Episode 55: Dr. Aimee Stotz D.O. Anesthesiology, Pain Management, and Osteopathic Neuromusculoskeletal Medicine

Dr. Aimee Stotz is board-certified in anesthesiology, pain management, and osteopathic neuromusculoskeletal medicine. Prior to attending osteopathic medical school, she worked as a physical therapist and discovered her passion for cranial sacral therapy. Drawn to osteopathic medicine, she decided to pursue a career as a DO at the Chicago College of Osteopathic Medicine. Following graduation, Dr. Stotz completed an internship with the Chicago Osteopathic Health Systems at Rush Medical School, a residency in anesthesiology from Northwestern University, and a fellowship in pain management at Loyola University. She has worked as a staff and attending anesthesiologist in a variety of different settings and currently performs anesthesia during gastrointestinal procedures. Additionally, Dr. Stotz serves as a clinical professor at both an allopathic and osteopathic medical college.

Dr. Stotz is a member of the American Society of Anesthesiologists, the American Osteopathic Association, the American Academy of Osteopathy, the Illinois State Medical Society, the Illinois State Osteopathic Society, and the Osteopathic Cranial Academy. She gives back to the osteopathic community by teaching and supervising Chicago College of Osteopathic Medicine students at the free Old Irving Park Community Clinic.

Transcript

My name is Dr. Ian Storch.

I'm a board certified gastroenterologist and osteopathic physician, and you are listening

to DO or do not.

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us at DoOrDoNotPodcast.com.

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We hope you enjoy this episode.

Hi, I'm Tiffany Carlson, a third year osteopathic medical student hailing from the Midwest and

you're listening to DO or Do Not.

On today's episode of DO or Do Not, I interview Dr. Amy Stotz.

Dr. Stotz is board certified in anesthesiology, pain management, and osteopathic neuromuscular

skeletal medicine.

Prior to attending osteopathic medical school, she worked as a physical therapist and became

interested in cranial sacral therapy.

She decided she wanted to practice the therapy, so graduated from the Chicago College of Osteopathic

Medicine.

She completed an internship with the Chicago Osteopathic Health Systems at Rush Medical

School, a residency in anesthesiology from Northwestern University, and a fellowship

in pain management at Loyola University, Chicago.

She's worked as a staff and attending anesthesiologist in a variety of different settings and currently

performs anesthesia during gastrointestinal procedures.

She's been a clinical professor at both allopathic and osteopathic medical colleges.

Dr. Stotz is a member of the American Society of Anesthesiologists, the American Osteopathic

Association, the American Academy of Osteopathy, the Illinois State Medical Society, the Illinois

State Osteopathic Society, and the Osteopathic Cranial Academy.

She gives back to the osteopathic community by teaching and supervising Chicago College

of Osteopathic Medical Students at the Free Old Irving Park Community Clinic.

We hope you enjoy hearing how she discovered osteopathic medicine.

Thanks for listening.

Well, thank you for joining us tonight on the DO or DO NOT podcast, really appreciate

your time.

No problem.

Can you hear me okay?

Yeah, it sounds perfect.

So we'll just kind of go from there.

So I'll just start, kind of tell us what is, if you have a normal day, what does that look

like?

And then just, you know, from your morning routine till the end of the day.

Okay.

Well, I'm an anesthesiologist, first of all, that might help set the frame for when I wake

up typically about five o'clock in the morning, and I shower, get, you know, ready to go make

my coffee, grab some lunch or some snacks, water, and then the night before you have

might make sure I have a clean uniform in my iPod or my iPad charged up, because that's

what I use for all my documentation of my cases.

So then I drive either 20 to 60 minutes to get to my office-based anesthesia practice,

and I have to be there 30 minutes before the start of the first case, and the first case

typically starts about seven o'clock or 730, so.

So we are 70% gastroenterology, GI, endoscopies, and colonoscopies, and then, so I have to

set up.

Let's see, I could have anywhere from six to 15 cases for the day, and it all depends.

I could have a morning doc and then an afternoon doc, so it's just the gastroenterologist

doc, and then I'm there the whole day, so.

We basically run propofol, which is the best sedative in the world, you get a deep sleep,

you're unaware before the scope is introduced.

I rarely use narcotics or other long-acting sedatives like something called burset, and

I see the patient, it takes five to 10 minutes, depending if they have any questions, I very

review the chart, all the information available to me with their medical history, medications,

allergies.

And then I go over the risk and benefits of the anesthesia, and I'm assigned a consent,

and then we head into the procedure room.

Procedures are, like I said, I'm just going to focus this on GI, since that's primarily

what I do.

You get all the monitors on, give them oxygen through nasal cannula, and then get them on

their side, and I start the medication.

We do a safety check once they enter the room, and the docs are there and everybody's there

to make sure we got the right patient, right procedure.

And then I start titrating the propofol, and my goal is to have them unaware but still

breathing on their own.

And so once the procedure's over, or as it's finishing, I start lighting up the propofol

so they wake up pretty quick.

And then we bring them to the recovery room.

Now the company I work for supplies the nurses who start the IV and do the recovery.

So they wake up pretty quick, like within two minutes.

They're pretty awake, and they get their instructions, and then about 20 minutes later, they're literally

walking out the door.

So I do that over and over and over for the day for GI cases.

And then I go home, figure out something to eat.

So you know, this whole new fad with intermittent fasting and all, this job does it automatically

for me.

I don't get up when I get home, or right after I'm done with my day, because it's nonstop

turnover.

And then I'll eat something 15 hours later after my last food in my mouth.

So it's been a good discipline, anyways.

Even trending before those intermittent fasts were a thing, so.

Right, exactly.

Anesthesiologists have been doing that for a long time, and when you're in a busy schedule.

Now when I worked in the hospital, of course you had people come in and check in on you

and had longer turnovers between big cases.

So that was the only difference.

But in office-based anesthesia, it is nonstop.

So I've been doing this since July.

My life is much better.

I don't take any call.

I take the clinics that are open, or the procedure, often people want to do procedures on Saturday.

So that's my choice if I want to work extra.

So that's my typical day.

I'm in bed a lot earlier than I used to be.

Can you tell us a little bit about how your days were prior to getting into this GI anesthesiology?

Well, this is office-based anesthesia.

I also do ENT and whatnot.

So what was my life like before?

I would get up at the same time, get ready, get there, and knew my schedule the day before.

So I could be assigned to an OR doing general surgery all day.

I could be doing gyne onc, where we're doing robotic laparoscopic assisted pelvic surgery.

I could be doing ortho, and so there was much greater variety in a hospital, of course,

or an ambulatory surgery center.

And also I would be doing GI, too, mixed in with that.

I worked in a small community hospital that did not do hearts, but where I was at, initially

after I became an attending, it was a trauma center.

We did transplants, hearts, but we had dedicated cardiovascular anesthesiologists that did

that.

So yeah, my life was crazy, 80-hour work weeks, on call, overnight.

One of the nice things about anesthesiology is we realized you're sleep deprived, your

performance is poor, and so you would go home post-call.

Most specialties, they could be up all night, surgeons, whatnot, trauma docs, intensivists,

they could be up all night and still have to work the next day.

So that was one nice thing about anesthesia, why I chose anesthesia, too.

When and how did you become interested in medicine and decide that you wanted to be

a physician?

Great question.

This is something my mom told me about early on in my life.

I said I wanted to be a doctor, but I don't remember that.

But when I was 16, I became a patient care tech in a rehab facility.

So my mom was a nurse.

But as I realized, doing patient care tech stuff and nursing, it's not really what I

wanted to do.

I was more interested in physical therapy and seeing what they do actively, moving and

exercising and whatnot.

So I decided to go into physical therapy.

So I went to U of I undergrad, Circle campus, and eventually applied to physical therapy

school.

They wait-listed me and then eventually was called two weeks after the curriculum started

and was able to get in the program at Northwestern.

Back then, it was an 18-month program.

You had to have three years undergrad, and then you get by the time I graduated in October

of 1981, I had a bachelor's of science in physical therapy.

So all through, so from 81 to 87, when I started osteopathic medical school, I did a lot of

continuing education.

I worked in a small community hospital, no longer in existence in Chicago, but it was

a great hospital in its time for a community hospital.

We had a variety of things, mostly ortho, but you would get some acute rehab, pain control

was part and parcel to almost every patient we saw.

And so I started taking continuing ed courses that were ortho-related, pain control, like

I would go to acupuncture courses, or not, TENS through the transcutaneous electrical

nerve stimulator we would use, learned a lot about acupuncture and started attending these

courses on myofascial release and craniosacral therapy by a physical therapist.

I'm like, wow, this stuff is cool.

So the brochure really is what interested me to take these courses, because it talked

a lot about the basic tenets of osteopathic medicine, but they didn't call it osteopathic

medicine.

And so I took a bunch of courses and started getting really good with my hands.

I'd go back to the hospital, try out all these things, and people were getting much better

faster.

Also, John Barnes was a physical therapist who initiated a lot of this work and teaching

it, but he had hooked up with an osteopathic physician, John Uplinger.

And so they would go around and do these courses together.

So I started taking more cranial courses, craniosacral therapy is what they would call

it, not cranial osteopathy courses.

So it was a technique-driven course.

And then I started going to these courses, coming back and applying these techniques,

and I was just overwhelmed with how well people were doing, and I was just like, I want to

know more.

I want to explain this better.

And I would start talking to my referring docs about what I was doing and how well their

patients were, and I would start trying to engage them in a conversation.

And they were like, oh, I don't want to hear about all that.

Just whatever you're doing, keep doing it.

You're doing great.

Thank you.

And I was like, what?

Because I was a physical therapist.

I wasn't a physician.

And I started realizing, hmm, I could go back and get my master's in physical therapy and

orthopedic-related physical therapy.

That might take 10 years because I'd have to do that part-time, or I could go to medical

school myself, and osteopathic medical school specifically, so right from the get-go.

Physical therapy led me right into the world of osteopathic medicine.

And so I also was a member of the Chicago Land Orthopedic Study Group, a bunch of physical

therapists to get together, and we would invite docs to come and share their experiences and

courses with us.

And we had Fred Mitchell Jr. come and do a muscle energy tutorial of the spine on a week

end.

So, I mean, the more and more I surrounded myself with these continuing courses, it was

all osteopathic-related.

My skills were phenomenal as a physical therapist.

And so I'm like, wow.

So one of my friends and I said, hey, let's take the MCATs.

Let's see if we can do this.

We're pretty smart people.

So we did.

Now I lost track of him, but I ended up going to night school at Loyola just to get brushed

up and take some necessary prereqs for medical school, like microbiology, organic chem, and

stuff.

I had a lot of sciences all through my undergraduate years as a physical therapist, but not some

other, not some specific courses for medical school.

And then I took a Kaplan course to get ready for MCATs.

Then I applied.

I applied to one school, Chicago College of Osteopathic Medicine, because I love Chicago

and didn't want to go anywhere else.

And this was my world.

And there's how I started out.

And I applied.

They called me up the next day, you're in.

I'm like, great.

So that started.

So you already were just going to try for osteopathic school.

How was your experience at Chicago, because you went there during kind of a transition

time.

Was it already at Downers Grove?

No, that was a time when the Chicago College of Osteopathic Medicine was the entity unto

itself and it owned the hospitals.

And we rotated through the hospitals.

There was Chicago Osteopathic Hospital in Hyde Park, and then there was another osteopathic

hospital in Olympia Field.

So all of our rotations were done through those schools.

But my year, when I started, there was a last year that the school was in Hyde Park, down

the block from the hospital.

So then the next year, we moved out and they bought the old George Williams Exercise Physiology

College in Downers Grove, and that's the current campus.

And so, yes, this was a major transition.

And we went out to Downers Grove, had makeshift classrooms there.

And I actually lived on campus my second year, because it was just so much more convenient.

There was just so much growth over those next 10, 15 years that they added the pharmacy

school, they added the PA school.

And I guess, I think you have to have so many schools before you can call the university.

So yeah, there was a lot of change going on, a lot of change, but that was the fun of it.

We had our own externships, we called them, our rotations, in the osteopathic hospital.

So it was a world of only DOs.

There'd be a few MDs there on staff, but it was all DOs.

So that's how most osteopathic hospitals were.

Were you able to do any research, because I know you were in that study group when you

were a physical therapist, did you do any research while you were at CCOM?

Oh, yeah.

I also had the great opportunity to become an OMM, Osteopathic Medial Medicine Fellow,

Undergraduate Teaching Fellow.

Now they're called scholars, because it's a scholarship program.

And so people think fellows are advanced trained people, but it's really, at that time, it's

a teaching scholarship.

So you apply during your second year, so that you then have five years of medical school

instead of four.

So your clinical years are spread out over three years, so that three months of those

three years, you're teaching the first and second year's osteopathic manipulative medicine.

So that's why it took me five years to graduate, not because I was remediating, but actually

I was in the top 10% of my class, and as a physical therapist, a lot of the material

was kind of review, but of course more intense.

But more importantly, the OMM workshops were like, this is phenomenal.

I was just thrilled.

And it was automatically teaching my colleagues, my co-students, because I already had a lot

of these skills already.

And so it worked out that I did research during the fellowship or scholarship program.

Now that was a big benefit, because I had Dr. Kelso, who's a PhD, who was a master in

osteopathic research, and he was available to me.

And so I developed this study comparing fibromyalgia, is it really somatic dysfunction in disguise?

So in the allopathic world, we called it fibromyalgia, but in the osteopathic world, we name everything

by what we find in the restrictions in the musculoskeletal system, the neuromusculoskeletal

system.

So we did this kind of like two and a half, three year project of Dr. Kapler, who was

one of my mentors, who was the chair of OMM at that time.

He and I would see the patient, record their tender points that documented their fibromyalgia,

and then he was blinded to the number of tender points, and then he would go treat them.

And I didn't know what he did.

Then I would reevaluate them after he treated them, record my tender points.

And one other thing we also had was a thermography machine available to us.

So we took an image of their back before and after treatment to see if we could reduce

the autonomic disturbances found in the paravirtebral musculature through the temperature, and

then see if it would get more normalized.

And so I think we had 12 patients and we would see them every other week for a total of six

or eight treatments.

So this went on for a while, and it was quite involved, and I actually was able to get a

grant for the study, a Burroughs Welcome Grant.

And that helped with paying for the thermography assistant and just everybody's time.

Then I presented my research when I was first year resident in a seizure resident.

So right at the beginning of my residency, I asked them, can I go and present this?

And so I presented my research and abstract, and unfortunately never completed the publication

because it would have been crunching a lot of numbers and time consuming, and I was busy

in another world.

So that's probably one of the saddest things when we really need research in the osteopathic

world than to complete that project.

But anyways, yes, I did research and it was a phenomenal process.

Maybe you can have Dr. Henderson crunch your numbers for you.

So you mentioned that you picked a residency in anesthesiology.

How did you decide upon your specialty?

And then what was the application process like for residency?

During our rotations and surgery, you were required to do one week of anesthesia.

So you spent your time with the anesthesiologist and you'd be behind the curtains and be talking

about what's the greatest thing about anesthesia.

And I really started realizing, wow, I like the OR environment.

I like the early mornings, getting there early and getting all things set up.

And so I did a further rotation.

I did an elective at Loyola, the trauma center, and then I did an elective in pain management

at Northwestern.

And through doing those electives and whatnot, because it's a very cutthroat world, I was

able to meet people to audition, elective basically, to get letters of recommendation.

So that helped me tremendously get into eventually Northwestern University's anesthesia residency.

Northwestern is one of the fine stands, one of the prestigious schools and it's allopathic.

So how was your experience being a osteopathic physician in training there?

Wow, this was back in the early 90s.

So there was still bias towards osteopathic physicians, but the chair of anesthesia was

a very open-minded, wonderful physician.

And when I went for my elective, I had met a lot of DOs that were in the program.

So they were very DO friendly.

I would say at least a third of each class of three years of residency had DOs in them.

So I did not meet that bias as a resident.

I think they were probably, if they were talking about us DOs, they're all behind our backs

because I did not feel any negativity.

No, I'm going to let the MD do this.

There was none of that going on.

I was treated fairly.

And I was one of 20 in my class.

And more importantly, about half of us were women, which is typical of anesthesia, but

still in a prestigious university, not so often, but you know, it does pay to know who

you're in.

It does help to know people.

And I interviewed with the chair of Northwestern and luck had it that his daughter and I went

to high school together.

And we went to St. Scholastica All Girls High School because he was very Catholic.

And he actually, I think he had like 12 children himself.

And that, just that little bit of opening up and being personable allowed him to see

the quality person that I was.

And my experience already out there practicing as a physical therapist, I was mature.

All these things really, really helped because I bombed my other interviews with the Northwestern

staff.

You know, it's like, I got all, I hate this question.

You can always be prepared if somebody asks you, what are your weaknesses?

It's like, it's like, it's an emotional override that occurs.

And I unfortunately could not come up with anything to talk about myself like that.

And so I just am very thankful that I knew Dr. Bruner daughter to get me to help me.

And so it was my first ranking choice, but I also applied at U of I, University of Chicago

and Loyola and they all wanted me.

I think a lot of that, like I said, I was in the top 10 of my class, my skills and knowledge

you know, they were able, they wanted me.

So there's a real take home point is it's not a competition of MD versus DO, it is really

who's the best candidate.

And that's what you have to show yourself, why you're just as good as anybody else.

It's not about them and us, does that answer your question?

I hope you understand.

Yes, no, I do.

I think that you do bring a good point of like that you're competing against, against

yourself, but against other people to be that best position no matter what.

So can you tell me once you got into residency, kind of what, what a residency looked like

at Northwestern for you?

Because we had a large class, my call wasn't too bad as a resident, but over time they

realized they had too many anesthesiologists and before within 10 years it had gone down

the number.

And also that was downtown at Northwestern Memorial, but when you were at other facilities,

there was a hospital called Columbus Hospital, it's no longer in existence, that we wrote

to you through Children's Memorial, which is now Lurie's, the VA downtown, which is

the building spent demolished, depending on the place you went, you could be on call every

fourth night versus up to, you know, every sixth night.

So you'd be on call and you would get like a lecture every morning before you'd go and

set up your OR and be prepared and see the patient and you would have to call your attendee

the night before.

So you would be, you know your assignments and your patients and you would review the

chart and you'd call and discuss your anesthetic plan.

So it wasn't like you just walked in and didn't know what you were doing after your first

month or so, you pretty much knew the process.

Well, it took me a little longer.

I think by the end of my first year, I was able to finally give a synopsis of my anesthetic

plan from the talking about the patient from beginning to the end and what I wanted to

do within three minutes before it would take 20 minutes to discuss everything.

And so I think that's just, again, something you learn the process you learn.

And so you'd be up at night studying, preparing, and then during the day, get there early,

set up your room, you would discuss things, you would be managing your patient, you'd

be watching the surgery, you would have to know what's happening and how to gauge how

deep they need to be and how light they are and monitor, you're monitoring them, their

blood pressure would drop, their heart rate would drop, their heart rate would go up.

You know, their CO2, the carbon dioxide would go up.

Why would that happen?

All these things you learn and how to adjust your medications, your anesthetic, what would

you do?

And how then also to communicate to the surgeon, hey, we're losing a lot of blood here.

Maybe you could stop and get hemostasis.

I mean, that would take a lot of guts for a resident to speak up and say that, you know,

and just, of course, you'd call your attending immediately, they come in and help you work

through all this.

But through those three years, you've figured it out.

What was your proudest moment in this process of figuring it all out?

The day I could complete the anesthetic plan within three minutes or less, discuss the

patient and come up with the plan and three, you know, because actually it was an inpatient

and on a speaker phone, speaker and into the office with all the attendings and I'm giving

my spiel and presenting and it's like, you can hear them all in the background going,

hey, she finally got it.

It's like, that was a very proud moment.

I can imagine her cracking before then.

Oh yeah.

Yeah.

Yeah.

So you, you chose anesthesiology.

Was there other specialties that you wanted?

And then would you go back and choose a different specialty?

I really liked ENT and urology.

I don't know why, but I always thought I'd be a family doc, a family medicine doc, but

I wasn't able to do a thing.

You'd have to know a lot about everything and then send them off to specialists to figure

it out.

Sometimes we're in the OR and just seeing the anatomy, physiology and action and having

that knowledge to get that poison appendix out and fix the ureters kink and get the kidney

stone out.

I mean, urology really was impressive because also at that time, urology, it's rare that

women were in urology, but women had tons of urological problems from weak pelvic floors

and things like that.

And then I think gyne in urology eventually became a specialty too.

But so yeah, I was, I was interested in that.

And then, like I said, ENT, I think probably because I was so interested in the cranium

and the cranial aspects and just what all that set packed into that head and how amazing

it is to be able to operate on an ear and a deformed mastoid and, you know, all these

things and head and neck was so intriguing.

With craniosacral, especially with osteopathic manipulative medicine, can you just kind of

explain a little bit?

I know it can be kind of complex, but I'm sure students would, you know, value learning

a little more about that.

Wow, that's days and years of discovery, but let me try to sum that up.

All right, first of all, one of the key tenets of osteopathic medicine is the body has the

ability to heal itself.

How does that exist?

Well, we talk about structure and function and how they complement each other and dictate

each other.

And what is it about our health?

We all have health inside and what is it that allows our bodies to keep healing healing

itself?

It's like our autonomic nervous system, our neuroendocrine system, and how they're all

interconnected and complex.

And then there's arterial capillary venous system and all the extracellular matrix, all

the fluid surrounding all the cells and compartments in our body that make up the musculoskeletal

system, the abdominal cavity, all the cavities in our body, heart and lungs, chest.

So when you have this knowledge of all the anatomy and physiology and you dig deeper

and you see there's this core connective tissue and that's the cranial sacral connection

that exists that through the dura, the deepest connective tissue in our body.

And it is part and parcel to our brain and then it's fluid between layers of more dura

that connects to our cranial bones on the inside of our cranium.

Our skulls are not skulls and skull is a dead bone.

Our craniums are live bones with sutures that are interdigitated purposely to move a small

amount that is palpable.

You could feel it.

And then it connects at the frame and magnum at the base of the cranium, first and second

vertebrae inside the canal all the way down to the sacrum.

So that's how this cranial sacral connection exists is through the dura, connective tissue.

Anatomists are famous for naming parts of things in one part of the body and then you

move to a different part of the body and they call it something else, but it's really all

the same.

It's just a continuous layer of tissue.

And so when you feel the head, you have your hands in certain positions on the head, you

sense all these different bones and then you just sit there and wait and sense this rhythm

just like our hearts have an automatic rhythm from the moment life is into, you know, the

sperm and egg come together, life occurs.

And that perpetuates a whole process all the way through their growth and development.

And so anyways, back to the head, your hands are on the head, you're feeling the heart

beating, the lungs breathing, all this movement that occurs.

And then there's this other automatic rhythm in our body that you might perceive, you might

not, but the physician is trained, the osmotic physician is trained to feel this change of

volume in our head ever so slightly because like I said, the sutures are interdigitated,

they're designed to move certain ways of all the cranial bones and it's in response to

the central two bones, the phenoid and oxyput and how they move and all the bones move in

concert with each other and then they reverse their direction just like inhalation and exhalation.

So reciprocal functions occur through the body all the way down to the sacrum and you

could feel these motions in the sacrum of this deep connective tissue.

So through our life traumas exist and strains go into our tissues and that's what we look

for in the cranium and in the body for somatic dysfunction, a restriction of flow of fluids,

whether it's artery, venous, lymphatics, everything that gives us a balance in our

lives to allow us to be healthy and so when these strains occur in our body from boatloads

of trauma growing up, craziness as we get older and are younger, 20s and 30s and then

in their 40s and 50s we start going, ow, why do I hurt and it comes out as pain because

the body can't compensate anymore and so a trained osteopathic cranial physician will

know what the body, guide what you need to do and can balance these things to let that

health continue to be expressed.

Sometimes it happens rapidly, sometimes it takes a long time.

The body does keep score, that was helpful to kind of integrate it all.

Can you talk to us about it, I know that a lot of the students at CCOM enjoy working

at the Old Irving Park.

Can you tell us a little bit about your work there and what you do?

Absolutely, since 2013 I started having students come through, first and second year students

come through and learn how to do mysteries and physicals and do osteopathic structural

exams and then we would treat the patient together so they could actually see what osteopathic

medical medicine is all about.

That's all we did was OMS.

I don't prescribe, I don't order tests, I don't do nothing, we just examine and treat

and it's a great experience for the first and second years to learn how to have early

clinical contact and see the future holds for them as far as evaluating patients for

let's say a complaint of shoulder pain and then working through that, you know they come

to us with all kinds of complaints.

I allow the students to team up, one scribes, one does a history and maybe that same person

does a physical exam and they come out and then present to me and then we go in and treat

the patients.

With this COVID limitations, the clinic was closed for most of this year and they allowed

us to come back but with a limited number of students unfortunately.

So prior to March of this year, I would have anywhere from 8 to 12 students there in two

or three rooms seeing patients and just everybody working hard and sitting around talking about

all this stuff and treating all the patients and it's a very, very enlightening process

for everybody.

We're going to transition a little bit, you were a post-traditional student at CCOM and

you were also a scholar, how did you pay for your first and second year of school though?

Well I saved up a lot of money as a physical therapist and also took out loans.

I probably accumulated about $87,000 in loans even though I had saved a lot of money.

But life got in the way in my third year of medical school, I got married because I was

pregnant and life got in the way, life happened.

So cost of living and of what you're doing every day and even though my husband worked

and took care of the kids and during medical school you're still having to pay the bills

and so the scholarship helped out tremendously.

So the first two years I had to take out some loans and then after that the scholarship

to help and we got a small stipend every month of $300, which didn't go far.

That was my debt, wasn't terrible compared to what I see and hear about now.

So you mentioned kids and a spouse, what does your spouse do and have they always been supportive

of your career?

My husband is a non-physician and he is a carpenter, contractor, jack of all trades.

He can build the house, fix the house, fix the plumbing, electricity, all that and so

he worked.

He actually had a regular job and so he would take my son to a daycare in a person's home

and pick them up and things were focused on my life and allowing me to do what I needed

to do.

And then we planned our second child during my internship and he decided I'm going to

stay home with the kids and not go to and fro.

He lasted a whole 10 months, maybe nine, 10 months.

It was just too much he wanted, he needed adult interaction.

So I had to talk to him, he was Mr. Mom and he continued to be Mr. Mom.

He did a lot of the shopping, taking care of the kids.

So I am very, very, very fortunate that I have him in my life and he was certainly supportive

of everything.

Then when I decided I wanted to do a pain fellowship, things were getting a little tough

then.

He thought I was going to be done, what another year?

And then my life is a pain attending, anesthesia pain attending, didn't end at three o'clock

in the afternoon like most anesthesiologists, three or four or five depending on your calling

off the next day.

He continued at home with a lot of phone calls and whatnot and like managing a lot of issues.

And that was, it took a couple more years for him to let me say, this is not working.

And so after seven and a half years at Loyola doing everything, moving up as associate professor

teaching medical students, teaching anesthesia residents, teaching pain fellowship, training

the fellows in the pain clinic, I had an old one clinic there too at Loyola, it was great

in pain management, but it was time, time to move on and get into private practice.

I was done with academia, it's a great transition when you're done with your residency to stay

in that comfortable environment.

But I was missing out a lot and you have to make a choice.

And that's when I chose to leave academia, go into private practice, had more time to

spend with my family because by now that was, my son was, my oldest was 14 and my youngest

was 11 when I left Loyola and moved into private practice.

So I didn't miss too much and I did miss a good chunk of, I mean, I was there, I could

still participate, but not on the level that I thought I could have, should have.

I think that transitions to like, how are you able to kind of obtain the dynamic of

work-life balance?

Well, there's a lot going on there.

So yeah, you come home, whatever the kid's schedule was, you would be there, do everything

you could do.

We make do.

Women are strong and can handle multiple tasks, I'm not putting men down, please don't misunderstand

me.

But when a man is the primary breadwinner and comes home and the wife and the kids are

all handled, he then fits his life in like that.

So same for me.

I guess I was a male counterpart of her relationship and so I'd come home and be involved in any

way in all possible, but it did tear on our relationship and so I didn't let that get

to the point of being divorced and all that craziness because that's not why I went into

it.

I didn't marry Madison and that was my husband's biggest fear is you married Madison, you're

not marrying me.

So I think a strong foundation and good communication skills make a difference, not run it out until

first time it gets bad.

How do you balance that?

Well, you just keep having insight, you exercise, you try to take care of yourself, when you're

not taking care of yourself, there's a problem because you've got to take care of the person

that's handling all these things.

So when you start having stress that you're not sure why and you're tearful all the time

and crying and then us women get menopause, but my husband swears he goes through menopause.

Anyways, a lot of those things influence our decisions and so I don't have the perfect

solution and answer.

You just keep working on it and compromising and working towards a solution.

I think the hardest part was my voice all of a sudden, who do I listen to?

Mom's home and she's telling us what to do.

She asked what do we do?

That was an interesting time because anesthesiologists are certainly control freaks and when I come

home I want to be in charge at home and I wasn't in charge.

So that wasn't always easy.

So you mentioned women being able to handle a lot.

Can you tell us what thing has made you successful in your life and career?

What is your superpower?

That's a tough question.

I don't have a super, I don't consider it a superpower.

I have a lot of patience.

I'm a great listener.

I try to look at things from the other person's perspective.

I'm a hard worker and I like to play hard too.

So trying to find that balance is really the most important thing I think and I'm not afraid

to touch people.

I offer OMM to my friends and family since I don't have a clinic that I charge people

for.

So I keep up my skills that way as well as in the clinic that I volunteer in.

It can be a tough question.

Medicine is a profession so you volunteer your time.

How else do you participate in the profession?

I am not politically connected in the anesthesia world, meaning like there was one person, Judith

O'Connell, she's one of my mentors in Osteopathic World, she said, you need to get involved

politically.

Well, that's true if you're good at that stuff, but I'm not good at that stuff.

Because I shield myself from all the political crack going on in the world, I don't have

a lot of time to bone up on that and read about that and know all the latest, greatest

facts from around the world and so I'm not politically involved.

I guess I live in my sheltered world and so I just do the best job every day to get my

patients through safely through their anesthesia, that's the best I can offer.

I think that is the best to offer.

Thank you so much for your time.

We've gone over kind of OMM and how you incorporated into your practice.

With OMM, what are your thoughts of it like adding to the patient experience and obviously

it is something you incorporate in your practice if you can.

Well, I do not incorporate osteopathic medicine in anesthesia, I do not manipulate people

under anesthesia.

I know that exists out there, some people do do that.

I was teaching for a long time in the Osteopathic Medical School and my schedule allowed me

to be on call and take off the next day and teach.

And so giving back by teaching students, that's why I still love to volunteer because that's

what energizes me is that I can still contribute on that level.

So I like to inspire people by showing them what skills they have and can help the body.

I'm part of a osteopathic cranial study group, a bunch of us docs who go to courses all the

time together and then we meet once a month and have intense conversations and discussions

and treat each other because usually you don't get treated regularly.

And so I go to a DO who does traditional osteopathic medicine and I see him probably every month

at least.

When I was at Loyola, I had a separate OMM clinic for chronic pain patients.

And then I realized that population sometimes can be very hard on physicians to listen to

their complaints and pain and how it interferes in their life.

But when you're on the table treating anybody and everybody, even chronic pain or acute

pain, whatever, there's no judgment that needs to be there.

And so you have to be able to be unbiased and open and just love your patients and love

people.

And so I just try to do that every day.

How I push the syringe, how I talk to my colleagues, it's a way, it's just a way about myself

and you got to put your personal stuff at the door on your way in and pick it up on

your way out if you choose to deal with what you have to deal with.

But OMM, it's just part and parcel to me and it's something you own and see and do.

And I've got a treatment table in my office here.

I treat my husband as much as I can and my kids.

I just constantly trying to help people improve their health.

Thank you so much for sharing your evening hour with us.

In closing, what was the best piece of advice that you got throughout your education?

It can be from growing up during college, medical school, residency, that you always

think of and would like to pass on to the next generation of osteopathic physicians.

Always do your best.

That has been trained in me growing up.

Always do your best.

Do unto others as you would have done to yourself.

So just treating people fairly, not get biased and attitudes about, I mean, oh, that was

so common.

You'd go back and talk about a patient and it would be like, oh, geez, I'm judging them.

Let's just see what we can do to help everybody.

And that's not an easy thing.

It's something you learn along the way and you just gotta be a daily affirmation.

Do your best, do the best for the patient, treat everybody fairly.

Well, thank you again, really, really appreciate this time and sharing your wisdom with us.

You're welcome.

My pleasure.

It's such an honor when you asked me, I was just like, ooh, I get to talk about myself

and it's scary, but at the same time, yeah, this is an opportunity to help future interested

students or continue to get an interest in osteopathic medicine.

This concludes our episode of Do or Do Not.

In all inquiries, comments, suggestions, and even let us know if there's someone you want

us to interview to do or do not podcast at gmail.com.

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We have plenty of more interviews lined up and we're excited to share them with you.

This is Tianyu Sheng.

Thank you guys so much for listening to Do or Do Not.