1 00:00:00,240 --> 00:00:03,240 Speaker 1: Hey, everybody, it's us Josh and Chuck, and we want 2 00:00:03,240 --> 00:00:06,200 Speaker 1: you to know we are coming somewhere near you. We're 3 00:00:06,320 --> 00:00:10,320 Speaker 1: sure if you live in North America this year, that's right, 4 00:00:10,360 --> 00:00:12,800 Speaker 1: We're going on tour, and uh, why don't we just 5 00:00:12,880 --> 00:00:16,600 Speaker 1: rattle through these dates? Okay? Uh? Toronto August eight at 6 00:00:16,600 --> 00:00:19,919 Speaker 1: the Dan and Fourth Music Hall, Chicago August nine, the 7 00:00:19,960 --> 00:00:22,599 Speaker 1: next day at Harris Theater. Then we are taking some 8 00:00:22,680 --> 00:00:25,720 Speaker 1: time off to recover after that two day grind. We're 9 00:00:25,720 --> 00:00:30,760 Speaker 1: eating Vancouver the Vogue Theater September twenty six, followed by Minneapolis. 10 00:00:30,800 --> 00:00:33,360 Speaker 1: We're gonna be at the Pantageous Theater again on September 11 00:00:34,479 --> 00:00:37,480 Speaker 1: that is correct, yep. And then Austin Chuck on October 12 00:00:37,520 --> 00:00:41,680 Speaker 1: tenth of the Paramount Theater, Yes, and very special show 13 00:00:42,120 --> 00:00:45,839 Speaker 1: and Lawrence Kansas at Liberty Hall on October eleven, yep. 14 00:00:45,920 --> 00:00:48,720 Speaker 1: And then we're gonna do a three night stand October 15 00:00:48,720 --> 00:00:53,840 Speaker 1: two at the Bellhouse in Brooklyn, New York. And then Chuck, 16 00:00:53,920 --> 00:00:56,560 Speaker 1: take it home. Uh, well take it home literally, because 17 00:00:56,600 --> 00:00:59,560 Speaker 1: we are finishing up November four right here in Atlanta 18 00:00:59,560 --> 00:01:02,280 Speaker 1: at the Bucket Theater and this is a very special 19 00:01:02,280 --> 00:01:05,560 Speaker 1: benefit show. Uh, and all the Proceeds will be going 20 00:01:05,600 --> 00:01:09,160 Speaker 1: to Lifeline Animal Project of Atlanta and the National Down 21 00:01:09,360 --> 00:01:13,120 Speaker 1: Syndrome Society YEP. And for more information in DWO buy tickets, 22 00:01:13,200 --> 00:01:17,240 Speaker 1: just go to s Y s K live dot com. 23 00:01:17,280 --> 00:01:20,440 Speaker 1: Welcome to stuff you should know. I'm from House Stuff 24 00:01:20,480 --> 00:01:29,960 Speaker 1: Works dot com. Hey, welcome to the podcast. Blame is 25 00:01:30,040 --> 00:01:34,280 Speaker 1: Josh Clark, and I'm proud to introduce my partner co 26 00:01:34,400 --> 00:01:39,040 Speaker 1: hosting Crime, one of those two Mr Charles W. Chuck 27 00:01:39,319 --> 00:01:45,600 Speaker 1: Wayne Chuck Tran Bryant Chuck Tran yep. And this week, Chuck, 28 00:01:45,680 --> 00:01:49,520 Speaker 1: we have a very special guest producer filling out the seats. 29 00:01:49,640 --> 00:01:56,160 Speaker 1: Right is the rump of Noel around. Yeah, Jerry's she's 30 00:01:56,200 --> 00:02:02,680 Speaker 1: at the beach because she needs a vacation. I'm good, guys. Yeah, 31 00:02:02,880 --> 00:02:05,040 Speaker 1: Jerry's romping at the beach with her wife and her 32 00:02:05,120 --> 00:02:09,600 Speaker 1: daughter and a bunch of friends. And you know, I 33 00:02:09,600 --> 00:02:17,280 Speaker 1: think that sounds lovely. Well, yeah, the beach rocks. Even 34 00:02:17,360 --> 00:02:20,200 Speaker 1: Miley Cyrus likes the beach. Now, I don't get it. 35 00:02:20,880 --> 00:02:23,359 Speaker 1: She's got this new single out about how her boyfriend 36 00:02:23,360 --> 00:02:25,600 Speaker 1: introduced her to the beach. Is pretty sweet song. Actually, 37 00:02:25,800 --> 00:02:29,320 Speaker 1: you know this stuff? I just I my my wife 38 00:02:29,680 --> 00:02:33,040 Speaker 1: produces me to think sometimes each otherwise would never ever 39 00:02:33,160 --> 00:02:35,440 Speaker 1: have come across like, I can pick on you for that, 40 00:02:35,480 --> 00:02:36,920 Speaker 1: but I would never pick on you me for that. 41 00:02:37,840 --> 00:02:40,440 Speaker 1: You know, what, are you a monster? You know? Pick 42 00:02:40,480 --> 00:02:44,880 Speaker 1: on a man's wife? Right? So, yeah, it is a cute, cute, 43 00:02:44,880 --> 00:02:47,120 Speaker 1: sweet song. Though I can I can give it a 44 00:02:47,160 --> 00:02:50,360 Speaker 1: hearty endorsement. Emily has her little secrets to from even me. 45 00:02:50,480 --> 00:02:52,239 Speaker 1: She's she singing this song the other day that was 46 00:02:52,280 --> 00:02:54,960 Speaker 1: on some TV show. I was like, how do you 47 00:02:55,000 --> 00:02:58,959 Speaker 1: know this? I've never heard the song, and she said, no, 48 00:02:59,000 --> 00:03:01,920 Speaker 1: you know it's a song. I know what song. I 49 00:03:01,919 --> 00:03:03,240 Speaker 1: don't even know what it was. It was just some 50 00:03:03,360 --> 00:03:06,000 Speaker 1: kind of bubblegum poppy thing you don't and that's kind 51 00:03:06,000 --> 00:03:08,800 Speaker 1: of not her. But you never you never know, you know, 52 00:03:09,639 --> 00:03:16,520 Speaker 1: I might have a fromer boyfriend, s Todd Todd Hodds 53 00:03:16,520 --> 00:03:19,880 Speaker 1: into bubblegum pop. He's a jerk, he's got frosted tips 54 00:03:19,919 --> 00:03:26,000 Speaker 1: on his hair, he's got a severe embre. So which 55 00:03:26,000 --> 00:03:30,400 Speaker 1: one are we doing? We're gonna do standardized patients and um, 56 00:03:30,440 --> 00:03:33,880 Speaker 1: it's funny. The the thought occurred to me to go 57 00:03:33,960 --> 00:03:37,320 Speaker 1: through this entire episode without mentioning sein felt at all, 58 00:03:37,960 --> 00:03:40,760 Speaker 1: just to make people really angry. Man. We would have 59 00:03:40,760 --> 00:03:43,600 Speaker 1: gotten so many emails though. But that's kind of like 60 00:03:43,800 --> 00:03:48,040 Speaker 1: you can't not mention the very famous Seinfeld episode where 61 00:03:48,120 --> 00:03:53,000 Speaker 1: Kramer and uh, who's the other guy, Mickey? Oh? Yeah, 62 00:03:53,040 --> 00:03:55,800 Speaker 1: I forgot Mickey was one too. Was that his name? Yeah, 63 00:03:55,840 --> 00:03:58,320 Speaker 1: it's his friend who was a little person. Yeah, and 64 00:03:58,360 --> 00:04:01,680 Speaker 1: they they were. I think Mickey got him into it, 65 00:04:01,760 --> 00:04:03,760 Speaker 1: and they were they were And I didn't even know 66 00:04:03,800 --> 00:04:05,840 Speaker 1: they were called standardized patients. I doubt if they said 67 00:04:05,840 --> 00:04:08,840 Speaker 1: that on the episode. I don't remember what they called them. 68 00:04:08,840 --> 00:04:12,160 Speaker 1: They surely they call them something. Well, they have a 69 00:04:12,160 --> 00:04:16,920 Speaker 1: few names, simulated patients, standardized patients, care actors. Well, there, 70 00:04:17,040 --> 00:04:19,720 Speaker 1: those are. Some of those are different. They're they're generally 71 00:04:19,760 --> 00:04:23,040 Speaker 1: the under the umbrella of say like a simulized or 72 00:04:23,080 --> 00:04:27,720 Speaker 1: stand simulated patient, but they're slightly there's little nuances there 73 00:04:27,760 --> 00:04:32,039 Speaker 1: that that make the whole thing revolting, lee fascinating. Programmed 74 00:04:32,040 --> 00:04:34,600 Speaker 1: patients and that what the first guy called it. Yeah. Man, 75 00:04:34,800 --> 00:04:37,240 Speaker 1: if that's not like a brain doctor's name for it, 76 00:04:37,320 --> 00:04:41,960 Speaker 1: then I don't know what. Uh, well, should we start there. Yeah, 77 00:04:42,040 --> 00:04:45,120 Speaker 1: let's go back to that guy, a doctor named Howard Barrow. 78 00:04:45,680 --> 00:04:48,839 Speaker 1: He worked out at USC Ego Trojans and he was 79 00:04:48,920 --> 00:04:52,240 Speaker 1: teaching back in the early sixties, late fifties, I believe, 80 00:04:53,080 --> 00:04:56,680 Speaker 1: and apparently at the time, Chuck, they would just teach 81 00:04:56,720 --> 00:05:00,120 Speaker 1: you everything and then say, okay, you've graduated, your going 82 00:05:00,200 --> 00:05:04,240 Speaker 1: goodbye to practice medicine. Good luck with a live human exactly, 83 00:05:04,600 --> 00:05:09,359 Speaker 1: you've never encountered one throughout your entire training, but you're 84 00:05:09,360 --> 00:05:13,279 Speaker 1: a doctor now, so we we wash our hands of you. Right. 85 00:05:13,800 --> 00:05:17,920 Speaker 1: And so this guy was teaching neurology and realized, like 86 00:05:18,680 --> 00:05:21,760 Speaker 1: I think he had a friend who had come to 87 00:05:21,760 --> 00:05:26,200 Speaker 1: to start like observing his graduates in a clinical setting, 88 00:05:26,480 --> 00:05:29,359 Speaker 1: but like after they graduated and we're practicing doctors and 89 00:05:29,400 --> 00:05:31,160 Speaker 1: we were like whoa, well, whoa, you guys are doing 90 00:05:31,200 --> 00:05:35,560 Speaker 1: this all wrong. Who taught you this? And like you did? 91 00:05:36,240 --> 00:05:38,440 Speaker 1: And uh, He's like, all right, well, we gotta do 92 00:05:38,480 --> 00:05:41,880 Speaker 1: something different. So that doctor figured out that he could 93 00:05:41,920 --> 00:05:46,120 Speaker 1: sit down and go through basically observe a doctor doing 94 00:05:46,800 --> 00:05:50,520 Speaker 1: an entire patient history and exam and everything. But each 95 00:05:50,560 --> 00:05:52,560 Speaker 1: one took like two to three hours, and they're like, 96 00:05:52,600 --> 00:05:54,960 Speaker 1: there's gotta be a better way to do this. So 97 00:05:55,120 --> 00:05:59,160 Speaker 1: Barrows was it was his idea, and his idea alone. 98 00:05:59,240 --> 00:06:02,680 Speaker 1: Right from what I understand I saw, I came across 99 00:06:02,720 --> 00:06:09,359 Speaker 1: another doctor, a woman pediatrician, woman named Paula's Stillman, who 100 00:06:09,520 --> 00:06:12,800 Speaker 1: came up with this idea also seemingly independently in the 101 00:06:12,880 --> 00:06:16,680 Speaker 1: early seventies. Um, because it didn't catch on big time 102 00:06:16,720 --> 00:06:19,280 Speaker 1: in the eighties. So I think she am Barrow are 103 00:06:19,360 --> 00:06:22,479 Speaker 1: kind of like the earliest practitioners of this thing. Well, 104 00:06:22,520 --> 00:06:25,320 Speaker 1: it wasn't a big hit at first, Like people kind 105 00:06:25,320 --> 00:06:27,320 Speaker 1: of made fun of them, uh. I know in this 106 00:06:27,440 --> 00:06:31,000 Speaker 1: one article you found they there were newspaper articles, one 107 00:06:31,040 --> 00:06:33,799 Speaker 1: in the l A Herald Examiner that had a headline 108 00:06:33,800 --> 00:06:38,000 Speaker 1: that said Hollywood invades USC Medical School. Uh. In in 109 00:06:38,040 --> 00:06:41,920 Speaker 1: the San Francisco Chronicle, of all places, they said scantily 110 00:06:41,960 --> 00:06:45,400 Speaker 1: clad models were making life a little more interesting for 111 00:06:45,440 --> 00:06:49,320 Speaker 1: the USC medical students, which is really I mean, I 112 00:06:49,320 --> 00:06:52,440 Speaker 1: guess it's a sign of the times, but really kind 113 00:06:52,440 --> 00:06:55,520 Speaker 1: of a crappy way too. You know, they made it 114 00:06:55,560 --> 00:06:59,080 Speaker 1: sound like it was some titilating sexual thing, right, because 115 00:06:59,160 --> 00:07:03,159 Speaker 1: you know, they had these people that are really doing 116 00:07:03,200 --> 00:07:07,400 Speaker 1: what you know, what I learned was a super valuable service. Well, yeah, 117 00:07:07,480 --> 00:07:10,880 Speaker 1: for sure, I think they were just trying to sex 118 00:07:10,920 --> 00:07:12,440 Speaker 1: it up for the paper. You know what I mean, 119 00:07:13,040 --> 00:07:16,680 Speaker 1: they're reading audience because they were like Zodiac Killer coming soon, 120 00:07:16,840 --> 00:07:21,440 Speaker 1: what's that stay tuned? But he wasn't around yet, so 121 00:07:21,440 --> 00:07:23,080 Speaker 1: they had to do something. So they were just trying 122 00:07:23,160 --> 00:07:25,920 Speaker 1: to take something that was actually, yeah, a valuable service 123 00:07:25,920 --> 00:07:29,680 Speaker 1: and pretty straightforward and again sex it up a little bit, 124 00:07:30,320 --> 00:07:33,280 Speaker 1: but it actually it kept it from catching on for 125 00:07:33,320 --> 00:07:35,360 Speaker 1: a while, at least at first. It wasn't until I 126 00:07:35,400 --> 00:07:38,280 Speaker 1: think the mid eighties that Barrow was able to like 127 00:07:38,360 --> 00:07:43,280 Speaker 1: get it to start to become adopted throughout the the 128 00:07:43,280 --> 00:07:46,360 Speaker 1: the medical universe and the United States at least. Yeah, 129 00:07:46,400 --> 00:07:49,280 Speaker 1: and you know what, we've done that thing again. Yeah, 130 00:07:49,280 --> 00:07:51,680 Speaker 1: I know where we haven't said what it is yet. 131 00:07:53,200 --> 00:07:56,280 Speaker 1: You had to have seen Seinfeld and know how to 132 00:07:56,320 --> 00:07:59,000 Speaker 1: read between the lines of our conversation. Yeah. So a 133 00:07:59,080 --> 00:08:03,360 Speaker 1: simulated patient or a standardized patient is um Sometimes you're 134 00:08:03,360 --> 00:08:07,320 Speaker 1: an actor. Sometimes they have no acting experience. Sometimes it 135 00:08:07,320 --> 00:08:10,040 Speaker 1: we'll get to who these people are, but they're generally 136 00:08:10,240 --> 00:08:12,800 Speaker 1: people looking to make a buck, who are who fit 137 00:08:12,880 --> 00:08:18,240 Speaker 1: the profile and of being a fake patient to a 138 00:08:18,240 --> 00:08:22,520 Speaker 1: medical student so they can get a real practical human 139 00:08:22,560 --> 00:08:28,000 Speaker 1: to human experience in medical school exactly because there's a 140 00:08:28,000 --> 00:08:32,600 Speaker 1: big difference between book learning in real life, right, and 141 00:08:32,640 --> 00:08:37,200 Speaker 1: if you're a doctor, a huge, huge part of your UM, 142 00:08:37,280 --> 00:08:44,199 Speaker 1: your job, especially UM non surgical doctrine is conversing with 143 00:08:44,280 --> 00:08:49,440 Speaker 1: a human being patient and and on the one hand, 144 00:08:49,480 --> 00:08:52,280 Speaker 1: treating them as a human being, not a set of symptoms. 145 00:08:52,280 --> 00:08:56,400 Speaker 1: That's a big one. But then also um, getting out 146 00:08:56,440 --> 00:08:59,400 Speaker 1: of them what's wrong with them so that you can 147 00:08:59,440 --> 00:09:03,200 Speaker 1: diagnose them. Yeah, that's I thought this was all sort 148 00:09:03,240 --> 00:09:06,520 Speaker 1: of just about bedside manner and like being you know, 149 00:09:06,960 --> 00:09:08,440 Speaker 1: because it's a big part of the job. You know, 150 00:09:08,520 --> 00:09:11,160 Speaker 1: you want a doctor. If you've ever had a doctor 151 00:09:11,200 --> 00:09:13,240 Speaker 1: that had a poor bedside manner, you know what I'm 152 00:09:13,280 --> 00:09:16,360 Speaker 1: talking about. UM, If you haven't, then you might take 153 00:09:16,400 --> 00:09:18,320 Speaker 1: it for granted that everyone's like that, but that's not 154 00:09:18,400 --> 00:09:20,560 Speaker 1: the case. But the second part of that I didn't 155 00:09:20,559 --> 00:09:23,960 Speaker 1: really think about. But um. The director of the Standardized 156 00:09:23,960 --> 00:09:28,360 Speaker 1: Patient Program at University of Pittsburgh School of Medicine, Valerie Former, 157 00:09:28,400 --> 00:09:30,360 Speaker 1: who they don't know if they interviewed her for this 158 00:09:30,559 --> 00:09:33,160 Speaker 1: or if she was just they pulled some quotes, but 159 00:09:33,760 --> 00:09:35,920 Speaker 1: I never really thought about it. She said, communication is 160 00:09:35,920 --> 00:09:39,320 Speaker 1: at the root of proper diagnosis, patient safety, and patient 161 00:09:39,400 --> 00:09:42,800 Speaker 1: satisfaction and miscommunication can lead to medical error, so they 162 00:09:42,840 --> 00:09:45,240 Speaker 1: have to A big part of the job is drawing 163 00:09:45,240 --> 00:09:47,760 Speaker 1: out of the patient what the heck is wrong with them, 164 00:09:47,760 --> 00:09:50,439 Speaker 1: because they can examin until the cows come home, but 165 00:09:50,480 --> 00:09:54,000 Speaker 1: they need words, right, So like, yeah, patient who comes 166 00:09:54,040 --> 00:09:57,760 Speaker 1: into the doctor's officer, that e er isn't gonna be like, um, 167 00:09:57,800 --> 00:10:00,720 Speaker 1: I have an abscess on my right kid. Need that 168 00:10:00,840 --> 00:10:03,480 Speaker 1: needs to be treated or else I'm gonna die of 169 00:10:03,520 --> 00:10:06,640 Speaker 1: sepsis in the next twelve hours. Is my my my 170 00:10:06,800 --> 00:10:09,839 Speaker 1: side hurts, That's what you get. So you have to 171 00:10:09,880 --> 00:10:12,720 Speaker 1: ask more questions and know what questions to ask. So yeah, 172 00:10:12,720 --> 00:10:15,520 Speaker 1: it's it's diagnosis, learning how to diagnose from talking to 173 00:10:15,559 --> 00:10:18,120 Speaker 1: people in drawing info out of them. But that bedside 174 00:10:18,120 --> 00:10:21,439 Speaker 1: manner that's not to be overlooked, Like that's a big 175 00:10:21,520 --> 00:10:24,440 Speaker 1: part of it because you know, if if people start 176 00:10:24,520 --> 00:10:27,920 Speaker 1: to think every doctor I've ever interacted with treated me 177 00:10:28,000 --> 00:10:30,360 Speaker 1: like I was just a bag of organs and bones, 178 00:10:30,880 --> 00:10:33,920 Speaker 1: which we couldn't couldn't sure, and couldn't care. But you're 179 00:10:33,920 --> 00:10:37,400 Speaker 1: not supposed to to let on that every like we 180 00:10:37,480 --> 00:10:40,559 Speaker 1: all have to pretend in this big grand manner, right exactly, 181 00:10:41,000 --> 00:10:43,600 Speaker 1: And but it will keep you from going to the doctor. 182 00:10:44,559 --> 00:10:46,280 Speaker 1: And if you stop going to the doctor, and then 183 00:10:46,320 --> 00:10:49,680 Speaker 1: health problems can can start to accumulate, and it's all 184 00:10:49,720 --> 00:10:53,600 Speaker 1: the doctor's fault for being a sociopathic jerk. Well yeah, 185 00:10:53,679 --> 00:10:56,360 Speaker 1: but you also you know in that um which one 186 00:10:56,400 --> 00:11:00,719 Speaker 1: were we talking about doctors being too empathetic? The empathy one? 187 00:11:01,480 --> 00:11:04,000 Speaker 1: Oh yeah, okay, there you have it. You didn't want 188 00:11:04,000 --> 00:11:06,520 Speaker 1: to dr fell to pieces. No, you you need to 189 00:11:06,600 --> 00:11:09,640 Speaker 1: learn to walk that fine line between being too clinical 190 00:11:09,840 --> 00:11:13,040 Speaker 1: and too much of an EmPATH to where the patient 191 00:11:13,080 --> 00:11:16,640 Speaker 1: feels eddies and taking care of but you feel confident 192 00:11:16,760 --> 00:11:20,199 Speaker 1: and they're not like breaking down and crying because they 193 00:11:20,200 --> 00:11:23,319 Speaker 1: have to tell you that you may be dying. Let's say. Yeah, 194 00:11:23,360 --> 00:11:26,319 Speaker 1: but the the lady from the University of Pittsburgh who 195 00:11:26,400 --> 00:11:28,960 Speaker 1: was interviewed in this article points out that there was 196 00:11:29,440 --> 00:11:32,280 Speaker 1: she she remembered at least one medical student who did 197 00:11:32,600 --> 00:11:37,160 Speaker 1: break down because of an interaction with a simulated patient 198 00:11:37,320 --> 00:11:42,120 Speaker 1: or standardized patient. UM and that that that that's the 199 00:11:42,200 --> 00:11:45,720 Speaker 1: point of a similizer or simulated or standardized patient is 200 00:11:46,400 --> 00:11:48,360 Speaker 1: so that you can go ahead and break down like 201 00:11:48,440 --> 00:11:52,120 Speaker 1: that and get it out UM In in a basically 202 00:11:52,160 --> 00:11:54,960 Speaker 1: a classroom setting, so that when you encounter this in 203 00:11:55,000 --> 00:11:58,480 Speaker 1: the real world, you'll have already gone through that. Yeah, 204 00:11:58,559 --> 00:12:01,440 Speaker 1: and um, we'll get into the nuts and bolts of 205 00:12:01,480 --> 00:12:04,960 Speaker 1: it in a bit. But um, if you're wondering if 206 00:12:05,000 --> 00:12:06,960 Speaker 1: you want to go do this, if you have to, 207 00:12:07,080 --> 00:12:11,120 Speaker 1: like you know, get a prostate exam. Um, you don't 208 00:12:11,160 --> 00:12:13,280 Speaker 1: have to, but if you're if you're open to that 209 00:12:13,400 --> 00:12:17,240 Speaker 1: kind of your intention, you can sign up for a 210 00:12:17,240 --> 00:12:20,800 Speaker 1: more intense uh and I imagine those are the ones 211 00:12:20,840 --> 00:12:23,280 Speaker 1: that pay a little bit better. But you can go 212 00:12:23,320 --> 00:12:25,920 Speaker 1: in and volunteer for a prostate exam or or or 213 00:12:25,960 --> 00:12:29,400 Speaker 1: breast exam or anything that involves something a little more 214 00:12:30,240 --> 00:12:34,840 Speaker 1: uh um invasive. Yeah, but you're not gonna get cut 215 00:12:34,960 --> 00:12:37,760 Speaker 1: or you're not gonna get a needled or anything like that. 216 00:12:37,800 --> 00:12:40,000 Speaker 1: They're not going to practice that kind of stuff on you. Right. 217 00:12:40,040 --> 00:12:42,239 Speaker 1: I was reading the f a Q on the University 218 00:12:42,240 --> 00:12:46,400 Speaker 1: of Pittsburgh site about their um simulated patients, and they 219 00:12:46,480 --> 00:12:51,040 Speaker 1: point out that patients simulated patients will not be given drugs. Yeah, 220 00:12:51,080 --> 00:12:53,319 Speaker 1: then that can inject you with like a cocktail of 221 00:12:53,360 --> 00:12:57,319 Speaker 1: antipsychotics and stimulation, and this may be a good way 222 00:12:57,320 --> 00:13:01,040 Speaker 1: to score, right, But it's on you, is the simulated 223 00:13:01,080 --> 00:13:06,520 Speaker 1: patient to um to act as if you're um going 224 00:13:06,520 --> 00:13:09,679 Speaker 1: through a psychotic break right there. Yeah, potentially so that 225 00:13:09,720 --> 00:13:11,600 Speaker 1: the doctor can learn how to deal with that kind 226 00:13:11,600 --> 00:13:14,800 Speaker 1: of thing. That's probably one of the more dramatic examples. 227 00:13:14,960 --> 00:13:16,920 Speaker 1: I think a lot of them are a lot more pedestrian, 228 00:13:17,240 --> 00:13:20,040 Speaker 1: but that is definitely in the mix as well. Well. 229 00:13:20,080 --> 00:13:24,679 Speaker 1: Even though you're as we'll see, it's you sort of, Um, 230 00:13:24,720 --> 00:13:27,679 Speaker 1: it's not scripted. You do have to be an improviser 231 00:13:27,720 --> 00:13:30,520 Speaker 1: of sorts, but you're supposed to stick to kind of 232 00:13:30,880 --> 00:13:32,400 Speaker 1: I don't think you're supposed to throw them any just 233 00:13:32,520 --> 00:13:36,520 Speaker 1: curveballs that you think of in the moment, uh, which 234 00:13:36,520 --> 00:13:38,440 Speaker 1: is what I would want to do, which is probably 235 00:13:38,760 --> 00:13:42,559 Speaker 1: I would not be a good sp That's what Kramer did. Yeah, 236 00:13:42,559 --> 00:13:44,560 Speaker 1: he he could have made it into like a real 237 00:13:44,600 --> 00:13:48,760 Speaker 1: acting gig, right right. And they say that actors can 238 00:13:48,840 --> 00:13:52,240 Speaker 1: be good at this, but it's not acting, like they 239 00:13:52,360 --> 00:13:56,240 Speaker 1: point out that, Um, there's no you're not searching for 240 00:13:56,840 --> 00:14:00,720 Speaker 1: moments of drama. You're not there to entertain. You know, 241 00:14:00,760 --> 00:14:04,280 Speaker 1: they're playing. You're not playing to the audience. So yeah, 242 00:14:04,280 --> 00:14:07,720 Speaker 1: it could be helpful to learn, say, um, I don't know. 243 00:14:07,800 --> 00:14:10,320 Speaker 1: Would it be character acting or method acting in this one? 244 00:14:10,760 --> 00:14:14,520 Speaker 1: Mm hmmm, probably method acting. So it would be useful 245 00:14:14,600 --> 00:14:17,720 Speaker 1: to learn some nuts and bolts of of that, just 246 00:14:17,840 --> 00:14:22,640 Speaker 1: practice and rehearse that type of acting. But you're not gonna, like, 247 00:14:22,720 --> 00:14:24,560 Speaker 1: you're not gonna go get your big break or something 248 00:14:24,640 --> 00:14:26,720 Speaker 1: doing this. That's not the point of it. Now. I 249 00:14:26,800 --> 00:14:29,920 Speaker 1: think I would, Uh, I would try and fart a 250 00:14:29,920 --> 00:14:33,240 Speaker 1: lot or something, just something very subtle. That'd be your 251 00:14:33,360 --> 00:14:37,120 Speaker 1: your trademark because yeah, that would be in the in 252 00:14:37,240 --> 00:14:39,560 Speaker 1: the in the lounge. Afterward they'd all be like, did 253 00:14:39,560 --> 00:14:43,240 Speaker 1: you get the kind I think he was farting? Right? 254 00:14:43,600 --> 00:14:47,200 Speaker 1: Was that on purpose? Or that'd be your standardized patient card. 255 00:14:47,720 --> 00:14:51,200 Speaker 1: It's say, Charles W. Chuck Bryant ask about my trademark 256 00:14:51,560 --> 00:14:54,880 Speaker 1: arts on command? Uh, all right, that was dumb. So 257 00:14:54,920 --> 00:14:56,840 Speaker 1: we should take a break. Yeah, so I can get 258 00:14:56,840 --> 00:15:21,480 Speaker 1: it together. Okay, So Chuck, let's get down into the 259 00:15:21,560 --> 00:15:23,720 Speaker 1: nuts and bolts. So the nitty gritty a little bit, right. 260 00:15:23,760 --> 00:15:26,880 Speaker 1: So I said earlier that all of this kind of 261 00:15:26,920 --> 00:15:31,640 Speaker 1: falls under the umbrella of a standardized or a simulated 262 00:15:31,680 --> 00:15:36,320 Speaker 1: patient um and then underneath that umbrella, which we've kind 263 00:15:36,320 --> 00:15:39,320 Speaker 1: of been using interchangeably, but really shouldn't UM. Is the 264 00:15:39,400 --> 00:15:43,280 Speaker 1: standardized patient is largely what we're talking about, and I 265 00:15:43,360 --> 00:15:48,440 Speaker 1: think synonymous with the standardized patient and is the programmed patient. 266 00:15:48,520 --> 00:15:52,600 Speaker 1: That first UM the first term that George Barrow used 267 00:15:52,640 --> 00:15:55,480 Speaker 1: for right. And the reason that it's called standardized or 268 00:15:55,520 --> 00:15:58,240 Speaker 1: programmed is because it's like you said, there isn't a script, 269 00:15:58,280 --> 00:16:00,480 Speaker 1: like you don't memorize the script of the doctor says 270 00:16:00,560 --> 00:16:03,120 Speaker 1: this and then you say that, but you do have 271 00:16:03,200 --> 00:16:07,360 Speaker 1: like a You are given a specific set of criteria 272 00:16:07,400 --> 00:16:10,000 Speaker 1: and it can be really detailed as well, and you're 273 00:16:10,040 --> 00:16:14,120 Speaker 1: expected to stick to that role, that character. You take 274 00:16:14,160 --> 00:16:17,080 Speaker 1: on a character, and your character is sick, your character 275 00:16:17,120 --> 00:16:20,800 Speaker 1: as a backstory, there's um certain things that your character 276 00:16:20,920 --> 00:16:24,320 Speaker 1: is capable of doing and incapable of doing because of 277 00:16:24,360 --> 00:16:28,960 Speaker 1: the medical condition, maybe because of a prior medical history. UM. 278 00:16:29,440 --> 00:16:33,480 Speaker 1: And then you go in there and you remain in 279 00:16:33,520 --> 00:16:37,960 Speaker 1: this character and you do it virtually the same way 280 00:16:37,960 --> 00:16:41,520 Speaker 1: as close to the same as possible for student doctor 281 00:16:41,560 --> 00:16:45,320 Speaker 1: after student doctor actor student doctor usually up to about 282 00:16:45,400 --> 00:16:49,200 Speaker 1: ten in a day, and they each student doctor is 283 00:16:49,200 --> 00:16:51,920 Speaker 1: supposed to get the same experience from you. And the 284 00:16:52,000 --> 00:16:54,640 Speaker 1: reason why they wanted that standard is because they're being 285 00:16:54,720 --> 00:16:57,560 Speaker 1: graded on this, they're being tested on this. It's it's 286 00:16:57,880 --> 00:17:02,000 Speaker 1: um the closest thing to sign a typically reproducible that's 287 00:17:02,080 --> 00:17:05,920 Speaker 1: something as objective as bedside manner could be made into. 288 00:17:06,200 --> 00:17:09,880 Speaker 1: That's the point of standardized patients specifically. Yeah, and you've 289 00:17:10,000 --> 00:17:13,040 Speaker 1: um the case that you've gotten. It's either uh, something 290 00:17:13,720 --> 00:17:16,600 Speaker 1: that's just made up, like hey, we need somebody that 291 00:17:16,680 --> 00:17:20,280 Speaker 1: has an uh maybe a rupture dependix or whatever. That's 292 00:17:20,320 --> 00:17:23,280 Speaker 1: kind of a run run of the meal, uh meal, 293 00:17:23,720 --> 00:17:28,520 Speaker 1: run of the breakfast, run of the mill situation. But 294 00:17:28,760 --> 00:17:33,240 Speaker 1: sometimes it's an actual case, like a real case UM 295 00:17:33,320 --> 00:17:37,040 Speaker 1: that they base it on, Like someone has actually experienced this, 296 00:17:37,160 --> 00:17:40,119 Speaker 1: it's been recorded, and they have this case study and 297 00:17:40,160 --> 00:17:43,479 Speaker 1: they want the doctor to go through this very specific thing, uh, 298 00:17:43,520 --> 00:17:45,960 Speaker 1: and in that case they want to really replicate that 299 00:17:46,680 --> 00:17:51,240 Speaker 1: right down to like the age, gender, and ethnicity of 300 00:17:51,280 --> 00:17:54,240 Speaker 1: that actual patient that had that actual case to begin with, 301 00:17:54,640 --> 00:17:57,239 Speaker 1: right exactly. I think George Barrow, the guy who came 302 00:17:57,320 --> 00:17:59,919 Speaker 1: up with us in the sixties, he based his first 303 00:18:00,359 --> 00:18:03,719 Speaker 1: UM standardized patient on an actual case that he handled 304 00:18:03,760 --> 00:18:07,240 Speaker 1: because he knew exactly how it presented, UM, exactly what 305 00:18:07,320 --> 00:18:10,119 Speaker 1: the medical history was so and it was something that 306 00:18:10,160 --> 00:18:14,760 Speaker 1: he felt could be reproduced pretty easily again and again. UM. 307 00:18:14,800 --> 00:18:18,600 Speaker 1: And there's this really interesting essay that was running The Believer, 308 00:18:18,760 --> 00:18:21,440 Speaker 1: but I think it made it into a collection UM 309 00:18:21,520 --> 00:18:25,600 Speaker 1: in the Writer's book by a writer named Leslie Jamison, 310 00:18:26,320 --> 00:18:29,000 Speaker 1: and the name of the essay is the Empathy Exams. 311 00:18:29,040 --> 00:18:34,640 Speaker 1: It's about her UM experience as a standardized patient. It's 312 00:18:34,800 --> 00:18:39,399 Speaker 1: really really interesting just how she's really investigating the character 313 00:18:39,520 --> 00:18:43,040 Speaker 1: that she's given. Like, I think her her main characters 314 00:18:43,040 --> 00:18:46,080 Speaker 1: Scott more than one UM, but her main winner, the 315 00:18:46,080 --> 00:18:49,040 Speaker 1: one that she seems most attached to, her brother like 316 00:18:49,320 --> 00:18:53,199 Speaker 1: drowned in after tailgating at a football game and then 317 00:18:53,240 --> 00:18:57,160 Speaker 1: jumping into a river and he drowned years back, and Um, 318 00:18:57,280 --> 00:19:01,440 Speaker 1: she's like still green being over the loss of her 319 00:19:01,480 --> 00:19:06,919 Speaker 1: brother and it's led to seizures, but she doesn't even 320 00:19:07,040 --> 00:19:10,800 Speaker 1: she the character doesn't know that these seizures are basically 321 00:19:10,880 --> 00:19:14,119 Speaker 1: coming out of grief. So it's for the doctors to 322 00:19:14,200 --> 00:19:17,000 Speaker 1: suss out. And that's just one of at least a 323 00:19:17,040 --> 00:19:20,760 Speaker 1: couple um it's standardized patients that she's played. But it's 324 00:19:20,840 --> 00:19:23,800 Speaker 1: really interesting. It's a great, great essay. Well, yeah, in 325 00:19:23,800 --> 00:19:26,760 Speaker 1: them in this article that you dug up. It said 326 00:19:26,760 --> 00:19:28,399 Speaker 1: that one of the there are a lot of reasons 327 00:19:28,440 --> 00:19:30,160 Speaker 1: someone might want to do this, but one of them 328 00:19:30,840 --> 00:19:33,080 Speaker 1: can certainly be that they had like a family member 329 00:19:33,600 --> 00:19:37,280 Speaker 1: that died of a certain disease or maybe was misdiagnosed 330 00:19:37,280 --> 00:19:40,320 Speaker 1: st even so they feel like this is like something 331 00:19:40,359 --> 00:19:42,919 Speaker 1: they can do to kind of help out, uh that 332 00:19:43,000 --> 00:19:45,840 Speaker 1: kind of research or whatever, you know, right, I ran 333 00:19:45,880 --> 00:19:49,680 Speaker 1: across though, that one of the pitfalls of UM standardized 334 00:19:49,720 --> 00:19:52,760 Speaker 1: patients is that the people who do it, they can 335 00:19:52,800 --> 00:19:55,480 Speaker 1: have a hidden agenda sometimes and it may be as 336 00:19:55,520 --> 00:19:58,560 Speaker 1: benign as yet, my brother was misdiagnosed, and I want 337 00:19:58,560 --> 00:20:02,679 Speaker 1: to make sure that doesn't happen to anybody else or UM, 338 00:20:02,720 --> 00:20:05,600 Speaker 1: it can be some I ran across in this comment 339 00:20:05,680 --> 00:20:10,159 Speaker 1: section on a biomedical blog about some doctors, said that 340 00:20:10,200 --> 00:20:12,959 Speaker 1: while he was in training, he came across a standardized 341 00:20:12,960 --> 00:20:15,879 Speaker 1: patient who was sure to list all of the herbal 342 00:20:15,920 --> 00:20:18,960 Speaker 1: medications that she was taking right then and then she 343 00:20:19,080 --> 00:20:21,160 Speaker 1: later said that it was because she wanted to make 344 00:20:21,160 --> 00:20:24,920 Speaker 1: sure that these medical students were made aware of alternative 345 00:20:24,960 --> 00:20:28,000 Speaker 1: medicine as well, So she had like a specific hidden 346 00:20:28,040 --> 00:20:31,400 Speaker 1: agenda that she wanted to get across to these med 347 00:20:31,480 --> 00:20:34,280 Speaker 1: students without going to the trouble of going to med 348 00:20:34,320 --> 00:20:37,520 Speaker 1: school herself and becoming a doctor teacher. We just kind 349 00:20:37,560 --> 00:20:41,199 Speaker 1: of came in under the radar basically, and apparently they 350 00:20:41,200 --> 00:20:43,199 Speaker 1: try to root people like that out because it's not 351 00:20:43,280 --> 00:20:45,199 Speaker 1: the point of the whole thing. But it's kind of 352 00:20:45,200 --> 00:20:49,719 Speaker 1: funny how they slipped in there. Sometimes. Yeah, and you know, 353 00:20:50,720 --> 00:20:53,639 Speaker 1: you're in character unless you're doing and we'll talk about 354 00:20:53,680 --> 00:20:56,560 Speaker 1: this later, but that one thing that you found and 355 00:20:56,600 --> 00:20:58,320 Speaker 1: sent me is that seemed like a little bit of 356 00:20:58,359 --> 00:21:01,080 Speaker 1: a different process where they might have a really specific 357 00:21:01,119 --> 00:21:05,399 Speaker 1: goal in mind where you kind of do almost like 358 00:21:05,400 --> 00:21:10,600 Speaker 1: play acting back and forth with the student doctor. But generally, uh, 359 00:21:10,760 --> 00:21:12,960 Speaker 1: they're trying to diagnose you. So you walk in the 360 00:21:13,040 --> 00:21:17,000 Speaker 1: room and you're in character. So if you've got kidney 361 00:21:17,000 --> 00:21:20,760 Speaker 1: pain or bad back or a limp or whatever, then 362 00:21:21,119 --> 00:21:22,760 Speaker 1: you don't walk in and say all right, let's get 363 00:21:22,800 --> 00:21:25,840 Speaker 1: started and then go oh like they try to make 364 00:21:25,880 --> 00:21:27,560 Speaker 1: it as real as possible. You walk in there in 365 00:21:27,680 --> 00:21:31,560 Speaker 1: character with you know, holding your side or or whatever 366 00:21:31,560 --> 00:21:35,359 Speaker 1: your ailment is. You don't you know, run your face 367 00:21:35,440 --> 00:21:38,920 Speaker 1: over your hand over your face over smiling, like frowning 368 00:21:39,240 --> 00:21:41,639 Speaker 1: to get in character. No, you don't do that. No, 369 00:21:41,920 --> 00:21:45,679 Speaker 1: And apparently I've seen that if standardized patients really good, 370 00:21:46,000 --> 00:21:49,119 Speaker 1: they'll be basically indistinguishable from some of the patients that 371 00:21:49,200 --> 00:21:54,200 Speaker 1: the the doctor will eventually run into and their clinical practice. Right, Yeah, 372 00:21:54,240 --> 00:21:56,240 Speaker 1: I mean it's it's tough, man, because you have to 373 00:21:57,320 --> 00:21:59,000 Speaker 1: I mean, if you're not an actor, you might be 374 00:22:00,040 --> 00:22:01,639 Speaker 1: have a talent you didn't know you had if you're 375 00:22:01,680 --> 00:22:05,640 Speaker 1: good at this, because you have to memorize and internalize 376 00:22:06,119 --> 00:22:10,239 Speaker 1: and study all this stuff, because you have to be 377 00:22:10,320 --> 00:22:13,199 Speaker 1: just as real as someone who is experiencing something, and 378 00:22:13,280 --> 00:22:17,600 Speaker 1: like that's that's the best. Like you, you would be 379 00:22:17,640 --> 00:22:20,919 Speaker 1: the best actor if you literally become that person that 380 00:22:20,960 --> 00:22:22,480 Speaker 1: you're playing. And that's kind of what you have to 381 00:22:22,520 --> 00:22:25,800 Speaker 1: do for this, right you know what I'm saying, Like 382 00:22:25,840 --> 00:22:27,600 Speaker 1: these people, if they are an actors, they might want 383 00:22:27,600 --> 00:22:31,160 Speaker 1: to look into it, sure if they're good at it. Yeah, 384 00:22:31,200 --> 00:22:34,000 Speaker 1: So let's talk about that. So acting is not being 385 00:22:34,040 --> 00:22:37,359 Speaker 1: an actor is not a prerequisite for this, right, Um. 386 00:22:37,440 --> 00:22:39,320 Speaker 1: But you could be an actor and be good at it. 387 00:22:39,359 --> 00:22:41,719 Speaker 1: You could be an actor and become very quickly frustrated 388 00:22:41,760 --> 00:22:44,199 Speaker 1: by the whole thing because it's not acting necessarily it's 389 00:22:44,359 --> 00:22:48,120 Speaker 1: very specific type of acting, right, it's literally medical acting. 390 00:22:48,680 --> 00:22:52,560 Speaker 1: But just that's not enough. You need to apparently be 391 00:22:53,480 --> 00:22:58,000 Speaker 1: ceaselessly upbeat, endlessly upbeat. And the reason why is because 392 00:22:58,480 --> 00:23:01,639 Speaker 1: you're going through this thing, say up to ten times 393 00:23:01,640 --> 00:23:04,120 Speaker 1: in a row. And these things last, from what I saw, 394 00:23:04,119 --> 00:23:07,760 Speaker 1: about forty five minutes. So you're doing this for forty 395 00:23:07,800 --> 00:23:10,520 Speaker 1: five minutes, half an hour or two an hour in 396 00:23:10,560 --> 00:23:14,560 Speaker 1: the in the waiting room beforehand exactly filling out forms. Yeah, 397 00:23:14,560 --> 00:23:16,320 Speaker 1: because you gotta get angry before you go in there. 398 00:23:16,560 --> 00:23:18,840 Speaker 1: Some guys like coughing along up next to you and 399 00:23:18,840 --> 00:23:22,840 Speaker 1: it's like, oh, I'm no continued, just um. It drives 400 00:23:22,880 --> 00:23:24,879 Speaker 1: me crazy when people are like, I'm not contagious. It's 401 00:23:24,920 --> 00:23:27,040 Speaker 1: like you don't know, you have no idea whether you're 402 00:23:27,040 --> 00:23:30,959 Speaker 1: contagious or not. Um. But so you have to do 403 00:23:31,000 --> 00:23:34,119 Speaker 1: this maybe ten times in a row. It's about forty 404 00:23:34,119 --> 00:23:36,879 Speaker 1: five minutes per from what I saw, and that that 405 00:23:37,200 --> 00:23:39,879 Speaker 1: tenth one needs to be as great a performance as 406 00:23:39,920 --> 00:23:43,720 Speaker 1: that first one because those are two different medical students. 407 00:23:43,760 --> 00:23:46,159 Speaker 1: There's ten different medical students seeing you, and each one 408 00:23:46,200 --> 00:23:50,280 Speaker 1: needs to get your best because, as far as they're concerned, 409 00:23:50,560 --> 00:23:53,680 Speaker 1: this is their training. They're not looking at your day, 410 00:23:54,040 --> 00:23:56,440 Speaker 1: you know, like, oh, I'm one of ten. It's this 411 00:23:56,480 --> 00:23:58,879 Speaker 1: is my this is my big, my big test, or 412 00:23:58,880 --> 00:24:01,200 Speaker 1: my big training. So you need to give each one 413 00:24:01,240 --> 00:24:04,080 Speaker 1: you're you're you're all in that sense, you have to 414 00:24:04,119 --> 00:24:06,159 Speaker 1: have a lot of energy, a lot of spunk, a 415 00:24:06,240 --> 00:24:08,840 Speaker 1: lot of positivity. Um. And then you also have to 416 00:24:08,880 --> 00:24:14,800 Speaker 1: be very comfortable dealing with medical professionals, which is not 417 00:24:14,840 --> 00:24:17,479 Speaker 1: necessarily always the easiest bunch to deal with from what 418 00:24:17,520 --> 00:24:19,240 Speaker 1: I understand. Well, no, I mean if you have a 419 00:24:19,240 --> 00:24:23,240 Speaker 1: phobia of doctors, then this is not the gig for you. Sure, 420 00:24:23,320 --> 00:24:27,160 Speaker 1: And I think if you are easily crushed by pushy, 421 00:24:27,440 --> 00:24:30,680 Speaker 1: um arrogant people, it might not be the best gig 422 00:24:30,760 --> 00:24:35,280 Speaker 1: for you either. But doctors can beat ted arrogant sometimes. 423 00:24:35,760 --> 00:24:39,560 Speaker 1: I mean we all saw Malice. I don't think I 424 00:24:39,600 --> 00:24:42,240 Speaker 1: saw that. Yeah you did. When Alec Baldwin is like, 425 00:24:42,440 --> 00:24:44,600 Speaker 1: do I have a God complex? I don't have a 426 00:24:44,640 --> 00:24:48,280 Speaker 1: God complex. I am God. I just thought that was 427 00:24:48,320 --> 00:24:55,560 Speaker 1: Alec Baldwin, like probably what you tweeted it, right? Uh, No, 428 00:24:55,600 --> 00:24:59,000 Speaker 1: I never did see that. Actually I remember the movie though, Um, yeah, 429 00:24:59,040 --> 00:25:02,480 Speaker 1: it was good eighties of late eighties movie. But but yeah, 430 00:25:02,520 --> 00:25:04,680 Speaker 1: So you can't just be like a wilting flower when 431 00:25:04,680 --> 00:25:07,639 Speaker 1: a med student gets all mad or pushy or whatever. 432 00:25:07,680 --> 00:25:10,520 Speaker 1: And you also have to be the type who could 433 00:25:10,640 --> 00:25:14,879 Speaker 1: conceivably take charge and can take control if if a 434 00:25:14,920 --> 00:25:18,320 Speaker 1: med student is doing that and UM kind of maybe 435 00:25:18,320 --> 00:25:21,080 Speaker 1: guide them back a little bit toward where they should be, 436 00:25:21,200 --> 00:25:23,520 Speaker 1: or at the very least being willing to give them 437 00:25:23,520 --> 00:25:27,320 Speaker 1: feedback to their face about how they just royally screwed 438 00:25:27,320 --> 00:25:30,800 Speaker 1: this whole thing up because they're over aggressive or because 439 00:25:30,840 --> 00:25:34,520 Speaker 1: they were um under assertive. Who knows you, I think 440 00:25:34,560 --> 00:25:36,760 Speaker 1: you run into all of that stuff, and you have 441 00:25:36,840 --> 00:25:38,879 Speaker 1: to be prepared to do this. So that brings up 442 00:25:38,880 --> 00:25:41,040 Speaker 1: another point too. You have to have a really good 443 00:25:41,080 --> 00:25:45,560 Speaker 1: memory because it depending on who you ask. A lot 444 00:25:45,640 --> 00:25:49,520 Speaker 1: of the um simulated patients will also be required to 445 00:25:49,600 --> 00:25:53,119 Speaker 1: give feedback. Some of them, I got the impression have 446 00:25:53,320 --> 00:25:56,560 Speaker 1: something to do with like the scoring or grading process 447 00:25:56,600 --> 00:26:00,600 Speaker 1: as well. So you have to be in care. So 448 00:26:00,720 --> 00:26:04,800 Speaker 1: you have to have your character's history, symptoms, everything memorized. 449 00:26:05,359 --> 00:26:08,879 Speaker 1: You have to stay in character. You have to um 450 00:26:09,119 --> 00:26:13,200 Speaker 1: respond to the doctor's questioning, and then you have to 451 00:26:13,320 --> 00:26:16,520 Speaker 1: um be paying attention to all the stuff the doctors 452 00:26:16,560 --> 00:26:19,480 Speaker 1: should be asking all the stuff the doctor is failing 453 00:26:19,520 --> 00:26:23,439 Speaker 1: to ask, and um, the doctor's just behavior in general, 454 00:26:23,600 --> 00:26:26,359 Speaker 1: so that you can give accurate feedback afterward, and then 455 00:26:26,400 --> 00:26:27,800 Speaker 1: you have to do it ten times in a row 456 00:26:27,800 --> 00:26:30,480 Speaker 1: in a day. Yeah, and this this serves a very 457 00:26:30,520 --> 00:26:36,960 Speaker 1: specific need, um beyond the obvious that uh, well, there's 458 00:26:36,960 --> 00:26:39,719 Speaker 1: a few things and then and they're all somewhat obvious, 459 00:26:39,720 --> 00:26:43,639 Speaker 1: but it bears going over um an experience of of 460 00:26:43,880 --> 00:26:46,600 Speaker 1: medical students. You don't want them practicing on a real 461 00:26:46,720 --> 00:26:49,880 Speaker 1: sick person because they if they mess up, that's not good. 462 00:26:50,480 --> 00:26:55,840 Speaker 1: So having almost like a live uh recessa annie on 463 00:26:55,880 --> 00:27:00,240 Speaker 1: your hands is good. I had a live or says 464 00:27:00,280 --> 00:27:02,560 Speaker 1: that any my mom used to bring those homes she 465 00:27:02,640 --> 00:27:05,560 Speaker 1: used to teach CPR. What would you do with them? 466 00:27:06,000 --> 00:27:08,760 Speaker 1: I tried to teach and then I learned to kiss. 467 00:27:09,880 --> 00:27:13,200 Speaker 1: I knew something weird went on. I tried to learn 468 00:27:13,240 --> 00:27:15,119 Speaker 1: CPR here that I think I've learned it like four 469 00:27:15,200 --> 00:27:18,360 Speaker 1: or five times in my life. I keep keep forgetting it. 470 00:27:18,480 --> 00:27:20,600 Speaker 1: So the one thing I do remember is you want 471 00:27:20,600 --> 00:27:25,760 Speaker 1: to do it to the You want to press the um. 472 00:27:25,840 --> 00:27:27,520 Speaker 1: Why is it called where you do where you give 473 00:27:27,600 --> 00:27:34,040 Speaker 1: chess compressions to the beat of staying alive. And then apparently, um, 474 00:27:34,200 --> 00:27:37,760 Speaker 1: you don't give breathing aid, like you don't pinch their 475 00:27:37,760 --> 00:27:41,720 Speaker 1: nose and breathe into their mouth for a couple of reasons. One, 476 00:27:41,880 --> 00:27:45,400 Speaker 1: you're exhaling carbon dioxide directly into their lungs, so that's stupid. 477 00:27:45,720 --> 00:27:47,879 Speaker 1: And then too, they don't really have a way to 478 00:27:47,920 --> 00:27:50,800 Speaker 1: expel it. So now they apparently, from what I understand, 479 00:27:50,840 --> 00:27:56,080 Speaker 1: they just recommend chess compressions until um paramedics arrive. Is 480 00:27:56,119 --> 00:27:59,639 Speaker 1: that the latest accurate? I don't know. I should probably 481 00:27:59,680 --> 00:28:02,160 Speaker 1: look at up before we publish this. Yeah, we should 482 00:28:02,160 --> 00:28:04,640 Speaker 1: say too that we're not trained medical professionals. Now we're 483 00:28:04,680 --> 00:28:08,200 Speaker 1: not even trained medical actors. And you are now taking 484 00:28:08,200 --> 00:28:10,240 Speaker 1: life saving advice from a guy who learned to kiss 485 00:28:10,280 --> 00:28:15,000 Speaker 1: from a lifeless Uh, synthetic. She wasn't lifeless when I 486 00:28:15,040 --> 00:28:21,399 Speaker 1: was kissing. She went her little curly wigs fun on 487 00:28:21,440 --> 00:28:25,000 Speaker 1: her head. Uh. All right. So the first thing is inexperience. 488 00:28:25,000 --> 00:28:27,320 Speaker 1: You don't want a medical student to be messing up 489 00:28:27,320 --> 00:28:31,600 Speaker 1: on real people. UM. Number two is availability. Uh, they 490 00:28:31,640 --> 00:28:33,480 Speaker 1: have to teach, they have to run the gamut of 491 00:28:33,520 --> 00:28:36,920 Speaker 1: medical issues, and you just can't count on having real 492 00:28:37,119 --> 00:28:40,040 Speaker 1: you know, being able to source real patients with that 493 00:28:40,080 --> 00:28:43,760 Speaker 1: specific problem. So it's really easy just to teach someone 494 00:28:43,840 --> 00:28:46,840 Speaker 1: to act like that. Uh. And finally, a real patient, 495 00:28:47,840 --> 00:28:52,960 Speaker 1: uh isn't supposed to provide feedback constructive feedback for their doctor. 496 00:28:53,000 --> 00:28:55,320 Speaker 1: I suppose they could. Yeah, even if they could, though 497 00:28:55,320 --> 00:28:57,600 Speaker 1: they're not necessarily like they're going to be like, again, 498 00:28:57,840 --> 00:29:00,280 Speaker 1: my kidneys absessed them in a lot of pain, don't 499 00:29:00,280 --> 00:29:02,760 Speaker 1: really care about your medical career. Just fixed me. Yeah, 500 00:29:02,800 --> 00:29:05,640 Speaker 1: you can you call seen at the end of this thing. 501 00:29:05,800 --> 00:29:08,400 Speaker 1: And then they go all right, now, let's like you said, 502 00:29:08,440 --> 00:29:11,240 Speaker 1: let's talk about it. I'm really not in pain, so 503 00:29:11,280 --> 00:29:14,200 Speaker 1: I'm fine to have this conversation. Sure, whereas the patient 504 00:29:14,280 --> 00:29:16,720 Speaker 1: would be like, I'm I gotta go urinate blood real quick. 505 00:29:16,760 --> 00:29:19,400 Speaker 1: I'll be right back green, I'll give you feedback doctor. 506 00:29:20,840 --> 00:29:24,440 Speaker 1: So that's a standardized patients right. Yeah, but there's there's 507 00:29:24,480 --> 00:29:26,760 Speaker 1: plenty of other kinds. Let's take a um, let's take 508 00:29:26,760 --> 00:29:49,640 Speaker 1: a break, and then we'll come back and talk about those. Okay, 509 00:29:51,640 --> 00:29:54,120 Speaker 1: one thing before we move on to that I think 510 00:29:54,160 --> 00:29:58,040 Speaker 1: we mentioned yet, is that, um, speaking of recessa Annie, 511 00:29:58,480 --> 00:30:03,360 Speaker 1: they have these really expense of surgical dummies. Now they 512 00:30:03,400 --> 00:30:06,120 Speaker 1: think they actually they call them robots. Uh, and this 513 00:30:06,200 --> 00:30:11,000 Speaker 1: is how surgeons practice now, um grand to a hundred grand. 514 00:30:11,040 --> 00:30:14,120 Speaker 1: And I looked them up. These things are amazing and 515 00:30:14,240 --> 00:30:18,600 Speaker 1: life like. Uh. They breathe and have pulses, and some 516 00:30:18,680 --> 00:30:21,640 Speaker 1: of them bleed. They know how to love. Some of 517 00:30:21,680 --> 00:30:27,200 Speaker 1: them give birth birth obviously, but uh, I kind of 518 00:30:27,240 --> 00:30:29,640 Speaker 1: did wonder, like, how do surgeons even practice these days? 519 00:30:29,640 --> 00:30:35,560 Speaker 1: I know they probably cut on cadavers in in med school, 520 00:30:35,560 --> 00:30:39,120 Speaker 1: but that you can only get so far. We've come 521 00:30:39,160 --> 00:30:41,400 Speaker 1: a long way from the days where med students were 522 00:30:41,440 --> 00:30:46,440 Speaker 1: forced to rob graves. Now we've got hundred thousand dollars 523 00:30:46,760 --> 00:30:50,160 Speaker 1: cadillacts of robots ready for surgery. Yeah. I mean they 524 00:30:50,160 --> 00:30:52,640 Speaker 1: look like I mean, some of them don't have if 525 00:30:52,640 --> 00:30:55,840 Speaker 1: they don't need it. They don't have legs and arms, 526 00:30:55,880 --> 00:30:57,880 Speaker 1: but they cover that up just to make it a 527 00:30:57,920 --> 00:31:00,920 Speaker 1: little more realistic. But they have cuts. And this one 528 00:31:01,000 --> 00:31:03,640 Speaker 1: dude I saw had like kind of a five o'clock 529 00:31:03,640 --> 00:31:08,200 Speaker 1: shadow beard. Um. It was creepy and awesome that they 530 00:31:08,240 --> 00:31:11,000 Speaker 1: have this stuff that's so lifelike. Oh man. So I 531 00:31:11,040 --> 00:31:14,680 Speaker 1: was on Twitter the other day shout out Twitter, um, 532 00:31:15,280 --> 00:31:19,520 Speaker 1: and Atlas Obscura had this um tweet where they were 533 00:31:19,840 --> 00:31:22,920 Speaker 1: They had a picture of this. It was a decapitated 534 00:31:22,960 --> 00:31:27,760 Speaker 1: serial killer whose head was pickled in a jar from 535 00:31:27,800 --> 00:31:31,160 Speaker 1: I think a teaching hospital and I believe Portugal, possibly Spain. 536 00:31:31,560 --> 00:31:33,480 Speaker 1: I think it was Portugal. It was Portugal, is like 537 00:31:33,840 --> 00:31:37,080 Speaker 1: first serial killer and um, they had his head pickled 538 00:31:37,200 --> 00:31:40,000 Speaker 1: and it was from eighteen forty when he was executed. 539 00:31:40,440 --> 00:31:44,320 Speaker 1: And man, it looks like he was from the seventies maybe, 540 00:31:44,680 --> 00:31:48,240 Speaker 1: like it's just so I mean, lifelike. Still it was 541 00:31:48,320 --> 00:31:52,480 Speaker 1: completely undegraded and just creepy. And his eyes are wide open, 542 00:31:53,040 --> 00:31:54,920 Speaker 1: just kind of like his mouth is a little slack, 543 00:31:54,960 --> 00:31:56,920 Speaker 1: but he looks like he could be thinking about something 544 00:31:57,000 --> 00:32:00,360 Speaker 1: rather than being headless. Well that's where the old race from. 545 00:32:00,400 --> 00:32:04,880 Speaker 1: A pickled head never loses its looks right. There's a 546 00:32:04,920 --> 00:32:08,680 Speaker 1: T shirt all right. So if you're a recruiter, uh, 547 00:32:08,840 --> 00:32:11,200 Speaker 1: let's say at the University of Pittsburgh, UM, and you're 548 00:32:11,240 --> 00:32:14,600 Speaker 1: trying to find these people and source them, you're gonna 549 00:32:14,600 --> 00:32:19,360 Speaker 1: be very picky, um because it's a it's a big deal. 550 00:32:19,400 --> 00:32:22,160 Speaker 1: It's it's not like a fly by night job like 551 00:32:22,600 --> 00:32:28,120 Speaker 1: this is something that medical students take very seriously. Uh, 552 00:32:28,360 --> 00:32:31,080 Speaker 1: you have to be intuitive. Um, like you said, you 553 00:32:31,120 --> 00:32:32,880 Speaker 1: had to weed through people that you might think have 554 00:32:33,040 --> 00:32:38,800 Speaker 1: some other sort of weird motive. Uh, but you know 555 00:32:38,840 --> 00:32:40,360 Speaker 1: you're gonna have to weed through a lot of people 556 00:32:40,680 --> 00:32:42,080 Speaker 1: because you know, this is also the kind of thing 557 00:32:42,080 --> 00:32:47,800 Speaker 1: where you can make twenty hour so, um, you also 558 00:32:47,840 --> 00:32:49,720 Speaker 1: want to I mean, obviously people want to get paid, 559 00:32:49,760 --> 00:32:53,280 Speaker 1: but their motives have to be more than just money, 560 00:32:53,400 --> 00:32:56,680 Speaker 1: I think. Well, yeah, I mean it's it's tricky too 561 00:32:56,720 --> 00:33:00,760 Speaker 1: because you you um expect you know how I caliber 562 00:33:00,840 --> 00:33:05,400 Speaker 1: of commitment and and um skill from your your pay 563 00:33:05,520 --> 00:33:09,800 Speaker 1: your teachers or your special standardized patients, right, yeah, and 564 00:33:09,840 --> 00:33:12,880 Speaker 1: they're very highly trained and there's a lot of like 565 00:33:13,440 --> 00:33:19,040 Speaker 1: um ongoing education that happens. Um. But at the same time, yeah, 566 00:33:19,040 --> 00:33:21,680 Speaker 1: you're paid handsomely if you look at it per hour, 567 00:33:22,000 --> 00:33:23,480 Speaker 1: but if you look at it over the course of 568 00:33:23,720 --> 00:33:26,240 Speaker 1: a month even you're probably not even gonna be able 569 00:33:26,280 --> 00:33:28,640 Speaker 1: to make rent off of this. No, it's it's a 570 00:33:28,640 --> 00:33:32,280 Speaker 1: part time gig if if that. But um, you know 571 00:33:32,320 --> 00:33:34,080 Speaker 1: you have to be a good listener as well as 572 00:33:34,560 --> 00:33:36,840 Speaker 1: all the things we mentioned like memorization and be a 573 00:33:36,880 --> 00:33:39,680 Speaker 1: decent actor. You have to be able to take direction. Well, 574 00:33:39,840 --> 00:33:42,400 Speaker 1: you have to be flexible if they change something up 575 00:33:42,440 --> 00:33:46,160 Speaker 1: on you. Um, like if it says in here, if 576 00:33:46,160 --> 00:33:49,080 Speaker 1: the simulation isn't achieving them is our goal. They you know, 577 00:33:49,120 --> 00:33:52,440 Speaker 1: they may come in between sessions and say, hey, listen, 578 00:33:53,240 --> 00:33:54,800 Speaker 1: I think we had the wrong approach here, So can 579 00:33:54,840 --> 00:33:58,480 Speaker 1: you can you do it this way right? Act better? 580 00:33:58,560 --> 00:34:01,840 Speaker 1: I think that was Christopher Walkin said that was the 581 00:34:01,840 --> 00:34:06,960 Speaker 1: only direction there was, really do it better? Yeah, but 582 00:34:07,480 --> 00:34:12,280 Speaker 1: I love that guy. Yeah, don't we all so? UM? 583 00:34:12,320 --> 00:34:15,000 Speaker 1: And you know, it's it's probably something you get into 584 00:34:15,760 --> 00:34:19,120 Speaker 1: if you have a desire to help people, if you 585 00:34:20,200 --> 00:34:24,959 Speaker 1: just have a zeal for interesting jobs, you know, yeah, 586 00:34:25,040 --> 00:34:27,680 Speaker 1: maybe if you have an interest in medicine or psychology 587 00:34:28,160 --> 00:34:31,520 Speaker 1: or being an educator like you're you're kind of you 588 00:34:31,560 --> 00:34:33,839 Speaker 1: are an educator in some ways. And if in fact, 589 00:34:33,840 --> 00:34:37,400 Speaker 1: I think some of them call them, uh educators like 590 00:34:37,480 --> 00:34:41,880 Speaker 1: medical educators. Yeah, there's a UM national association, a national 591 00:34:41,960 --> 00:34:47,760 Speaker 1: group called the Association of Standardized Patient Educators UM, and 592 00:34:47,800 --> 00:34:51,960 Speaker 1: I think they have like ongoing education and core curriculum 593 00:34:52,040 --> 00:34:55,719 Speaker 1: and UM. It's it's pretty interesting to see just how 594 00:34:55,760 --> 00:34:58,839 Speaker 1: how much training you can get in this. And I 595 00:34:58,840 --> 00:35:02,720 Speaker 1: imagine if you're really good and really highly trained you 596 00:35:02,719 --> 00:35:06,200 Speaker 1: you you're not going to be some part time, you know, 597 00:35:06,920 --> 00:35:11,640 Speaker 1: adjunct employee of a local medical school. You could conceivably 598 00:35:12,440 --> 00:35:15,440 Speaker 1: go around the country or possibly the world, especially if 599 00:35:15,480 --> 00:35:19,279 Speaker 1: you have a specialty. Sure, you know. One of the 600 00:35:19,320 --> 00:35:22,640 Speaker 1: downsides of this is that, uh, and this is kind 601 00:35:22,640 --> 00:35:25,200 Speaker 1: of a shame, but there there is no like controlled, 602 00:35:25,600 --> 00:35:31,200 Speaker 1: randomized trial that can actually prove the effectiveness. But by 603 00:35:31,239 --> 00:35:34,840 Speaker 1: all accounts across the board, everyone says this is super 604 00:35:34,880 --> 00:35:40,080 Speaker 1: important and highly highly effective as support students. It just 605 00:35:40,080 --> 00:35:46,640 Speaker 1: can't prove it. Yeah, that drives them crazy. Probably. So 606 00:35:46,640 --> 00:35:50,160 Speaker 1: so you've got you've got standardized patients one of the 607 00:35:50,160 --> 00:35:52,880 Speaker 1: other ones you touched on. That's worth diving into a 608 00:35:52,880 --> 00:35:58,439 Speaker 1: little more. Care actors, right, yeah, these are they fall 609 00:35:58,560 --> 00:36:01,880 Speaker 1: under that same umbrella of umulated patient. But these guys 610 00:36:01,880 --> 00:36:06,360 Speaker 1: are um Whereas like a standardized patient is really going 611 00:36:06,440 --> 00:36:10,720 Speaker 1: to help a you know, second or third year medical 612 00:36:11,080 --> 00:36:15,880 Speaker 1: um student who has no clinical experience whatsoever and is 613 00:36:16,000 --> 00:36:19,760 Speaker 1: learning the very basics of like physical exams or bedtimee 614 00:36:19,760 --> 00:36:22,240 Speaker 1: men or and all that stuff. A care acter is 615 00:36:22,239 --> 00:36:25,640 Speaker 1: is much more useful for somebody who's already in practice 616 00:36:25,960 --> 00:36:28,080 Speaker 1: and has a lot of experience, which just wants to 617 00:36:28,080 --> 00:36:32,240 Speaker 1: get better at it right, So like a care actor 618 00:36:32,680 --> 00:36:36,839 Speaker 1: will basically be there to add lib a little bit 619 00:36:37,200 --> 00:36:40,520 Speaker 1: based on whatever the doctor wants to work on, Say 620 00:36:40,560 --> 00:36:43,640 Speaker 1: the doctor wants to work on empathy. Rather than go 621 00:36:43,719 --> 00:36:46,759 Speaker 1: through the whole history and the whole patient encounter from 622 00:36:46,760 --> 00:36:49,040 Speaker 1: beginning to end, they're going to focus on that one 623 00:36:49,200 --> 00:36:54,440 Speaker 1: part of the patient and patient doctor interaction and they're 624 00:36:54,440 --> 00:36:57,040 Speaker 1: gonna do it over and over again. There's an ability 625 00:36:57,160 --> 00:37:00,080 Speaker 1: rather than having to start at the beginning and this 626 00:37:00,239 --> 00:37:02,560 Speaker 1: at the end, you can stop and try something over 627 00:37:02,600 --> 00:37:04,319 Speaker 1: again if you didn't like it or you want to 628 00:37:04,360 --> 00:37:06,719 Speaker 1: repeat it. Um. Like I said, there's a lot of 629 00:37:06,719 --> 00:37:11,160 Speaker 1: ad libbing, and um, the doctor can say, okay, I 630 00:37:11,200 --> 00:37:15,840 Speaker 1: want to We're gonna do a patient who has um 631 00:37:16,200 --> 00:37:20,080 Speaker 1: psychosis and is in the midst of a psychotic break 632 00:37:20,520 --> 00:37:23,080 Speaker 1: and it's on a scale of one to tenants and eleven, 633 00:37:23,600 --> 00:37:28,320 Speaker 1: and I need to be empathetic, so let's try and 634 00:37:28,400 --> 00:37:30,239 Speaker 1: then they're they're gonna go from there and they can 635 00:37:30,280 --> 00:37:32,439 Speaker 1: just kind of switch it up as need be. Yeah, 636 00:37:32,520 --> 00:37:34,640 Speaker 1: And I think this is really cool because the doctor 637 00:37:34,680 --> 00:37:38,200 Speaker 1: can get as specific as they want. They can say, like, 638 00:37:38,239 --> 00:37:39,640 Speaker 1: you know what, I feel like I have a pretty 639 00:37:39,640 --> 00:37:42,040 Speaker 1: good bedside manner, but I have a really hard time 640 00:37:42,080 --> 00:37:45,040 Speaker 1: dealing with patients when they get angry at me. UM. 641 00:37:45,239 --> 00:37:48,160 Speaker 1: So they'll say, all right, let's let's dial up an exercise. Yeah, 642 00:37:48,160 --> 00:37:51,560 Speaker 1: they're like, oh, you want something anger exactly you asked 643 00:37:51,560 --> 00:37:53,359 Speaker 1: for it, and they'll bring someone in there, or like 644 00:37:53,400 --> 00:37:57,080 Speaker 1: you said, if someone was if the doctor was like, hey, 645 00:37:57,080 --> 00:38:00,920 Speaker 1: I do pretty well even with UM patients to have 646 00:38:02,560 --> 00:38:05,160 Speaker 1: like a psychotic episode, but maybe not right in the 647 00:38:05,200 --> 00:38:08,719 Speaker 1: middle of a psychotic episode. I've had some real trouble there. 648 00:38:09,440 --> 00:38:12,200 Speaker 1: So they again, they come in there and like you said, 649 00:38:12,239 --> 00:38:14,919 Speaker 1: this is different. They're not surprised on what they're gonna get. 650 00:38:15,280 --> 00:38:19,000 Speaker 1: This is just a very specific training method. Yeah, or 651 00:38:19,120 --> 00:38:23,439 Speaker 1: the doctors like, I'm fine with kids unless they turn 652 00:38:23,520 --> 00:38:27,120 Speaker 1: their eyelids inside out, and then I can't. I just 653 00:38:27,200 --> 00:38:29,680 Speaker 1: completely lose it so cold you ever do that? But 654 00:38:29,880 --> 00:38:32,200 Speaker 1: now I wasn't one of those either. I can roll 655 00:38:32,239 --> 00:38:35,200 Speaker 1: my tongue perfectly and wi a my ears. Yeah, I 656 00:38:35,239 --> 00:38:37,439 Speaker 1: can do those things too. I can't turn my tongue 657 00:38:37,480 --> 00:38:41,080 Speaker 1: into like a clover club though, you know that kids 658 00:38:41,080 --> 00:38:42,960 Speaker 1: who could do that, Yeah, I can do that. I 659 00:38:43,000 --> 00:38:44,520 Speaker 1: can't do that. I don't know I didn't know you 660 00:38:44,520 --> 00:38:47,279 Speaker 1: could do that. Yeah, I hadn't pulled that one out 661 00:38:47,280 --> 00:38:49,440 Speaker 1: in a while though. No, you got to. But the 662 00:38:49,440 --> 00:38:52,040 Speaker 1: islet's saying, that's just there's no reason you do that 663 00:38:52,360 --> 00:38:56,400 Speaker 1: unless you're you know, you're not gonna impress ross and 664 00:38:57,440 --> 00:39:00,279 Speaker 1: you're not going anywhere in life if you're one up 665 00:39:00,320 --> 00:39:02,520 Speaker 1: to the girls in class with your eyelids turned inside out. 666 00:39:04,040 --> 00:39:07,520 Speaker 1: There's no way to woo a girl. Young guys, young boys, 667 00:39:07,520 --> 00:39:10,440 Speaker 1: if you're listening to this, don't don't don't don't do that. 668 00:39:10,800 --> 00:39:12,960 Speaker 1: You know what you do Be nice to girls and 669 00:39:13,120 --> 00:39:17,439 Speaker 1: listen to them, and trust me on that. I'm still 670 00:39:17,520 --> 00:39:22,200 Speaker 1: learning that one. Are we all as we grow Now? 671 00:39:22,280 --> 00:39:25,120 Speaker 1: I'm always nice, but I could always work on the listening. Sure, man, 672 00:39:26,000 --> 00:39:32,239 Speaker 1: Uh was personal. That was good advice, Chuck. You know 673 00:39:32,280 --> 00:39:34,440 Speaker 1: if you start out like a if you start a 674 00:39:34,640 --> 00:39:36,680 Speaker 1: fifth or sixth grade boy out on the right track 675 00:39:36,760 --> 00:39:40,960 Speaker 1: like that, yeah, it canna be good humans. I feel 676 00:39:41,000 --> 00:39:44,240 Speaker 1: like girls are inherently good. Sure you don't see girls 677 00:39:44,360 --> 00:39:48,799 Speaker 1: running around with their eyelids turned inside out. Never, not 678 00:39:48,880 --> 00:39:55,200 Speaker 1: even wonder woman would do that. Uh, that's true. What else? 679 00:39:56,520 --> 00:40:01,800 Speaker 1: So you got standardized patients care actors and then there's UM. 680 00:40:01,840 --> 00:40:06,080 Speaker 1: I ran across another one called unannounced standardized Patients. I'm 681 00:40:06,080 --> 00:40:08,960 Speaker 1: not kidding. They they're basically you know what a secret 682 00:40:09,000 --> 00:40:13,839 Speaker 1: shopper is. Yes, they are highly trained standardized patients who 683 00:40:13,840 --> 00:40:16,920 Speaker 1: are secret shoppers at hospitals and doctors offices and stuff 684 00:40:16,920 --> 00:40:19,799 Speaker 1: like that to go in from beginning to end to 685 00:40:19,960 --> 00:40:23,839 Speaker 1: rate the experience from the patient's eyes. Yeah. That's yeah, 686 00:40:23,880 --> 00:40:26,760 Speaker 1: that's scary. Yeah yeah. But it's cool though that any 687 00:40:26,840 --> 00:40:30,400 Speaker 1: hospital would do this because you know, it's it shows 688 00:40:30,719 --> 00:40:34,520 Speaker 1: um a bit of a dedication to customer service, yeah, 689 00:40:34,600 --> 00:40:36,879 Speaker 1: which I think that people forget that. You know, when 690 00:40:36,920 --> 00:40:40,560 Speaker 1: you go in for medical care, you're the customer. You 691 00:40:40,600 --> 00:40:43,640 Speaker 1: should be treated well. Like we demand to be treated 692 00:40:43,680 --> 00:40:48,360 Speaker 1: well from cable providers, from car dealers, from grocery stores, 693 00:40:48,440 --> 00:40:52,359 Speaker 1: from everybody. But we just go into a hospital like 694 00:40:52,440 --> 00:40:57,480 Speaker 1: complete supplicants, like please don't murder me, you know. And 695 00:40:57,480 --> 00:41:00,600 Speaker 1: and if if you demand to be treat did like 696 00:41:00,880 --> 00:41:06,759 Speaker 1: a a good a customer, well then well then they 697 00:41:06,760 --> 00:41:12,680 Speaker 1: do kill you. It's a conundrum. They're like, oh, I 698 00:41:12,680 --> 00:41:15,480 Speaker 1: guess somebody shouldn't have mouthed off, and then the pillow 699 00:41:15,520 --> 00:41:19,080 Speaker 1: goes over the faith you sent that one cool article 700 00:41:19,360 --> 00:41:24,080 Speaker 1: UM of the doctor Uh what was he? What do 701 00:41:24,160 --> 00:41:29,080 Speaker 1: you call himself? The MUDA that the guy who basically 702 00:41:29,200 --> 00:41:36,000 Speaker 1: has recruited medical professionals that are self uh not actors, 703 00:41:36,040 --> 00:41:39,000 Speaker 1: but you know, well they're they're medical actors. That did. 704 00:41:39,080 --> 00:41:41,520 Speaker 1: Dude wasn't even a doctor, he was just a he 705 00:41:41,640 --> 00:41:45,719 Speaker 1: was a doctor. No, he was a freelance UM like 706 00:41:45,920 --> 00:41:51,520 Speaker 1: teaching actor or or UM teaching patient, right, and he 707 00:41:51,600 --> 00:41:55,600 Speaker 1: got really good at it and he specialized UM in 708 00:41:56,000 --> 00:42:01,680 Speaker 1: male eurogenital exams, right, so prostrate exam, testicular exam. And 709 00:42:01,719 --> 00:42:05,359 Speaker 1: this guy would travel the country UM doing this and 710 00:42:05,480 --> 00:42:08,960 Speaker 1: he set up shop actually in Atlanta, a company called 711 00:42:09,200 --> 00:42:14,279 Speaker 1: UM Clinical Skills USA, right, and recruited other people. And 712 00:42:14,360 --> 00:42:19,640 Speaker 1: these people are they just go around the country allowing 713 00:42:20,400 --> 00:42:24,800 Speaker 1: medical students to give them rectal exams, breast exams, UM, 714 00:42:25,040 --> 00:42:29,560 Speaker 1: vaginal exam, cervical exams, UM, so that they can these 715 00:42:29,560 --> 00:42:33,640 Speaker 1: students can practice on a live person, but more than 716 00:42:33,680 --> 00:42:36,480 Speaker 1: just a live person because in this articles articles by 717 00:42:36,719 --> 00:42:40,400 Speaker 1: UM Elizabeth Coles and I think evocative, Well, these medical 718 00:42:40,480 --> 00:42:42,680 Speaker 1: models use their own bodies as teaching tools and it's 719 00:42:42,719 --> 00:42:46,680 Speaker 1: really great. But she makes mention that apparently medical schools 720 00:42:47,080 --> 00:42:52,120 Speaker 1: to train um MED students on gynecological exams. Back in 721 00:42:52,160 --> 00:42:55,200 Speaker 1: the day, they would hire prostitutes. Did not know that. 722 00:42:56,120 --> 00:42:58,160 Speaker 1: I didn't know that either. I thought these people, though, 723 00:42:58,440 --> 00:43:02,560 Speaker 1: had medical background, because are training them as well, aren't they? Yes? 724 00:43:03,400 --> 00:43:05,279 Speaker 1: A little to the left, little to the right, right 725 00:43:05,480 --> 00:43:08,560 Speaker 1: there it is, Yes, So these people are trained in 726 00:43:09,000 --> 00:43:12,879 Speaker 1: the exam. They're not medical professionals. UM one's a one 727 00:43:13,000 --> 00:43:16,040 Speaker 1: one that they interview is a real estate agent or no, 728 00:43:16,120 --> 00:43:19,360 Speaker 1: an insurance agent. One guy's retired from that GM plant, 729 00:43:19,360 --> 00:43:23,200 Speaker 1: which I suspect probably the one in Doraville. Um. No, 730 00:43:23,360 --> 00:43:25,880 Speaker 1: they're just they they know what the exam is supposed 731 00:43:25,880 --> 00:43:28,960 Speaker 1: to be like, and then they've subjected themselves to the 732 00:43:29,000 --> 00:43:32,560 Speaker 1: exam so many times that they know the right way 733 00:43:32,560 --> 00:43:35,799 Speaker 1: to do it so well that they can teach med 734 00:43:35,880 --> 00:43:37,919 Speaker 1: students how to do it. But this is still under 735 00:43:37,960 --> 00:43:44,239 Speaker 1: the supervision of trained professionals, right. I have the impression that, 736 00:43:44,400 --> 00:43:49,680 Speaker 1: like the the the med school teacher who brings these 737 00:43:49,719 --> 00:43:53,080 Speaker 1: people in says, listen to what this person has to say. 738 00:43:53,520 --> 00:43:56,640 Speaker 1: They're the trained professionals. All right, Wow, that's interesting. Yeah, 739 00:43:56,680 --> 00:44:00,160 Speaker 1: So this one guy who's UM a male eurogenetic an 740 00:44:00,160 --> 00:44:05,759 Speaker 1: auld teaching associate that they interview, um, Mike Manning. He 741 00:44:05,840 --> 00:44:09,160 Speaker 1: said that he he estimates his head somewhere around four 742 00:44:09,680 --> 00:44:16,640 Speaker 1: thousand prostate exams man in nine years. Wow. So yes, 743 00:44:16,719 --> 00:44:19,879 Speaker 1: that guy probably knows more about how to yeah, yeah, 744 00:44:20,080 --> 00:44:23,359 Speaker 1: give a prostate exam than anybody in the world. Well. 745 00:44:23,400 --> 00:44:26,359 Speaker 1: I saw the one picture, um of the guy like, 746 00:44:26,520 --> 00:44:30,200 Speaker 1: you know, bent over the table. Uh, and it's from 747 00:44:30,239 --> 00:44:35,120 Speaker 1: you know, his front and then the doctor student doctor 748 00:44:35,160 --> 00:44:38,160 Speaker 1: behind him, and he's kind of looking back like you know, 749 00:44:38,480 --> 00:44:41,640 Speaker 1: that's that's it. That's correct. Yeah, I think that was 750 00:44:41,680 --> 00:44:44,800 Speaker 1: the guy. I think that was Mike Manning or Mark Manning. Yeah, 751 00:44:45,200 --> 00:44:48,759 Speaker 1: isn't it interesting? Yeah? I mean what a I don't 752 00:44:48,760 --> 00:44:50,880 Speaker 1: want to call it weird, but what a just what 753 00:44:50,960 --> 00:44:55,680 Speaker 1: a fascinating thing too to have a knack for and 754 00:44:55,680 --> 00:44:59,759 Speaker 1: and not mind and just be like yeah four thousand times, 755 00:44:59,800 --> 00:45:03,480 Speaker 1: so do it. Yeah, it's pretty pretty interesting that these 756 00:45:04,000 --> 00:45:08,120 Speaker 1: the people who all work for him too, um are 757 00:45:08,160 --> 00:45:10,640 Speaker 1: are They've kind of become a bit of a family. 758 00:45:11,080 --> 00:45:13,160 Speaker 1: I love that they like go to bars and go 759 00:45:13,239 --> 00:45:16,239 Speaker 1: to dinner and hang out. Yeah, they do. Um. One 760 00:45:16,280 --> 00:45:19,680 Speaker 1: of the one of them as uh, she's actually she 761 00:45:19,719 --> 00:45:22,880 Speaker 1: would be considered a gynecological Teaching Associated g t A 762 00:45:23,000 --> 00:45:26,600 Speaker 1: rather than m u t A. Her name is Katie Patterson, 763 00:45:27,080 --> 00:45:30,359 Speaker 1: but like she travels the country teaching med students how 764 00:45:30,400 --> 00:45:34,200 Speaker 1: to correctly insert a speculum um. I mean, like these 765 00:45:34,239 --> 00:45:38,240 Speaker 1: people are literally donating their body to science. But while 766 00:45:38,280 --> 00:45:41,000 Speaker 1: there's still a lot, I mean it's amazing. And yeah, 767 00:45:41,040 --> 00:45:43,120 Speaker 1: they're getting paid, but I mean they're not getting paid 768 00:45:43,440 --> 00:45:46,080 Speaker 1: enormous amounts of money. They're getting paid something between thirty 769 00:45:46,080 --> 00:45:49,399 Speaker 1: five and fifty bucks per student per day. So say 770 00:45:49,440 --> 00:45:53,399 Speaker 1: you have ten ten students, you make ficks in a day. 771 00:45:53,480 --> 00:45:56,400 Speaker 1: It's not bad at all, But you're only working thirty 772 00:45:56,480 --> 00:45:59,760 Speaker 1: days out of out of the year. Maybe maybe fifty 773 00:46:00,239 --> 00:46:02,600 Speaker 1: doesn't add up too much. So clearly these people are 774 00:46:02,680 --> 00:46:07,799 Speaker 1: driven by by much more um benevolent thing than than 775 00:46:07,880 --> 00:46:12,319 Speaker 1: moneyless their hearts. You know, yeah you got anything else, 776 00:46:13,360 --> 00:46:16,680 Speaker 1: I got nothing else? Son, turn out better than I thought, Chuck. Yeah, 777 00:46:16,840 --> 00:46:19,560 Speaker 1: I think if you um, maybe if you're out there 778 00:46:19,600 --> 00:46:23,440 Speaker 1: and you all this sounds like, hey, I could probably 779 00:46:23,480 --> 00:46:26,120 Speaker 1: do that. And I have a desire to help people learn, 780 00:46:26,200 --> 00:46:29,680 Speaker 1: and I don't mind being you know, poked and prodded, 781 00:46:29,760 --> 00:46:32,120 Speaker 1: and I want to make a few bucks. Look into it. 782 00:46:32,320 --> 00:46:35,040 Speaker 1: We should reiterate that the people who are the male 783 00:46:35,120 --> 00:46:39,240 Speaker 1: eurogenital teaching Associates and the ladies who are the gynecological 784 00:46:39,280 --> 00:46:44,920 Speaker 1: teaching associates, they're very specific. And yes, you could say 785 00:46:45,280 --> 00:46:47,680 Speaker 1: I want to sign up for rectal exams and they'd say, 786 00:46:47,800 --> 00:46:52,320 Speaker 1: come on in, we need rectal exam volunteers. Bad. But um, 787 00:46:52,640 --> 00:46:57,439 Speaker 1: just becoming a simulated patient of some sort. You could 788 00:46:57,480 --> 00:46:59,719 Speaker 1: say I never want to do rectal exams. I just 789 00:46:59,760 --> 00:47:02,400 Speaker 1: want to do you know, bedside man or something like that, 790 00:47:02,480 --> 00:47:04,759 Speaker 1: and they would they would probably just stick to that, 791 00:47:04,840 --> 00:47:06,319 Speaker 1: you know. Yeah, they're not going to force you to 792 00:47:06,400 --> 00:47:10,000 Speaker 1: ever do anything that you're not comfortable with. And again, regretfully, 793 00:47:10,120 --> 00:47:14,400 Speaker 1: they don't give you any drugs. But if you do 794 00:47:14,600 --> 00:47:16,560 Speaker 1: want that kind of thing, Yeah, if you are interested, 795 00:47:17,000 --> 00:47:19,440 Speaker 1: check out your local mid school. They probably have some 796 00:47:19,440 --> 00:47:22,719 Speaker 1: sort of program. Or again, go to the Association of 797 00:47:22,840 --> 00:47:27,520 Speaker 1: Standardized Patient Educators. Bring in if you're an actor, beach 798 00:47:27,560 --> 00:47:31,000 Speaker 1: waiting tables. Yeah, and in the meantime, you can type 799 00:47:31,040 --> 00:47:34,880 Speaker 1: standardized patients into the search bart how stuff works dot com. 800 00:47:34,920 --> 00:47:42,719 Speaker 1: And since I said search bar, it's time for a listener. Uh, 801 00:47:42,719 --> 00:47:47,960 Speaker 1: I'm gonna call this uh South Africa and Canadian All right, 802 00:47:48,920 --> 00:47:51,279 Speaker 1: does pique your interest? Yeah, but I know what this 803 00:47:51,320 --> 00:47:53,840 Speaker 1: one's about. Hey, guys, never really had a reason to 804 00:47:53,840 --> 00:47:57,239 Speaker 1: get into contact into now since you announced your tour 805 00:47:57,440 --> 00:48:00,360 Speaker 1: up to Canada, and that fired my cylinders into action. 806 00:48:01,160 --> 00:48:02,680 Speaker 1: Listen to you, guys for a couple of years, probably 807 00:48:02,719 --> 00:48:09,239 Speaker 1: from early to fifteen to been listening forever. I was 808 00:48:09,320 --> 00:48:12,640 Speaker 1: then living in South Africa. At nineteen, fresh out of 809 00:48:12,680 --> 00:48:14,400 Speaker 1: high school, I made the daring decision to leave my 810 00:48:14,440 --> 00:48:17,440 Speaker 1: family and friends try and make something of myself. I 811 00:48:17,480 --> 00:48:20,880 Speaker 1: have Canadian citizenship as well, due to my father being 812 00:48:20,920 --> 00:48:25,640 Speaker 1: born in Toronto or Toronto Toronto, so I landed there 813 00:48:25,640 --> 00:48:27,560 Speaker 1: in Toronto early last year and made my way a 814 00:48:27,600 --> 00:48:31,759 Speaker 1: little east and then a lot west to Vancouver, where 815 00:48:31,760 --> 00:48:33,640 Speaker 1: I would be seeing you in September of this year. 816 00:48:34,560 --> 00:48:36,279 Speaker 1: The point is being away from family and friends is 817 00:48:36,320 --> 00:48:38,959 Speaker 1: brutal at a nine hour time difference, and brutal turns 818 00:48:39,000 --> 00:48:42,320 Speaker 1: to lethal. I often feel lonely or anxious of the future. 819 00:48:42,320 --> 00:48:44,360 Speaker 1: And when this happens, stuff you should know, and the 820 00:48:44,440 --> 00:48:47,120 Speaker 1: three of you, lovely people make it not seem so bad, 821 00:48:47,160 --> 00:48:48,840 Speaker 1: as it feels like there's someone right here with me 822 00:48:49,239 --> 00:48:52,640 Speaker 1: chatting casually about some neato topic it is. So I 823 00:48:52,719 --> 00:48:54,359 Speaker 1: just want to say thank you for making this move 824 00:48:54,360 --> 00:49:00,400 Speaker 1: tolerable when it feels sometimes not so great. Who's that 825 00:49:00,400 --> 00:49:05,000 Speaker 1: that is? K H? And I don't know if k 826 00:49:05,200 --> 00:49:11,480 Speaker 1: E y A is Yeah, ka ka Kaya? I don't 827 00:49:11,520 --> 00:49:17,040 Speaker 1: know how Kaya identifies on the gender spectrum. Well, who cares? Right? 828 00:49:17,280 --> 00:49:20,680 Speaker 1: That's right, k H. They age sounds for how are you? 829 00:49:20,840 --> 00:49:22,040 Speaker 1: I just want to use the right pronoun, you know 830 00:49:22,080 --> 00:49:27,640 Speaker 1: what I'm saying? Sure, So what's that one? Is it sis? Sis? 831 00:49:27,719 --> 00:49:33,480 Speaker 1: Gender like gender neutral? I'm not sure about they. I 832 00:49:33,520 --> 00:49:35,880 Speaker 1: think they is like making a big, a big push 833 00:49:35,960 --> 00:49:39,359 Speaker 1: right now? Well, a nice email from thy Yeah, thanks 834 00:49:39,360 --> 00:49:43,640 Speaker 1: a lot, Kaya, that's pretty awesome. Congratulations for striking out 835 00:49:43,680 --> 00:49:46,359 Speaker 1: on your own. It's pretty amazing. And thanks for coming 836 00:49:46,360 --> 00:49:48,880 Speaker 1: to our show in Vancouver, and even more than that, 837 00:49:49,280 --> 00:49:51,160 Speaker 1: thanks for giving us a reason to plug our show 838 00:49:51,160 --> 00:49:54,280 Speaker 1: in Vancouver and the rest of our tour where people 839 00:49:54,280 --> 00:49:56,160 Speaker 1: can get tickets at s y s K live dot 840 00:49:56,239 --> 00:49:59,160 Speaker 1: com and right all right, Well, if you want to 841 00:49:59,200 --> 00:50:01,040 Speaker 1: get in touch with us, like KAA did, you can 842 00:50:01,120 --> 00:50:03,799 Speaker 1: tweet to us at s Y s K podcast. You 843 00:50:03,840 --> 00:50:06,480 Speaker 1: can join us on Facebook dot com slash stuff as 844 00:50:06,480 --> 00:50:08,760 Speaker 1: you know, you can send us an email to Stuff 845 00:50:08,760 --> 00:50:11,760 Speaker 1: Podcasts at how stuff Works dot com, and, as always, 846 00:50:12,040 --> 00:50:13,960 Speaker 1: join us at our home on the web, Stuff you 847 00:50:14,000 --> 00:50:20,800 Speaker 1: Should Know dot com. For more on this and thousands 848 00:50:20,800 --> 00:50:33,640 Speaker 1: of other topics, is it how stuff Works dot com.