Speaker 1: Hey, everybody, it's us Josh and Chuck, and we want
Speaker 1: you to know we are coming somewhere near you. We're
Speaker 1: sure if you live in North America this year, that's right,
Speaker 1: We're going on tour, and uh, why don't we just
Speaker 1: rattle through these dates? Okay? Uh? Toronto August eight at
Speaker 1: the Dan and Fourth Music Hall, Chicago August nine, the
Speaker 1: next day at Harris Theater. Then we are taking some
Speaker 1: time off to recover after that two day grind. We're
Speaker 1: eating Vancouver the Vogue Theater September twenty six, followed by Minneapolis.
Speaker 1: We're gonna be at the Pantageous Theater again on September
Speaker 1: that is correct, yep. And then Austin Chuck on October
Speaker 1: tenth of the Paramount Theater, Yes, and very special show
Speaker 1: and Lawrence Kansas at Liberty Hall on October eleven, yep.
Speaker 1: And then we're gonna do a three night stand October
Speaker 1: two at the Bellhouse in Brooklyn, New York. And then Chuck,
Speaker 1: take it home. Uh, well take it home literally, because
Speaker 1: we are finishing up November four right here in Atlanta
Speaker 1: at the Bucket Theater and this is a very special
Speaker 1: benefit show. Uh, and all the Proceeds will be going
Speaker 1: to Lifeline Animal Project of Atlanta and the National Down
Speaker 1: Syndrome Society YEP. And for more information in DWO buy tickets,
Speaker 1: just go to s Y s K live dot com.
Speaker 1: Welcome to stuff you should know. I'm from House Stuff
Speaker 1: Works dot com. Hey, welcome to the podcast. Blame is
Speaker 1: Josh Clark, and I'm proud to introduce my partner co
Speaker 1: hosting Crime, one of those two Mr Charles W. Chuck
Speaker 1: Wayne Chuck Tran Bryant Chuck Tran yep. And this week, Chuck,
Speaker 1: we have a very special guest producer filling out the seats.
Speaker 1: Right is the rump of Noel around. Yeah, Jerry's she's
Speaker 1: at the beach because she needs a vacation. I'm good, guys. Yeah,
Speaker 1: Jerry's romping at the beach with her wife and her
Speaker 1: daughter and a bunch of friends. And you know, I
Speaker 1: think that sounds lovely. Well, yeah, the beach rocks. Even
Speaker 1: Miley Cyrus likes the beach. Now, I don't get it.
Speaker 1: She's got this new single out about how her boyfriend
Speaker 1: introduced her to the beach. Is pretty sweet song. Actually,
Speaker 1: you know this stuff? I just I my my wife
Speaker 1: produces me to think sometimes each otherwise would never ever
Speaker 1: have come across like, I can pick on you for that,
Speaker 1: but I would never pick on you me for that.
Speaker 1: You know, what, are you a monster? You know? Pick
Speaker 1: on a man's wife? Right? So, yeah, it is a cute, cute,
Speaker 1: sweet song. Though I can I can give it a
Speaker 1: hearty endorsement. Emily has her little secrets to from even me.
Speaker 1: She's she singing this song the other day that was
Speaker 1: on some TV show. I was like, how do you
Speaker 1: know this? I've never heard the song, and she said, no,
Speaker 1: you know it's a song. I know what song. I
Speaker 1: don't even know what it was. It was just some
Speaker 1: kind of bubblegum poppy thing you don't and that's kind
Speaker 1: of not her. But you never you never know, you know,
Speaker 1: I might have a fromer boyfriend, s Todd Todd Hodds
Speaker 1: into bubblegum pop. He's a jerk, he's got frosted tips
Speaker 1: on his hair, he's got a severe embre. So which
Speaker 1: one are we doing? We're gonna do standardized patients and um,
Speaker 1: it's funny. The the thought occurred to me to go
Speaker 1: through this entire episode without mentioning sein felt at all,
Speaker 1: just to make people really angry. Man. We would have
Speaker 1: gotten so many emails though. But that's kind of like
Speaker 1: you can't not mention the very famous Seinfeld episode where
Speaker 1: Kramer and uh, who's the other guy, Mickey? Oh? Yeah,
Speaker 1: I forgot Mickey was one too. Was that his name? Yeah,
Speaker 1: it's his friend who was a little person. Yeah, and
Speaker 1: they they were. I think Mickey got him into it,
Speaker 1: and they were they were And I didn't even know
Speaker 1: they were called standardized patients. I doubt if they said
Speaker 1: that on the episode. I don't remember what they called them.
Speaker 1: They surely they call them something. Well, they have a
Speaker 1: few names, simulated patients, standardized patients, care actors. Well, there,
Speaker 1: those are. Some of those are different. They're they're generally
Speaker 1: the under the umbrella of say like a simulized or
Speaker 1: stand simulated patient, but they're slightly there's little nuances there
Speaker 1: that that make the whole thing revolting, lee fascinating. Programmed
Speaker 1: patients and that what the first guy called it. Yeah. Man,
Speaker 1: if that's not like a brain doctor's name for it,
Speaker 1: then I don't know what. Uh, well, should we start there. Yeah,
Speaker 1: let's go back to that guy, a doctor named Howard Barrow.
Speaker 1: He worked out at USC Ego Trojans and he was
Speaker 1: teaching back in the early sixties, late fifties, I believe,
Speaker 1: and apparently at the time, Chuck, they would just teach
Speaker 1: you everything and then say, okay, you've graduated, your going
Speaker 1: goodbye to practice medicine. Good luck with a live human exactly,
Speaker 1: you've never encountered one throughout your entire training, but you're
Speaker 1: a doctor now, so we we wash our hands of you. Right.
Speaker 1: And so this guy was teaching neurology and realized, like
Speaker 1: I think he had a friend who had come to
Speaker 1: to start like observing his graduates in a clinical setting,
Speaker 1: but like after they graduated and we're practicing doctors and
Speaker 1: we were like whoa, well, whoa, you guys are doing
Speaker 1: this all wrong. Who taught you this? And like you did?
Speaker 1: And uh, He's like, all right, well, we gotta do
Speaker 1: something different. So that doctor figured out that he could
Speaker 1: sit down and go through basically observe a doctor doing
Speaker 1: an entire patient history and exam and everything. But each
Speaker 1: one took like two to three hours, and they're like,
Speaker 1: there's gotta be a better way to do this. So
Speaker 1: Barrows was it was his idea, and his idea alone.
Speaker 1: Right from what I understand I saw, I came across
Speaker 1: another doctor, a woman pediatrician, woman named Paula's Stillman, who
Speaker 1: came up with this idea also seemingly independently in the
Speaker 1: early seventies. Um, because it didn't catch on big time
Speaker 1: in the eighties. So I think she am Barrow are
Speaker 1: kind of like the earliest practitioners of this thing. Well,
Speaker 1: it wasn't a big hit at first, Like people kind
Speaker 1: of made fun of them, uh. I know in this
Speaker 1: one article you found they there were newspaper articles, one
Speaker 1: in the l A Herald Examiner that had a headline
Speaker 1: that said Hollywood invades USC Medical School. Uh. In in
Speaker 1: the San Francisco Chronicle, of all places, they said scantily
Speaker 1: clad models were making life a little more interesting for
Speaker 1: the USC medical students, which is really I mean, I
Speaker 1: guess it's a sign of the times, but really kind
Speaker 1: of a crappy way too. You know, they made it
Speaker 1: sound like it was some titilating sexual thing, right, because
Speaker 1: you know, they had these people that are really doing
Speaker 1: what you know, what I learned was a super valuable service. Well, yeah,
Speaker 1: for sure, I think they were just trying to sex
Speaker 1: it up for the paper. You know what I mean,
Speaker 1: they're reading audience because they were like Zodiac Killer coming soon,
Speaker 1: what's that stay tuned? But he wasn't around yet, so
Speaker 1: they had to do something. So they were just trying
Speaker 1: to take something that was actually, yeah, a valuable service
Speaker 1: and pretty straightforward and again sex it up a little bit,
Speaker 1: but it actually it kept it from catching on for
Speaker 1: a while, at least at first. It wasn't until I
Speaker 1: think the mid eighties that Barrow was able to like
Speaker 1: get it to start to become adopted throughout the the
Speaker 1: the medical universe and the United States at least. Yeah,
Speaker 1: and you know what, we've done that thing again. Yeah,
Speaker 1: I know where we haven't said what it is yet.
Speaker 1: You had to have seen Seinfeld and know how to
Speaker 1: read between the lines of our conversation. Yeah. So a
Speaker 1: simulated patient or a standardized patient is um Sometimes you're
Speaker 1: an actor. Sometimes they have no acting experience. Sometimes it
Speaker 1: we'll get to who these people are, but they're generally
Speaker 1: people looking to make a buck, who are who fit
Speaker 1: the profile and of being a fake patient to a
Speaker 1: medical student so they can get a real practical human
Speaker 1: to human experience in medical school exactly because there's a
Speaker 1: big difference between book learning in real life, right, and
Speaker 1: if you're a doctor, a huge, huge part of your UM,
Speaker 1: your job, especially UM non surgical doctrine is conversing with
Speaker 1: a human being patient and and on the one hand,
Speaker 1: treating them as a human being, not a set of symptoms.
Speaker 1: That's a big one. But then also um, getting out
Speaker 1: of them what's wrong with them so that you can
Speaker 1: diagnose them. Yeah, that's I thought this was all sort
Speaker 1: of just about bedside manner and like being you know,
Speaker 1: because it's a big part of the job. You know,
Speaker 1: you want a doctor. If you've ever had a doctor
Speaker 1: that had a poor bedside manner, you know what I'm
Speaker 1: talking about. UM, If you haven't, then you might take
Speaker 1: it for granted that everyone's like that, but that's not
Speaker 1: the case. But the second part of that I didn't
Speaker 1: really think about. But um. The director of the Standardized
Speaker 1: Patient Program at University of Pittsburgh School of Medicine, Valerie Former,
Speaker 1: who they don't know if they interviewed her for this
Speaker 1: or if she was just they pulled some quotes, but
Speaker 1: I never really thought about it. She said, communication is
Speaker 1: at the root of proper diagnosis, patient safety, and patient
Speaker 1: satisfaction and miscommunication can lead to medical error, so they
Speaker 1: have to A big part of the job is drawing
Speaker 1: out of the patient what the heck is wrong with them,
Speaker 1: because they can examin until the cows come home, but
Speaker 1: they need words, right, So like, yeah, patient who comes
Speaker 1: into the doctor's officer, that e er isn't gonna be like, um,
Speaker 1: I have an abscess on my right kid. Need that
Speaker 1: needs to be treated or else I'm gonna die of
Speaker 1: sepsis in the next twelve hours. Is my my my
Speaker 1: side hurts, That's what you get. So you have to
Speaker 1: ask more questions and know what questions to ask. So yeah,
Speaker 1: it's it's diagnosis, learning how to diagnose from talking to
Speaker 1: people in drawing info out of them. But that bedside
Speaker 1: manner that's not to be overlooked, Like that's a big
Speaker 1: part of it because you know, if if people start
Speaker 1: to think every doctor I've ever interacted with treated me
Speaker 1: like I was just a bag of organs and bones,
Speaker 1: which we couldn't couldn't sure, and couldn't care. But you're
Speaker 1: not supposed to to let on that every like we
Speaker 1: all have to pretend in this big grand manner, right exactly,
Speaker 1: And but it will keep you from going to the doctor.
Speaker 1: And if you stop going to the doctor, and then
Speaker 1: health problems can can start to accumulate, and it's all
Speaker 1: the doctor's fault for being a sociopathic jerk. Well yeah,
Speaker 1: but you also you know in that um which one
Speaker 1: were we talking about doctors being too empathetic? The empathy one?
Speaker 1: Oh yeah, okay, there you have it. You didn't want
Speaker 1: to dr fell to pieces. No, you you need to
Speaker 1: learn to walk that fine line between being too clinical
Speaker 1: and too much of an EmPATH to where the patient
Speaker 1: feels eddies and taking care of but you feel confident
Speaker 1: and they're not like breaking down and crying because they
Speaker 1: have to tell you that you may be dying. Let's say. Yeah,
Speaker 1: but the the lady from the University of Pittsburgh who
Speaker 1: was interviewed in this article points out that there was
Speaker 1: she she remembered at least one medical student who did
Speaker 1: break down because of an interaction with a simulated patient
Speaker 1: or standardized patient. UM and that that that that's the
Speaker 1: point of a similizer or simulated or standardized patient is
Speaker 1: so that you can go ahead and break down like
Speaker 1: that and get it out UM In in a basically
Speaker 1: a classroom setting, so that when you encounter this in
Speaker 1: the real world, you'll have already gone through that. Yeah,
Speaker 1: and um, we'll get into the nuts and bolts of
Speaker 1: it in a bit. But um, if you're wondering if
Speaker 1: you want to go do this, if you have to,
Speaker 1: like you know, get a prostate exam. Um, you don't
Speaker 1: have to, but if you're if you're open to that
Speaker 1: kind of your intention, you can sign up for a
Speaker 1: more intense uh and I imagine those are the ones
Speaker 1: that pay a little bit better. But you can go
Speaker 1: in and volunteer for a prostate exam or or or
Speaker 1: breast exam or anything that involves something a little more
Speaker 1: uh um invasive. Yeah, but you're not gonna get cut
Speaker 1: or you're not gonna get a needled or anything like that.
Speaker 1: They're not going to practice that kind of stuff on you. Right.
Speaker 1: I was reading the f a Q on the University
Speaker 1: of Pittsburgh site about their um simulated patients, and they
Speaker 1: point out that patients simulated patients will not be given drugs. Yeah,
Speaker 1: then that can inject you with like a cocktail of
Speaker 1: antipsychotics and stimulation, and this may be a good way
Speaker 1: to score, right, But it's on you, is the simulated
Speaker 1: patient to um to act as if you're um going
Speaker 1: through a psychotic break right there. Yeah, potentially so that
Speaker 1: the doctor can learn how to deal with that kind
Speaker 1: of thing. That's probably one of the more dramatic examples.
Speaker 1: I think a lot of them are a lot more pedestrian,
Speaker 1: but that is definitely in the mix as well. Well.
Speaker 1: Even though you're as we'll see, it's you sort of, Um,
Speaker 1: it's not scripted. You do have to be an improviser
Speaker 1: of sorts, but you're supposed to stick to kind of
Speaker 1: I don't think you're supposed to throw them any just
Speaker 1: curveballs that you think of in the moment, uh, which
Speaker 1: is what I would want to do, which is probably
Speaker 1: I would not be a good sp That's what Kramer did. Yeah,
Speaker 1: he he could have made it into like a real
Speaker 1: acting gig, right right. And they say that actors can
Speaker 1: be good at this, but it's not acting, like they
Speaker 1: point out that, Um, there's no you're not searching for
Speaker 1: moments of drama. You're not there to entertain. You know,
Speaker 1: they're playing. You're not playing to the audience. So yeah,
Speaker 1: it could be helpful to learn, say, um, I don't know.
Speaker 1: Would it be character acting or method acting in this one?
Speaker 1: Mm hmmm, probably method acting. So it would be useful
Speaker 1: to learn some nuts and bolts of of that, just
Speaker 1: practice and rehearse that type of acting. But you're not gonna, like,
Speaker 1: you're not gonna go get your big break or something
Speaker 1: doing this. That's not the point of it. Now. I
Speaker 1: think I would, Uh, I would try and fart a
Speaker 1: lot or something, just something very subtle. That'd be your
Speaker 1: your trademark because yeah, that would be in the in
Speaker 1: the in the lounge. Afterward they'd all be like, did
Speaker 1: you get the kind I think he was farting? Right?
Speaker 1: Was that on purpose? Or that'd be your standardized patient card.
Speaker 1: It's say, Charles W. Chuck Bryant ask about my trademark
Speaker 1: arts on command? Uh, all right, that was dumb. So
Speaker 1: we should take a break. Yeah, so I can get
Speaker 1: it together. Okay, So Chuck, let's get down into the
Speaker 1: nuts and bolts. So the nitty gritty a little bit, right.
Speaker 1: So I said earlier that all of this kind of
Speaker 1: falls under the umbrella of a standardized or a simulated
Speaker 1: patient um and then underneath that umbrella, which we've kind
Speaker 1: of been using interchangeably, but really shouldn't UM. Is the
Speaker 1: standardized patient is largely what we're talking about, and I
Speaker 1: think synonymous with the standardized patient and is the programmed patient.
Speaker 1: That first UM the first term that George Barrow used
Speaker 1: for right. And the reason that it's called standardized or
Speaker 1: programmed is because it's like you said, there isn't a script,
Speaker 1: like you don't memorize the script of the doctor says
Speaker 1: this and then you say that, but you do have
Speaker 1: like a You are given a specific set of criteria
Speaker 1: and it can be really detailed as well, and you're
Speaker 1: expected to stick to that role, that character. You take
Speaker 1: on a character, and your character is sick, your character
Speaker 1: as a backstory, there's um certain things that your character
Speaker 1: is capable of doing and incapable of doing because of
Speaker 1: the medical condition, maybe because of a prior medical history. UM.
Speaker 1: And then you go in there and you remain in
Speaker 1: this character and you do it virtually the same way
Speaker 1: as close to the same as possible for student doctor
Speaker 1: after student doctor actor student doctor usually up to about
Speaker 1: ten in a day, and they each student doctor is
Speaker 1: supposed to get the same experience from you. And the
Speaker 1: reason why they wanted that standard is because they're being
Speaker 1: graded on this, they're being tested on this. It's it's
Speaker 1: um the closest thing to sign a typically reproducible that's
Speaker 1: something as objective as bedside manner could be made into.
Speaker 1: That's the point of standardized patients specifically. Yeah, and you've
Speaker 1: um the case that you've gotten. It's either uh, something
Speaker 1: that's just made up, like hey, we need somebody that
Speaker 1: has an uh maybe a rupture dependix or whatever. That's
Speaker 1: kind of a run run of the meal, uh meal,
Speaker 1: run of the breakfast, run of the mill situation. But
Speaker 1: sometimes it's an actual case, like a real case UM
Speaker 1: that they base it on, Like someone has actually experienced this,
Speaker 1: it's been recorded, and they have this case study and
Speaker 1: they want the doctor to go through this very specific thing, uh,
Speaker 1: and in that case they want to really replicate that
Speaker 1: right down to like the age, gender, and ethnicity of
Speaker 1: that actual patient that had that actual case to begin with,
Speaker 1: right exactly. I think George Barrow, the guy who came
Speaker 1: up with us in the sixties, he based his first
Speaker 1: UM standardized patient on an actual case that he handled
Speaker 1: because he knew exactly how it presented, UM, exactly what
Speaker 1: the medical history was so and it was something that
Speaker 1: he felt could be reproduced pretty easily again and again. UM.
Speaker 1: And there's this really interesting essay that was running The Believer,
Speaker 1: but I think it made it into a collection UM
Speaker 1: in the Writer's book by a writer named Leslie Jamison,
Speaker 1: and the name of the essay is the Empathy Exams.
Speaker 1: It's about her UM experience as a standardized patient. It's
Speaker 1: really really interesting just how she's really investigating the character
Speaker 1: that she's given. Like, I think her her main characters
Speaker 1: Scott more than one UM, but her main winner, the
Speaker 1: one that she seems most attached to, her brother like
Speaker 1: drowned in after tailgating at a football game and then
Speaker 1: jumping into a river and he drowned years back, and Um,
Speaker 1: she's like still green being over the loss of her
Speaker 1: brother and it's led to seizures, but she doesn't even
Speaker 1: she the character doesn't know that these seizures are basically
Speaker 1: coming out of grief. So it's for the doctors to
Speaker 1: suss out. And that's just one of at least a
Speaker 1: couple um it's standardized patients that she's played. But it's
Speaker 1: really interesting. It's a great, great essay. Well, yeah, in
Speaker 1: them in this article that you dug up. It said
Speaker 1: that one of the there are a lot of reasons
Speaker 1: someone might want to do this, but one of them
Speaker 1: can certainly be that they had like a family member
Speaker 1: that died of a certain disease or maybe was misdiagnosed
Speaker 1: st even so they feel like this is like something
Speaker 1: they can do to kind of help out, uh that
Speaker 1: kind of research or whatever, you know, right, I ran
Speaker 1: across though, that one of the pitfalls of UM standardized
Speaker 1: patients is that the people who do it, they can
Speaker 1: have a hidden agenda sometimes and it may be as
Speaker 1: benign as yet, my brother was misdiagnosed, and I want
Speaker 1: to make sure that doesn't happen to anybody else or UM,
Speaker 1: it can be some I ran across in this comment
Speaker 1: section on a biomedical blog about some doctors, said that
Speaker 1: while he was in training, he came across a standardized
Speaker 1: patient who was sure to list all of the herbal
Speaker 1: medications that she was taking right then and then she
Speaker 1: later said that it was because she wanted to make
Speaker 1: sure that these medical students were made aware of alternative
Speaker 1: medicine as well, So she had like a specific hidden
Speaker 1: agenda that she wanted to get across to these med
Speaker 1: students without going to the trouble of going to med
Speaker 1: school herself and becoming a doctor teacher. We just kind
Speaker 1: of came in under the radar basically, and apparently they
Speaker 1: try to root people like that out because it's not
Speaker 1: the point of the whole thing. But it's kind of
Speaker 1: funny how they slipped in there. Sometimes. Yeah, and you know,
Speaker 1: you're in character unless you're doing and we'll talk about
Speaker 1: this later, but that one thing that you found and
Speaker 1: sent me is that seemed like a little bit of
Speaker 1: a different process where they might have a really specific
Speaker 1: goal in mind where you kind of do almost like
Speaker 1: play acting back and forth with the student doctor. But generally, uh,
Speaker 1: they're trying to diagnose you. So you walk in the
Speaker 1: room and you're in character. So if you've got kidney
Speaker 1: pain or bad back or a limp or whatever, then
Speaker 1: you don't walk in and say all right, let's get
Speaker 1: started and then go oh like they try to make
Speaker 1: it as real as possible. You walk in there in
Speaker 1: character with you know, holding your side or or whatever
Speaker 1: your ailment is. You don't you know, run your face
Speaker 1: over your hand over your face over smiling, like frowning
Speaker 1: to get in character. No, you don't do that. No,
Speaker 1: And apparently I've seen that if standardized patients really good,
Speaker 1: they'll be basically indistinguishable from some of the patients that
Speaker 1: the the doctor will eventually run into and their clinical practice. Right, Yeah,
Speaker 1: I mean it's it's tough, man, because you have to
Speaker 1: I mean, if you're not an actor, you might be
Speaker 1: have a talent you didn't know you had if you're
Speaker 1: good at this, because you have to memorize and internalize
Speaker 1: and study all this stuff, because you have to be
Speaker 1: just as real as someone who is experiencing something, and
Speaker 1: like that's that's the best. Like you, you would be
Speaker 1: the best actor if you literally become that person that
Speaker 1: you're playing. And that's kind of what you have to
Speaker 1: do for this, right you know what I'm saying, Like
Speaker 1: these people, if they are an actors, they might want
Speaker 1: to look into it, sure if they're good at it. Yeah,
Speaker 1: So let's talk about that. So acting is not being
Speaker 1: an actor is not a prerequisite for this, right, Um.
Speaker 1: But you could be an actor and be good at it.
Speaker 1: You could be an actor and become very quickly frustrated
Speaker 1: by the whole thing because it's not acting necessarily it's
Speaker 1: very specific type of acting, right, it's literally medical acting.
Speaker 1: But just that's not enough. You need to apparently be
Speaker 1: ceaselessly upbeat, endlessly upbeat. And the reason why is because
Speaker 1: you're going through this thing, say up to ten times
Speaker 1: in a row. And these things last, from what I saw,
Speaker 1: about forty five minutes. So you're doing this for forty
Speaker 1: five minutes, half an hour or two an hour in
Speaker 1: the in the waiting room beforehand exactly filling out forms. Yeah,
Speaker 1: because you gotta get angry before you go in there.
Speaker 1: Some guys like coughing along up next to you and
Speaker 1: it's like, oh, I'm no continued, just um. It drives
Speaker 1: me crazy when people are like, I'm not contagious. It's
Speaker 1: like you don't know, you have no idea whether you're
Speaker 1: contagious or not. Um. But so you have to do
Speaker 1: this maybe ten times in a row. It's about forty
Speaker 1: five minutes per from what I saw, and that that
Speaker 1: tenth one needs to be as great a performance as
Speaker 1: that first one because those are two different medical students.
Speaker 1: There's ten different medical students seeing you, and each one
Speaker 1: needs to get your best because, as far as they're concerned,
Speaker 1: this is their training. They're not looking at your day,
Speaker 1: you know, like, oh, I'm one of ten. It's this
Speaker 1: is my this is my big, my big test, or
Speaker 1: my big training. So you need to give each one
Speaker 1: you're you're you're all in that sense, you have to
Speaker 1: have a lot of energy, a lot of spunk, a
Speaker 1: lot of positivity. Um. And then you also have to
Speaker 1: be very comfortable dealing with medical professionals, which is not
Speaker 1: necessarily always the easiest bunch to deal with from what
Speaker 1: I understand. Well, no, I mean if you have a
Speaker 1: phobia of doctors, then this is not the gig for you. Sure,
Speaker 1: And I think if you are easily crushed by pushy,
Speaker 1: um arrogant people, it might not be the best gig
Speaker 1: for you either. But doctors can beat ted arrogant sometimes.
Speaker 1: I mean we all saw Malice. I don't think I
Speaker 1: saw that. Yeah you did. When Alec Baldwin is like,
Speaker 1: do I have a God complex? I don't have a
Speaker 1: God complex. I am God. I just thought that was
Speaker 1: Alec Baldwin, like probably what you tweeted it, right? Uh, No,
Speaker 1: I never did see that. Actually I remember the movie though, Um, yeah,
Speaker 1: it was good eighties of late eighties movie. But but yeah,
Speaker 1: So you can't just be like a wilting flower when
Speaker 1: a med student gets all mad or pushy or whatever.
Speaker 1: And you also have to be the type who could
Speaker 1: conceivably take charge and can take control if if a
Speaker 1: med student is doing that and UM kind of maybe
Speaker 1: guide them back a little bit toward where they should be,
Speaker 1: or at the very least being willing to give them
Speaker 1: feedback to their face about how they just royally screwed
Speaker 1: this whole thing up because they're over aggressive or because
Speaker 1: they were um under assertive. Who knows you, I think
Speaker 1: you run into all of that stuff, and you have
Speaker 1: to be prepared to do this. So that brings up
Speaker 1: another point too. You have to have a really good
Speaker 1: memory because it depending on who you ask. A lot
Speaker 1: of the um simulated patients will also be required to
Speaker 1: give feedback. Some of them, I got the impression have
Speaker 1: something to do with like the scoring or grading process
Speaker 1: as well. So you have to be in care. So
Speaker 1: you have to have your character's history, symptoms, everything memorized.
Speaker 1: You have to stay in character. You have to um
Speaker 1: respond to the doctor's questioning, and then you have to
Speaker 1: um be paying attention to all the stuff the doctors
Speaker 1: should be asking all the stuff the doctor is failing
Speaker 1: to ask, and um, the doctor's just behavior in general,
Speaker 1: so that you can give accurate feedback afterward, and then
Speaker 1: you have to do it ten times in a row
Speaker 1: in a day. Yeah, and this this serves a very
Speaker 1: specific need, um beyond the obvious that uh, well, there's
Speaker 1: a few things and then and they're all somewhat obvious,
Speaker 1: but it bears going over um an experience of of
Speaker 1: medical students. You don't want them practicing on a real
Speaker 1: sick person because they if they mess up, that's not good.
Speaker 1: So having almost like a live uh recessa annie on
Speaker 1: your hands is good. I had a live or says
Speaker 1: that any my mom used to bring those homes she
Speaker 1: used to teach CPR. What would you do with them?
Speaker 1: I tried to teach and then I learned to kiss.
Speaker 1: I knew something weird went on. I tried to learn
Speaker 1: CPR here that I think I've learned it like four
Speaker 1: or five times in my life. I keep keep forgetting it.
Speaker 1: So the one thing I do remember is you want
Speaker 1: to do it to the You want to press the um.
Speaker 1: Why is it called where you do where you give
Speaker 1: chess compressions to the beat of staying alive. And then apparently, um,
Speaker 1: you don't give breathing aid, like you don't pinch their
Speaker 1: nose and breathe into their mouth for a couple of reasons. One,
Speaker 1: you're exhaling carbon dioxide directly into their lungs, so that's stupid.
Speaker 1: And then too, they don't really have a way to
Speaker 1: expel it. So now they apparently, from what I understand,
Speaker 1: they just recommend chess compressions until um paramedics arrive. Is
Speaker 1: that the latest accurate? I don't know. I should probably
Speaker 1: look at up before we publish this. Yeah, we should
Speaker 1: say too that we're not trained medical professionals. Now we're
Speaker 1: not even trained medical actors. And you are now taking
Speaker 1: life saving advice from a guy who learned to kiss
Speaker 1: from a lifeless Uh, synthetic. She wasn't lifeless when I
Speaker 1: was kissing. She went her little curly wigs fun on
Speaker 1: her head. Uh. All right. So the first thing is inexperience.
Speaker 1: You don't want a medical student to be messing up
Speaker 1: on real people. UM. Number two is availability. Uh, they
Speaker 1: have to teach, they have to run the gamut of
Speaker 1: medical issues, and you just can't count on having real
Speaker 1: you know, being able to source real patients with that
Speaker 1: specific problem. So it's really easy just to teach someone
Speaker 1: to act like that. Uh. And finally, a real patient,
Speaker 1: uh isn't supposed to provide feedback constructive feedback for their doctor.
Speaker 1: I suppose they could. Yeah, even if they could, though
Speaker 1: they're not necessarily like they're going to be like, again,
Speaker 1: my kidneys absessed them in a lot of pain, don't
Speaker 1: really care about your medical career. Just fixed me. Yeah,
Speaker 1: you can you call seen at the end of this thing.
Speaker 1: And then they go all right, now, let's like you said,
Speaker 1: let's talk about it. I'm really not in pain, so
Speaker 1: I'm fine to have this conversation. Sure, whereas the patient
Speaker 1: would be like, I'm I gotta go urinate blood real quick.
Speaker 1: I'll be right back green, I'll give you feedback doctor.
Speaker 1: So that's a standardized patients right. Yeah, but there's there's
Speaker 1: plenty of other kinds. Let's take a um, let's take
Speaker 1: a break, and then we'll come back and talk about those. Okay,
Speaker 1: one thing before we move on to that I think
Speaker 1: we mentioned yet, is that, um, speaking of recessa Annie,
Speaker 1: they have these really expense of surgical dummies. Now they
Speaker 1: think they actually they call them robots. Uh, and this
Speaker 1: is how surgeons practice now, um grand to a hundred grand.
Speaker 1: And I looked them up. These things are amazing and
Speaker 1: life like. Uh. They breathe and have pulses, and some
Speaker 1: of them bleed. They know how to love. Some of
Speaker 1: them give birth birth obviously, but uh, I kind of
Speaker 1: did wonder, like, how do surgeons even practice these days?
Speaker 1: I know they probably cut on cadavers in in med school,
Speaker 1: but that you can only get so far. We've come
Speaker 1: a long way from the days where med students were
Speaker 1: forced to rob graves. Now we've got hundred thousand dollars
Speaker 1: cadillacts of robots ready for surgery. Yeah. I mean they
Speaker 1: look like I mean, some of them don't have if
Speaker 1: they don't need it. They don't have legs and arms,
Speaker 1: but they cover that up just to make it a
Speaker 1: little more realistic. But they have cuts. And this one
Speaker 1: dude I saw had like kind of a five o'clock
Speaker 1: shadow beard. Um. It was creepy and awesome that they
Speaker 1: have this stuff that's so lifelike. Oh man. So I
Speaker 1: was on Twitter the other day shout out Twitter, um,
Speaker 1: and Atlas Obscura had this um tweet where they were
Speaker 1: They had a picture of this. It was a decapitated
Speaker 1: serial killer whose head was pickled in a jar from
Speaker 1: I think a teaching hospital and I believe Portugal, possibly Spain.
Speaker 1: I think it was Portugal. It was Portugal, is like
Speaker 1: first serial killer and um, they had his head pickled
Speaker 1: and it was from eighteen forty when he was executed.
Speaker 1: And man, it looks like he was from the seventies maybe,
Speaker 1: like it's just so I mean, lifelike. Still it was
Speaker 1: completely undegraded and just creepy. And his eyes are wide open,
Speaker 1: just kind of like his mouth is a little slack,
Speaker 1: but he looks like he could be thinking about something
Speaker 1: rather than being headless. Well that's where the old race from.
Speaker 1: A pickled head never loses its looks right. There's a
Speaker 1: T shirt all right. So if you're a recruiter, uh,
Speaker 1: let's say at the University of Pittsburgh, UM, and you're
Speaker 1: trying to find these people and source them, you're gonna
Speaker 1: be very picky, um because it's a it's a big deal.
Speaker 1: It's it's not like a fly by night job like
Speaker 1: this is something that medical students take very seriously. Uh,
Speaker 1: you have to be intuitive. Um, like you said, you
Speaker 1: had to weed through people that you might think have
Speaker 1: some other sort of weird motive. Uh, but you know
Speaker 1: you're gonna have to weed through a lot of people
Speaker 1: because you know, this is also the kind of thing
Speaker 1: where you can make twenty hour so, um, you also
Speaker 1: want to I mean, obviously people want to get paid,
Speaker 1: but their motives have to be more than just money,
Speaker 1: I think. Well, yeah, I mean it's it's tricky too
Speaker 1: because you you um expect you know how I caliber
Speaker 1: of commitment and and um skill from your your pay
Speaker 1: your teachers or your special standardized patients, right, yeah, and
Speaker 1: they're very highly trained and there's a lot of like
Speaker 1: um ongoing education that happens. Um. But at the same time, yeah,
Speaker 1: you're paid handsomely if you look at it per hour,
Speaker 1: but if you look at it over the course of
Speaker 1: a month even you're probably not even gonna be able
Speaker 1: to make rent off of this. No, it's it's a
Speaker 1: part time gig if if that. But um, you know
Speaker 1: you have to be a good listener as well as
Speaker 1: all the things we mentioned like memorization and be a
Speaker 1: decent actor. You have to be able to take direction. Well,
Speaker 1: you have to be flexible if they change something up
Speaker 1: on you. Um, like if it says in here, if
Speaker 1: the simulation isn't achieving them is our goal. They you know,
Speaker 1: they may come in between sessions and say, hey, listen,
Speaker 1: I think we had the wrong approach here, So can
Speaker 1: you can you do it this way right? Act better?
Speaker 1: I think that was Christopher Walkin said that was the
Speaker 1: only direction there was, really do it better? Yeah, but
Speaker 1: I love that guy. Yeah, don't we all so? UM?
Speaker 1: And you know, it's it's probably something you get into
Speaker 1: if you have a desire to help people, if you
Speaker 1: just have a zeal for interesting jobs, you know, yeah,
Speaker 1: maybe if you have an interest in medicine or psychology
Speaker 1: or being an educator like you're you're kind of you
Speaker 1: are an educator in some ways. And if in fact,
Speaker 1: I think some of them call them, uh educators like
Speaker 1: medical educators. Yeah, there's a UM national association, a national
Speaker 1: group called the Association of Standardized Patient Educators UM, and
Speaker 1: I think they have like ongoing education and core curriculum
Speaker 1: and UM. It's it's pretty interesting to see just how
Speaker 1: how much training you can get in this. And I
Speaker 1: imagine if you're really good and really highly trained you
Speaker 1: you you're not going to be some part time, you know,
Speaker 1: adjunct employee of a local medical school. You could conceivably
Speaker 1: go around the country or possibly the world, especially if
Speaker 1: you have a specialty. Sure, you know. One of the
Speaker 1: downsides of this is that, uh, and this is kind
Speaker 1: of a shame, but there there is no like controlled,
Speaker 1: randomized trial that can actually prove the effectiveness. But by
Speaker 1: all accounts across the board, everyone says this is super
Speaker 1: important and highly highly effective as support students. It just
Speaker 1: can't prove it. Yeah, that drives them crazy. Probably. So
Speaker 1: so you've got you've got standardized patients one of the
Speaker 1: other ones you touched on. That's worth diving into a
Speaker 1: little more. Care actors, right, yeah, these are they fall
Speaker 1: under that same umbrella of umulated patient. But these guys
Speaker 1: are um Whereas like a standardized patient is really going
Speaker 1: to help a you know, second or third year medical
Speaker 1: um student who has no clinical experience whatsoever and is
Speaker 1: learning the very basics of like physical exams or bedtimee
Speaker 1: men or and all that stuff. A care acter is
Speaker 1: is much more useful for somebody who's already in practice
Speaker 1: and has a lot of experience, which just wants to
Speaker 1: get better at it right, So like a care actor
Speaker 1: will basically be there to add lib a little bit
Speaker 1: based on whatever the doctor wants to work on, Say
Speaker 1: the doctor wants to work on empathy. Rather than go
Speaker 1: through the whole history and the whole patient encounter from
Speaker 1: beginning to end, they're going to focus on that one
Speaker 1: part of the patient and patient doctor interaction and they're
Speaker 1: gonna do it over and over again. There's an ability
Speaker 1: rather than having to start at the beginning and this
Speaker 1: at the end, you can stop and try something over
Speaker 1: again if you didn't like it or you want to
Speaker 1: repeat it. Um. Like I said, there's a lot of
Speaker 1: ad libbing, and um, the doctor can say, okay, I
Speaker 1: want to We're gonna do a patient who has um
Speaker 1: psychosis and is in the midst of a psychotic break
Speaker 1: and it's on a scale of one to tenants and eleven,
Speaker 1: and I need to be empathetic, so let's try and
Speaker 1: then they're they're gonna go from there and they can
Speaker 1: just kind of switch it up as need be. Yeah,
Speaker 1: And I think this is really cool because the doctor
Speaker 1: can get as specific as they want. They can say, like,
Speaker 1: you know what, I feel like I have a pretty
Speaker 1: good bedside manner, but I have a really hard time
Speaker 1: dealing with patients when they get angry at me. UM.
Speaker 1: So they'll say, all right, let's let's dial up an exercise. Yeah,
Speaker 1: they're like, oh, you want something anger exactly you asked
Speaker 1: for it, and they'll bring someone in there, or like
Speaker 1: you said, if someone was if the doctor was like, hey,
Speaker 1: I do pretty well even with UM patients to have
Speaker 1: like a psychotic episode, but maybe not right in the
Speaker 1: middle of a psychotic episode. I've had some real trouble there.
Speaker 1: So they again, they come in there and like you said,
Speaker 1: this is different. They're not surprised on what they're gonna get.
Speaker 1: This is just a very specific training method. Yeah, or
Speaker 1: the doctors like, I'm fine with kids unless they turn
Speaker 1: their eyelids inside out, and then I can't. I just
Speaker 1: completely lose it so cold you ever do that? But
Speaker 1: now I wasn't one of those either. I can roll
Speaker 1: my tongue perfectly and wi a my ears. Yeah, I
Speaker 1: can do those things too. I can't turn my tongue
Speaker 1: into like a clover club though, you know that kids
Speaker 1: who could do that, Yeah, I can do that. I
Speaker 1: can't do that. I don't know I didn't know you
Speaker 1: could do that. Yeah, I hadn't pulled that one out
Speaker 1: in a while though. No, you got to. But the
Speaker 1: islet's saying, that's just there's no reason you do that
Speaker 1: unless you're you know, you're not gonna impress ross and
Speaker 1: you're not going anywhere in life if you're one up
Speaker 1: to the girls in class with your eyelids turned inside out.
Speaker 1: There's no way to woo a girl. Young guys, young boys,
Speaker 1: if you're listening to this, don't don't don't don't do that.
Speaker 1: You know what you do Be nice to girls and
Speaker 1: listen to them, and trust me on that. I'm still
Speaker 1: learning that one. Are we all as we grow Now?
Speaker 1: I'm always nice, but I could always work on the listening. Sure, man,
Speaker 1: Uh was personal. That was good advice, Chuck. You know
Speaker 1: if you start out like a if you start a
Speaker 1: fifth or sixth grade boy out on the right track
Speaker 1: like that, yeah, it canna be good humans. I feel
Speaker 1: like girls are inherently good. Sure you don't see girls
Speaker 1: running around with their eyelids turned inside out. Never, not
Speaker 1: even wonder woman would do that. Uh, that's true. What else?
Speaker 1: So you got standardized patients care actors and then there's UM.
Speaker 1: I ran across another one called unannounced standardized Patients. I'm
Speaker 1: not kidding. They they're basically you know what a secret
Speaker 1: shopper is. Yes, they are highly trained standardized patients who
Speaker 1: are secret shoppers at hospitals and doctors offices and stuff
Speaker 1: like that to go in from beginning to end to
Speaker 1: rate the experience from the patient's eyes. Yeah. That's yeah,
Speaker 1: that's scary. Yeah yeah. But it's cool though that any
Speaker 1: hospital would do this because you know, it's it shows
Speaker 1: um a bit of a dedication to customer service, yeah,
Speaker 1: which I think that people forget that. You know, when
Speaker 1: you go in for medical care, you're the customer. You
Speaker 1: should be treated well. Like we demand to be treated
Speaker 1: well from cable providers, from car dealers, from grocery stores,
Speaker 1: from everybody. But we just go into a hospital like
Speaker 1: complete supplicants, like please don't murder me, you know. And
Speaker 1: and if if you demand to be treat did like
Speaker 1: a a good a customer, well then well then they
Speaker 1: do kill you. It's a conundrum. They're like, oh, I
Speaker 1: guess somebody shouldn't have mouthed off, and then the pillow
Speaker 1: goes over the faith you sent that one cool article
Speaker 1: UM of the doctor Uh what was he? What do
Speaker 1: you call himself? The MUDA that the guy who basically
Speaker 1: has recruited medical professionals that are self uh not actors,
Speaker 1: but you know, well they're they're medical actors. That did.
Speaker 1: Dude wasn't even a doctor, he was just a he
Speaker 1: was a doctor. No, he was a freelance UM like
Speaker 1: teaching actor or or UM teaching patient, right, and he
Speaker 1: got really good at it and he specialized UM in
Speaker 1: male eurogenital exams, right, so prostrate exam, testicular exam. And
Speaker 1: this guy would travel the country UM doing this and
Speaker 1: he set up shop actually in Atlanta, a company called
Speaker 1: UM Clinical Skills USA, right, and recruited other people. And
Speaker 1: these people are they just go around the country allowing
Speaker 1: medical students to give them rectal exams, breast exams, UM,
Speaker 1: vaginal exam, cervical exams, UM, so that they can these
Speaker 1: students can practice on a live person, but more than
Speaker 1: just a live person because in this articles articles by
Speaker 1: UM Elizabeth Coles and I think evocative, Well, these medical
Speaker 1: models use their own bodies as teaching tools and it's
Speaker 1: really great. But she makes mention that apparently medical schools
Speaker 1: to train um MED students on gynecological exams. Back in
Speaker 1: the day, they would hire prostitutes. Did not know that.
Speaker 1: I didn't know that either. I thought these people, though,
Speaker 1: had medical background, because are training them as well, aren't they? Yes?
Speaker 1: A little to the left, little to the right, right
Speaker 1: there it is, Yes, So these people are trained in
Speaker 1: the exam. They're not medical professionals. UM one's a one
Speaker 1: one that they interview is a real estate agent or no,
Speaker 1: an insurance agent. One guy's retired from that GM plant,
Speaker 1: which I suspect probably the one in Doraville. Um. No,
Speaker 1: they're just they they know what the exam is supposed
Speaker 1: to be like, and then they've subjected themselves to the
Speaker 1: exam so many times that they know the right way
Speaker 1: to do it so well that they can teach med
Speaker 1: students how to do it. But this is still under
Speaker 1: the supervision of trained professionals, right. I have the impression that,
Speaker 1: like the the the med school teacher who brings these
Speaker 1: people in says, listen to what this person has to say.
Speaker 1: They're the trained professionals. All right, Wow, that's interesting. Yeah,
Speaker 1: So this one guy who's UM a male eurogenetic an
Speaker 1: auld teaching associate that they interview, um, Mike Manning. He
Speaker 1: said that he he estimates his head somewhere around four
Speaker 1: thousand prostate exams man in nine years. Wow. So yes,
Speaker 1: that guy probably knows more about how to yeah, yeah,
Speaker 1: give a prostate exam than anybody in the world. Well.
Speaker 1: I saw the one picture, um of the guy like,
Speaker 1: you know, bent over the table. Uh, and it's from
Speaker 1: you know, his front and then the doctor student doctor
Speaker 1: behind him, and he's kind of looking back like you know,
Speaker 1: that's that's it. That's correct. Yeah, I think that was
Speaker 1: the guy. I think that was Mike Manning or Mark Manning. Yeah,
Speaker 1: isn't it interesting? Yeah? I mean what a I don't
Speaker 1: want to call it weird, but what a just what
Speaker 1: a fascinating thing too to have a knack for and
Speaker 1: and not mind and just be like yeah four thousand times,
Speaker 1: so do it. Yeah, it's pretty pretty interesting that these
Speaker 1: the people who all work for him too, um are
Speaker 1: are They've kind of become a bit of a family.
Speaker 1: I love that they like go to bars and go
Speaker 1: to dinner and hang out. Yeah, they do. Um. One
Speaker 1: of the one of them as uh, she's actually she
Speaker 1: would be considered a gynecological Teaching Associated g t A
Speaker 1: rather than m u t A. Her name is Katie Patterson,
Speaker 1: but like she travels the country teaching med students how
Speaker 1: to correctly insert a speculum um. I mean, like these
Speaker 1: people are literally donating their body to science. But while
Speaker 1: there's still a lot, I mean it's amazing. And yeah,
Speaker 1: they're getting paid, but I mean they're not getting paid
Speaker 1: enormous amounts of money. They're getting paid something between thirty
Speaker 1: five and fifty bucks per student per day. So say
Speaker 1: you have ten ten students, you make ficks in a day.
Speaker 1: It's not bad at all, But you're only working thirty
Speaker 1: days out of out of the year. Maybe maybe fifty
Speaker 1: doesn't add up too much. So clearly these people are
Speaker 1: driven by by much more um benevolent thing than than
Speaker 1: moneyless their hearts. You know, yeah you got anything else,
Speaker 1: I got nothing else? Son, turn out better than I thought, Chuck. Yeah,
Speaker 1: I think if you um, maybe if you're out there
Speaker 1: and you all this sounds like, hey, I could probably
Speaker 1: do that. And I have a desire to help people learn,
Speaker 1: and I don't mind being you know, poked and prodded,
Speaker 1: and I want to make a few bucks. Look into it.
Speaker 1: We should reiterate that the people who are the male
Speaker 1: eurogenital teaching Associates and the ladies who are the gynecological
Speaker 1: teaching associates, they're very specific. And yes, you could say
Speaker 1: I want to sign up for rectal exams and they'd say,
Speaker 1: come on in, we need rectal exam volunteers. Bad. But um,
Speaker 1: just becoming a simulated patient of some sort. You could
Speaker 1: say I never want to do rectal exams. I just
Speaker 1: want to do you know, bedside man or something like that,
Speaker 1: and they would they would probably just stick to that,
Speaker 1: you know. Yeah, they're not going to force you to
Speaker 1: ever do anything that you're not comfortable with. And again, regretfully,
Speaker 1: they don't give you any drugs. But if you do
Speaker 1: want that kind of thing, Yeah, if you are interested,
Speaker 1: check out your local mid school. They probably have some
Speaker 1: sort of program. Or again, go to the Association of
Speaker 1: Standardized Patient Educators. Bring in if you're an actor, beach
Speaker 1: waiting tables. Yeah, and in the meantime, you can type
Speaker 1: standardized patients into the search bart how stuff works dot com.
Speaker 1: And since I said search bar, it's time for a listener. Uh,
Speaker 1: I'm gonna call this uh South Africa and Canadian All right,
Speaker 1: does pique your interest? Yeah, but I know what this
Speaker 1: one's about. Hey, guys, never really had a reason to
Speaker 1: get into contact into now since you announced your tour
Speaker 1: up to Canada, and that fired my cylinders into action.
Speaker 1: Listen to you, guys for a couple of years, probably
Speaker 1: from early to fifteen to been listening forever. I was
Speaker 1: then living in South Africa. At nineteen, fresh out of
Speaker 1: high school, I made the daring decision to leave my
Speaker 1: family and friends try and make something of myself. I
Speaker 1: have Canadian citizenship as well, due to my father being
Speaker 1: born in Toronto or Toronto Toronto, so I landed there
Speaker 1: in Toronto early last year and made my way a
Speaker 1: little east and then a lot west to Vancouver, where
Speaker 1: I would be seeing you in September of this year.
Speaker 1: The point is being away from family and friends is
Speaker 1: brutal at a nine hour time difference, and brutal turns
Speaker 1: to lethal. I often feel lonely or anxious of the future.
Speaker 1: And when this happens, stuff you should know, and the
Speaker 1: three of you, lovely people make it not seem so bad,
Speaker 1: as it feels like there's someone right here with me
Speaker 1: chatting casually about some neato topic it is. So I
Speaker 1: just want to say thank you for making this move
Speaker 1: tolerable when it feels sometimes not so great. Who's that
Speaker 1: that is? K H? And I don't know if k
Speaker 1: E y A is Yeah, ka ka Kaya? I don't
Speaker 1: know how Kaya identifies on the gender spectrum. Well, who cares? Right?
Speaker 1: That's right, k H. They age sounds for how are you?
Speaker 1: I just want to use the right pronoun, you know
Speaker 1: what I'm saying? Sure, So what's that one? Is it sis? Sis?
Speaker 1: Gender like gender neutral? I'm not sure about they. I
Speaker 1: think they is like making a big, a big push
Speaker 1: right now? Well, a nice email from thy Yeah, thanks
Speaker 1: a lot, Kaya, that's pretty awesome. Congratulations for striking out
Speaker 1: on your own. It's pretty amazing. And thanks for coming
Speaker 1: to our show in Vancouver, and even more than that,
Speaker 1: thanks for giving us a reason to plug our show
Speaker 1: in Vancouver and the rest of our tour where people
Speaker 1: can get tickets at s y s K live dot
Speaker 1: com and right all right, Well, if you want to
Speaker 1: get in touch with us, like KAA did, you can
Speaker 1: tweet to us at s Y s K podcast. You
Speaker 1: can join us on Facebook dot com slash stuff as
Speaker 1: you know, you can send us an email to Stuff
Speaker 1: Podcasts at how stuff Works dot com, and, as always,
Speaker 1: join us at our home on the web, Stuff you
Speaker 1: Should Know dot com. For more on this and thousands
Speaker 1: of other topics, is it how stuff Works dot com.