1 00:00:06,240 --> 00:00:11,440 Speaker 1: Welcome to Why Not Me? Embracing Autism and Mental Health Worldwide? 2 00:00:12,160 --> 00:00:19,680 Speaker 1: Hosted by Tony Mantor, broadcasting from the heart of Music City, USA, Nashville, Tennessee. 3 00:00:20,720 --> 00:00:24,840 Speaker 1: Join us as our guests share their raw, powerful stories. 4 00:00:25,360 --> 00:00:29,360 Speaker 1: Some will spark laughter, others will move you to tears. 5 00:00:30,360 --> 00:00:35,959 Speaker 1: These real life journeys inspire, connect and remind you that 6 00:00:36,000 --> 00:00:40,919 Speaker 1: you're never alone. We're igniting a global movement to empower 7 00:00:41,080 --> 00:00:46,120 Speaker 1: everyone to make a lasting difference by fostering deep awareness 8 00:00:46,560 --> 00:00:52,760 Speaker 1: on wavering acceptance, and profound understanding of autism and mental health. 9 00:00:53,159 --> 00:00:57,320 Speaker 1: Tune in, be inspired, and join us in transforming the 10 00:00:57,360 --> 00:01:04,720 Speaker 1: world one story at a time. Hi, I'm Tony Mantur. 11 00:01:05,040 --> 00:01:09,679 Speaker 1: Welcome to Why Not Me? Embracing Autism and Mental Health Worldwide. 12 00:01:10,000 --> 00:01:14,120 Speaker 1: Joining us today is David Hager, who, interestingly never planned 13 00:01:14,120 --> 00:01:17,520 Speaker 1: on becoming a psychiatrist. He started college at Texas A 14 00:01:17,600 --> 00:01:20,920 Speaker 1: and M dreaming of a white coat for four legged patients, 15 00:01:20,959 --> 00:01:25,000 Speaker 1: set on veterinary medicine, but somewhere between anatomy labs and 16 00:01:25,080 --> 00:01:28,560 Speaker 1: late night soul searching, the human mind pulled harder than 17 00:01:28,600 --> 00:01:32,360 Speaker 1: any animal heart ever could. He pivoted earned his MD 18 00:01:32,600 --> 00:01:37,440 Speaker 1: at UTMB Galveston, completed his psychiatry residency and moved forward 19 00:01:37,440 --> 00:01:40,959 Speaker 1: from there. He then walked into state prisons in Florida 20 00:01:41,200 --> 00:01:44,679 Speaker 1: and Illinois, where the patients were human but often treated 21 00:01:44,760 --> 00:01:48,120 Speaker 1: us less. His journey is outstanding and he has so 22 00:01:48,240 --> 00:01:51,520 Speaker 1: much information to give us today. So before we dive 23 00:01:51,560 --> 00:01:55,200 Speaker 1: into our episode, we'll be back with an uninterrupted show 24 00:01:55,560 --> 00:01:58,560 Speaker 1: right after a word from our sponsors. Thanks for coming on. 25 00:01:59,280 --> 00:02:03,680 Speaker 2: Yeah, this is interesting as the first first time experience 26 00:02:03,760 --> 00:02:04,040 Speaker 2: for me. 27 00:02:04,200 --> 00:02:07,000 Speaker 1: Well, that's good. I do not think there'll be any problems. 28 00:02:07,880 --> 00:02:10,880 Speaker 1: I think the most important thing is getting it started. 29 00:02:10,960 --> 00:02:13,480 Speaker 1: So let's do that. If you would introduce yourself and 30 00:02:13,520 --> 00:02:14,400 Speaker 1: tell us what you do. 31 00:02:14,919 --> 00:02:17,960 Speaker 2: Oh, I'm David Hager and I am a psychiatrist. 32 00:02:18,320 --> 00:02:22,080 Speaker 1: Okay, now the big question, what led you to go 33 00:02:22,160 --> 00:02:23,160 Speaker 1: into psychiatry? 34 00:02:24,840 --> 00:02:29,120 Speaker 2: Well, I didn't plan on psychiatry. I went to Texas 35 00:02:29,160 --> 00:02:30,560 Speaker 2: A and M to be a veterinarian. 36 00:02:30,760 --> 00:02:33,800 Speaker 1: Okay, I safely can say I didn't expect that. 37 00:02:34,360 --> 00:02:37,040 Speaker 2: Yeah, it's actually more difficult to get into VET school 38 00:02:37,080 --> 00:02:38,080 Speaker 2: than medical school. 39 00:02:39,400 --> 00:02:40,360 Speaker 1: That's interesting. 40 00:02:40,800 --> 00:02:43,040 Speaker 2: Yeah it is. It's just it's a numbers things. So 41 00:02:43,240 --> 00:02:47,440 Speaker 2: I applied in my sophomore, junior, and senior years of 42 00:02:47,600 --> 00:02:51,680 Speaker 2: college to vet school, and then that last time, I 43 00:02:51,680 --> 00:02:55,639 Speaker 2: also applied to med school because I realized there's a 44 00:02:55,680 --> 00:02:57,799 Speaker 2: couple of things. One is the veterinarians I was working 45 00:02:57,800 --> 00:03:00,560 Speaker 2: with al said they wish they had gone to medical school, 46 00:03:00,800 --> 00:03:03,000 Speaker 2: and I realized the main reason I wasn't going to 47 00:03:03,040 --> 00:03:06,280 Speaker 2: medical school or considering it is because my father wanted 48 00:03:06,280 --> 00:03:08,560 Speaker 2: me to go to medical school. Anyway, wound up in 49 00:03:08,639 --> 00:03:12,240 Speaker 2: medical school. I was accepted to three med schools and 50 00:03:12,280 --> 00:03:14,280 Speaker 2: I got a third alternate spot, that time to the 51 00:03:14,320 --> 00:03:14,840 Speaker 2: BET School. 52 00:03:15,360 --> 00:03:15,560 Speaker 1: Yeah. 53 00:03:15,639 --> 00:03:21,160 Speaker 2: So went to utmbing Galveston. After going through the third year, 54 00:03:21,200 --> 00:03:25,200 Speaker 2: which is the usual round of clinicals, I had it 55 00:03:25,240 --> 00:03:30,240 Speaker 2: boiled down to surgery or psychiatry. Okay, Pschiatry was unexpected. 56 00:03:30,639 --> 00:03:34,280 Speaker 2: What I liked about psychiatry was listening to people's stories. 57 00:03:34,520 --> 00:03:37,560 Speaker 1: Yeah, I get that completely, and those stories can get 58 00:03:37,600 --> 00:03:38,560 Speaker 1: pretty intense. 59 00:03:38,960 --> 00:03:39,360 Speaker 2: They can. 60 00:03:39,520 --> 00:03:41,960 Speaker 1: Yeah. I guess my question is how do you deal 61 00:03:42,000 --> 00:03:44,800 Speaker 1: with that from a standpoint of someone that wants to 62 00:03:44,840 --> 00:03:47,920 Speaker 1: help someone. I've been told all my life that I'm 63 00:03:47,960 --> 00:03:50,640 Speaker 1: a fixer because I like to help people. In us 64 00:03:50,640 --> 00:03:54,800 Speaker 1: scope of work, fixing means helping people, and sometimes when 65 00:03:54,840 --> 00:03:58,400 Speaker 1: you're trying to help these people, you can't fix them right. 66 00:03:58,520 --> 00:04:01,440 Speaker 1: That can be very frustrating. So how do you deal 67 00:04:01,480 --> 00:04:01,800 Speaker 1: with that? 68 00:04:02,400 --> 00:04:06,640 Speaker 2: Well, not always gracefully. I'm a human, you know, sometimes 69 00:04:06,680 --> 00:04:11,280 Speaker 2: with a stiff professional formality, and sometimes I think more 70 00:04:11,400 --> 00:04:14,640 Speaker 2: so as my career has progressed and I've become more 71 00:04:14,720 --> 00:04:20,080 Speaker 2: human as a psychiatrist, that I'm able to listen to 72 00:04:20,120 --> 00:04:25,279 Speaker 2: people's stories without having to be necessarily strictly a psychiatrist 73 00:04:25,320 --> 00:04:26,120 Speaker 2: while doing so. 74 00:04:26,480 --> 00:04:31,000 Speaker 1: Okay, that makes sense. Now, I'm guessing by doing it 75 00:04:31,040 --> 00:04:35,160 Speaker 1: this way, you're able to hopefully break down some barriers 76 00:04:35,480 --> 00:04:38,839 Speaker 1: which will allow them to get into a comfort zone 77 00:04:38,960 --> 00:04:42,000 Speaker 1: with you, which allows them to tell you more things 78 00:04:42,040 --> 00:04:44,680 Speaker 1: that you need to hear in order to be able 79 00:04:44,720 --> 00:04:45,360 Speaker 1: to help them. 80 00:04:45,680 --> 00:04:49,080 Speaker 2: Yeah, a lot depends on the setting. How clinical interviews 81 00:04:49,120 --> 00:04:52,880 Speaker 2: go in a correctional setting, for instance, is very different 82 00:04:52,920 --> 00:04:56,960 Speaker 2: from how interviews go and let's say a substance abuse rehab. 83 00:04:57,880 --> 00:05:00,640 Speaker 2: I had worked for several years at a rehab and 84 00:05:00,920 --> 00:05:02,080 Speaker 2: lots of stories there. 85 00:05:02,200 --> 00:05:04,200 Speaker 1: I can only imagine it. 86 00:05:04,120 --> 00:05:07,120 Speaker 2: Worked better to be a little bit more myself in 87 00:05:07,160 --> 00:05:12,080 Speaker 2: those settings. You don't really let people know much about 88 00:05:12,120 --> 00:05:15,960 Speaker 2: yourself personally. When you're working with folks in a prisoner 89 00:05:16,040 --> 00:05:16,479 Speaker 2: a jail. 90 00:05:16,680 --> 00:05:17,719 Speaker 1: Yeah, that makes sense. 91 00:05:18,279 --> 00:05:21,120 Speaker 2: Yeah, But one of the ways I tried to deal 92 00:05:21,160 --> 00:05:27,080 Speaker 2: with that to reduce some of the formality of the 93 00:05:27,120 --> 00:05:31,279 Speaker 2: interviews was I actually I wrote a program to do 94 00:05:31,480 --> 00:05:35,640 Speaker 2: a computer psychiatric interview before I saw the patients, so 95 00:05:35,920 --> 00:05:39,080 Speaker 2: get through a lot of these structured stuff beforehand that 96 00:05:39,120 --> 00:05:42,000 Speaker 2: I could follow up on during the actual face to 97 00:05:42,040 --> 00:05:45,600 Speaker 2: face interview and then focus more on the human elements 98 00:05:45,640 --> 00:05:48,800 Speaker 2: instead of going through a whole bunch of rigid diagnostic 99 00:05:48,839 --> 00:05:50,479 Speaker 2: stuff that can chew up a lot of time. 100 00:05:50,640 --> 00:05:53,800 Speaker 1: That computer program is such a great idea. Saves a 101 00:05:53,839 --> 00:05:57,320 Speaker 1: lot of time. I'm sure. I'm sure you'll like everyone else, 102 00:05:57,600 --> 00:05:59,920 Speaker 1: that you have a limited amount of time to give 103 00:06:00,080 --> 00:06:00,760 Speaker 1: to these people. 104 00:06:01,120 --> 00:06:01,320 Speaker 2: Right. 105 00:06:01,680 --> 00:06:05,760 Speaker 1: What happens when a patient starts opening up and digging 106 00:06:05,800 --> 00:06:08,720 Speaker 1: into some of these things that you really need to know, 107 00:06:09,520 --> 00:06:12,760 Speaker 1: and then all of a sudden, the time's up. Yeah, 108 00:06:12,920 --> 00:06:15,520 Speaker 1: so do you go into over time, do you punch 109 00:06:15,560 --> 00:06:16,800 Speaker 1: the clock? What do you do? 110 00:06:17,279 --> 00:06:19,599 Speaker 2: Again? That depends on the setting. You know, in that 111 00:06:19,720 --> 00:06:23,760 Speaker 2: substance abuse rehab setting ahead of schedule, and patients are 112 00:06:23,839 --> 00:06:26,520 Speaker 2: kind of notorious for bringing up the most difficult thing 113 00:06:26,680 --> 00:06:30,400 Speaker 2: right at the end of a session, and there's a 114 00:06:30,440 --> 00:06:35,359 Speaker 2: tab dancing that then occurs, hopefully a compassionate tab dancing 115 00:06:35,520 --> 00:06:39,360 Speaker 2: that says our time is limited, and I hope continue 116 00:06:39,360 --> 00:06:43,599 Speaker 2: to talk about this the next time we sit down. Yeah, 117 00:06:43,839 --> 00:06:47,200 Speaker 2: that's a tough one. On the other hand, in institutional settings, 118 00:06:47,400 --> 00:06:50,840 Speaker 2: there's not so much of a hard time limit. Can 119 00:06:50,880 --> 00:06:53,080 Speaker 2: be a lot more flexible in how long a particular 120 00:06:53,160 --> 00:06:54,000 Speaker 2: session lasts. 121 00:06:54,160 --> 00:06:57,440 Speaker 1: That makes total sense. Are you working with people that 122 00:06:57,480 --> 00:07:01,800 Speaker 1: are incarcerated, or are you still working with people that 123 00:07:02,360 --> 00:07:05,440 Speaker 1: need help with substance abuse? Or is it a little 124 00:07:05,440 --> 00:07:08,200 Speaker 1: bit of everything. What's your schedule look like? Now? 125 00:07:08,640 --> 00:07:13,160 Speaker 2: Well, I'm partially retired now, okay, but you know what 126 00:07:13,160 --> 00:07:15,760 Speaker 2: I'm doing right now is contract work, and I'm doing 127 00:07:15,760 --> 00:07:21,040 Speaker 2: contract work, doing correctional psychiatry because over the years, I 128 00:07:21,120 --> 00:07:23,760 Speaker 2: have found that to be the most interesting work. Okay, 129 00:07:24,520 --> 00:07:28,320 Speaker 2: and the contract work is there was other factors that 130 00:07:28,560 --> 00:07:31,080 Speaker 2: play into why it works out well for us at 131 00:07:31,080 --> 00:07:33,320 Speaker 2: this point, so that I can work half the year 132 00:07:33,440 --> 00:07:35,840 Speaker 2: and still get by. Tell you a little bit about 133 00:07:35,840 --> 00:07:39,320 Speaker 2: how I got into correctional work and what that experience 134 00:07:39,320 --> 00:07:39,920 Speaker 2: has been like. 135 00:07:40,280 --> 00:07:42,480 Speaker 1: Yeah, that sounds great. When did that start? 136 00:07:42,880 --> 00:07:45,280 Speaker 2: It's two thousand and one. I'll tell you that I'm 137 00:07:45,320 --> 00:07:47,280 Speaker 2: not great at running a business, and I had a 138 00:07:47,320 --> 00:07:50,520 Speaker 2: practice in southwest Florida, a private practice with a number 139 00:07:50,520 --> 00:07:54,600 Speaker 2: of clinicians, and that financially didn't go well. I wound 140 00:07:54,720 --> 00:07:56,000 Speaker 2: up in a lot of debt. Out of that, I 141 00:07:56,040 --> 00:07:59,520 Speaker 2: learned some hard lessons. And the job that was available 142 00:07:59,560 --> 00:08:02,520 Speaker 2: in nearby I was at a prison, and I had 143 00:08:02,520 --> 00:08:05,880 Speaker 2: an interest in forensics already. I was doing court evaluations 144 00:08:05,920 --> 00:08:07,560 Speaker 2: and such, and so I figured it was a good 145 00:08:07,600 --> 00:08:09,840 Speaker 2: way to round out or flesh out some of my 146 00:08:09,880 --> 00:08:12,880 Speaker 2: forensic experience. So I started working at this prison, Charlotte 147 00:08:12,880 --> 00:08:15,680 Speaker 2: Correctional in southwest Florida. It turns out that's a place 148 00:08:15,720 --> 00:08:18,480 Speaker 2: that has a bit of a reputation. It's a tough place. 149 00:08:18,720 --> 00:08:21,360 Speaker 2: It's a close management camp on site, which is a 150 00:08:21,400 --> 00:08:23,640 Speaker 2: prison within a prison, and it also happens to have 151 00:08:23,680 --> 00:08:25,880 Speaker 2: the crisis unit, one of the crisis units, and a 152 00:08:25,920 --> 00:08:29,000 Speaker 2: transitional care unit for people with severe mental illness or 153 00:08:29,120 --> 00:08:33,560 Speaker 2: well people with mental health concerns. Because it kind of 154 00:08:33,679 --> 00:08:38,120 Speaker 2: parses out into a few basic categories in a correctional setting. 155 00:08:38,400 --> 00:08:41,120 Speaker 1: Okay, can you expand on that sum. 156 00:08:41,440 --> 00:08:44,080 Speaker 2: You've got people who are real deal, severely mentally ill, 157 00:08:44,520 --> 00:08:47,840 Speaker 2: You've got people who are trying to make you believe 158 00:08:47,920 --> 00:08:51,240 Speaker 2: that the real deal mentally ill because of various reasons. 159 00:08:51,240 --> 00:08:55,000 Speaker 2: Either they want special considerations, or they want the medications, 160 00:08:55,120 --> 00:08:57,320 Speaker 2: or either they want to take the medications or sell 161 00:08:57,360 --> 00:09:01,440 Speaker 2: the medications. And then there's a population that it's important 162 00:09:01,440 --> 00:09:04,200 Speaker 2: to manage from a safety perspective of the folks who 163 00:09:04,240 --> 00:09:06,719 Speaker 2: are at risk for suicide. There are some people who 164 00:09:06,720 --> 00:09:09,560 Speaker 2: are actually at true risk for suicide. But you know, 165 00:09:09,600 --> 00:09:13,080 Speaker 2: our experience is that most of the people who say 166 00:09:13,080 --> 00:09:16,640 Speaker 2: they're at risk for suicide are using that particular process 167 00:09:16,640 --> 00:09:20,080 Speaker 2: to try to make a change happen. So at Charlotte Correction, 168 00:09:20,240 --> 00:09:24,600 Speaker 2: I begin to appreciate what happens to people who have 169 00:09:24,880 --> 00:09:27,880 Speaker 2: severe mental illness, real deal severe mental illness. 170 00:09:28,120 --> 00:09:32,920 Speaker 1: With that said, does anyone or any particular situation stand 171 00:09:32,960 --> 00:09:33,439 Speaker 1: out to you. 172 00:09:33,960 --> 00:09:36,679 Speaker 2: I remember this one guy in particular. You know, I'd 173 00:09:36,720 --> 00:09:39,360 Speaker 2: go look at the classification file for people where I 174 00:09:39,400 --> 00:09:41,719 Speaker 2: wasn't really sure what was going on, and this one guy, 175 00:09:41,760 --> 00:09:44,920 Speaker 2: I wasn't quite sure, And I looked through his classification 176 00:09:45,080 --> 00:09:47,760 Speaker 2: file and I saw his history of arrests, and it 177 00:09:47,840 --> 00:09:50,760 Speaker 2: was a whole bunch. It was like thirty trespassing arrests. 178 00:09:51,000 --> 00:09:51,480 Speaker 1: Wow. 179 00:09:51,679 --> 00:09:54,000 Speaker 2: Yeah, and then he became you know, in the course 180 00:09:54,040 --> 00:09:56,000 Speaker 2: of me trying to take care of him, he became 181 00:09:56,080 --> 00:10:00,280 Speaker 2: floridly psychotic. He became you know, there was no ambiguity 182 00:10:00,320 --> 00:10:02,640 Speaker 2: at all, you know, there was the progression of people 183 00:10:03,360 --> 00:10:08,760 Speaker 2: for this person anyway of all these misdemeanors, misdemeanor arrests, 184 00:10:08,800 --> 00:10:12,040 Speaker 2: and eventually he finally got popped with a felony and 185 00:10:12,200 --> 00:10:14,600 Speaker 2: he wound up off the streets for a longer period 186 00:10:14,640 --> 00:10:16,199 Speaker 2: of time. And why he didn't wind up in a 187 00:10:16,240 --> 00:10:19,400 Speaker 2: forensic psych hospital, it's just, you know, it's luck of 188 00:10:19,440 --> 00:10:22,680 Speaker 2: the draw, it seems, probably depends on whose public defender 189 00:10:22,960 --> 00:10:26,080 Speaker 2: was or how well put together he was at the 190 00:10:26,080 --> 00:10:30,239 Speaker 2: time of the hearing. Real deal people, because of Anna's ignosia, 191 00:10:30,800 --> 00:10:35,600 Speaker 2: they don't declare themselves. There was actually there's a semi 192 00:10:35,640 --> 00:10:38,640 Speaker 2: apocryphal story out of one of the big urban jails 193 00:10:38,640 --> 00:10:41,760 Speaker 2: in Houston. I remember a colleague telling me, and it 194 00:10:41,800 --> 00:10:46,520 Speaker 2: fits perfectly. A haired, busy psychiatrist was showing up for 195 00:10:46,559 --> 00:10:48,960 Speaker 2: what was essentially a mental health sick call, and she 196 00:10:49,040 --> 00:10:52,680 Speaker 2: saw that there was an impossible number of people to see, 197 00:10:52,960 --> 00:10:55,040 Speaker 2: so she had to make a decision about who she's 198 00:10:55,040 --> 00:10:57,040 Speaker 2: going to try to see and who she wasn't So 199 00:10:57,080 --> 00:11:00,120 Speaker 2: she calls out to them. She says, okay, ill of 200 00:11:00,200 --> 00:11:02,880 Speaker 2: y'all here who have a mental illness, raise your hand. 201 00:11:03,200 --> 00:11:05,160 Speaker 2: So a whole bunch of hands go up, and she says, okay, 202 00:11:05,200 --> 00:11:06,959 Speaker 2: y'all can go back to your cells. I'll see the 203 00:11:07,040 --> 00:11:07,440 Speaker 2: rest of you. 204 00:11:07,640 --> 00:11:10,360 Speaker 1: Wow, that's pretty unbelievable. 205 00:11:10,520 --> 00:11:13,560 Speaker 2: Actually, that's kind of the that's the world. That's the 206 00:11:13,559 --> 00:11:17,840 Speaker 2: world of corrections. I worked at that facility for fifteen months. 207 00:11:18,200 --> 00:11:21,560 Speaker 2: I worked subsequently at the Palm Beach County Jail. Jail 208 00:11:21,640 --> 00:11:25,320 Speaker 2: work is very different. It's a whole different vibe. 209 00:11:25,559 --> 00:11:29,000 Speaker 1: Yeah, I can just imagine now what happened after that? 210 00:11:29,080 --> 00:11:29,719 Speaker 1: Where did you go? 211 00:11:30,280 --> 00:11:33,679 Speaker 2: I went up to Indiana. I was the director of 212 00:11:33,720 --> 00:11:36,320 Speaker 2: the mental health services for the Indiana Department of Correction 213 00:11:36,440 --> 00:11:39,720 Speaker 2: for a while and we lost that at rebid, working 214 00:11:39,760 --> 00:11:42,880 Speaker 2: for one of the for profit companies contracts come and go. 215 00:11:43,040 --> 00:11:46,280 Speaker 2: And I subsequently worked at the Marion County Jail and 216 00:11:46,400 --> 00:11:49,920 Speaker 2: Vaalujah County Corrections in central Florida. After that, I went 217 00:11:49,960 --> 00:11:54,080 Speaker 2: on in two thousand and eight to shift from corrections, which, 218 00:11:54,320 --> 00:11:57,800 Speaker 2: especially in jail work, it can be difficult there's stories 219 00:11:57,840 --> 00:12:01,120 Speaker 2: around them. There are difficult political stories that and I 220 00:12:01,160 --> 00:12:05,359 Speaker 2: came back to Texas and worked at Curville State Hospital, 221 00:12:05,679 --> 00:12:09,640 Speaker 2: which is a primarily forensic hospital. It's one hundred percent forensic. 222 00:12:09,679 --> 00:12:12,240 Speaker 2: At this point. You have a crisis unit, but that 223 00:12:12,280 --> 00:12:15,280 Speaker 2: went away while I was there, and it has specialized 224 00:12:15,320 --> 00:12:18,960 Speaker 2: even more in people who are not guilty by reason 225 00:12:19,000 --> 00:12:22,360 Speaker 2: of insanity. So that's pretty much the entire population at 226 00:12:22,400 --> 00:12:24,880 Speaker 2: Kerville State Hospital. So I worked there for four years 227 00:12:24,960 --> 00:12:28,800 Speaker 2: at one point, and then two years again during the pandemic. 228 00:12:29,080 --> 00:12:32,000 Speaker 1: That's quite a path of different scenarios that you've worked with. 229 00:12:32,080 --> 00:12:37,520 Speaker 2: In working with a forensic population in that setting, different experience, 230 00:12:38,240 --> 00:12:41,160 Speaker 2: a different system, feel to how that system works. But 231 00:12:41,200 --> 00:12:44,199 Speaker 2: there's the length of stay. If you look at prisons 232 00:12:44,679 --> 00:12:48,640 Speaker 2: and you look at forensic psych hospitals, there's one common theme, 233 00:12:49,040 --> 00:12:51,800 Speaker 2: and that is the length of stay is much much longer. 234 00:12:52,040 --> 00:12:54,000 Speaker 2: You can debate whether that's a good thing or a 235 00:12:54,040 --> 00:12:57,440 Speaker 2: bad thing for some of the people as debilitated as 236 00:12:57,520 --> 00:13:00,000 Speaker 2: they were, especially at the forensic psych hospital at Curve 237 00:13:00,200 --> 00:13:02,480 Speaker 2: State Hospital. Oh my god, some of these people are 238 00:13:02,559 --> 00:13:06,480 Speaker 2: so low functioning there was no other option for them. Really. 239 00:13:06,760 --> 00:13:09,880 Speaker 2: Another thing while working at Kerville State Hospital is a 240 00:13:10,000 --> 00:13:15,240 Speaker 2: sad comment that families would make. A repeated question from 241 00:13:15,320 --> 00:13:18,520 Speaker 2: families was why did my loved one have to kill 242 00:13:18,559 --> 00:13:20,160 Speaker 2: somebody to get services like this? 243 00:13:20,559 --> 00:13:24,160 Speaker 1: Yeah, that's a tough question, and unfortunately I've heard that 244 00:13:24,480 --> 00:13:27,520 Speaker 1: so many times with people that have been on my podcast. 245 00:13:28,360 --> 00:13:31,040 Speaker 1: This podcast has been really good to get a lot 246 00:13:31,080 --> 00:13:35,800 Speaker 1: of information out there. Unfortunately, a lot of this information 247 00:13:36,320 --> 00:13:38,880 Speaker 1: is things that people just don't want to hear and 248 00:13:38,920 --> 00:13:41,760 Speaker 1: shouldn't have to hear. Now, a lot of people will 249 00:13:41,800 --> 00:13:45,520 Speaker 1: see something that's on TV. They don't understand it, they 250 00:13:45,520 --> 00:13:49,000 Speaker 1: don't know what it is. Because of the sensationalism of 251 00:13:49,040 --> 00:13:53,320 Speaker 1: the TV, they will get their perception of what it is. 252 00:13:53,880 --> 00:13:58,520 Speaker 1: Usually it's the wrong perception. Unfortunately, it's a situation of 253 00:13:58,559 --> 00:14:02,679 Speaker 1: where the system fail the person that had the problem 254 00:14:04,000 --> 00:14:08,319 Speaker 1: before I started addressing serious mental illness and and itsignosia 255 00:14:08,520 --> 00:14:10,920 Speaker 1: on this podcast. I hate to say it, but I 256 00:14:10,960 --> 00:14:13,760 Speaker 1: had a lot of the same thoughts. It truly is 257 00:14:13,880 --> 00:14:16,360 Speaker 1: sad that you had to comment on how many people 258 00:14:16,400 --> 00:14:19,080 Speaker 1: will say, why did my loved one have to do 259 00:14:19,160 --> 00:14:21,680 Speaker 1: something so bad to get the help that they need. 260 00:14:22,160 --> 00:14:26,800 Speaker 1: What's even sadder is it doesn't seem to matter which 261 00:14:26,920 --> 00:14:31,240 Speaker 1: state I'm talking with, they all have the same issues. 262 00:14:31,640 --> 00:14:35,640 Speaker 1: So I'm interested because you've worked in so many different facilities, 263 00:14:36,080 --> 00:14:41,000 Speaker 1: You've seen the issues that they face firsthand. So everyone 264 00:14:41,120 --> 00:14:45,040 Speaker 1: has a different approach. I'm interested in what your approach 265 00:14:45,080 --> 00:14:48,280 Speaker 1: would be. What are your thoughts, how do you think 266 00:14:48,400 --> 00:14:52,720 Speaker 1: we can make things better to help people that really 267 00:14:52,760 --> 00:14:53,440 Speaker 1: need the help. 268 00:14:54,120 --> 00:14:57,040 Speaker 2: It's a sad irony that at this point the criminal 269 00:14:57,200 --> 00:15:00,480 Speaker 2: justice system does a better job with accountability. I hate 270 00:15:00,480 --> 00:15:03,840 Speaker 2: to use the word containment, but a containment within a process, 271 00:15:04,080 --> 00:15:09,160 Speaker 2: whether it's outpatient or whether it's somebody who's incarcerated actually 272 00:15:09,360 --> 00:15:11,560 Speaker 2: or in a forensic system. Because if they're in a 273 00:15:11,600 --> 00:15:15,320 Speaker 2: forensic system, forensic psychiatry hospital are still under the umbrella 274 00:15:15,360 --> 00:15:18,240 Speaker 2: of the criminal justice system in some way or another. 275 00:15:18,560 --> 00:15:22,680 Speaker 2: So the civil sector way it works, if somebody with 276 00:15:22,720 --> 00:15:25,520 Speaker 2: a severe mental illness doesn't show up for an appointment, 277 00:15:25,560 --> 00:15:28,600 Speaker 2: well that person will be replaced by somebody who does 278 00:15:28,640 --> 00:15:31,120 Speaker 2: show up for appointments, and that tends to be a 279 00:15:31,240 --> 00:15:32,600 Speaker 2: less sick population. 280 00:15:33,040 --> 00:15:35,680 Speaker 1: So what do we do to change that outcome? 281 00:15:36,400 --> 00:15:39,720 Speaker 2: My personal take on this is when that person, but 282 00:15:39,800 --> 00:15:41,840 Speaker 2: the truce se your mental illness, doesn't show up for 283 00:15:41,840 --> 00:15:44,480 Speaker 2: an appointment, you go get them, you go track them down, 284 00:15:44,720 --> 00:15:48,080 Speaker 2: and AOT is supposed to be a way to do that. 285 00:15:48,400 --> 00:15:52,520 Speaker 2: And certainly programs like a sort of community treatment, those 286 00:15:52,520 --> 00:15:55,840 Speaker 2: are good programs. They're not used enough. And then AOT 287 00:15:56,520 --> 00:15:58,920 Speaker 2: I don't think it's used enough. And when I've seen 288 00:15:58,960 --> 00:16:02,120 Speaker 2: it used, I did some outpatient forensic work as well. 289 00:16:02,440 --> 00:16:06,360 Speaker 2: It's not necessarily backed up with as much omph as 290 00:16:06,400 --> 00:16:08,840 Speaker 2: it should be. Like if the person doesn't show up 291 00:16:08,840 --> 00:16:12,040 Speaker 2: for the psychiatrists appointment, and then doesn't show up for 292 00:16:12,040 --> 00:16:14,480 Speaker 2: the psychiatrists appointment, and then doesn't show up for the 293 00:16:14,480 --> 00:16:19,720 Speaker 2: psychiatrists appointment, there's inconsistency about whether anybody actually goes to say, hey, 294 00:16:19,720 --> 00:16:22,280 Speaker 2: how can we not showing up for the appointment? So 295 00:16:22,360 --> 00:16:24,640 Speaker 2: there's some inconsistency and implementation of that. 296 00:16:24,760 --> 00:16:26,040 Speaker 1: What's the next step then. 297 00:16:26,440 --> 00:16:30,920 Speaker 2: So I think beefing up AOT assisted outpatient treatment. You know, 298 00:16:30,960 --> 00:16:35,160 Speaker 2: the original idea was outpatient commitment, but the phraseology was 299 00:16:35,240 --> 00:16:39,280 Speaker 2: changed to AOT, making a sort of community treatment more 300 00:16:39,320 --> 00:16:42,400 Speaker 2: available for the real deal people so that people aren't 301 00:16:42,440 --> 00:16:45,160 Speaker 2: lost to follow up. And then I have something that's 302 00:16:45,200 --> 00:16:49,240 Speaker 2: a little off script. Okay, there are other psychiatrists who 303 00:16:49,240 --> 00:16:54,080 Speaker 2: think along these lines and neurologists. You know, historically schizophrenia 304 00:16:54,120 --> 00:16:58,600 Speaker 2: spectrum illnesses have been they've fallen under psychiatry. They just 305 00:16:58,640 --> 00:17:01,560 Speaker 2: have you know what the original term or name for 306 00:17:01,600 --> 00:17:02,560 Speaker 2: schizophrenia was. 307 00:17:02,720 --> 00:17:04,479 Speaker 1: That's something that I do not know. 308 00:17:05,160 --> 00:17:08,640 Speaker 2: Yeah, the original name for schizophrenia in the early nineteen 309 00:17:08,720 --> 00:17:12,560 Speaker 2: hundreds was dementia precox a premature dementia. 310 00:17:12,680 --> 00:17:15,520 Speaker 1: Now that's very interesting on how that's changed over the 311 00:17:15,600 --> 00:17:16,399 Speaker 1: years as well. 312 00:17:17,200 --> 00:17:21,720 Speaker 2: Yeah, and that way of looking at the illness holds. 313 00:17:21,960 --> 00:17:24,600 Speaker 2: The more we learn about it, the more we realize 314 00:17:24,720 --> 00:17:27,400 Speaker 2: or I mean, it's accepted it's a brain level disorder, 315 00:17:27,640 --> 00:17:31,720 Speaker 2: it's a neuropsychiatric disorder, it's a neurological disorder. In fact, 316 00:17:31,760 --> 00:17:35,520 Speaker 2: what I tell families and patients, I don't say that 317 00:17:35,600 --> 00:17:38,240 Speaker 2: they have a mental illness, you know, people with schizophrenia. 318 00:17:38,320 --> 00:17:40,520 Speaker 2: I don't say they have a mental illness anymore because 319 00:17:40,520 --> 00:17:43,120 Speaker 2: that gets conflated with a lot of other stuff that 320 00:17:43,400 --> 00:17:47,200 Speaker 2: you know, panic disorders a mental illness. Drinking too much 321 00:17:47,200 --> 00:17:50,200 Speaker 2: coffee is a mental illness apparently, because it's in DSM. Right, 322 00:17:50,400 --> 00:17:53,199 Speaker 2: look at the list of things that's in DSM. You know, 323 00:17:53,240 --> 00:17:57,600 Speaker 2: it's a book of psychiatric disorders and schizophrenia is kind 324 00:17:57,600 --> 00:18:00,440 Speaker 2: of in there as well. But schizophrenia is pretty. 325 00:18:00,920 --> 00:18:03,119 Speaker 1: Yeah, it is, and I think that you have a 326 00:18:03,280 --> 00:18:05,760 Speaker 1: great way of looking at it and which other people 327 00:18:05,760 --> 00:18:07,520 Speaker 1: would look at it the same way as well. 328 00:18:08,040 --> 00:18:11,760 Speaker 2: So I tell families and I talk with patients about 329 00:18:11,760 --> 00:18:17,800 Speaker 2: schizophrenia being a neurological disorder with neurological symptoms. Helps families 330 00:18:17,840 --> 00:18:20,879 Speaker 2: to accept it better and understand it better, especially when 331 00:18:20,920 --> 00:18:25,040 Speaker 2: I point out that there is neuropsychological decline, a cognitive decline, 332 00:18:25,400 --> 00:18:30,399 Speaker 2: that hallucinations and delusions are neurological symptoms. They're not unique 333 00:18:30,440 --> 00:18:36,080 Speaker 2: to schizophrenia. There's an enormous multitude of pathways. Anybody can 334 00:18:36,119 --> 00:18:39,040 Speaker 2: become psychotic. Actually, I do a teaching thing with patients. 335 00:18:39,160 --> 00:18:41,040 Speaker 2: I used to do it with my forensic patients, my 336 00:18:41,119 --> 00:18:43,880 Speaker 2: guys they're at Kerville State Hospital. I would teach them 337 00:18:43,920 --> 00:18:47,520 Speaker 2: about psychosis. I would start with what is psychosis? And 338 00:18:47,560 --> 00:18:49,560 Speaker 2: the ones who already knew the answer would say the 339 00:18:49,640 --> 00:18:52,040 Speaker 2: right answer, but sort of a trick question. I'd say, 340 00:18:52,040 --> 00:18:56,360 Speaker 2: what is psychosis? And the answer is psychosis is a symptom. 341 00:18:56,520 --> 00:18:57,919 Speaker 1: Wow, that makes sense. 342 00:18:58,400 --> 00:19:01,760 Speaker 2: It's a symptom of something, whether it's because I have 343 00:19:01,800 --> 00:19:04,879 Speaker 2: a brain tumor, or because I'm doing too many drugs, 344 00:19:05,240 --> 00:19:08,119 Speaker 2: or because I have schizophrenia. It's a symptom of something. 345 00:19:08,200 --> 00:19:11,399 Speaker 2: Psychosis is a symptom, and hallucinations and delusions are the 346 00:19:11,440 --> 00:19:16,320 Speaker 2: common forms of manifestations of psychosis. So schizophrenia is a 347 00:19:16,400 --> 00:19:23,400 Speaker 2: neurological disorder with neurological symptoms including neuropsychological decline, delusions. Hallucinations 348 00:19:24,000 --> 00:19:29,719 Speaker 2: can include disordered thinking, disordered behavior, and also anazygnosia. And 349 00:19:29,760 --> 00:19:31,439 Speaker 2: I talk some about anazagnosia. 350 00:19:31,760 --> 00:19:34,800 Speaker 1: How do you define that to people that don't understand it? 351 00:19:35,480 --> 00:19:38,760 Speaker 2: So when I talk generally about what agnosias are in neurology, 352 00:19:38,840 --> 00:19:41,040 Speaker 2: because there's a variety of agnosias, and then whant to 353 00:19:41,080 --> 00:19:45,320 Speaker 2: talk about what anazygnosia is because anazygnosia is not unique 354 00:19:45,359 --> 00:19:48,600 Speaker 2: to schizophrenia, present in other disorders as well. And one 355 00:19:48,640 --> 00:19:50,840 Speaker 2: of the common ones that people can relate to is 356 00:19:50,880 --> 00:19:54,000 Speaker 2: Alzheimer's disease. So I'll ask people, do you know anybody 357 00:19:54,040 --> 00:19:58,159 Speaker 2: with Alzheimer's? Did they know they had Alzheimer's? Then you 358 00:19:58,160 --> 00:19:59,879 Speaker 2: should say no, and I'll say, well that's antas a 359 00:20:00,640 --> 00:20:03,439 Speaker 2: And the same thing applies to people with schizophrenia and 360 00:20:03,480 --> 00:20:04,080 Speaker 2: then they get it. 361 00:20:04,119 --> 00:20:05,119 Speaker 1: Well, that's impressive. 362 00:20:05,560 --> 00:20:09,040 Speaker 2: The people with schizophrenia don't necessarily get it, but depends 363 00:20:09,040 --> 00:20:12,400 Speaker 2: on how they're doing because they're Fortunately some people with schizophrenia, 364 00:20:12,840 --> 00:20:17,440 Speaker 2: with treatment, with effective medication, some insight returns and that's 365 00:20:17,480 --> 00:20:20,760 Speaker 2: a blessing. You know, as much advantage of that as possible, 366 00:20:20,920 --> 00:20:24,399 Speaker 2: and kind of cram as much education and rapport building 367 00:20:24,440 --> 00:20:27,479 Speaker 2: into that time of lucidity as possible if that's how 368 00:20:27,520 --> 00:20:31,000 Speaker 2: the course of the illness proceeds in response to the medication. 369 00:20:31,200 --> 00:20:36,240 Speaker 2: But yeah, schizophrenia neurological illness with neurological symptoms. So here's 370 00:20:36,240 --> 00:20:39,040 Speaker 2: a little bit of a question for you. Okay, how 371 00:20:39,080 --> 00:20:42,199 Speaker 2: many homeless people have you run into that have Alzheimer's disease? 372 00:20:42,400 --> 00:20:44,560 Speaker 1: To my knowledge, that would be none. 373 00:20:44,960 --> 00:20:46,919 Speaker 2: How many homeless people have you run into who have 374 00:20:47,040 --> 00:20:48,600 Speaker 2: multi sclerosis. 375 00:20:47,960 --> 00:20:50,159 Speaker 1: Again, that would probably be none. 376 00:20:50,040 --> 00:20:53,160 Speaker 2: Which can also be accompanied by anazygnosia. If you look 377 00:20:53,200 --> 00:20:56,240 Speaker 2: at neurological disorders, you don't see a lot of those, 378 00:20:56,480 --> 00:20:59,720 Speaker 2: you know, sleeping under the bushes because the law says 379 00:20:59,760 --> 00:21:03,200 Speaker 2: they can choose to be there. Going back aways, I've 380 00:21:03,280 --> 00:21:07,320 Speaker 2: long thought it to be unfair that a person who 381 00:21:07,440 --> 00:21:13,040 Speaker 2: is psychotic and doesn't know she's afflicted because of dementia 382 00:21:13,320 --> 00:21:17,120 Speaker 2: is handled differently from somebody who is psychotic and has 383 00:21:17,160 --> 00:21:21,480 Speaker 2: anasagnosias unable to function normally. But they're in their thirties, 384 00:21:22,359 --> 00:21:24,760 Speaker 2: so it's okay for that person who has a similar 385 00:21:24,800 --> 00:21:28,960 Speaker 2: level of neuropsychiatrict ability to consign themselves to sleeping under 386 00:21:29,000 --> 00:21:31,680 Speaker 2: the bushes because they quote unquote choose to be there. 387 00:21:32,119 --> 00:21:34,760 Speaker 2: I don't know. It's you know, there's the recent executive 388 00:21:34,880 --> 00:21:40,520 Speaker 2: order encouraging reinstitutionalization, and I've got mixed feelings about that. 389 00:21:40,760 --> 00:21:43,520 Speaker 2: But on the other hand, there are some people who 390 00:21:43,600 --> 00:21:45,560 Speaker 2: don't need to be sleeping under bushes anymore. 391 00:21:45,760 --> 00:21:49,159 Speaker 1: Yes, I agree, and hopefully something like that would be 392 00:21:49,320 --> 00:21:52,840 Speaker 1: enough ammunition to get our legislators involved, make some new 393 00:21:52,960 --> 00:21:55,800 Speaker 1: laws and help these people out that need that help. 394 00:21:56,119 --> 00:22:00,320 Speaker 2: I remember a conversation I had with a legislator actually 395 00:22:00,400 --> 00:22:02,320 Speaker 2: was I was involved for a while trying to keep 396 00:22:02,320 --> 00:22:05,159 Speaker 2: a state hospital open in southwest Florida, and it was 397 00:22:05,160 --> 00:22:07,679 Speaker 2: slated foreclosure. Who was back in the nineties. Went up 398 00:22:07,680 --> 00:22:09,920 Speaker 2: to Tallahassee a couple of times. One of the times 399 00:22:09,920 --> 00:22:12,080 Speaker 2: I went up, I spoke with a guy who used 400 00:22:12,080 --> 00:22:13,840 Speaker 2: to be my boss. He was a physician who became 401 00:22:13,880 --> 00:22:16,679 Speaker 2: a Florida legislator, and I asked him that question about, 402 00:22:16,760 --> 00:22:19,119 Speaker 2: you know, why is it that grandma with dementia we 403 00:22:19,240 --> 00:22:21,240 Speaker 2: take better care of her than the thirty year old 404 00:22:21,280 --> 00:22:24,840 Speaker 2: who's hiding from the lasers under the bushes in the park. 405 00:22:25,200 --> 00:22:27,840 Speaker 2: And he was kind of a blunt guy. I won't 406 00:22:28,000 --> 00:22:31,760 Speaker 2: use all of the words that he used, okay, but 407 00:22:31,920 --> 00:22:34,280 Speaker 2: he said, it's because we care about grandma, but we 408 00:22:34,280 --> 00:22:38,080 Speaker 2: don't give a blank about the lady under the bushes. So, 409 00:22:38,520 --> 00:22:42,120 Speaker 2: working in jails, working in prisons, I see from that 410 00:22:42,240 --> 00:22:45,640 Speaker 2: perspective how broken things are on the civil side, because 411 00:22:45,680 --> 00:22:46,280 Speaker 2: they come to me. 412 00:22:46,560 --> 00:22:50,399 Speaker 1: Yeah, I cannot disagree with you at all. What do 413 00:22:50,440 --> 00:22:54,640 Speaker 1: you think is important that people here? They may be 414 00:22:54,760 --> 00:23:00,920 Speaker 1: well versed on schizophrenia annex ignosia, or they may they 415 00:23:01,160 --> 00:23:04,239 Speaker 1: may not have encountered anyone, but yet they're hearing what 416 00:23:04,280 --> 00:23:07,159 Speaker 1: you have to say. What is important for them to 417 00:23:07,320 --> 00:23:10,000 Speaker 1: know and understand about this subject? 418 00:23:10,640 --> 00:23:14,719 Speaker 2: Personally, based on my experience with families and to some extent, 419 00:23:14,760 --> 00:23:20,280 Speaker 2: with the patients, reframing the illness to be a neurological illness, 420 00:23:20,600 --> 00:23:24,080 Speaker 2: it's a neurological illness. It's the old dementia precox. It 421 00:23:24,119 --> 00:23:26,879 Speaker 2: still is the illness has always been with us, and 422 00:23:26,960 --> 00:23:29,119 Speaker 2: think in terms of how would you manage a person 423 00:23:29,600 --> 00:23:32,359 Speaker 2: with a dementia and would you just let them sleep 424 00:23:32,400 --> 00:23:33,080 Speaker 2: under the bushes? 425 00:23:33,160 --> 00:23:36,080 Speaker 1: Yeah, I agree that is a great point to make. 426 00:23:36,680 --> 00:23:39,000 Speaker 1: I think one of the biggest issues that I've seen 427 00:23:39,520 --> 00:23:42,960 Speaker 1: since I've been doing this is that everyone has their 428 00:23:43,000 --> 00:23:46,600 Speaker 1: thoughts on what they think it is. Because of that, 429 00:23:46,760 --> 00:23:50,520 Speaker 1: I try and use the word perception because everyone can 430 00:23:50,560 --> 00:23:53,040 Speaker 1: have their perception on what they think it is, but 431 00:23:53,240 --> 00:23:57,879 Speaker 1: usually the reality is something completely different. So I don't 432 00:23:57,920 --> 00:24:01,480 Speaker 1: like to use that word stigma anymore because I think 433 00:24:01,520 --> 00:24:05,280 Speaker 1: people have to learn and understand, or at least try 434 00:24:05,320 --> 00:24:08,359 Speaker 1: to understand, so that way they might have a little 435 00:24:08,400 --> 00:24:11,760 Speaker 1: empathy for what others are actually going through. This way, 436 00:24:11,800 --> 00:24:16,159 Speaker 1: when they hear something about serious mental illness or anexignosia, 437 00:24:16,240 --> 00:24:19,040 Speaker 1: at least they'll have a comprehension of what people are 438 00:24:19,080 --> 00:24:21,600 Speaker 1: talking about. I really think the way that you put 439 00:24:21,680 --> 00:24:23,800 Speaker 1: it across is really good. Yeah. 440 00:24:23,840 --> 00:24:27,560 Speaker 2: Anazagnosia is a neurological symptom. You can see with dementia, 441 00:24:27,640 --> 00:24:29,480 Speaker 2: you can see it with certain strokes, you can see 442 00:24:29,520 --> 00:24:34,480 Speaker 2: it multiple sclerosis. Any number of other neurological afflictions can 443 00:24:34,560 --> 00:24:39,200 Speaker 2: have that anazagnosia, which is the inability to know that 444 00:24:39,280 --> 00:24:41,639 Speaker 2: one is afflicted. At a friend of mine who this 445 00:24:41,800 --> 00:24:43,600 Speaker 2: is a common one. At a friend of mine who 446 00:24:43,600 --> 00:24:47,960 Speaker 2: had a dense stroke affected half of his body, and 447 00:24:48,000 --> 00:24:50,720 Speaker 2: as can happen with that kind of a stroke, he 448 00:24:50,880 --> 00:24:53,800 Speaker 2: no longer knew that part of his body existed anymore, 449 00:24:54,440 --> 00:24:58,360 Speaker 2: and so he had what's called himI neglect. He functioned 450 00:24:58,400 --> 00:25:01,000 Speaker 2: as if that part of his body didn't don't exist anymore, 451 00:25:01,200 --> 00:25:03,720 Speaker 2: and it caused problems for them. That's a form of 452 00:25:03,720 --> 00:25:04,560 Speaker 2: and as ignosia. 453 00:25:04,680 --> 00:25:07,439 Speaker 1: I think that's a great analogy. You are one of 454 00:25:07,440 --> 00:25:10,560 Speaker 1: the first people I've spoken with that has brought out 455 00:25:10,760 --> 00:25:14,760 Speaker 1: anisignosia in this kind of context, and I think it's 456 00:25:14,840 --> 00:25:17,760 Speaker 1: just a great way of putting it across. With this 457 00:25:17,840 --> 00:25:21,080 Speaker 1: kind of thought process, it might just change the way 458 00:25:21,119 --> 00:25:24,000 Speaker 1: people think about things and perceive them. 459 00:25:24,280 --> 00:25:30,240 Speaker 2: Yeah, it's it's not a willful denial of the illness. 460 00:25:30,600 --> 00:25:33,200 Speaker 2: It is flied out and inability to see. It's like 461 00:25:33,280 --> 00:25:35,560 Speaker 2: a person who's color blind. They're just certain colors that 462 00:25:35,640 --> 00:25:36,320 Speaker 2: can't be seen. 463 00:25:36,520 --> 00:25:39,199 Speaker 1: Yeah, that is so true. I think you've got a 464 00:25:39,480 --> 00:25:42,120 Speaker 1: great look at things. And I think all the stories 465 00:25:42,119 --> 00:25:45,560 Speaker 1: that you've heard across your career has helped you bring 466 00:25:45,600 --> 00:25:46,560 Speaker 1: this to the light for. 467 00:25:46,480 --> 00:25:51,800 Speaker 2: Everyone's And that's what attracted me originally to psychiatry, was 468 00:25:51,800 --> 00:25:53,720 Speaker 2: the ability to hear people's stories. 469 00:25:53,800 --> 00:25:57,000 Speaker 1: Yeah, both good and unfortunately some that weren't so good. 470 00:25:57,280 --> 00:26:00,400 Speaker 2: Got a lot of change in the profession. A whole 471 00:26:00,440 --> 00:26:01,600 Speaker 2: other conversation. 472 00:26:02,080 --> 00:26:05,680 Speaker 1: Yeah, I'm sure. Now that brings up another interesting point. 473 00:26:05,840 --> 00:26:09,520 Speaker 1: You've moved around and done so many different things along 474 00:26:09,560 --> 00:26:12,560 Speaker 1: the way. You've also seen so many different things from 475 00:26:12,560 --> 00:26:15,600 Speaker 1: your different jobs that you've done. Now, instead of talking 476 00:26:15,640 --> 00:26:18,439 Speaker 1: about the people you've helped, how has this helped you? 477 00:26:19,000 --> 00:26:21,960 Speaker 1: How have you seen yourself evolved from the early days 478 00:26:22,040 --> 00:26:22,840 Speaker 1: to today. 479 00:26:23,320 --> 00:26:27,320 Speaker 2: Well, you know, I thought I knew something when I 480 00:26:27,400 --> 00:26:31,240 Speaker 2: finished my psychiatry residency in nineteen ninety two. I was 481 00:26:31,280 --> 00:26:35,199 Speaker 2: a smart fella. And then life happened, and I've had 482 00:26:35,200 --> 00:26:39,800 Speaker 2: a few decades of life since then, including substantial hardships, 483 00:26:40,080 --> 00:26:42,240 Speaker 2: personal hardships on my own end that I've had to 484 00:26:42,280 --> 00:26:49,240 Speaker 2: recover through and that and having to learn that, having 485 00:26:49,280 --> 00:26:53,200 Speaker 2: to learn from other people who've had hardship, who don't 486 00:26:53,240 --> 00:26:57,080 Speaker 2: necessarily have college educations, but learned by their example. You know, 487 00:26:57,119 --> 00:26:59,440 Speaker 2: I'm an alcoholic, I'm in recovery, and I've had to 488 00:26:59,520 --> 00:27:02,119 Speaker 2: learn from to people how to live life, and that 489 00:27:02,280 --> 00:27:04,879 Speaker 2: actually works out. It's worked out much better than I 490 00:27:04,920 --> 00:27:05,840 Speaker 2: could do on my own. 491 00:27:06,160 --> 00:27:11,200 Speaker 1: Yeah, lots of times life gives us more knowledge than 492 00:27:11,320 --> 00:27:15,760 Speaker 1: college ever would. Well, this has been a great episode, 493 00:27:16,320 --> 00:27:21,200 Speaker 1: lots of good conversation, lots of good information. I really 494 00:27:21,240 --> 00:27:23,679 Speaker 1: appreciate you taking the time to join us today. 495 00:27:24,200 --> 00:27:26,080 Speaker 2: Yeah, I appreciate you interviewing me. 496 00:27:26,200 --> 00:27:35,600 Speaker 1: Oh, it's been my pleasure. Thanks again. Thanks for taking 497 00:27:35,640 --> 00:27:38,200 Speaker 1: time out of your busy schedule to listen to our 498 00:27:38,240 --> 00:27:41,960 Speaker 1: show today. We hope you enjoyed it as much as 499 00:27:41,960 --> 00:27:45,920 Speaker 1: we enjoyed bringing it to you. If you know someone 500 00:27:45,960 --> 00:27:49,400 Speaker 1: who has a story to share, tell them to contact 501 00:27:49,480 --> 00:27:54,760 Speaker 1: us at whyom dot world. One last thing, spread the 502 00:27:54,760 --> 00:28:00,399 Speaker 1: word about why not me our conversations. Our inspiring asked 503 00:28:00,760 --> 00:28:10,200 Speaker 1: the show, you are not alone in this world. H