Introduction

SPEAKER_02 0:00

Welcome to the Silver Possum Podcast. I'm your host, Dr. Magda Holberg. I'm a geriatric medicine physician, and every episode I'll be interviewing an older adult about anything that they want to talk about. And without further ado, welcome to our first episode. So we can have you introduce yourself if you want to use your you could use an assume name if you want. That's fine.

SPEAKER_00 0:50

Ready?

SPEAKER_02 0:50

Yeah.

SPEAKER_00 0:50

Hi, I'm Chris Costas. I'm a retired infectious disease doctor in Chicago.

SPEAKER_02 0:56

Yeah, great. Thanks for coming on the podcast. I'm really interested in kind of like learning about some of your special interests.

SPEAKER_00 1:04

I started out thinking I wanted to be a pediatrician, uh, and then I ended up getting board certified in pediatrics and internal medicine. And in Arizona, I worked in a Phoenix uh in a pediatric hospital that attracted patients from the whole um desert around Nevada, Arizona. And I ended up seeing a lot of obscure infections. There's a lot of fungal things that people got from the desert. We had so many immigrants coming over the border. We ended up seeing a lot of third-world sort of parasitic uh and uh viral diseases. I happened to do a rotation in infectious diseases with a doctor who had been trained at the Channing Laboratory at Harvard and was the first, one of the first infectious disease doctors in America, but had moved to Phoenix. I just really got along with this person and I decided that's what I wanted to do. So then I briefly I went to Washington, D.C., where I finished up part of my pediatrics training. And there I met, I did a lot of pediatric infectious diseases at the DC Children's Hospital, but we decided to come back to Chicago because of family. And so then I ended up doing a fellowship at the University of Chicago, but mostly I studied fungal diseases. And this goes way, way back, Magda, which is an interesting history. So I think it might be worth talking about.

SPEAKER_02 2:30

Yeah, absolutely.

SPEAKER_00 2:31

I became an infectious disease doctor. So when I was an intern at Cook County in the early 80s, a patient came and there was an admitting ward, which was like an emergency hospital. And we were in this emergency hospital, and a patient came in who was a young man in his 20s and proceeded to very rapidly die and was just uh bleeding everywhere. I mean, it was a complete mess. And we resuscitated him. And a week later, another young man came in and died almost the same way, but couldn't breathe. And those were the first cases I think of uh overwhelming cytomegalovirus and pneumocystis pneumonia. And then a week later, there was an article in the MMR, in the MMWR, which is the Morbidity and Mortality Weekly Report. It was a uh journal published by the CDC that told you what infections were happening in America. It has since been, it's no longer published as of the last set of budget cuts with the CDC, but it's what all of us used to look at to figure out what was happening. And these deaths in uh San Francisco were mirroring what I was seeing in Chicago, and that was the beginning of AIDS. But it was still, by the time I got to being an infectious disease fellow, it had just gotten a name and was just being described. And I remember being at the uh big infectious disease conference, the infectious disease society of America, and there was at that time maybe a thousand infectious disease doctors. It's never been a very big specialty by comparison to like cardiology, where there's like 20, 30 times the number of infectious disease doctors. And we were sitting around about 500 of us in a room, and they said, Well, we have to vote now whether we want this uh acquired immune deficiency syndrome to be an infectious disease, or whether it's really we should send it over to the immunologist and say, No, it's an immunologic problem, it's your problem, not ours. And at that time, there's a whole bunch of articles coming out in the uh in the doctor journals about how, you know, infectious diseases was dead because there were so many antibiotics, and you know, we were just busy culturing ourselves and that there really was no call for this as a subspecialty. And so everyone said, well, you know, sure, we should take on any disease we can because we're struggling here. I remember voting as to whether HIV should be taken over by the infectious disease doctors. Now, I had always grown up in in Lakeview and was in Lakeview at the age of two. It was a very uh seedy, unpleasant neighborhood. You know, we used to, when I was, I remember being 10 and chasing prostitutes out of the backyard uh with my aunt. Somewhere it became a gay neighborhood. And that was probably when I was like 13, 14, maybe. I'm now 68. The neighborhood I grew up in became this gay neighborhood, and because of just, you know, who we had as tenants, we never really it was never, it never had a perrent foreign sort of quality to it. It it what your sexual orientation was was just sort of what the neighborhood it was never was very normal, probably. Yeah, it was incredibly normal. This is what was happening in the neighborhood. Um, and so I became uh became more and more interested in HIV. And then I was I was way out on the on in in a in in Evanston. So, and everyone thought that uh HIV was sort of an inner city disease, but it was actually happening in Waukegan and in in parts of the uh uh state stretching all the way up into like Madison, Wisconsin. So it's the the border. And so probably I ended up seeing all the HIV patients between Madison, Wisconsin, all the way south to probably, oh, probably an avenue called Devon Avenue, which weirdly enough has a great uh collection of uh of of East Asians. And so therefore we were always, you know, the the hospital ended up seeing a fair amount of HIV, but also a fair amount of tropical diseases. At one time, I think I was taking care of more lepers in the city. There was a there was a leprosarium in Mississippi. The doctor there, brilliant woman, but ran the leprosarium. And so when I had leprosy questions, I would call the university, but they didn't really know because if you had like actually in you know intractable leprosy, they sent you to Mississippi. So she was Oh my gosh, I can't believe they did that.

SPEAKER_02 7:20

I guess I do believe it, but they just people would just go there to recover.

SPEAKER_00 7:24

Yes, and get treatment.

SPEAKER_02 7:25

Oh, okay.

SPEAKER_00 7:26

Um, but to be isolated. I ended up working at Howard Brown, which is how I met you. But maybe like four years before that, she called me up and said, Chris, I'm 82. I need to retire. I can't do this anymore. She goes, but you know, you've seen more leprosy than most people. Do you want to come down and run the leprosarium? She goes, you know, it's a 10-room mansion that I live in. And then everyone lives in little houses out on the plantation because this all used to be a plantation. And she goes, It's a beautiful place to live. There's a stream that goes through it, you can garden. Wow. She goes, it's not a lot of work. She goes, but you know, I I talked to Peggy, my wife. I said, Well, do you do you want to go run the leprosarium? And she just looked at me and said, No, Chris, I don't want to live on a letter. We're from Chicago. So, anyways, but anyway, so so getting back to it, so I I ended up with um with a with a a rather large HIV practice. Then finally, public health infrastructure started to take over, and the City of Chicago Board of Health Clinic started to see HIV patients, and so they didn't need to come to to me. And so the the the northern part of the practice sort of uh came down. But it was very that was the sort of early HIV, which has always been one of my sort of interests. The other one is tropical diseases because I was over there by Devon, so I was seeing um, you know, various forms of malaria, typhoid fever, cholera, tuberculosis, um, you know, it sort of all those sorts of weird the African community also moved in, and that's when I started to see, you know, some more of the this sort of obscure African diseases, of which HIV was as much as it is in America, was in Africa. And so uh people would keep coming. Um so that was an interest. And then late 80s, everyone was dying of HIV, who got it, you know, because it was incurable at the time. I took up uh weaving tapestries because it was incredibly monotonous and it it doesn't require it requires a certain amount of complex thought, but it's more about how you're moving your hands and making the the thread go through the weft, you know. Um, so I I learned weaving. Because the patients were dying and they were miserable. I had a few friends go into hospice, which I thought was not intellectually very rewarding. I mean, I guess it is if that's what you like. So I ended up using a lot, uh I I end up seeing people getting uh acupuncture and so I ended up learning acupuncture in Chinese medicine, uh, primarily as a way of doing uh pain relief and symptom relief because uh it was just too hard to deal with a lot of the symptoms. But the but the Chinese herbal sort of regimens had a lot of efficacy in in things like nausea, neuropathies they would help with. And so I ended up learning acupuncture and Chinese herbal medicine. Because of the patients coming from India, I sort of ended up with a a a working knowledge of Ayurvedic medicine, but it was so hard to get those uh products without having them be contaminated because a lot of the stuff that was coming from India had heavy metals in it, as did the Chinese herbs, but there was enough American herbalists at the time. I ended up at a Catholic hospital, which was uh St. Francis in Evanston. For various reasons, the Sisters of Perpetual Prayer were very integrated into the priest community and into the community of monks in the city. Sort of a fun story. I'll I'll digress one more time. Um, so I had this clinic, right? Uh, and Sister Alfreda told me, Chris, you know, you can do whatever you want in your clinics, but just don't label them as anything, because an infectious disease clinic is not one that's going to attract people because they're not going to want to sit in a room with infected people. And an HIV clinic I don't want to be known for, but we have to take care of these HIV patients. So I said, fine. So I had the clinic, and Sister Alfreda came back to me and said, Chris, since you have a clinic, but it really doesn't have a name, there's a lot of people with HIV that don't want to go to an HIV clinic downtown. So I'm going to send them to you. And I said, fine. And that's how I ended up with a bunch of priests and monks for patients.

SPEAKER_02 12:01

Oh, that's great.

SPEAKER_00 12:02

Yeah. So for years I ended up being sort of the and there was another doctor who was an addictionologist. And so whenever a religious of almost any denomination had, you know, alcohol withdrawal or one, they would end up in this in this in this weird clinic. Simultaneous to that, um, at that point in time, there was a lot of trans patients who also had HIV, but also had STIs and infectious diseases. Now, this is at that point in time, Howard Brown was like a clinic, like like a room where there was a doctor. Right. So, so so what ended up happening is a lot of these people who had STIs would come and see me. They would not go to the public health system because for trans patients, it was it wasn't exactly safe because the the public health clinics were very sort of polarized, poor communities where that wasn't acceptable. So I I ended up with a large number of trans patients in the 80s and early 90s, where I would be doing trans medicine. And I did that for probably 10, maybe seven years. But eventually what happened was um I got busier and busier from hospital work, and I had to like close the clinics down to two days. And what happened was that the priests and the monks were in the same clinic as the trans patients. At one point in time, Sister Alfreda, a cardinal, and one of my patients all sat down with me and said, Chris, is this working? This is an abomination to God, and you can't take care of the trans patients here. You can't, you can't do that. And you and you can't, and you you we really don't want you to do that medicine. And I said, But um, these people need that. They said, You don't understand. Those people are all going to hell, and you're gonna go with them because you're making things available that are inhorrent to God. So just you can't do that. It we you know, we care about your soul, which I thought was, you know, it's the opposite of I thought it was completely ignorant. And in some ways, like, like, like, oh my God, you know, we're back at the 1300s, you know, what's going on here. But at the same time, it was that they did care about me and I did take care of them. And, you know, it was this sort of agreement. And so that's when, but at that point in time, um, there was like a couple of doctors that were doing a lot of trans medicine. Fred Etner was one of them. And so all those patients ended up going over to Fred because I had to close that clinic and they didn't want to go to a different hospital because they, you know, by that point in time, it wasn't so much dealing with the administration, the administration I didn't deal with, but the lab techs, the x-ray technicians, the they had gotten used to just seeing trans patients so that they didn't, there was no freak out there. Right. And those patients did not want to go, because they all knew the lab techs, they got their blood drawn, they they knew the x-ray people, they could, you know, wear whatever underwear they wanted, you know, don't you no one was gonna say anything. And so it ended up being that that hospital was very friendly to those people, and so they didn't want to switch, and Fred was already there, so that just all started. So I stopped doing that until I got back to Howard Brown, or I did much, much less of it. So, so so sort of transmedicine I've been interested in, infectious diseases I've been interested in, HIV I've been interested in, tropical medicine I've been interested in. And then I ended up doing, you know, a fair amount of Chinese medicine. And so for a while I was working with two Chinese doctors, and I would I had a clinic out in out on Ogden Avenue, way out in um beyond Western Springs, like sort of out there. And then here, foster in Ravenswood, I would be seeing people. And then I was working with a friend Martha Howard, who has is still practicing uh alternative medicine. So I did that for a long time. Um I think that I just sort of it was interesting. My brother-in-laws, you know, ended up owning emergency rooms and doing various sort of uh they became MBA, MD, JD business people.

SPEAKER_02 16:26

Like entrepreneurial medicine.

Leadership adventures

SPEAKER_00 16:29

And so I just never had any interest in entrepreneurial medicine. I mean, you sort of you sort of ended up doing that somewhat because of the I did. In in some ways, someone needed to, and y you were around.

SPEAKER_02 16:42

Um No, that's true. Yeah, it was the by default. So I was never I never went in with the intention of going into leadership. Like I thought leadership was kind of interesting, but I was never our agency had contracted to a point where they needed stepping in for in a crisis, you know. And then one foot before the next, and you kind of end up in leadership, and it's not always very fun to say it was not very fun. It's not fun. I mean, it was interesting and I learned a lot and actually did challenge me to be a different person, like much more assertive. And every retreat, every time they did a big retreat, I would often feel like really resigning. Truthfully told. Truthfully told, it was always the time where I was like the closest to like handing in a resignation was the um were the retreats because it was so painful. I mean, both the the personality testing, the some of the posturing and strange things that people would say that you just are like, that's not true. You know, like people just say stuff and it's this weird space where you would say and do things that you normally would never say or do. So, like medicine plus leadership is a very different thing to say, I think people should not be in leadership. Like, I think you should have an expiration date. It's kind of like terms, like there should be terms of service where you uh, because I don't think it is good to have uh especially a clinical leader there for too long because you get stagnant. Both as a per human being, I think you stagnate as a human being, but also organizationally, I think there's stagnation, like there's blind spots that you don't see that need to get addressed. And like kind of sometimes bringing in new people is a good way of turning the soil a little bit. But yes, it is a weird the MBA MD kind of thing is strange to me. So my sisters people who enjoy that, I'm not sure where that's coming from.

SPEAKER_00 18:32

My sisters live in sort of matching mansions in a gated community in San Diego. That's beautiful across the cul-de-sac from one another.

SPEAKER_02 18:40

Oh my god, that's beautiful. Actually, it kind of all makes sense.

SPEAKER_00 18:43

Oh, no, no, no. It really makes sense. And it's very funny. But you know, they all that like to me, a gated community is like the last thing I want to be in. I walk out the door and I take the bus everywhere. I don't really drive.

SPEAKER_02 18:57

It's very freeing. Yeah.

SPEAKER_00 18:58

You know, I like being around like as many people and strangers as possible. And they have the exact opposite. But so I'm at this Catholic hospital and it keeps getting bought by larger and different systems. And as that happens, at one time I was in charge of infection control for like six hospitals, and another time I was in charge of the pharmacy and therapeutics of of Hawaii. Like six, like six or eight hospitals, and so in charge of quality for like five hospitals. And at various points in time, I would do these things. And I I agree with you. I always like thought I'm like sitting here picking the less, the less evil, but I'm also picking the most good, but I could never see it from that from that side. So eventually I I you interviewed me.

SPEAKER_02 19:45

Yeah, I remember interviewing you.

SPEAKER_00 19:47

And you said to me, you know, do you want any leader for your physician?

SPEAKER_02 19:51

You're like, hell no. I know you were you were pretty much like, no, absolutely, absolutely not.

ID docs and what they do

SPEAKER_00 19:56

Absolutely not. No, no, I just I just want to take care of people. I don't really want to do anything else because I've done all that stuff, kind of, and I I didn't like it.

SPEAKER_02 20:05

Um Yeah, I had a lot of um, I've definitely had that experience with physicians. And it's very funny to talk to infectious disease specialists, particularly because they always end up on the committees. Like you always get put on hospital committees, quality improvement, infection control. It's like the quality improvement drudgery of the of the hospital universe. Right. But then the hospital administration probably calls you in. Every time there's a crisis, you kind of end up getting activated, which is is very strange, but super interesting to me.

SPEAKER_00 20:35

Yeah, there's three reasons why that happens. The reason that happens is one is when there's an epidemic, it you're instantly flooded into the community. And we all have some training in public health as part of the fellowship. And the other thing we always have is training in epidemiology and statistics, so that if you're trying to do any kind of data-driven look at what you're really doing in the hospital, that's not, you know, that's not financial, but is driven by numbers, you end up with the infectious disease doctor because they all have a statistical mathematics sort of background.

SPEAKER_01 21:09

Yeah.

SPEAKER_00 21:10

And then the third is that the infectious, the reason infectious, weirdly enough, most infectious disease doctors go on to become hospital leadership or psychiatrists. Um, which I'm I I I never really quite understood. But the leadership is because you end up having to deal with every other doctor type. Like if you're an obstetrician, you don't interface with everyone. You don't interface with hardly anybody. If you're, you know, if you're a surgeon, you generally don't necessarily interface with the pediatricians or the but the infectious disease doctors integrate with everybody.

SPEAKER_02 21:43

And so we have to learn how to Yeah, it is it's a it's a really interesting set of skills. And um they've often so they used to call this uh the ID mafia. I mean, I I don't you've heard this the it uh particularly in like Chicago hospital leadership of just all of the Like Stuart Levin, like all of the chief medical officers always infectious disease, or like the hospital leadership or the leaders of the programs. It's it's very interesting.

SPEAKER_00 22:11

So I so yeah, I guess an interest is leadership, but I you know you get forced in. Yeah, you get forced in.

SPEAKER_02 22:17

So and I've yet to meet a boring infectious disease doctor. I mean, maybe you know some, but I haven't met any because they're always really interesting. And they're also very much themselves. Like that's what I've always like as a specialty. I don't know if the specialties have flavors, but I do feel like they're themselves. Like they always bring themselves to whatever it is. Like I can't imagine like Stuart Levin being anyone but Stu Levin. You know, like he's just who he was and um no filter. Like no filter. Like, how do you end up rising through the ranks with no filter? But you do, but people do, and they're actually well respected. I mean, probably for what they know, but also just it's very interesting.

SPEAKER_00 22:56

Well, there's not a lot of us, so you have to deal, you can't just call another one in. It doesn't work that way.

SPEAKER_02 23:01

There's only one. I know you, yeah, that makes sense, actually.

SPEAKER_00 23:04

The other thing that that's strange about infectious diseases is that it doesn't make a lot of money.

SPEAKER_02 23:08

Oh, yeah. It's that's not doesn't seem fair to me.

SPEAKER_00 23:11

Which is all fine, you know. So my brother-in-laws would all laugh at me, you know, whenever there's like a major epidemic, they'd say, So you're making money. And I'd say, absolutely.

SPEAKER_02 23:21

No, you're just work more and you make no, like you're basically there. Can't imagine. I talked to so many ID docs during uh COVID times as well, and just how chaotic that was, like basically everyone calling them, um, the hospitals calling them in the middle of the night. Not even just for patients, but just in general for like help designing a response to COVID and just crazy stuff. Like you just are like, it's just part of the salary. Like, so basically, all these salaried ID docs were just kind of like having to do interview, like being interviewed for the media, like just tons of it was it was a lot of extra engagement. And there's no, like I felt like people were just sort of risking their lives going in the hospital taking care of patients, and it was just very chaotic for a lot of the ID docs that I knew.

SPEAKER_00 24:09

It was very chaotic.

SPEAKER_02 24:10

Yeah.

SPEAKER_00 24:10

What graciously what happened to me was that the first COVID case was reported in Chicago. And um, the next day I signed a contract with Howard Brown.

SPEAKER_02 24:21

Oh, thank God.

Telemedicine

SPEAKER_00 24:22

And so I left, right? So so then I I ended up uh at at the Devon Clinic, which was not far from where I worked because all my patients could come. And then the everything sort of went into this weird lockdown, and I just couldn't stand to do telemedicine. So you let me just go into the clinic every day.

SPEAKER_02 24:40

Oh, yeah, that's my favorite, honestly.

SPEAKER_00 24:42

Which was my favorite.

Everyone was dying

SPEAKER_02 24:43

Yeah, I like, I like uh I like in-person medicine a ton more than telemedicine. I mean, I I don't mind telemedicine, but I don't get the same thing out of it. Like I don't understand how people are doing behavioral health telephonically or a video. I just find it really hard to believe because I feel like there's so much, it doesn't feel as valuable to me. I just think there's just a whole set of other things that happen that doesn't in a visit that I I just can't get done the same way.

SPEAKER_00 25:09

On a tangent again. Sure. So at one point in time, you know, everyone was dying. Things were like oh my patience, right? I mean, it was like 12 a week or something. I mean, it was like this like This is during the 80s? This is the this is the uh the early 90s less. Early 90s? Okay. And the kids are like three and four. It was very stressful, let's say. And so Peggy and I went into couples therapy, which lasted for not a long time because the problem wasn't really Peggy. I mean, she was like dealing with the kids and you know, teaching um art at uh at Columbia and you know, but my life was like, you know, it was like just just like you know, oatmeal on a plate. It was, you know, it just sort of slopped everywhere. So and so I ended up going to a men's, a men's empowerment weekend.

SPEAKER_02 26:00

Oh, I love this for you.

Teaching

SPEAKER_00 26:02

Called the men's room. This sounds great. It changed its name to Victories of the Heart. And there was them and there was the the the warriors. But basically, um they used a gestalt Fritz Pearl's sort of methodology of doing psychotherapy. Weirdly enough, I ended up with um one of Fritz Pearl's best students as a patient whom I really loved, and she had a house next to Loyola University. The police knew, you know, uh she was very gregarious and just sort of really fun. And so all the police knew Charlotte, right? And so whenever there was like a problem teen in that little part of Rogers Park, they would grab the kid and bring them to Charlotte. And Charlotte would do her like Fritz Pearl's gestalt therapy with like these teenagers and like very quickly sort of get them back on track and out. And so it was this whole underground way of like avoiding Juvie Court and everything. I mean, there's all sorts of like ways that the city works that that aren't um Jeffrey, David Graber. No, I don't think so. He his original work was in um like how underground systems subvert the power dynamic that's happening at the pre-social media. I mean, even social media, you know, there's a whole set of conversations that never end up on social media. But and so Charlotte was part of that. But in any case, so there was this whole group of sort of gestalt therapists. So I ended up studying body-centered psychotherapy for a while or through something called a Hakomi method, but all body psychotherapy is about the same, you know. And so what drove me nuts about telemedicine is that you there's so many things you don't see that the body's doing. You don't see them tapping their foot, you don't see, you know, because everyone's got their laptop in front of them. So you're you're you're you're not seeing three-quarters of the body, you know, when you're in an exam room with somebody. And and and what and what happens is that's a very alienating experience because the patient gets put on a table in some form of undress, which immediately sets a power balance up. And so at some point at at County, um, in the pediatric training, I met a woman named Zina Lillian, who was a doctor, whose husband had started the Institute for Juvenile Research. She said, you know, with children, you can't, you you, you cannot ignore the power dynamic. And you, you know, you're the parent now in this weird way, and so you're in charge, and so you can't be sort of Namby pamby with the kids. You really have to like show them that you're trustworthy and they'll respond to you in that way. She goes, the problem comes with adults because now you're not you're not their parent. You're you're not in charge of them in that sense. And she said, what her husband had sort of like was working on was like, do you take advantage of the power dynamic and always use it as a diagnostic tool to see by pinging the person with the power dynamic and they ping back, what can you tell about what's happening? Or do you try and neutralize that in hopes that you're more you're more uh attuned to the patient, the patient's more attuned to you and therefore is more likely to be compliant with the therapy that that the two of you decide upon. Which I thought, you know, was coming from a pediatrician, it was sort of interesting. Like very early on in my in my uh training, that whole concept of power dynamic was there. But that's that's such a part of medicine. I was like, I was teaching two years ago. Medical students said something, I said, Well, you know, you have to read about a little bit more about this. And she said, Well, I do read. And I said, I understand, you know, but there's a lot to read, and you have to sort of be varied. And she said, Well, I think that's very condescending and kind of abusive.

SPEAKER_02 30:03

I was like, Oh no.

SPEAKER_00 30:05

And I said, Oh, you don't know what abuse is. And she said, What do you mean? I said, Well, when I was a medical resident, I got burned in the middle of surgery. They would stab you with a scalpel if your hand was in the wrong way. I got punched by my attendings, I got called, you know, dum cough. I mean, I said, You have no idea what, you know. I I said the worst was uh at Cook County as an intern, we would have uh uh clinical case reviews. I don't know if you were you ever there.

SPEAKER_02 30:36

I I was, I think, for some of some of us, yeah.

SPEAKER_00 30:39

There would be this room, the surgical room from the 1890s, you know.

SPEAKER_02 30:42

There'd be like the old hospital. Right, so in the old county. I love the surgical amphitheater in the old county hospital, it was beautiful.

SPEAKER_00 30:50

Okay, so there's the surgical amphitheater. This is where CPCs happened. So the attendings would sit at the top rows in the back, and then everyone would sit beneath them, and then you would sit where the opera person was being operated upon. You would go through everyone who died that week. And I remember I sat there once, and one of the attending said, So, Chris, why did you kill this person? I just looked at him and said, I guarantee you it wasn't on purpose, you know. They would just tear you apart in front of everybody, and it that was just that was completely unpleasant and abusive. And so I just thought, oh, it's it's so cute. She thinks I'm being abusive.

Neuropathy and pharmaceuticals

SPEAKER_02 31:34

Um, and maybe I was, but but telling them to read doesn't sound very abusive. Right. I mean, I think it's like as if, you know, you're yeah, of course, I'm not saying you didn't read, it just might be there's more, yeah. I guess what I get worried about is, you know, I want to see curiosity. And that's you need in a certain headspace, they can't be curious anymore to the side. I just think as animals, like as humans, but as animals, I guess that's what happens. But I think curiosity is really underrated. Like, I don't need people to know it. What I get disturbed by is just if there's a complete absence of any, like, why is this happening to this other human being? Like just when you're seeing a patient just being like, Wow, that's weird, you know. I think that's strange that that medicine did that in this case, you know. I think just being interested in it. I don't know if they're yeah, I just I enjoy it if people are curious. I can forgive a lot, but uh when it's like kind of a like robotic lack of curiosity, I don't see that in medical students, but I do see it in in younger populations, I guess, a lack of curiosity. Because sometimes I'm just like, well, are you interested in what's happening? Right. Like, or do you maybe you don't recognize what's happening that this is on you? Yeah, you don't know what you don't know. And I think that's what's really tricky. I I I trained at Rush, and Rush was actually pretty nice, meaning that they weren't there wasn't a lot of there really wasn't a lot of abuse happening. Um there was one there were a few attendings that I really enjoyed. Um one of which he would jump up on, he would literally jump up on the table. So when he got, when he got an answer back that he didn't like or that he thought was like inadequate, he would leap up onto the table of the uh nurse's station. So essentially you have tons of staff, there'll be like 20 staff members probably around, and he's on the table and he jumps up on the table and he starts pointing downward, like basically like yelling at the top of his lungs about like, that is not how this is working, you know, that is not how this is done. And you know, like it was something, some it was like probably an intern saying something like, I think this is what's going on with this patient, just like leaps up there and is like, ah, you know, and I can remember some very, very funny. I mean, honestly, even in the moment it was kind of funny because it was so over the top. But it is a different, but that is a different experience than what people probably have now. And I think it was interesting, very character-building. And I have to say, some of those experiences are a lot more helpful than um people being really nice to you. Let's put it that way. I learned more from some of those experiences. Um, I do teach some, so I have I have students on Wednesday afternoons, actually from Northwestern. Um, and they're medical students, which actually has been pretty helpful. I started doing that a few years ago as a it's an ECMH, so it's the um education-centered medical home. And they have this program. They basically come for their whole four years. So they start as a first-year medical student and then they come usually once or twice a month. I started doing that. Actually, I started like doing that program a few years ago because I wanted to enrich myself, mostly because I was feeling like disconnected from medicine. But that was because I was also a medical leader, so I wasn't doing as much clinic. So actually, getting back into clinic full-time was really very therapeutic for me. But the medical students are part of the therapy, I say part of the therapy, because you kind of end up, it's hard to be cynical or it's hard to be well, I guess I can find a way to be cynical or to be a jerk with with people, but it is, it's interesting to see it through their eyes, is very interesting. Now for something completely different. Have you found anything that works for neuropathy? I'm always like, I am actually struggling with. I mean, I have a lot of patients with neuropathy and I can't figure out what will work. They're charging like 30 bucks for like lidocaine spray. Like they charge the things that they charge for are ridiculous.

SPEAKER_00 35:46

Ridiculous.

SPEAKER_02 35:46

It's ridiculous because it's basically just a compound that you could mix in your kitchen. I I mean, I guess, but I don't know if there's anything that works, you know.

SPEAKER_00 35:56

I don't know. I'm I'm I'm still trying things. Okay, so um typically people are prescribing neuron and uh pregabalin. But there was a huge study in Taiwan looking at two million people, and they showed that um the people that were on those two drugs had a 300% higher chance of getting dementia than the ones that were not. Now, it doesn't prove causality, but it proves that that it doesn't stop it. It doesn't stop dementia, therefore, you know, and maybe it contributes to it, but that those drugs are not aren't are not working right, right? So there was a bunch of studies looking at uh mitochondrial dysfunction. And so anything that improves mitochondrial function probably will help with the neuropathy. And so I've been experimenting with with ozone or O3, which if taken increases the mitochondrial number and increases their function. There is, I have an ozone generator if you want to see it, but uh I've been drinking ozone water, but now they found out that they can get huge amounts of ozone into glycerin. So glycerinalized um you can make it yourself with an ozone generator.

SPEAKER_02 37:08

Oh, you can buy it. Yeah.

SPEAKER_00 37:10

So you buy glycerin with And that's been ozonated, and that'll last out of the refrigerator for three months, in the refrigerator for 30 days. It's got a gigantic amount of ozone in it, such that drinking a half a teaspoon twice a day will have all the effects on the mitochondria you want.

SPEAKER_02 37:29

Oh, wild. This looks really interesting, actually.

SPEAKER_00 37:31

Yeah.

SPEAKER_02 37:32

So it will act, and it's actually very heavy.

SPEAKER_00 37:34

It's absorbed, oh, yeah, it's it's incredibly heavy for what it is. Um and so each each ml I think has like 10,000 milligrams of ozone, which is a huge amount. Um, so, anyways, I've been trying this now, and it it it does seem to decrease it. So it's helping. Um and I'm drinking it. Sweat places are have opened up. Have you noticed this? I have no up the block is sweat house where you can sit in an infrared sauna and then um take a shower with um vitamin C infused water and then get into a tub of 47 degree water that has vitamin C in it, and then go back into the sauna for shock therapy. And I just read a whole bunch of stuff about shock, these shocks. They skyrocket your blood pressure and they skyrocket your heart rate. But if you get your face wet, it causes a diving reflex, which immediately lowers your heart rate, but pulls all your adrenaline down and is like a way of suppressing almost all anxiety. And so, in a sense, you push yourself into the anxiety and then you put your face in the water, you splash your face, and then it brings everything down. Now, and that causes a diving response which has an incredible relaxation effect. And so someone was looking at uh Scandinavians that do the sauna cold dive sauna, and they actually have shown that those areas that do that tend to epidemiologically have less anxiety diagnoses in their psychiatric clinics.

SPEAKER_02 39:17

Oh, that's fascinating. That's amazing. Yeah, and so it would be recommended then if you did the cold plunge as you go, would you go put your body in and then put your face in, or do all of it at once? Like are you supposed to go under?

SPEAKER_00 39:29

The last thing I read was going under all the way. Going under, but but get your body in first, take a few breaths, and then go under. Then go under. But you should put your head under.

SPEAKER_02 39:38

Yeah. That's wild. Yeah, I'm being directly marketed to by the sweat house, actually.

SPEAKER_00 39:42

Okay, so that's sweathouse.

SPEAKER_02 39:44

Now the the sweathouse has found me on the face the Facebook uh algorithm. So they've been like, they can they're they're like, you seem stressed.

SPEAKER_00 39:52

The other place is Perspire, uh-huh, which does not have the cold plunge, but they have red light and infrared. So supposedly the infrared matter, but matters waves, and waves is light is matter.

SPEAKER_02 40:05

I know what you mean, yeah, sort of like we're a wave, but we're a particle or something. Right, right.

SPEAKER_00 40:10

This is you know, the all the the, you know, if you smoke too much marijuana and you watch too much Joe Rogan, right? But um but but is there ever too much Joe Rogan?

SPEAKER_02 40:17

There's never too much. So he's fascinating, honestly. I think he's such an interesting guy.

SPEAKER_00 40:24

He is.

SPEAKER_02 40:24

I can't I have started watching him and I don't know why, but he's very entertaining.

SPEAKER_00 40:28

No, he is entertaining. He is but he is entertaining. I don't know that I, you know, I'm I'm not I don't know.

SPEAKER_02 40:33

I don't know if I believe everything he believes, but I don't think it's a lot of people.

SPEAKER_00 40:35

I don't know that he's smart to be the guests are there. The red blood cells are all there, there's a lot of iron in them, and the iron will absorb the infrared and it actually takes red blood cells, they they actually flash. They, you know, like like uh they emit light? Yes, yes, just like you know when you see the elevated uh go across the when you see the L and it's wet out and you see it spark. Yes. Oh yeah. So that that's it's sort of it's it's in that it's in that realm of light. It isn't like a continuous light bulb, it's like these little flashes. If you think about it, if red light is absorbed through the skin, um, the near red light, which are you're using, is it also gets absorbed to some degree by the red blood cells. And so those two go back and they make things hyperoxygenate for some reason. And so they they're they're in some ways they cause mitochondrial function to increase. And that increase increase in mitochondrial function decreases inflammation. Infrared spectrum that's somewhere around 800 to 1000 tends to be very anti-inflammatory, and the one around 650, which is the in the visible range of like, you know, these red light panels that people are yes, yeah, they tend also to be absorbed, but not, you know, but have a different effect than the but together, they the the 650 visible red tends to also be somewhat anti-inflammatory, but ends up bringing uh more blood vessels and a bunch of stuff and changes a bunch of different little things that are happening in your skin. I've decided I'll go to perspire because Peggy'll go with me, and and I'll see if that helps the neuropathy at all. And because we we started with neuropathy. So you asked me what. I said one of them was using ozone. The next one is is going to be trying infrared light. Um, the other thing is um there's a lot of literature. There's a Substack by a guy named, but they've been writing about uh uh dimethyl sulfoxide, DMSO. And DMSO has a way of stabilizing nerves, and it's a wonderful pain med. Um, you can get it in a 70-30% mix and you rub it wherever you have pain and it penetrates, but it penetrates very deeply. Put it on with lidocaine, the penetrance of the lidocaine goes way deeper.

SPEAKER_02 42:59

Yeah.

Vaccines

SPEAKER_00 42:59

And so you have to be careful like with drug absorption, yeah. Right. You know, like like if you're using um Voltaran gel, you know, dichlofinac, it's going to increase the absorption of that dichlofinac tremendously. You you can't quite use it at the same time. You have to separate it. But I've been using DMSO now for all sorts of pain in my shoulder, pain in my back. Um, there's a little bit of neuropathy in my hands, so I've been using it and it tends to work. Peggy was trying it, but she got a rash, but that's probably because 70% is too high a concentration. But you can buy it in various concentrations, and it works very well for most pain syndromes and gets you away from uh Tylenol and ibuprofen. I and I have no idea what to do with those drugs. Um, in some ways, I I I'm not overly joyed with with with Robert Kennedy, but in some ways I am. Um I mean, having been a pediatric infectious disease doctor for decades. You know, what they did with vaccines, I always thought was totally bizarre. Like, I always wondered why are we giving some of the vaccines we give when we give them? Like, do we really need rotavirus vaccine? Almost nobody died of chicken pox, but it cost a lot of money because parents stayed home. And so some of the some of the vaccines were economically driven. And I think that rethinking that and re-question and and questioning all this stuff again, I don't have a problem with sort of getting rid of it by fiat.

SPEAKER_02 44:29

I don't I know exactly what you mean. No, I have a very similar relationship with some of the vaccine, not that I've not been in practice forever, but as you go, like the vaccination schedule only grows but never decline. Like they never remove vaccines from the vaccine schedule. So to me, that seems bizarre. Like it's not as if we're bugs that we're fighting off. Like there's not very many new bugs on the scene. So why, as human beings, do we have it makes no sense other than the pharmaceutical industry as a revenue generator? Because basically, once you end up requiring it, then they have to cover it. And also the pricing of vaccines makes absolutely no sense. So just working in leadership and understanding that, you know, millions of dollars, um, even for a small clinic, it literally is millions of dollars of vaccine for vaccines, meaning every vaccine costs so much money. I'm sure they're not easy to manufacture, they're not easy to research, but it is a little bit, I think we should, I think questioning it is is healthy. I would never want to shame patients into taking vaccines. You know, so that's the other part is like, I don't think that works. And I also am very confused by the insurance companies mandating all of these flu vaccinations. And uh, it doesn't mean they're not a good tool. I mean, I I guess that's what I'm trying to understand is like when have we ever said, no, we should really get rid of this vaccine?

It was 1987....

SPEAKER_00 45:51

Lyme uh was the only one because it had an adverse effect. Um, but uh. So it's like 1987. I'm at um I'm at DC Children's Hospital. Bill is the head of the infectious disease department, and you know, but he's an infectious disease doctor, so he's got all the leadership roles, and he says to me, Chris, I really want you to be a fellow. You should stay here. And um they hadn't invented Prozac yet. And certain parts of the family that lived in Washington became much more tolerable once the drug came out. And so I said, I don't know that I really want to stay in Washington because I have to like, you know. I said, Well, Bill, I what do you think I should do in terms of research? And he said, Oh, that I've worked that out already. You're gonna go work at the FDA. Oh wow. Um you'll do your fellowship like analyzing studies, and then when you leave here, you're gonna go work at the FDA with them because they'll have trained you to do everything. And after about five years, you'll go work for a big pharmaceutical company and you'll make more money than I ever made, and it'll be fine. And I said, Great, thanks, Bill. I walked out. Peggy said, Well, you know, are we gonna stay? And I said, only if I wanted to be a complete whore. I can't believe you offered me that. I just and so that revolving door, right? That's that revolving door that that that that Kennedy was talking about, or McCarey or Vinet Persia, all these people that that Trump put in, they're identifying something that's very real, that was sort of on the table. I mean, in plain English, you know, that was not it was uh open secret property.

SPEAKER_02 47:45

Yeah, yeah. But it wasn't considered, it was like not considered weird.

SPEAKER_00 47:50

Make money. What do you you know, what the hell? You're an infectious disease doctor. Why why'd you pick genteel poverty? I'm offering you.

SPEAKER_02 47:56

Yeah, that's always the hard part with it, is just it was weird to me to watch kind of HIV be a moneymaker.

SPEAKER_01 48:06

Right.

SPEAKER_02 48:07

Not that I, you know, not a lot of it is pharmaceutical, you know.

SPEAKER_01 48:10

Yeah.

SPEAKER_02 48:10

And it were, I mean, granted, it's one of the things that can be treated and can be controlled with medication, and you have to be on medication for life, which and the stuff actually works and it doesn't have very many side effects. Like, I mean, a lot of medication regimens are very manageable. Um, but it is a strange phenomenon. Like the collaboration of research entities and pharmaceutical, yeah, pharmaceutical kind of patents is very a little bit concerning, you know. So a lot of times I do like I would do the courses for new providers on learning HIV medicine, and we kind of go over how do we end up with, you know, different versions of Tenofavir, right? Tanophavir disputated. Exactly. Like when were they they strategize? I mean, there's this is not an is not a secret, but meaning that they've they basically laid it out to to run the patents out, yeah, i in different ways in order to just maximize the length of the patent, which I understand it's part of the business model, but it is it doesn't seem like it's a very we're very far away from like a societal approach to public health. You know, I'm not sure that JFK is gonna get us there, right? Or whatever his name is. I'm not sure he's gonna, he's he's like, I'm not sure he's plugged in, but uh and that's the problem with I a lot of times my son's been learning about capitalism. So he just finished his economics, his senior year, they do like an economics block. And it's very fun to it was fun to like drive him to school every day and have him go through the test questions with me about like what the difference is between like end stage capitalism and you know, like we are not, we're not actually a pure capitalist society. We have social, we have social good as part of it. But like, yeah, very interesting to think about numbers of discoveries or the same kinds of treatments without the system we have. But there has to be a better way. There has to be a better way or a cheaper way to do it. Cause I'm very uh I I guess I would say I'm very frustrated with Medicare. Um, Medicare drug coverage. Like I'm very frustrated with that just because it's very what I'm most frustrated with Medicare drug coverage is mostly that it's illogical. So that frustrates me the most, which is I'm literally like, I have patients coming in asking for prescription meds for things that we could do over the counter because they can't afford$5 a month. And they can't. They really are kind of at that fixed budget area where they're not going to get, they're just trying to get some ibuprofen or some acetamenophen. They'll take whatever we can prescribe because that will be covered. So whoever thought that like taking everything off the formulary that was over the counter would save money for Medicare doesn't understand what is going on in the medical field or doesn't understand the way human beings operate. You know, I mean, I think that's part of it, like human behavior and how how resourceful people can be. It doesn't mean that people are saving money by doing that. They're just going to go in and get a pregablin instead of acetamenophen. And pregablin probably costs a lot more, but it's what they'll cover. There has to be a better way. And also, I think compounding pharmacies, I really think are the wave of the future. Like, I feel like compounding is the way to go. I think there's a lot we could do with compounding pharmacies and the fact that nothing compounded is ever covered by insurance because they're like, oh, it's not scientific. And I'm kind of like, come on, people, like it's got the same ingredients in it. I don't know what to tell you. Like, what kind of science are you guys doing? Like, I don't know what science you're doing. But the fact that these ingredients are pretty much the same and it's a non-sterile product to begin with, and somebody is compounding it versus buying it. Come on. Like, I understand that brand, there's manufacture differences, but it's very, it's a very peculiar system that does not really understand how patients make decisions. I guess they don't understand how patients make decisions in their own lives or how they can actually like maintain function. I don't think I have the answers, but I do find it to be very illogical. And I really wish we had a better system.

SPEAKER_00 52:30

But don't you think, Magda, that there's so many different layers of what's real, you know? So, like, let's look at um uh at Part D, right? You know, there's all these different part D's, they're all covering things. Some of them don't cover this, some of them cover that, the advantage plan covers everything, but in some ways it's not better health care. Um, so on one level, like it's all about maximizing profit, and then you get into the whole 340B system that where the federal government sells drugs to federally qualified clinics. But what what happens then is is those drugs pay for people and pay for health care. Um and so if you and and it's about the differential, they buy it at a discounted rate and then sell it at the at the full rate to the insured patients. And so if you start lowering prices, you're going to destroy part of the way that we pay for uh poor people that is outside of the Affordable Care Act slash Obamacare. It's a way that the red states can take money from the federal government without saying that they're actually participating in, you know, socialist health care. So, you know, there's there's that political layer. Yeah I mean, and when you start putting all the layers on, it becomes confusing. And then you get um and then you get like these weird. So then let's let's take another step back from that then. So we're looking at, let's say, a medical intervention, right? You know, so there was this like paper that came out about wearing electric vests that shock you and keep you alive. The paper in the end said that it was, you know, we should be using these uh electronic vests that are like$40,000 on everybody who, you know, might have an arrhythmia. The the the study that they did was um was looking at these shock vests versus nothing, not any medicine that stops arrhythmia.

SPEAKER_02 54:41

Oh, geez. Okay. Well, that's so hard.

SPEAKER_00 54:43

Of course, it's going to work better than nothing. Right. But it didn't really compare it to what what medication what you and I would do with a patient. In the real world, yeah. In the real world, we would do this, but that's not what they studied. And it was, you know, it was obviously it was obviously a study only made to like get this thing through Medicare and Medicaid. And so there's an interesting substack um called uh Sensible Medicine. All right. And it's run by three, I think, libertarian doctors. Uh one of that at the University of Chicago, of course, because you know, although it pretends to be liberal, it it it's it can be as far right wing and you know, let's make the atomic bomb as any place in America, right? And then the other guy's at Ohio State, which is like, you know, Ohio State, just saying Ohio State. You know it's a repressive uh uh uh sort of an institution, right? It is in Ohio State famous for all the you know riots. Right. And then the other person I think is it's was it became the head of vaccines, and that was um Vene Prasad, who was a paid person saying, these vaccines don't work, which in fact they didn't, but but I mean they worked at like not dying, but they didn't stop transmission, they didn't stop infection, they they just they they kept you from dying, which I thought was very I thought that was a good thing, you know. I you know, of course, everyone like yelled at Fauci for like that. But yeah. But in any case, where the that they're they're just shilling products, you know?

SPEAKER_02 56:17

Oh, for sure. I mean, I think that I've seen that with pain management. A lot of the spinal stimulators, I'm very concerned about, just because I have a lot of patients where it doesn't work, but it's also kind of like the willingness, sort of our willingness to incentivize certain interventions versus others is part of the problem. I mean, it really is, because some of it I this is part of why I try to talk to patients about topical cream pain management, basically being like, let's just go back to like the Amish, like we'll just kind of like cook some cayenne pepper in the kitchen and try, yeah. Yeah, like cook some uh cayenne pepper cream in the kitchen with some coconut oil and then rub that on, um, versus buying buying some of the products that are almost the same thing, you know, or using like cabbage leaves and other weird stuff that shouldn't work. Uh, but maybe the, you know, it's kind of very interesting to watch things go in and out of style because some of the stuff I'm just like the other thing I've also often I look at a lot is veterinary medicine, because my theory with this is with veterinary medicine is we the pet doesn't usually, I mean, I don't think they know that they're having an intervention necessarily. So if you're using glucosamine and chondroitin for pets and they're saying it's working, I'm just not sure. It's not like it's a placebo effect. I mean, the dog doesn't know it's getting something different. So I'm so every time I'm trying to figure out like what the hell works or doesn't work, I do actually look at veterinary medicine because I'm like, the amount of research that they've done in veterinary medicine is shocking how interesting it is, you know.

SPEAKER_00 57:53

Huge amount of information about this stuff in veterinary medicine. Really? Around ionized injecting it into tumors, giving it intravenously, bosone, yeah. Um someone injected it into horses with encephalitis, um, you know, in fairly high doses, and it cured the encephalitis.

SPEAKER_02 58:13

Unbelievable.

SPEAKER_00 58:14

Because it's it's also antiviral.

SPEAKER_02 58:16

But um, what do you think about um oregano oil?

SPEAKER_00 58:20

I've used oregano oil.

SPEAKER_02 58:22

They say it's as good as antibiotics, but I don't know if that's really for topical things, it's pretty good.

SPEAKER_00 58:26

This stuff works much better than anything else.

SPEAKER_01 58:28

Yeah.

SPEAKER_00 58:29

In terms of because it it's a sterulent, right? I mean, it it it it it kills everything. The other thing I've been experimenting with in terms of this hyperoxygenation is um is hydrogen peroxide. Um interesting. Give me a second, I'll be right back. Do you want to take a look at it?

SPEAKER_02 58:45

Oh, yeah, I'll take a cookie now. I'm ready for cookies.

SPEAKER_00 58:48

There's cowboy cookies, which are oat.

SPEAKER_02 58:50

Oat cookies, these look like healthy cookies.

SPEAKER_00 58:53

Oh well, they're gonna freed for me, but oh, okay.

SPEAKER_02 58:57

Oh yeah. Cowboy cookie. Oh yeah.

SPEAKER_00 58:59

I'll be right back. I'm gonna sure.

SPEAKER_02 59:02

Very good biscuits. All right, thank you. Oh, hydrogen peroxide, 35%. So this is wild. Where do you so you must order this from the chemical company?

SPEAKER_00 59:19

It's a it's a it's a you know used as a as a cleaning agent.

SPEAKER_02 59:25

Yeah, this is amazing.

SPEAKER_00 59:27

So if you pour two cups in a bathtub of water that's warm and you sit in it, it'll do very much the same thing as ozone, because it dissociates into O3, which you're which you'll absorb. So I've been using hydrogen peroxide as a way of of one treating skin, chronic skin problems, because I have erythrasma. And um, because of the immunosuppressives, it doesn't go away. But if I soak in that, it kills all that back all those bacteria, and so the rashes all go away.

SPEAKER_01 59:57

Wild.

SPEAKER_00 59:58

And it also hyperoxygenates everything. Experimenting with this, now at the height of COVID, people were putting um, I think 10 drops of of the 35% in a nebulizer with sterile water and inhaling it trying to kill the COVID in their respiratory tree. There's also people using iodine nasal sprays. I mean the iodine nasal sprays worked.

SPEAKER_02 1:00:20

Mm-hmm. Which was not like original to me, but is that all of these substances that cannot be patented are underutilized. So basically, because they can't be patented, there's no curiosity or there's no incentive to use them. They're frequently cannot, we cannot prescribe them because they're not patented because they're not studied in the same way. But even when they are studied, it's like they're not adopted really widely because there's not really like anybody advocating for their adoption.

SPEAKER_00 1:00:51

Right.

SPEAKER_02 1:00:51

Because they they don't make anyone any money.

SPEAKER_00 1:00:53

Well, the hydrogen peroxide data goes back to around 1924, 1923. So, you know, uh you're not gonna find like if you're trying to look for like giving them current stuff. So you're not gonna find anything. The ozone stuff is mostly in the veterinary literature.

SPEAKER_02 1:01:09

And there's some in human it's also veterinary medicine, meaning so honey is used heavily heavily in veterinary medicine, and that's where it kind of was like, oh, really underutilized, undervalued kind of intervention.

1991 lunch

SPEAKER_00 1:01:21

Well, think of menuka honey is that it's you know, they're from a eucalyptus leaves, so that they tend to be it has an antibacterial effect, but all honey is is so hyper osmotic, hyper osmotic that it'll kill everything. 1987. No, 1991. I'm at lunch with Fauci and um the head of infectious diseases at the University of San Francisco. There's a head of the University of Chicago, right? And um they all said, well, we should probably sterilize all these women with AIDS because you know they're they're just gonna give it to the baby and the baby's gonna die. And I said, you know, I don't think sterilization is is is is would would be you know morally acceptable to most Americans. And they sort of looked at me and said, Well, you might be right about that.

SPEAKER_02 1:02:17

And that's what these that's what's happening behind closed doors. Yeah, I know, I totally know what you're saying. Yeah, these are these are they're saying it out loud, which is crazy.

SPEAKER_00 1:02:29

Yeah, yeah, these are morally bankrupt people. I mean, just so you know.

SPEAKER_02 1:02:33

Oh, I believe it. No, I believe that.

SPEAKER_00 1:02:34

And I'm like, yeah, but they've done a lot of good for things.

SPEAKER_02 1:02:37

I know what you mean.

SPEAKER_00 1:02:38

And they're trying the best they can.

SPEAKER_02 1:02:39

I know exactly what you mean. Yeah, I know what you mean. It takes a certain, it takes a certain personality to even exist in some of those spaces. So you kind of have, I mean, I can understand there's like a little bit of evil that has to be there to even operate to make some of the decisions that you have to make.

SPEAKER_00 1:02:55

But it gets back to what you said about leadership. You know, you you don't see your blind spots.

unknown 1:03:00

No.

SPEAKER_02 1:03:01

They like you don't know what would horrify other people because you kind of it's normal to you. Right.

SPEAKER_00 1:03:06

They would never think that sterilizing women with HIV was a bad thing.

SPEAKER_02 1:03:13

Yeah. God, that's the this kind of like validates what I it's unfortunately sort of validates what I fear about. You know, not that I'm you know, I I think it's I'm intrigued by these personal like big personalities, but like it doesn't mean they don't operate.

SPEAKER_00 1:03:26

Right.

SPEAKER_02 1:03:27

It doesn't mean they operate under so that's you know, like that's a different type of pragmatism, which is also pragmatic but not ethical, you know.

SPEAKER_00 1:03:36

So I I walk out with my boss from the University of Chicago, Polarino. I said, um did I say the wrong thing? Paul just laughed at me.

SPEAKER_02 1:03:47

He said, like, whatever. I didn't he didn't prep you for this meeting very well. Like that's a feeling they're gonna say a bunch of crazy things in the meeting.

SPEAKER_00 1:03:55

He said, Chris, sometimes people say really stupid shit. You just have to say that stupid shit. Yeah. You did. But it's okay. He said, probably better that they at least hear it from somebody before they start running with the idea in our group than like you know, get broadsided from the outside world. And I said, Okay, Paul. Yeah.

SPEAKER_02 1:04:17

Cool. Well, thanks for letting me pick your brain. Oh no. Oh my gosh. Yeah, we will do, we should do it again. So we'll do, I'll set up a time in January if you have time. Did you enjoy this episode? If so, head over to our website, podcastthesilverpossum.org, and uh you can find a link by the episode that allows you to donate to an older adult in need. We will see you next time. Thanks for listening.