Age Proof
Age Proof: Unlock the Real Fountain of Youth
What if the secret to staying young isn’t a myth, but just hidden in plain sight?
Age Proof is where real science meets real-life results.
Each episode brings you inside conversations with doctors, biohackers, and longevity experts who are redefining what it means to grow older. Together, we unpack breakthrough treatments, debunk outdated health myths, and explore everything from anti-aging supplements to the newest regenerative therapies.
No trends, no shortcuts, just practical, science-backed tools to help you feel better, move better, and stay sharp as you age.
This is Age Proof, where growing older comes with smarter choices and stronger health.
Age Proof
HERE’S HOW THE MIND OF A CHAMPION WORKS!
The mental game might be the biggest edge in sports, business, and beyond.
Dr. Brook Choulet, founder of Choulet Performance Psychiatry, shares how top performers—from NFL players to physicians and CEOs—stay sharp under pressure. It’s not just about working harder. It’s about smart routines, mental health habits, and building a “perfect week” that supports success.
We dive into real tools for avoiding burnout, boosting focus, and improving sleep, plus how different types of athletes face unique mental challenges (and how that mirrors business leadership).
Whether you're leading a team or chasing a personal goal, this episode offers practical ways to level up your mindset and protect your mental edge for the long haul.
I'm Dr Rob, and this week we have the pleasure of hosting Brooke Shulay, who runs Shulay Performance Psychiatry, based in Paradise Valley in Beverly Hills.
Speaker 2:Thanks so much for having me today. I'm excited to be here.
Speaker 1:Great to have you. So today we're going to talk about all things with the mental state, especially like with high performers, which also can equal high stress. So what kind of people are your clientele?
Speaker 2:Yeah, so I mostly see 40% athletes, 40% executives, working professionals, physicians, and then 20% all their kids. So I do see kids to ages five plus. But I love working with executives and physicians that own practices.
Speaker 1:That's kind of my bread and butter nice, and are the kids all related to your clients that you have a lot of times?
Speaker 2:or the parents will be high performers and their kids are the 4.0 students that are upset. They don't have the 4.2, or athletes, so youth athletes are a big one I see trying to balance high school and then their club, whether it's club soccer, club, basketball, so a lot of kind of sports overlap there.
Speaker 3:With the NFL draft this past weekend. Did you have like anything to do with, like, do you see any of those people that go into the draft?
Speaker 2:yeah, so I. I'm a listed provider on the nfl player association's mental health directory, so if there's any player that needs services in a state that I'm licensed in, the pa will contact me. So it could be anyone from rookies all the way to people currently playing to retired players and physician burnout's just been a bigger thing, you know, and it's become bigger and bigger.
Speaker 3:And I've tried to partake in different, you know, because like the first five years I was in practice, I was pretty much doing it on my own. And you get into that state and kind of don't know and you start having more complications and issues like that so are are you seeing more physicians coming to you or you know, because it's kind of like looked down upon so not. Not enough people go and see seek therapy for something like this or.
Speaker 1:But when you see it, is it like later in progression than like when normal person would come see you.
Speaker 2:Yeah, oftentimes, like physicians are the worst patients, right, we try and treat ourselves until things get really bad, and so we're all kind of lucky that we own our own businesses and we kind of have somewhat of a say in our day to day practice. But a lot of the physicians I see with significant like clinically significant burnout are hospital employed or or like corporate medicine employed, even an outpatient, and in those types of environments there's a large sense of a lack of control, right? So like the owner tells me how many patients I need to see, or the insurance company dictates patient appointment duration, company dictates patient duration or appointment duration, and so a lot of times we talk about how can you modify certain things that are within your control to make your working environment better so your business is going to pick up even more because private equity is just taking over the life out of everyone taking well we we
Speaker 1:know, can we fund you to scale your business is what we're trying to ask. This is definitely going to be a hot topic.
Speaker 3:Yeah, because, like yeah, like day by day. Well, I get texts, emails like from few companies to buy our practice and I know like more than half dozen physicians that have, or plastic surgeons that have already turned to private equity.
Speaker 1:High-end people too. Yeah, Like high-end. I was just like shocked to hear the names that have already sold out.
Speaker 3:And so like that's where I'm thinking, I'm like, and from them taking over the derm practices, like I heard a lot of dissatisfaction in the physicians, so this is probably a good I'm guessing that comes from private equity requiring dermatologists to do work.
Speaker 1:Yeah maybe and not just the.
Speaker 3:NPs. They need to carry their own slack.
Speaker 2:Well, I think that's the tough part is we're all used to being our own bosses and making business decisions. So then, when you have someone else that comes in with, at first, an appealing offer and you might be tempted to take the money. Well, a lot of times they have a certain amount of time you have to stay. And then during that period of time, people can be really unhappy and feeling like they're being overworked and underpaid. So it's such a trade-off in terms of what you want your life to look like.
Speaker 1:Yeah, so do you see an age discrepancy or the amount of time they've been in the profession? Obviously the senior people. In a practice. When you sell out to private equity, you have two years, maybe three years, obligation, where the junior people have about five years or so On top of that. The junior partners also not just for private equity, for just being becoming employed physicians. Like you thought you'd have all this autonomy and you went through all this training and got all this shit all these years to like go out on your own and then be like oh wait, I have a whole nother set of bosses and a whole nother set of people to answer to.
Speaker 2:Yeah, I mean, I think it's risky for private equity to come in and expect that everyone's going to stay. I've seen it in my own patients, I've seen it in the community, as I'm sure you have, that private equity comes in and then the people that aren't bound to staying there that were the employees and not an owner of the practice they want out because it's just not the same. And so to me, and I'm sure for you guys too, keeping physicians happy is a huge thing that I take seriously. So really enabling like physician autonomy and allowing them to feel like they're running their own solo practice within our group, that stuff, I think, breeds kind of loyalty and longevity in a business.
Speaker 3:And what sorts of like you know information do you give to physicians and how can they help themselves when they you know, outside?
Speaker 2:of being in your practice. Yeah Well, it's really clinically significant. I go through what's called the Maslow Burnout Inventory.
Speaker 3:Oh yeah.
Speaker 1:So there's kind of like a questionnaire you can go through. Is there a pyramid Maslow? No, it's more just questions like how I'm thinking of the food pyramid. Yeah, exactly.
Speaker 2:It's questions about like how much empathy do you still have towards your patients, how drained do you feel after a day? Connectedness to your job, and caring and compassion. So you can. There's three different categories and you can actually go through and put an objective number, which I like to do, because sometimes people they're like oh, I'm not sure if it's burnout, I just I'm unhappy. And then you go through that scale and it's like very clinically significant, and then we can get into a good discussion of well, how can you start to make some changes.
Speaker 1:I know I was feeling burnt out about like a year and a half in Like I was really happy with like my patient care outcomes and everything. But I was working like 100 to 120 hours a week and I was not getting the reimbursements. Like I was just like this is, this is not worth it. And I know for a few months in a row I was just fresh in my practice technically right, less than two years and I'm like what's going to be my fastest route to retirement? Because if I got to work extra hard to hit that, I'm down to do it and get out of here and there's something like I don't know I got to work extra hard to hit that I'm down to do it and get out of here and there's something like I don't know I had to do extra years to get here. So I spent like 10 years of training after med school to be where I was and then within like a year and a half, I'm like I got to get out of here.
Speaker 2:Yeah, and oftentimes as a business owner, you're also doing all the other things in the beginning right, like PR and HR and all those things plus patient care. It can be really unsustainable quickly, and so one big tool I give to people Dan Martell wrote this book called Buy Back your Time, and in that book it talks about creating your perfect week, and so that is one of the downfalls of what we do right Is that we don't have a set schedule because we're our own bosses, and so it talks about actually creating a set schedule where Monday, wednesday, friday, let's say like gym, from eight to 930. And you actually block off your own time, and I found that that's like the biggest protective factor against burnout is actually blocking your time to make sure you're still allocating time to things that you enjoy doing too.
Speaker 3:Yeah, and that's that's what I've tried to get him to do is like I'm like plan out your vacations, take those weeks out ahead of time.
Speaker 1:And then he tells me I'm taking too much time off.
Speaker 3:Well, my, my wife gets like eight weeks a year off. So we we know, like know like she works for a bigger company but like she does a lot of the stuff in the office. So we automatically know we're and I'm like no, we're going away and just like mentally and everything I think it prepares us and you just got to leave the stuff behind.
Speaker 1:Schedule it Like that period where I was feeling burnt out, like that's the last time I was like I can definitely say I was dissatisfied with what I was doing. And since then there were certain things I did. First thing, I finally started getting reimbursed, which was nice. Uh, that alleviated some stress. At that point I was working, like no joke, 80 to 120 hours a week, which sounds ridiculous. But on top of that I went like nine to ten months without any time off, more than like an extended weekend. So since then, like I made sure to look at my daughter's schedule so I'm like at the very least I can take four weeks off like fall break, winter break, spring break, and over the summer I've gradually like actually extended it to be like you know what I can squeeze in a couple days here and there. So like it probably works out to like five to six weeks off a year and that's where I see the good balance probably works out to like five to six weeks off a year, and that's where I see the good balance.
Speaker 3:What are your like? Do you recommend lifestyle changes that people should make when they come and see you?
Speaker 2:yeah, some lifestyle changes just include intentional movement. So sometimes people like you said, when you're working those 80 to 120 hour weeks, you don't necessarily have an hour five times a week to go to the gym. It's just not feasible.
Speaker 1:I wasn't working out at all. I was in the worst shape of my life.
Speaker 2:Yeah, and it's not sustainable, right. So, like for me, for example, I schedule my appointments in 50 minute increments so I can have 10 minutes between visits to like get up, walk outside in the courtyard of our office, building things like that, so it's at least moving and getting out. Maybe I'll call someone. So I'm killing two birds with one stone, and just different things like that.
Speaker 2:So asking yourself what brings you joy, like for some people it's working out, for some people that feels like an obligation for some people it's social connection and so actually building in that time where vacation's great to start with that and building in that time, but you have to create something sustainable weekly. So, like every Thursday afternoon is just my me time, where if I need to schedule like doctor's appointments or a haircut or whatever it is, every Thursday afternoon is blocked off just for that, for whatever I need to do for me, for whatever I need to do for me. And I find that when people start to carve out that time where if you imagine like a red solo cup and you're slowly draining energy and looking throughout the week.
Speaker 2:What are you doing to actually replenish that or refill yourself?
Speaker 1:It seems so hard for me. For me it's like block out time, what do you mean? Like it's just been difficult, like that's why, like my daughter's school schedule has worked well for me, cause I'm like I can definitely block this time out and do it like a year, two years in advance, but like when it comes out to like oh, maybe like three months, I almost feel guilty doing it.
Speaker 2:I promise you you can do it Like if you, if you start from scratch, like let's say quarter two or quarter three, and you actually redo your entire calendar where, let's say, you are only available between 8am and 2pm every day and that's it. Well then, how do you build in that time? It actually can make you more productive and more high performing because you're more concentrated, and I had a few executives come to me that were working like 80 hour weeks and they felt like their schedules were controlling them.
Speaker 2:And as soon as we implemented a really regimented schedule, as if they were employed but, dictating how their time spent. They're like holy shit, like this works I feel so much better and this is sustainable.
Speaker 3:I think if you journal document or just just like with eating food, like once you journal what you're eating, you you know then you notice what like? You're like oh, I'm putting all these extra calories that don't matter. And if you're journaling like, you know journal how much time you spent on your phone.
Speaker 1:Like that time could have been spent. Your phone does that for you?
Speaker 3:Yeah, it does, it does, but like there's a lot of stuff that you waste your time on that you don't need to be wasting you know, and it's building routines and like, especially like in the mornings, like I have my routines, although, like sometimes the kids but I try to stick with those routines.
Speaker 3:You know, like in the wintertime I cold plunge in the pool, I do my workouts before they even wake up and like try to get those stuff done right away. Now it's like you know I I don't do the workouts in the morning, the kids are sleeping and I just try to do the workouts at nighttime. The kids just join in and working out.
Speaker 2:That's huge, though. A lot of the most elite top athletes have such regimented routine and discipline, and it's different for every one of them. But just that ability to predict what's coming in your schedule sets you up for feeling more relaxed, less tense and higher performance overall that fits into what you were saying.
Speaker 1:like if you can predict and set in that time for yourself also goes with the screen time thing so like if, if you can predict, set up like, let's say, like a wednesday or thursday afternoon for yourself to whatever get a massage, go, get an intense workout in sauna, cold plunge, and that'll just make all the hours for the rest of your week way more like enhanced productive, so you can just like even at nighttime, like I gotta put my son to sleep, but I put out my red light mat lay on the mat while I put him to sleep and, and you know, at least I didn't waste my time doing that I don't think that's considered wasting your time.
Speaker 1:It's productive, no, but like it's productive Like then.
Speaker 3:I don't have to take another like 20 minutes, half an hour to lay on the red light after I put him to sleep, because he's like moving around drinking his milk until he goes to sleep, so it's like yeah, and it's all about what works for you and it's different for every person.
Speaker 2:There's some athletes I worked with that. Before every game they would go drive through Starbucks.
Speaker 1:No, I'm kidding, and that was like their routine, right? Because?
Speaker 2:if you think about it, that's mindfulness. You're sitting waiting in line.
Speaker 1:Oh yeah, some people eat like gummy bears and stuff before games, stuff before games. So it's like everybody's like, oh, why are they doing that? It's like, oh, randy moss doesn't stretch. Before games, like have you seen that guy play a game? Like I don't know where you're coming, coming off telling them what to do but you bring up a really good point before too.
Speaker 2:Um, I always tell people to do a task audit is what I call it and then that brings up how to buy back your time, which is through delegation. So if you're realizing like, oh, I don't know, maybe you realize, over the last week you spent an hour paying various bills in the practice, well, that's something that takes a low, low skill right and you're low passion to do that. So that's something that you would delegate.
Speaker 3:Yeah, yeah, and that's you know, and getting my wife to kind of because she micromanages a lot of things and like getting her to trust someone to like delegate that stuff out, and she's gotten better and better at it. But like, yeah, that, yeah, Like it does. At times she's like she's like I got 400 emails to read or thousand emails to read and I'm like, just take it one step at a time.
Speaker 1:Just delete all of them. Yeah, start fresh. If it's important, they'll email you back, they'll email you back. Or if they're good salespeople, they'll email you right back.
Speaker 2:Well, my biggest email hack is the two-minute rule, which is, if it takes you less than two minutes to do, just knock it out and then file the email away. Yeah, and a lot of people they feel like they just get so overwhelmed with emails that they just can't.
Speaker 2:Even so, you have different email files, though yeah, so every so I do I go through this exercise with executives too, or practice owners is uh, creating subfolders yeah like psychotically organized uh, so like locations of your practices and then, within that website, marketing insurance, like all the things, so that when you hire an executive assistant again to buy back your own time and delegate, they will be able to follow your organizational system too. That makes sense.
Speaker 3:And look, even with athletes. I know athletes, they're traveling all the time and they're not around people, but they're around. You know, sometimes they feel like it's a family, as a team. Sometimes it's a broken family. But do you do any recommendations with, like you know, like finding someone that they find and that supports them? That's going to be important and how they think psychiatrically.
Speaker 2:Yeah, I think a lot of them luckily come into the league with that, so either their college coach or their high school coach or some mentor someone this was public. I recently did an interview with DeMar DeRozan on the Kings and he talked about the importance of his community and how that for him has been coaches, teammates and just having those people to go to when things get hard, whether it's on court stuff or off court stuff. So having that community is huge and it doesn't have to be a mental health professional if things are otherwise going well it's. It's just important for everyone to feel supported in some way.
Speaker 3:And then do you discuss sleep with the athletes at all?
Speaker 2:Yes, so there is a study I love to quote from. I think it came out of Stanford, but they looked at 120-some athletes that got less than eight hours of sleep a night and those athletes were at 65% increased risk of injury. And so when?
Speaker 2:it's huge and so when I have high schoolers that are like, oh well. Or college students oh, I had to stay up late to study for the test, or I stayed up late watching film so I could be prepared for the next game I reframe for them sleep as a performance strategy. So sleep is when your kind of mind is consolidating memory and recovering physically in order for you to have improved cognitive and physical performance.
Speaker 1:Significant growth hormone release too.
Speaker 3:One thing that laid on me was like if you're not getting that deep sleep, like that trash just stays in your brain and your brain doesn't clear that out. So you wake up the next morning and you still got these bad thoughts and bad feelings in your head. So if you're getting enough sleep, all that stuff gets cleared out and you start fresh the next day.
Speaker 1:And the other thing is I wear the aura ring and I kind of listened to it because if it, no, that's my wedding ring, but I was going to get a different ring to compare it. There's the super, but but.
Speaker 3:But the aura ring like tells you your readiness your readiness score, your stress level and yeah, and like it seriously, like it can tell me I'm sick before I know it, and also like I'm like I'm not going to push it hard working out today.
Speaker 1:Can it lie to you and affect your thought process on it, like you're feeling really good? You know what Oura Ring? I felt like shit when I rolled out of bed, but now I feel really good If it says go for it, like I usually go for it.
Speaker 3:But if it says like your recovery score is like in the 60s, 50s, 60s, I'm like, yeah, I'm not going to go work out and at my age I'm like yeah, it goes up to. I'm like I'm going to tear my pec muscle or my Achilles is going to pop. I'm like I'll keep it light today until I'm, like, well recovered.
Speaker 1:So I think it affects how you know it, kind of messes with the brain. I can picture you waking up and the aura ring gives you a 100 score and you just run outside and throw rocks over the house.
Speaker 3:I would.
Speaker 2:Yeah, sleep is really important and and so that's why, from a young age, I love working with adolescents and young adults, because they're still kind of malleable. You can still help them establish routines and change their ways, because as we get older and become adults, we're more rigid and we're kind of stuck in our thought process, so I find that age group really fun to work with.
Speaker 1:So I know there's some genetic variance. Some people can get by with like four to six hours of sleep and be like fully functional. Where are you at with sleep? What do you need?
Speaker 2:For me I need about seven to eight hours and I wouldn't necessarily I don't know every. Everyone has a different opinion, but I wouldn't necessarily say that some people can just get by on four to six hours, I would, I would almost say, well with those people.
Speaker 2:Do they have some sort of bipolar disorder? Because in bipolar disorder you could sleep, you know, less than six hours and still feel super high energy the next day and then crash at some point, whether that's a few days or a week down the road. So I do think that people that get less sleep I also screen for substances like are you, you know, using some sort of a stimulant?
Speaker 3:Yeah, but it's going to lead to dementia, Alzheimer's, and we've talked about this before because Dave Asprey, you know, when he wrote the Bulletproof Diet and stuff, he talked about not sleeping. He's like oh, you don't really, you only need four to six hours and go and talk to him. Today he talks about you got to get at least eight hours of sleep.
Speaker 1:So his thought process it matters what he's selling now. Yeah, now he's selling.
Speaker 3:Well, so his matters. What he's selling now, yeah, now he's selling. Well, he's part of aura ring. They, they advertise everything but like. But like, no, everyone like over the past, like since covid, like has kind of taken sleep to a different level because, like for me, I was like, oh, I'll sleep whenever. Now, like that's one of the reasons I was like I don't want to do trauma call and make me more nervous about trauma call is.
Speaker 1:I don't want to get called in middle of the reasons.
Speaker 3:I was like I don't want to do trauma call and it makes me more nervous about trauma call. I don't want to get called in the middle of the night. I want to get my deep sleep and my deep sleep comes usually between 8 pm and midnight. Whenever I fall asleep earlier, that's when I get my deep sleep and most of my REM sleep, and then you know a lot of the the rest of the time it's like light sleep till the morning.
Speaker 2:So so for you guys, now that you're like further into your careers too. And you've owned this practice for how long now?
Speaker 3:It's going on 10 years.
Speaker 2:Yeah, so do you feel like you're in a better work-life balance now that you have some systems in place?
Speaker 3:Yeah definitely. Yeah, from when I. You're in a better work-life balance now that you have some systems in place. Yeah, definitely. Yeah, from when I started.
Speaker 1:I started five years ago. It's definitely a better work-life balance, especially not taking trauma call. We had to stop doing like medicare medicaid because they had more complications and those were like the after hours care like because they had again. They had more complications, less reimbursement. But overall it for me absolutely, and it was it's, and this guy doesn't wake up at night to call so they end up calling me anyways so apparently this guy gets very good sleep I've been picking up your phone call.
Speaker 1:But yeah, no, no, I don't know what he has to say, but for me definitely way better work-life balance it's not that I don't wake up, it's my wife got mad at me because like my ring would wake up the kids. So, and your daughter's older, so I forget, okay, I'll get up then but, but it is better.
Speaker 3:But, like I, I like to be kind of uncomfortable and like if I'm not doing something, I feel like I need to be doing something. So I'm always trying to do, do things, um, you know, whether it's medicine or something else.
Speaker 1:So it's like percentage wise right, like it's a percentage of stress you put on yourself and some people respond differently with different percentages.
Speaker 3:Yeah, I always like to be highly stressed, I think.
Speaker 1:I like how we bring a psychiatrist on board and we're like this is what we think you should be saying.
Speaker 2:Well, it's interesting because if you talk about like a peak performance or flow state, right which is when you're so immersed in something that you don't even realize, kind of that time is passing, it's a bell curve. So as the stress level increases, performance increases. But once you hit that unoptimal point of high stress everything deteriorates from there. So finding that ideal level of stress where it's like manageable, right and you're still kind of worried about something and working towards something, is when you can really kind of achieve peak performance when you're optimally stressed.
Speaker 3:Just like your workouts too. You know when you're lifting and stuff. If you lift too much, you're going to tear your pec muscle, or you lift, you stress yourself, you get your HIIT workouts in and you're totally fine, right, yeah?
Speaker 2:you're not over stressing it yeah, and so over that bell curve then is like panic or fear. You know, all these things you. You can see even like rookie players or even people in the league where the mental side just gets to them and they crumble in that moment because it's high stress, high pressure, let's say, like the main person's injured and they're in to them and they crumble in that moment because it's high stress, high pressure, let's say, like the main person's injured and they're in for backup and they feel that they're not usually in that intense kind of environment.
Speaker 1:The mental toll can really deteriorate performance. You play with sorry. You work with baseball players too.
Speaker 2:I have more for baseball. I do therapeutic use exemption. So, people that have ADHD.
Speaker 1:That are looking to get ADHD medication approved, I'll do like a therapeutic use exemption evaluation from like being a big fan, like watching these sports, like you see some people that just straight up get into a funk, like more than any other sport. I think I don't know as a spectator that they'll just get into a funk. You have some streaky NBA players, some NFL players to a degree, but like baseball players. Just see some people be like oh man, I drafted you on my fantasy team and you're coming up short for two months, I mean one hypothesis is so.
Speaker 2:There's studies that show that people in individual sports, so like golf or singles tennis, have a higher internalized sense of failure as opposed to team sports so like basketball or football. But baseball is interesting because even though it's a team sport, you could argue that, like the pitcher is kind of playing an individual sport in that moment and so if they really screw up, there's a higher internalized sense of failure after that kind of mess up, even though it's a team sport.
Speaker 2:So that's why um also with aesthetic sports. So gymnasts, acrobatics, different things that also have aesthetics involved. Those athletes are at higher risk of anxiety compared to other athletes. Really so it's also interesting to unpack, like what sport are they in? Is it single team? And then looking at that kind of additional pressure, same with, like the goalie in soccer yes, they're in a team sport, but that goalie is kind of doing an individual sport.
Speaker 1:So we grew up wrestling, so we're a highly individualized sport, but you have responsibility to the team.
Speaker 3:And do you take care of any MMA fighters, any UFC fighters?
Speaker 2:I have taken care of fighters in general at different levels. Yeah, fighters, I have taken care of fighters in general at different levels. Yeah, okay, but that's a whole other component too, because you could argue that's somewhat aesthetic too right yeah like they're being kind of judged on their weight, right like every time you go up, your weights posted. Imagine if, like every time we walked into work, our weights posted or same with salary, these athletes are running around with public salaries. Imagine if your salary was public.
Speaker 2:So there's a whole other level of of um expectation and boundary setting. That comes in with athletes, when, let's say, you did just sign a $22 million contract and now your mom's calling you for this, your brother's calling you cause he totaled his car.
Speaker 1:Like you, you have to be able to set boundaries, and that's something I help them with too okay, that makes a lot of sense, especially the boundary setting with like okay, I can't help everybody with everything, um, and then feeling some guilt behind saying how about meditation?
Speaker 3:how, how does meditation?
Speaker 2:yeah, I love I love recommending meditation and sometimes people are like, well, I don't have the time for that. It's like, well, you can even do just five minutes of meditation three times a week and you'll notice a difference. And I kind of made a bet with one of my patients. He's like I don't think I'm going to notice anything.
Speaker 1:And sure enough, a month later he's like, oh, you know what, like I actually did notice, I'm less irritable, I'm less reactive, and so just the athlete, or more, exec, a business side, business side just that five minutes a day can really make a big difference, and the thing a lot of people don't notice like the first time they do it they don't get much out of it, but don't realize they're training their brain to meditate, to like slow down, like step out of where you're at, but like maybe the second time might be a little better, third, four, by the time you're like five, six times in and you're dedicate, dedicated to it to achieve your goals, like just not just like clear your head, just like proactively, give your mind like a rest that you're going to get better at it.
Speaker 3:I just think you can pull and like I'm always. You know it was building my physical health Once I was back to being healthy and like losing the weight. Then it was like how can I super function my brain? And like and like. Meditation plays such a huge part of it, and I have all these different head gears that I see athletes use it too, and it just gets you into that meditative state.
Speaker 1:He shines rainbows into his eyeballs, but but I feel like you can just take drugs for that.
Speaker 3:But like it, it helps all around with, like responding to your employees helps all around with like responding to your employees, responding to your, even like at home, to your wife, to your kids. You know, like I notice if I don't meditate or use one of the devices, like I'll be a lot more irritable. Like you know, like I'll try to feed my son and he doesn't want to eat something, I'll get a little more irritated.
Speaker 1:His irritation, he just shuts down. It's not like he gets like violent or angry, just like you know. I know ruse isn't paying attention yeah, I just stopped feeding him.
Speaker 3:I'm like he'll get hungry. I call it turtle mode when you just kind of like retreat.
Speaker 1:Yeah, hardcore turtle.
Speaker 3:But it's like you know, especially with my wife, it's like, instead of like answering back, it's like you take a breath, you think about what you're going to say and you're able to answer it a lot better. If you don't meditate, you respond with a bad answer and get even into more trouble than you were before. So like I think it helps all out with like a lot of aspects and you just function a lot better.
Speaker 1:So I found out uh, wonders of meditation. He knows the story and like it was like junior high is. I got beat a lot as a kid because I acted like an asshole and so, so, like I knew how to talk my way out of it. Yeah, yeah, yeah he knew how to talk his way out me. I would just like be like can I clear my head while all this crap is going on, and then my younger brother, who's a neurosurgeon, would just try to swear and argue his way out of it and I, I would just like just be like you know what, if I can clear my head while my mom is crazy yelling at me and hitting me, I can do this in any circumstance.
Speaker 1:And I became really good at it and like, like, just, I've gradually lost that process, like, the older, I get it's been harder for me to be able to like, just like, just pay attention to myself, my mind like just be able to like um yeah, because a lot of um, uh, people that are high performers, they have high functioning anxiety where they always feel like they need to be busy.
Speaker 2:Not calling you out, I'm just no, no, you're 100 but like it's a way to to preoccupy your mind so that you don't have to focus on what you're actually thinking about. So, meditation a lot of times, what I'll get is well, I think I'm doing it wrong. I'm like, well, what do you mean? You're doing it wrong. It's like, well, I'm just thinking about all these things.
Speaker 1:I'm trying to meditate Congratulations.
Speaker 2:You've unlocked step one, which is just being consciously aware of your thoughts, and that's really what the foundation of meditation is is being consciously aware and intentional about your thoughts and observing things as they go by. So I always use the analogy of the bullet train in Japan, where it's like you're on this train and you see things just shooting by and there's not one scene that sticks around for long. And so it's. The same thing with meditation is you're just observing your thoughts as they go by and not getting attached to them, but just saying, oh yeah, I felt upset in that moment, or oh yes, that was a difficult situation, and increasing self-awareness, while detaching from some of those things that I, I like, say that sticks to you like honey instead of runs off like water.
Speaker 1:So the way I thought about it, coming back to like wrestling is like a wrestling match is like six or seven minutes long I actually don't know how long they are now, but it's not like. The greatest wrestlers are just like go, go, go, like just go for a takedown the whole time, go for points the whole time. It's like they're crouched down waiting for their moment and they strike and expend a bunch of energy at the time they think is right and you got to just be willing to go at that time. But that meditation period I feel like for your mind is between those takedowns where, like, you're like okay, your mind needs some downtime if you want it to perform optimally during, like when it needs to fire.
Speaker 2:Yeah, exactly.
Speaker 3:Yeah, like during surgeries you know we do microsurgery and those Can get pretty intense but it's like taking the time to just like do some breath work you know box breathing or something and doing it three or four times and then getting back under the microscope. I used to hold my breath.
Speaker 1:Yeah, my first couple of years I used to hold my breath.
Speaker 3:Yeah.
Speaker 1:And like lately, I can't tell you the last time I held my breath Once in a while. You notice certain things, like holding your breaths the first time Once in a while. You notice certain things like holding your breaths. The first sign. Second sign is like your traps start like firing and like, just like, gradually like.
Speaker 2:And that's part of mindfulness, right, is being observant of what's going on in your body, yeah, and so, especially when I talk to people that that like get quickly enraged, right, and kind of go from zero to a hundred, is really slow that down into like micro movements and almost just think, like what happens. First does your like stomach feel a certain way, do you start sweating and then intervene and cut the circuit at the point before you explode, so that meditation helps with self-awareness too so, anyways, we can scale this business to all neurosurgeons, including our brother number three.
Speaker 3:So another question for you. What's your daily routine? When you wake up in the morning, Are you rubbing the bananas on your face?
Speaker 2:putting your water in.
Speaker 3:Saratoga water or anything like that.
Speaker 2:Yeah, so I have a two-year-old and so with that she's kind of my morning boss and I make a conscious decision to prioritize sleep, so I will sleep until she wakes up which is usually around six. I go to bed maybe around 10 PM and I wake up at six approximately.
Speaker 2:Yeah, and I have a pretty easy time going to sleep again, like if someone's having a hard time falling asleep and they have racing thoughts, or like they just can't stop worrying about something you might want to consider like do you have anxiety Because trouble falling asleep, staying asleep and I'm sure we've all had those tests day before a test where you wake up before your alarm goes- off because your adrenaline is so jacked up that you're waking up early.
Speaker 2:So I tend to sleep from 10 to 6, and then Monday, wednesday, friday I have from 8 to 9.30 blocked off for gym time. I get to the office by 10, and my working hours are 10 to 4.30,. Monday, tuesday, wednesday I take external meetings, so I batch my days to make productivity better. Thursday Friday is for external meetings, conferences or speaking, and that's pretty much my week. So every day I get done by 4.30, so I'm home by 5, and then I put my daughter to bed at 7 30 and and then I kind of will work while watching tv but you're in control of that I would say yeah, no, I, I agree with but.
Speaker 1:But like I think in medicine, like look at him he's like if I were to go home at 4 30 every day, I would go nuts, I would strangle but I think like there's like a lot of external pressures, like my wife's an anesthesiologist and
Speaker 3:like, like these first case starts, these guys have surgeries all day and she's like a couple minutes late and they lay into her like, like that she's late and me, as a surgeon, I'm like they can't start the case without me and I'm not going to like drive fast and put my life at risk to, like, you know, go in and make sure the wheels roll in by 730. And there's a lot of these external pressures that, like they're putting on physicians that you know, does it really make a difference? Look, look at your turnovers. Like there there's, you know, the time in between cases, or you can't find the surgeon. The patient's been scrubbed, but they're worried about that two or three minutes.
Speaker 1:They're like not on time, that's administration, that's just like it doesn't matter.
Speaker 3:But there's a lot of the physicians are kind of kind of no, but they, they it just like it doesn't.
Speaker 1:But there's a lot of the physicians are kind of kind of no, but they, they.
Speaker 3:It's cyclical right because but it's not a way to start your day anyways, I just think.
Speaker 2:But I think the key word, there is detachment right because if you know you're doing the best you can and you know you're not screwing up or making a mistake, then so what if someone else is unhappy? Because, especially in a hospital system, like you said, there there's so many factors, there's so many different people involved in a case, and so, as long as you're confident in treating people kindly and being professional to me I'd say to, to someone that really cares about what everyone else is thinking, to practice detachment so that it's not bothering you, cause the only person that that's days getting ruined is yours.
Speaker 2:If you're letting that stuff bother, you, yeah, and the less you care, the more they get irritated, I know exactly yeah but then I mean, what I would say to that if if we were in my office, is I would say well, what kind of language are you using with them on a scale of passive, assertive and aggressive?
Speaker 1:oh well, well you're. You're dealing with like not not us but you're dealing with some surgeons and I've seen it during training and even in the hospital, like the last week, two weeks you're like where the fuck are you coming from? Like how do you think that's productive whatsoever, even if they're completely wrong, and not not just anesthesia, it's like nursing staff and it's just like okay, if you think that's what's going to make the world work a little bit better, go for it. But like I don't know but that's passive right.
Speaker 2:So how can you stay assertive in that moment?
Speaker 1:because that's kind of just dismissive but then guiding them while they're flipping out. Is that what you're saying?
Speaker 2:well, not guiding them, but saying, uh, like holding someone accountable in a kind way. So, uh, I'm not sure why you're speaking to me like that, but I'm gonna go get ready and I'll see you inside in a few minutes. So that's, that's holding them accountable for the way that they're speaking to you, rather than not that there's anything wrong with being passive.
Speaker 3:That sounds exactly like my wife. My wife will tell them that and then they try to be nice sort of the rest of the day, right, and so that if you can lead by example, by holding boundaries, by assertively speaking to others, then you tend to be a lot less frustrated.
Speaker 2:So, you tend to be in a better mood because you're just holding people accountable. The people I see that tip into burnout are the ones that are passive, passive, passive, all day long and then they get to that explosion point like flipping out because they feel so suppressed and that they haven't spoken up.
Speaker 2:but there's a way to speak up in a in an assertive and kind manner. Um, like I'm I'm not really sure why you spoke to me like that. I prefer to just communicate in a respectful way. So I'm going to head back for five minutes and hopefully we can reset when I come back in the.
Speaker 1:OR that makes sense, but that's also why I stay aggressive the whole time. No, we're. Why are you talking? No, I'm not late. Why is my patient not in the room? Sir, you weren't in the hospital yet, that's not a good excuse.
Speaker 3:Well, this well, the operating room's kind of you know, like we're nice, so like if, if someone's not a good like tech or a nurse, they'll put them in our room.
Speaker 1:Yeah, they do repeatedly and we're just like I'm not going to change my way, but it's like this person doesn't even know how to do these eight-hour cases, yeah, but we're stuck with them. So then we end up having to spend extra time being like, hey, stop putting this person there. Not just because I don't want to spend time with the patient or the person, the scrub tech, it's like they literally don't know the instruments, and everything I have to ask twice leads to 5 to 120. Extra seconds doesn't seem like much, but then two minutes like 10 times 40 times.
Speaker 3:When you look at the data and it's continuously moving to, you know when we have efficient staff. We're finishing at 1, 2 in the afternoon versus 5, 6 at night. You know it makes a big difference.
Speaker 2:Yeah, and it's all about controlling what you can control.
Speaker 3:Yeah, so I know we started hot and went over everything, so just tell us a little about you. How did you start and how did you get into psychiatry?
Speaker 2:So my mom and grandpa are child and adolescent psychiatrists. But my grandpa did academics and my mom did solo private practice and then I actually started my group practice while I was in residency. So I started hiring board certified psychiatrists while I was in training so that I could have a job to move into when I was done. And like I didn't have the startup fund, so I was moonlighting like crazy.
Speaker 3:And.
Speaker 2:I was like running out of didactics answering the front desk phone like. I wasn't the doctor. So that's how I started. And then that was just four, four and a half years ago now, and I grew the group to 10 of us clinicians now. So we have five psychiatrists, four psychologists and then a mental skills coach.
Speaker 3:And are you and do you implement any of the naturopathic or the wellness or some of the newer stuff biohacking and stuff that's coming along?
Speaker 2:Yeah, I would say look at lifestyle modifications. So it's not just let's throw more medication at a problem or here's a new symptom, so let's play whack-a-mole and add another medication to address that symptom. So we we definitely have a philosophy of the least number of medications at the least dose possible, and almost all of our psychiatrists do therapy as well. So if we're seeing someone, we kind of like to see them for a minimum of 30 minutes. So we'll see people for 30 or 50 minutes and then, on the flip side, what's interesting and kind of fills my cup up when I'm not doing patient care is I like to do a lot of writing and media work for psychiatry.
Speaker 3:So I, you work for Forbes?
Speaker 2:Yeah, I write for Forbes sports money. I would say the IRS would definitely classify that as a hobby and not a source of income. But to me I really enjoy doing it because I get to meet interesting people, I do interviews and it's like such a different outlet.
Speaker 1:It's technically branding and it feeds back into it, so I wouldn't consider it not a source of income.
Speaker 2:Yeah, but to me me it's more of a like a permanent marketing strategy rather than just paying for, like, google ads or something. So I I definitely don't believe just personally for our business and paid google ads or like targeted marketing, so it's all kind of a slower burn, brand building over time and one one thing.
Speaker 1:Uh, one of my friends again a high performer, head of like vascular surgery up in the Midwest. What his recommendation was like just go talk to a therapist and it's like the first one you might not connect with, the second one you might not connect with, but one of them along the ways. It's not like necessarily you being too demanding if you're not connecting with the therapist, so don't like negate from talking to another therapist because you think the next one will be exactly like that one.
Speaker 2:So that that opened up my mind to, um, it is a pretty big field in variety as far as like the person, yeah, exactly, and so I always tell, even when I see teenagers whose parents drag them there, that like hey, if I'm not the right fit, just tell me and I'll help you find someone.
Speaker 3:That is because to me that's the most important thing so plastic surgeries still kind of thought as taboo, but more people again thinking of it as normal. Do you think therapy is going towards that way as well?
Speaker 2:I think so, especially when you have more and more athletes that are speaking out about mental health issues, or high performance celebrities, actors, actresses, talking about mental health concerns, and then even brands too. So like Powerade just came out with a new initiative for all of their athletes that they've signed as kind of like a brand ambassador that they can take a step back from their contract due to mental health issues without fearing loss of, like, their contract with Powerade. So even brands are following and that you know same sentiment as well.
Speaker 3:I actually have two friends that have 18 year old, like super hockey, hockey stars, but both of them don't want to continue doing hockey anymore and they could, they would both make the nhl yeah and it's kind of crazy and it is that something you do. You see a lot more because I I don't know like one of them.
Speaker 3:I know his dad spent like hundreds of thousands of dollars last time, not just the dollars, it's the time too, you know it's like I've been to so many tournaments and like travel the country and last time I had dinner with him was the day he found out was like his son flew back from. He was I forget what kind of hockey there's a prep school in canada no no, it was. Michigan, yeah, michigan was one of those.
Speaker 1:It was a place with a lot of ice and a lot of hockey yeah, and he flew back.
Speaker 3:He's like I'm not gonna play hockey anymore and like he totally.
Speaker 2:I kind of commend that kid, though, because a lot of times I see kids who are in their sport because they're like oh, my parents invested so much, I have to do this, but they're miserable so it's like you know, I always encourage parents. I actually spend, especially with youth athletes, like half the session with the parent hey how are you talking to them after games? Are you being critical, are you being their second coach, or are they getting in the car and you're being supportive and, you know, emotionally connecting with them?
Speaker 1:so this it around, like this brings in a circle right. It's like hating to disappoint, where like this is especially like pronounced from what I saw, whether in residency or just starting out is like people getting into residency and and just realizing like they worked so hard and this isn't the profession they wanted, yeah, and people like, oh, okay, this is burnout. It's like it's significant regret. It's just like you know what like this sucks. I really don't want to do it. I thought I did, but I worked my ass off and I don't know how to tell myself that this isn't what I want to do but for me.
Speaker 3:For me, I think I started over performing when, like I've always been over performing where I wasn't being compared like, because our mom would always compare us to like other people that were smart, nerdy, whatever, and, like you know, we're Persian, so they she pushed us, yeah, into medicine, but like we kind of went away from it and we accidentally fell into medicine, like all of us practicing physicians, and like the more she pushed, the less we wanted to do it. And then you know, like I had talked with my dad and like it just made sense to me. I'm like, oh, I might go, I might go to med school, but from then it's like you know, kept the noise from mom out and like I performed much better.
Speaker 3:Like I was at high level for like ever since I went to med school I was like top student and then top in my residency.
Speaker 1:There are a few kids that respond to that high pressure, but you were self-motivated at that point.
Speaker 3:Yeah. So it's like telling someone oh, you need to lose weight versus that person actually wanting to get healthier, because she unmotivated me right, like like in college, like I didn't even drink and like she would call me and think I was drinking every night and I was like I'm not drinking.
Speaker 1:She's like you're, you're laughing.
Speaker 3:No, no, it drove me to drink more and then I joined.
Speaker 1:Okay, I was gonna say no, that was at the beginning I was actually studious, like like.
Speaker 3:Then I joined the rugby team and the rugby team drank way too much like, which made me look like nothing. But but the rugby team had me join the football team because I was too nuts to be in rugby.
Speaker 1:I remember talking to Rose. I was like how did you get your bench press to 425? She's like oh, it's easy. You just drink beers and do push-ups.
Speaker 2:Yeah, exactly, well, I went to a six-year med program out of high school, and so talk about dropout.
Speaker 1:Where was this at?
Speaker 2:University of Missouri, Kansas City.
Speaker 3:And so we started with 120. 20 and we're all 18, and then we got down to like 80 within a year and a half. That's so interesting because, like the, the person that my mom used to compare us to was another, was another persian family their son went to a six-year program and he dropped out like after two years. She's like, what was he thinking?
Speaker 1:I'm like, and he's highly successful yeah, he's very successful and very happy right now. Science and he, yeah, be in political science. Yeah, he just was pushed into it.
Speaker 3:He was like I don't want to do medicine and my mom was always like what's wrong with that kid? And I'm like, well, you compared us to him, Look.
Speaker 1:So my class and I went to a Caribbean school. Because I didn't try much.
Speaker 2:Yeah, we all went to.
Speaker 1:Caribbean schools. My, my mom uh, not my mom, sorry. So we started with 120 kids and the first couple weekends we'd go out and then, like two weeks in, my friend and I were like hey, what happened? This guy just just disappeared. Oh, he disappeared too. Like we dropped 25 kids within two weeks.
Speaker 3:We're just like, oh, these were people that were like okay, they're gonna become doctors too, and they yeah, especially like some of the middle eastern indian families, like they're, the kids would come and they'd island hop the med schools because they would fail, they would fail they were and they were afraid to tell their parents they're like oh they or they would tell their parents, and their parents would be like, well, this school doesn't want you there anymore, so you're going to go to this, yeah.
Speaker 2:Yeah, my roommate, actually her mom and my mom went to the six year program together.
Speaker 3:Yeah.
Speaker 2:So of course her mom's like you're going to go to the six year program too, and she dropped out after the first year.
Speaker 1:Was your mom? Like six year program.
Speaker 2:Why don't you have a five year programyear program? No, they actually encouraged me to do whatever I wanted and I I picked out roommates at ucla. I'm from san diego and I was all set to go there and then I found out two weeks later. I got in and I remember like crying I'm like I don't want to go and then, like I ended up deciding it would be best and I'm glad I did it, but it was I mean, like my fun years didn't happen till the last two years of that six-year program.
Speaker 1:That's pretty intense.
Speaker 2:Yeah, you go all year round. 25 credits a semester. Oh wow, yeah, oh yeah I would always sign up for undergrad.
Speaker 1:I took six years to graduate undergrad with like a 60-credit degree, so I would always start with like 18 credits and end up finishing the semester with like 12.
Speaker 3:Yeah, I was between 21 to 23 and I finished early. Yeah, yeah, yeah.
Speaker 1:We're not the same.
Speaker 3:Where can we find you, brooke, you can find me.
Speaker 1:This is my address when I'm in Paradise Valley.
Speaker 2:People can just find me on my website, brookshulamdcom, and people are actually shocked to find out that the phone number on there and the email on there are my direct mobile and email address, so people can always get a hold of me.
Speaker 3:Awesome, sounds good. Thank you, I'm out.