaker-3 (13:51.041)
I it was his uncle.

I hope not.

You

Alright, so your current position. Tell us more about that. Like what's your actual duties are there?

Yeah, so I'm a resident still. I'm in my third or four years for a residency program. You know, being a doc is a very long, as you can see, very long process. So like I said, you have medical school and then basically after that you go to residency. I my internship near BAMC and then I came to do, came to apply for aerospace and occupational medicine. It's a double boarded program.

speaker-2 (14:37.736)
And those and basically the first two years, which I'm in my second of here. First two years are aerospace focused very operational heavy operational medicine being like austere.

a lot of like movement on the battlefield type knowledge, things like that. So we go through a lot of military medical school, military schools, as well as we do a lot of what we call TDY or like take travel for, for trainings and stuff. And then basically as a resident, you know, you're, just learning the medicine, you're reading books, you're preparing for your board exams, you're seeing patients. So we have, you know, the clinic.

where we basically I see a bunch of the pilots or, you know, pilot applicants coming into the army, make sure they're fit to fly, you know, apply the army standards to their basically field of work. And then we'll see, you know, sick hall, whatever. We do have a pretty wide breadth of activity. So as a flight surgeon and

in the army when I'm done with my residency program. Usually I'll do one of a few things, but usually a pipeline is once we get out, we'd be what's called a cab surgeon or is it combat aviation brigade surgeon. As a brigade surgeon, basically you're kind of over watching the clinic, making sure that those functions are going nominally. You will.

See patients as a primary care provider and as their flight surgeon. And then you'll also be in charge of the flight paramedic training. So you have to make sure that they're being trained appropriately. You have to hop on the helicopter and fly with them every once in a while, not as a pilot. Historically, we did fly as pilots, but I think because of costs and I have heard because of mishaps, flight surgeons no longer fly.

speaker-2 (16:42.668)
Which is a bummer, but you know. So right now it's really just a, you know, sit down and get your work done and learn is where I'm at.

So as far as this program's go, has anyone from the army been in space? Yeah.

Yeah, so we have a we have an army astronaut program. I don't remember the most recent guy. He's actually now in command.

any chance that you'll ever be going into space or you're just training the paramedics that go on the flight?

I don't think I will ever want to go to space. The mission sets right now are too long for me.

speaker-1 (17:18.69)
How long would that be? Like, months?

The ISS mission sets are usually pretty long, like I think now around six to nine months. During the day of the shuttle, they were about shorter. were, you know, two weeks to I think a month because during the shuttle days, they were building the ISS and things like that. So those mission sets were, you know, forced to be shorter. And now with the ISS, are able to do longer research up there. So they're staying up there longer because it's really the travel that it's expensive, right, to and from.

Has there been any reports of any unusual activity up there that you can?

Like alien wise? No, not that I know of.

or anything else.

speaker-2 (18:03.158)
I mean

They be fuckin' in the ISS.

There's probably some funky activity.

This conversation's out of this world.

Yeah. How far do you think we're out from actually just sending robots into space instead of humans?

speaker-3 (18:20.12)
question. Good question.

You're have a hard time trying to convince. I think they'll have to be better than us at that point. So it'll be a while. What I mean by better than us is they'll have to maneuver better than we do. Jump higher, run faster, be more stable.

So are you saying all your astronauts are are black men? LeBron James is out there in space.

You

That's exactly what I'm

speaker-0 (18:49.762)
day

they wouldn't need oxygen they can have thrusters built into them they don't have to be bipedal

They don't, you're right. There are, I mean, there would be a lot of benefit.

he would be out of a job too. How you gonna therapy on a on a robot? You're gonna be out there with your oil can lubing them up.

I just become a mechanic.

speaker-2 (19:13.518)
Exactly. Mike is right though, right? They would have to be autonomous to some extent because there is like such a delay in communication of information between like here and Mars. So if we send some things to Mars, you know, 10 second delay of data transfer, right?

Only 10 seconds? I thought it was like six minutes.

tomorrow's? don't think so. I don't-

We have lasers now, Mike.

Yeah, hey, light is fast, but it's not that fast.

speaker-3 (19:44.223)
line of sight.

three to 22 minutes depending on planets orbital position. That's what AI tells me.

Thanks, Robot.

Speaking of AI, what do you think the future of medicine is with AI? you have ideas about that?

I don't have much. don't have a whole lot of knowledge, but AI is already being implemented. Radiology is opening its arms to AI. They're allowing it to do like preliminary reads and the physician will go back through and double check. It's being implemented in use of documentation for physicians. So there's apps out there already which utilize AI. can bring your phone into a patient encounter, hit the record button, and then once you leave the encounter, a note will be populated.

speaker-2 (20:35.094)
for so that you don't have to spend 10 minutes as a physician. Hopefully that'll translate to longer patient encounters. But almost undoubtedly it will transfer into more patient encounters that are the same length so that we're all miserable. We got to pay the insurance companies.

Hahaha

speaker-0 (20:55.022)
Of course, course. We're going to pay for the AI fund or something, you know, on our, our, medical bills eventually, you know, it's like, we use AI to diagnose you. There's your AI bill.

I swear to fucking god they better not do that shit. They don't have to pay someone.

You know they will! You know they will!

You already pay taxes on a house that you already own, so...

Let's not go down the road of being pissed at insurance companies right now.

speaker-0 (21:23.554)
Yeah, that's another conversation.

Yeah, but that's how it'll likely go. then what I think is, you know, I don't really know how to change. There's really with AI becoming super intelligence, Super intelligence theoretically would be able to do anything better than we would, right?

Right. It's already beaten me. I'm telling you right now.

I don't think, you know, no job, no career is safe from that, but I think we're, you know, a ways, a little ways away from, you know, getting super intelligence.

Next decade or two. I think it's so fast on the rise so. It's priced.

speaker-2 (22:02.975)
And I have no idea.

speaker-2 (22:08.046)
I think so, I mean, we already have quantum computing.

Quantum computing though doesn't deal with the computing that we know now. It deals in the abstract. In the abstract, yes.

possibilities.

Yeah. but I mean, to even get there, right? To go from zero and one to get to quantum computing where it's zero and one simultaneously. It's like, how do you?

Well, we're lucky today. Tyler Keller is sick on the show, so we need it. We need to die. We need a diagnosis.

speaker-1 (22:46.168)
Please don't be herpes.

What's going on, buddy?

Well, my son came home from the beginning of school, coffin, yak and snot and, and all of that. And now here I am. Sore throat coffin. It's probably just allergies. don't know. Or I might be dying. Might be day. You want to my butt hole and you give me examination.

Yeah, I'm probably dying with cancer.

speaker-3 (23:18.807)
Not again, Keller.

You'll do this already? Yeah, it sounds like you got a URI. You haven't been running fevers or anything?

I don't know, I don't check for stuff like that, I'm a man.

So then it's probably viral if you're upright and you're chilling you're probably fine. It's probably like rhino virus or

I actually feel better while I'm sleeping though, which is weird.

speaker-3 (23:45.966)
Don't we all?

No, usually if I'm sick like this, I can't sleep cause all the congestion and shit running into my throat and lungs, but I've been sleeping pretty good. And then when I get up, that's when it all just comes out.

Get it out in the shower in the morning.

dry. Yeah. But my drains been stopping up because my daughter has long hair. My wife has long hair and they all use my shower and I can't get it to stop stopping up like my face right now.

Get one of the little metal grates.

speaker-1 (24:26.742)
Metal grates.

Sounds like you both need to write a router.

go over your dreams.

Let's not make it sexual, Jeremy.

Why not?

speaker-2 (24:36.12)
Man.

So general practicing of medicine. Have you had any encounters where stuff was left inside of people?

I haven't, no. But you see the pictures of that all the time online. It's a big ER thing, right? People are doing, you know, they're pleasuring themselves at home or whatever, and then they can't get it out. Yeah, that's a big ER visit. But I haven't seen anything, thank the Lord. I don't think I would want to deal with it. It's usually more... Yeah, it's usually pain in the ass if you get my drift.

PAY.

speaker-2 (25:19.618)
AHHHH

any weird encounters at all?

Yeah, I was gonna say, what's the weirdest, weirdest thing you've run into without violating anybody's HIPAA rights?

We had one, and I don't know, we get a lot, I mean, there's a lot medically, right? Like I think my first patient was struggling with cancer. My first patient, like ever, was struggling with cancer, but that's not weird. It's just notable. I mean, all the psych patients, like I already said, all those people who come in with all those things, I just, you know, my LIDAR doesn't go off very well. Well, they believe it, but.

That's the first part of telling a successful lie is you.

speaker-2 (26:02.646)
Weirdest, weirdest patient.

No.

Thank

I had a patient, so this is medically interesting, nothing crazy. I had a patient who was in ICU because they had a lung infection and it was not doing well. She ended up getting something called ARDS, which is acute respiratory distress syndrome. She had to be intubated and then we had to cannulate her with ECMO, which is called extracorporeal membrane oxygenation. Basically, the lungs are very damaged, you need to assist.

oxygenating the blood. You need to help the lungs out in doing that. So you'll basically put these two large boricannulae into their femoral vessels. It can be the artery or the vein, depending on the way you're doing it. It'll pull out blood, it'll oxygenate it, and then it'll push back in. So it's kind of like assisting the lungs, and then sometimes it can be used to also assist the function of the heart. So she was on ECMO.

speaker-2 (27:05.996)
And then one night she, you know, she coded. We were able to restore circulation and then, you know, called her family. then the next day she coded again and they were like, Hey, we don't want to resuscitate her again. But the interesting portion of this story is that when we imaged her after we got, after we cannulated her in her femoral vessels, she was,

She some interesting anatomy internally. She didn't have a spleen on her left side and she actually had a liver that was midline. She didn't have like an IVC or an inferior vena cava. That's a large vessel that goes like the large vein that comes from your heart. It sends blood back to your heart on the bottom side. And she also had three lobes on her left lung, which is abnormal.

You usually have two on your left and three on your right. And they diagnosed her with this very interesting, I guess you could call it disease or pathology, but it was called heterotaxis syndrome with right-sided isomerism. So basically she was like mirrored her, her organs were mirrored internally when they're not supposed to, right? You're supposed to have different organs on different sides, things like that. So it's not because of that, because she didn't have a spleen and stuff, she was

more at risk for getting some infections to include, you know, lung infections and she had a history of a lot of pneumonia and stuff in her life. But the interesting thing is usually when you cannulate someone with ECMO, it goes into that IVC or into that inferior vena cava, that vein that goes from the heart. And since she didn't have one, we cannulated it into what's called the zygous vein or this smaller vessel that like runs right over or right in front of the

vertebrae or your spinal column. But it was effective, it still working. And so, you know, I was doing some research on this, and it's pretty rare, you don't see a whole lot of people with it. But the interesting thing was, she was, I think, early 60s, and she'd never been diagnosed with it at this point. And we were not the first people to image her. But it was very, very interesting case. I don't think I will see a case like that probably again in my career.

speaker-1 (29:33.74)
Yeah, think that's what I think.

It was an interesting case.

And now I'm, I'm very convinced that I, that's what I have. You convinced me. Yeah.

So

speaker-0 (29:51.337)
You're definitely one of one killer.

We had, here's a story for you. We had a guy come in. It was a trauma, a code trauma at BAMC. We had a guy come in. you know, I was on, on trauma and my intern here there and I had the, was holding the pager, which is like, no one ever wanted to hold the pager cause he answered all the calls. so I was holding the pager and I saw that they were activating code trauma, like EMA has called and they were, they're about to bring this guy and it said like gunshot wound to the chest.

which penetrating trauma can be an indication for doing a thoracotomy or doing a clamshell thoracotomy, is basically, you'll like open a portion of their chest. They'll bleed if they're bleeding or if you get like blood return, you can convert into like a clamshell, which means basically you crack open their ribs, like you widen them, spread them apart. And then you get to the sternum, you cut through the sternum and then you widen them apart. So basically you're just splaying open the chest.

kinky.

like a clam shell would, right? So I saw the code on the pager and I looked to my upper level resident and I was like, hey, if we go in his chest, I want to pump his heart. And she was like, okay. So we went down there he came in. He was pretty obviously in a bad shit, in a bad place. They were doing compressions. I think they had been doing compressions for probably 10 minutes or so. do thoracostomies on both sides. We get a lot of return. Thoracostomies is like just a hole in the chest.

speaker-2 (31:22.446)
got a lot of blood return on the right side, transitioned to, you know, the thoracotomy. And then so I'm squeezing his heart. And when I'm squeezing his heart, I'm like, this guy's not gonna, not gonna live. There was no, I could feel there's no blood flow going through it. but the story on this guy, you know, I heard you hear, you know, things happening in the periphery. You're like, oh yeah, motor vehicle accident. And I turned, was like, I thought this guy was shot in the chest. Cause I was not on the side where he was shot. So I did not personally,

visualized the bullet wound. They're like, oh yeah, so he was running from the cops. He got in a car accident, jumped out, turned around, started shooting at the cops, and they shot back. And that's how he found himself in RER. It was a rough day. He did not survive.

You know, the, of this whole story, the one thing that stuck out to me is that technology has come so far and y'all are still using goddamn pagers.

yeah. yeah. yeah. Try it in truth. Trust it.

Well, rest in peace, guy who ran from the cops and shot at him.

speaker-0 (32:34.284)
Yeah, that's our decision.

often.

There's like three other things you could have done.

So from, as a doctor, what would be your best medical advice as far as just being healthy and living a good life?

The, you know, the biggest things to look at is your diet, right? Your diet and then how active are you? For people who trying to lose weight, diet will get you 80 % there. Most people say Mediterranean diet, which is a lot of fish, a lot of leafy greens, olive oil, you know, not using a whole lot of butter, like not a lot of carbs. Basically, what would someone from Italy be eating on a day-to-day basis? Kind of just follow that. Although they eat a lot of carbs with pasta. Yeah.

speaker-1 (33:22.414)
Yeah.

You know songs of the carbs but Having a diet right leafy greens helps with your gut health Helps with you know being regular Carbs basically just gets turned into fat like almost almost invariably and then it increases inflammation makes you exhausted tired So diet is a big one and I think people are all know that fat diets hit or miss some people love the keto diet some people

love other I don't know. I know the data is behind the Mediterranean diet.

Then is, you know, exercise. People say exercise, when people hear exercise, they think, I got to go to the gym, you know, I got to do this or that. I would say like, get involved in some, you know, community activity that will get you moving outside walking around. If you're younger and you can run, you know, play ultimate frisbee with friends, like do those kinds of things, because those will be, they'll be good. They, you know, it gives you a blend of cardiovascular activity that will

help with your cardiovascular health, like long distance running and short distance sprints, Exercise will give you kind of both those. So those would be probably my two biggest. And then also, you know, communal aspect, it'll help with your psychological health as well. So those are, I think, the biggest things, probably the easiest way to stay healthy.

speaker-1 (34:52.216)
So go touch grass, nerd.

Go touch grass.

Eat some fish.

Eat some fish every once in a while. Leafy greens.

I'm with a with saying eat fish. Does that are you saying solely fish or no selfish or fine? Selfish, I have a cold, I have a.

speaker-3 (35:13.026)
that selfish?

speaker-0 (35:16.948)
They're very, very greedy fish.

Yes, no, like shrimp and stuff like that is that.

Yeah, and you got, mean, even with fish, you got to be careful, right? You can have too much fish. Some fish are high in mercury and mercury is, yeah. So you just got to be careful. This is, mean, with anything like whenever you hear and learn about nutrition, it's always variety. You always want variety in what you eat. Eat a lot of fruits, eat a lot of veggies, you know, some grains.

Shrimp is bugs.

I agree

speaker-2 (35:49.678)
Sea bugs.

They're delicious.

Thank you.

the bug.

scallops, clams, like all of

speaker-3 (35:59.028)
like shrimp less and less as I get older.

I don't like fish as much as I like all the other things.

big crawfish boil guy.

speaker-1 (36:12.898)
Yeah, he's got lots of boils.

I'm

He has the plague.

The bubonic. The buboes.

There's bubble wrap on my dick.

speaker-2 (36:29.122)
I don't think that's the plague.

speaker-0 (36:33.55)
You got anything for Tyler? You want to ask?

Yeah, man. For democracy?

divers.

you

So did

speaker-2 (36:42.158)
Yeah, absolutely. I've played a couple hours of that. It's fun. I'm not very good.

We got to change that.

Yeah, you two gotta link up, man. I've been trying to get you two together.

Stole my cousin from me. Now he's gonna steal the doctor too.

After this, every team needs a healer.

speaker-2 (37:03.736)
That's right. Yeah, let me know. I'll play with you. Sounds like fun.

But if you kill everyone, if you're just a destroyer, then you don't need a healer.

And that's why nobody wants to fucking play with you.

speaker-2 (37:16.998)
Y'all are off the cuff today.

No, this is a normal day.

Yeah, you're hearing the unedited

Right. Live and on Ed.

It's not really edited.

speaker-3 (37:31.214)
You got no fucking idea, okay?

I'm surprised you'll have anything that's useful, like that you can use at the end of this.

You obviously haven't listened to all of our shows.

He's a doctor he ain't got time for shit this shit

Not all of it,

speaker-0 (37:49.614)
Of course not. Of course not.

Three fucking idiots sitting around saying bullshit. He's saving lives and going to space. Currently.

I'm doing only half of those things.

What we'll leave on this. Do you want, what do you want to tell the world as far as, know, young, aspiring, possible future doctors out there? You know, what, what's the, what's your best advice? You know, being the position you're in right now.

Everyone I know who applies to medical school or thinks of doctors, like, man, they're so smart. Mike has known me for a long time. Mike can attest to the fact that I've got probably pretty average intelligence. But if you want to be a doctor, work hard. That's literally the only secret, right? Work hard. That's all it takes. Long nights, know, lot of studying. There's no, you can be of average intelligence and get through medical school if you work hard.

speaker-1 (38:50.094)
I could prove you wrong.

Average, not less.

Damn.

Jeremy, what's your deal today? I don't know man

We are friends, I'm on fire!

speaker-1 (39:03.214)
I've seen your nipples.

I've seen my nipples, they're not special.

Yeah.

Well, Tyler, thanks for joining us. We really, really, really, really appreciate really the insight to.

don't know if y'all know anything more than aerospace medicine than you did prior. All good. Glad I was here. Yeah. It's fun.

speaker-0 (39:22.83)
Stop it!

Well, maybe we'll have you on some other time and we'll actually talk more about.

We'll get a little more in depth.

Yeah, I'll get better at my NASA history, but.

sounds we We want alien encounters. want people who've had it.

speaker-2 (39:42.008)
Dude, me too, me too.

think he knows something, but he's not telling us.

Yeah, he can. got that secret clearance. He can't say anything.

Yeah, that's right.

You guys can't see because we don't show video, but he's nodding.

speaker-2 (39:59.767)
That's right. That's right. I'm doing the motion that we got to cut here and go to break Of course. Yeah. Thanks for having me guys. I appreciate y'all

Thanks for coming on, man.

Thank you for letting us waste your time.

It was fun. Good waste of time, I like.

All right, Jeremy, your closing thoughts, please.

speaker-3 (40:19.128)
doesn't have a flared bass, don't put it in your ass. Peace motherfuckers.

You

speaker-2 (40:28.846)
you

Holy mack.

you

you

speaker-0 (40:55.308)
Still bread podcast is Daniel Keller, Jeremy Pope and Michael Kalisnik recorded live at SMG studios, division of SMG communications, executive producers, Michael Kalisnik and Tony skippers and Clark.