Giving back: Is it always a good thing? #396

Let's go ahead and do this . But I'm also joined by my lovely co-host .

People lose love , ones , people go through strife and sometimes you don't feel like being in a holiday happy spirit , you just kind of in a morning spirit or you just in a some , you know , whatever mode that you're in .

We thinking about you if you're not so happy , and I just want to let you know that we there for you guys , because life happens and you can't be happy and cheerful all the damn time .

This episode we're going to do a Q&A and then we're going to talk about something that is going on Instagram on I think I've got the name of that Instagram pages but basically we're going to talk about is it okay for a man to just tell his wife that you're going to take time off because I said so and I make more money than you In ?

You know you give gifts to your family , your friends , and you may give your time , donations and things like that , and we just wanted to put out there that one of the things that we're going to be doing , despite the giving season , one of the things that we have planned on doing , is giving back to the Student National Medical Association .

Student National Medical Association , otherwise known as the SNMA , many of you may have heard of , many of you may have been a part of , many of you may have been leaders in whether it's chapter , regional or national officers .

But for those of you who don't know what SNMA is , it is the largest minority medical student organization out there , just dedicated to making sure that there is equity in medical education . That's kind of the gist of it . There's a little bit more to the mission , but I'll just leave it at that .

But me and I have pledged to donate for the SNMA's 60th year . Snma started in 1964 . So we have pledged to donate $10,000 to the SNMA in its 60th year and we are asking those of you who care about the SNMA to also pledge to donate some amount . Doesn't have to be the same amount as we are , but we are asking you to donate in its 60th year .

There are medical students , pre-med students , who really could benefit from your donations .

With the programming that SNMA does and all the initiatives and all the opportunities that it has , we are asking you to donate so that those opportunities that you wish you had as a medical student that you could give potentially to those other pre-meds and medical students coming behind you . So the link is going to be in the show notes .

If you want to donate to the SNMA , we have a link in the show notes and let's hope that you do that today .

Just know that this is an organization that's really helping folks who are gonna go out into rural communities , they're gonna go into urban communities , they're gonna go into suburban communities , they're gonna go into communities across the world and your donation can help with scholarships to help them get through maybe some tough times of getting books or maybe even

trying to get that .

You guys all know , if you're trying to get into medical school or if you're in medical school and there may be a hard time trying to bridge that gap between what your loans will cover and what that person may have to put up with , that's gonna help with that type of situation and sometimes it helps with social programming also , because sometimes you can't just

be all work and all just all work . You need an opportunity to network with people , the ability for people to go to these S and M a conferences and find out what's going on with residencies , where residencies are recruiting , what sub internships are recruiting .

These are very valuable things to make sure that a lot of these students get an opportunity to get out and help communities that need that need help .

. So I got a question from a surgeon who is going overseas to do some work and they asked me a question because me and you have been doing medical mission work for well over 10 years now . And it's something that we are , we find very integral , fulfilling to what we do .

Talking about people to S and M , you know alumni who are doing medical service in another country . Also , don't forget y'all , s and M also has programs . Do they still do that overseas ?

He's like Listen , you've been doing medical mission work for , you know , hello years . What's your biggest advice for me going ? And that's something that I think that people who are listening right now , you know people who are not sure about whether they should be a part of a medical mission or they want to follow somebody or follow an organization .

You know , let's have a discussion about the things that are really important when you want to align yourself with a medical mission or you just want to start your own medical mission , and let's jump in , let's just jump right into it .

Now , obviously the United States does a big . You know we got resources for that . But even you know in certain areas of the United States is really hard to find a vascular surgeon who can do an AV fistula and then also , at the same time , you know just the way in which people get reimbursed for dialysis . That's changed dramatically .

So you know it used to be hospital driven , where hospitals will have their own dialysis centers .

The folks need to really understand what that means . What that means is is the easy part is doing the operations , guys . That's the easy part , that's the fun part , that's the easy part . But in order for people on the ground there to take you seriously , particularly if you want to come back , you have to be able to do chess moves .

You got to be able to come up with plays and moves that you're going to make or think about so that , when you leave , this stuff can be sustainable . And what is sustainability ? Sustainability is well . When you do these surgeries and there's a complication , who are these folks going to ? Right ?

So it's great that you're doing a bunch of these AV fish , but everybody knows every surgery has a complication , right . And with AV fish list , sometimes you know they take a long time to open up , or sometimes they just don't open up and you got to take it down . Who's going to do that ? Right ?

Because if you give someone an AV fish and it doesn't work , and now all of a sudden they got this connection and it may start bleeding , you probably made the situation possibly worse , right ?

So you never want to walk into a situation where you do a procedure , you do a mission , you do whatever it is , and then there's no way for these patients to have anybody who else they can rely on to get help with their complications . So don't do surgeries that , in my opinion at least , nobody else knows about or at least knows how to fix .

That's one of my biggest things that you got to work on is sustainability in that realm . The next thing that I would say also is is is you know you got me on that .

Yeah , I think that is one of the biggest things on the ground that people want to see . If you want to get their buy in , they need to know that you're going to come back . When you're coming back , what dates you're coming back ? How are they going to contact you ? And sometimes they may need to call you for complications .

So if you're going to be with an organization and you're trying to find out , ah , is this the organization that I want to go on , you need to interview them and ask them questions . Okay , I'm going on the trip with you guys . Like , what happens afterwards when we do all of these procedures or we do whatever it may be ?

Like , how do we find out if what we did is effective ? I think if you ask that question to anybody who's running an organization , they'll be like , oh , this person's on an up and up , they want to know what's going on .

And if there isn't a direct answer , you know sometimes you got to be really wary of that Because you don't want to just go places , do operations and then just leave .

And then you know you kind of just go there and do these free operations and not really work on the process of improving healthcare in that area Right , because that's not improving healthcare , that's just operating .

But you most people who want to go to missions , you really want to make sure or you really are thinking about how is it that I can really affect the system ? And doing just a procedure or handing out medications there's got to be more to that .

I don't know if you have any thoughts on that , because in your realm when we go on a trip I think you do you don't do that much surgery , but you do a lot of screening and then we always bring maybe some Eurogynecologic surgeons with us . These are either gynecologists or folks who are really adept at that Eurogyne .

You know all that stuff , right , they're really good at all that stuff Apparently you don't . That's all that complicated Euro stuff that they may not obviously have a specialty or they may not have someone on a ground for . What's your thoughts on that type of situation ?

When are you going to be potentially available you know , even by phone or by video , you know to help kind of mitigate any you know any crazy circumstances that you might have left behind . So I think that that's going to be important . The main thing , though , also is making sure that the patients that they choose are actual good candidates for surgery .

That's another thing , right , because everybody wants surgery , but not everybody's a good candidate for surgery . Right , we've definitely gone overseas , where we've had patients blood pressure is 220 , over 180 , and they think they're getting surgery today .

They're not on any medication , they've never been diagnosed with hypertension , or they haven't , just just haven't been treated . It's like , yeah , I'm sorry , not today , right ?

But what you want to be very careful about is not going on a medical mission simply for the experience of going on a medical mission At first . That's kind of why you go right , oh , this would be a great experience , sounds like a great experience , but at the end of the day , I'm actually interested in it Because that's the I mean .

But at the end of the day , once I , you know , once I use a scalpel , to you know , to make the incision , pretty much whatever the belly looks like is what it's going to look like . It's going to look like that in America , it's going to look like that in Africa , doesn't matter where I go .

If I do something to this patient whereby this patient cannot be cared for after I leave , then I've actually created an experience for them that could be horrific . Yeah , but thankfully , I had a good experience .

Obviously they don't use expired staplers there . But these are the things that you have to think about when you're going there . It's like , okay , I'm coming and I'm bringing all of this esoteric equipment , I'm bringing laparoscopic stuff and I'm doing all of these different things . Like the question is is , when you leave , are they going to be able to do that ?

Now , you remember the first time I went . The first time I went was that when we did that lap coli , laparoscopic coli , yeah , so the first time I went , we did a laparoscopic colisostectomy . We used some laparoscopic equipment and we did the case and we said , yeah , the patient could even go home the same day , you know , at worst the next day .

And people were like , really , I was like , yeah , they can go home the next day and kind of go back to doing what they're doing . But the question was , when we left the hospital and we're going back to the United States . In my mind I was like oh man , we left all of this laparoscopic equipment . Are they going to use it ?

We come back the next year or even years after that that stuff is collecting dust In the condor .

If the CO2 machine is not working , who do you think has to manage that I do . So all of these different things , oh my God , zoom again . Zoom strikes back Y'all . If you're all watching on YouTube , shout out to y'all who are watching on YouTube . You're going to see what I'm talking about . I don't know what's going on with these videos .

So creating a trying to go there and say I'm going to start this laparoscopic program , I'm going to dump all these equipment there that they don't need in the United States and I'll give it to them in Ghana , and there's no ability for someone to fix that equipment , there's no ability for someone to service that equipment .

You can't even get CO2 tanks very quickly . That's going to be really tough . So now you're introducing a new skill set , possibly to somebody , and they're like now , you just made my day more complicated .

I think what I've learned the most about my going to medical missions is that you try to you one , you try to integrate yourself into the system so that you can potentially help with volume . That's number one , right ?

So if you can help with volume cause a lot of times you have patients who do need you know , who do need surgery or need some other type of treatment , and they're not able to get it , either because they don't have the money to do it or there just isn't time . There isn't just there just aren't enough doctors to do it .

So that's one of the things that you can do is involve yourself and interject yourself in that way so that you can be helpful . So if there are 50 patients that need help and only 25 can get help from the doctors you know , based on the system that already exists , then maybe you go in and you see 15 of those patients who could not be seen , right ?

That would actually be helpful . So I think volume is . You know , basically helping with volume is number one that you can do to kind of help . Number two is , oh okay , number one subscribe and you're free , going in with an educational mindset and understanding that there should be an educational exchange .

Right , you shouldn't be going into a different country and thinking I'm just operating on my own , I don't need the other doctors here from this country , I'll just have my own OR I'll do my own thing .

When you come back , I'm telling you these surgeons they're great , they're cold , they're really good . So I agree with you there . My bad , sorry , I got you .

You have to have buy-in , you have to have resources , and part of those resources is going to be equipment , money and manpower . Don't forget about the manpower . You have doctors , you have nurses all these people that need to be trained in understanding what is going on .

And if you don't have that , like you said , where the CO2 machine goes out and the doctor's already scrubbed , we don't expect for the doctor to unscrub . What we expect is that for the circulator to be able to troubleshoot that . That's what we expect . But if the circulator , the circulating nurse , doesn't know how to manage this machine , then what you doing ?

He asked some really good questions , to the point where I was like , man , how do you know to ask some of these questions ? And some of them had to do with sustainability . A lot of them had to do with his role , specifically so that he's prepared mentally as to what to expect when boots on the ground are there . I was really impressed with that .

So we're going to discuss him with the directors to see if he'll be a good fit . I think so . I think the questions were really good . But yeah , I think if you're a pre-med , if you're a medical student , I think it is OK to ask what's going to be my role when I get there ? What are the plans ? What happens afterwards ?

Is there outside of the meetings getting me ready to go overseas ? Like I need a visa , I need to know a little bit about the country and all of that stuff . That stuff is the easy part . That stuff is really about me . What will I be doing to help out ? Are we going to be having a pre-op conference ? Will there be meetings afterwards ?

If they do , that's a red flag . I'll tell you that right now . So , don't worry , bing , bing , bing , bing , you know what I'm saying so you should be able to ask those questions .

space to do that ?

But this doctor , he's an anesthesiologist , he's getting ready for a case and it just shows him getting ready for a case , working at the anesthesia machine , making sure all of that stuff is there , and there's a caption on it that says that I'm working this hard so that my wife doesn't have to , so that my pregnant wife doesn't have to .

And if you go further down into the captions , basically he's saying that his father worked really hard when his mother was pregnant to make sure that she didn't have to work while she was pregnant . And he's doing the same thing as a anesthesiologist and he's just really happy that he makes so much money , in essence , that his partner doesn't have to do that .

And I didn't even read the captions . I already had my thoughts on it . You mean the comments , the comments you just told us about the caption . So it's really interesting . Yeah , it's really interesting from that perspective and I think it's funny .

Looking at that caption , I think about what my thoughts were before I got married and now I get the privilege of being able to give my thoughts , 10 years into marriage .

She's not going to work , and I think that that's a real myopic way of looking at things , right , because I think a lot of times , when you make a lot of money and you make more money than your partner , specifically if it's a lot more , I think a lot of times people equate money with power .

Let's just be straight , honest , right , you feel like you have a leg up in a relationship and I think that thought process of my wife is not going to work makes it seem like you're telling her you are not going to work and I just I find that really odd .

I find that because we don't have that type of relationship right , and , as a matter of fact , that's one of the things that you have to do , that's one of the things that I just I never wanted to have that type of relationship with anybody .

I dated definitely someone who I married , which is almost like an authoritarian type of relationship with my significant other , which is this is more of a discussion . Actually , right , this is a discussion that happens between two people . My wife wants to work while she's pregnant . She's going to work if that's what

she wants to do . Now , the caveat is is , if you work and you're putting the baby at risk , then obviously we both have veto power and I think that you have to start thinking about , like , listen , if you're working and you're putting yourself and the baby at risk forever , it may be that's a problem . I ain't talking about that .

So basically , me and I have instituted something called the veto and that basically is that when we both disagree on something , that one of us can say the word veto , which basically means that we feel so utterly strong about our viewpoint and so utterly against the viewpoint of the other that what we say is final .

Now we don't institute the veto very often at all . I don't think we've had a veto in years .

You and I had a similar , we had a similar situation in that when I was , you know , when we were doing IVF right , and you said to me you're going to quit your job . Remember , you said it just like that too , remember .

And then one day , on a very long drive to the IVF you know facility , I started thinking and I was like , you know , I've spent a lot of my time , you know , dedicated to making the career that I have . I've spent a lot of time in that career basically helping other people grow their families . And now I can't grow mine .

And I think you know , since I've done everything that I possibly can to help other people grow theirs , why shouldn't I do everything that I possibly can to grow mine ? And if that means that I got to park myself , you know , somewhere and not necessarily work , then that's what I'm going to do . And then I came home and I told you you know what ?

This cycle doesn't go . I'm going to quit . And that cycle ended up being unsuccessful .

That's when we had the locums company and if somebody couldn't cover a call or if there was a call that was just uncovered , then I would just take the shift . But again , I was home most of the time . I barely went into the hospital . You know , I can count on the number on one hand , the number of babies I delivered while I was pregnant .

Let's get back to that post , because that post right there , I think , is in my opinion I didn't like that post .

I didn't like that post because I felt like , like that is a you're telling your partner you not working and I just I don't understand why people who make money more so than their spouse would take that approach , because it doesn't have to just be you're not working because you're pregnant .

It can be for a whole host of other reasons , right , but you , I think a lot of times you see it on the man , the men side , right , like the ego , I'm a protector , I'm a provider , and as soon as I make a certain amount of money , my wife or my spouse is never going to have to work again .

And in my mind I'm just like , why , like , why would you not want that ? I guess because in my , in my experience , my mother made less than my dad , but my mother still worked . And there were a couple of times when my dad lost his job because of the 88 stock market crash . And then you know some other times where my mom had to hold it down .

You know what I'm saying . She held it down and kept it going until he was able to get back on his feet . And so I've always seen women who are very , you know , in control , contributory , major contributors , right yeah , and the household . So for me , I just I always expected to be of a woman who was going to do the same thing .

I just I just never understood that whole concept of why I'm making all this money , so my , my significant other doesn't have to . He's like , well , how's this person going to contribute ? Right , Well , yeah that part I don't get . I just I don't know , I just feel like that , that masculine , that type of masculine , that type of masculinity .

I just think that's a red flag , I think .

I hope that that was a discussion that he actually had had with his wife , that he just put out there but wasn't very thorough in saying exactly how this transpired . I think that , going back to the whole having money and being the one in control , I think it sets up a very dangerous relationship .

It sets up a very dangerous dynamic in a relationship because and like you said , a very myopic kind of view , but I think it's very dangerous because if someone constantly thinks that the money is what makes them in control , then what happens when there is no money ? What happens if that money stops ?

Like you said , and I had the same dynamic in my household as you had in your household where there were times when my dad wasn't necessarily primarily the breadwinner it was my mom , but they worked together to build this household , to build what it is that they have now , 50 , some odd years later .

What happens when you have a man who's like no , I make the money . And therefore , x , y and Z . This is what I'm supposed to do . What happens if he can't provide anymore ?

But if that money should ever stop , have you set up a situation where your relationship has become so transactional that now the woman sees you literally only as a provider . She doesn't see you as a companion , she sees you only as a provider . You are her sugar daddy , and if you can't give no sugar , bye-bye daddy , you know like .

So he's saying that he really feels really honored to be in a situation where he can work and not have to have his wife or significant other work and stuff . And I'm just like I get it .

But I just think that prior to me being in a relationship , or prior to me being in a relationship where , or prior to me getting married , living with you , like that that's kind of same thoughts I'll be the provider , protector and all these different things . And now I realize that it's really about this is a companionship .

This is equally beneficial for you and for me and stuff . And we're partners and we got to make it work and that means we have to discuss things as partners , not as employer , employee or parent .

Well , one of the things that you and I talked about the other day was we talked about the other day when we were saying , like having this type of parental transactional relationship I forget where the hell I was going with it , but essentially having that sort of relationship really sets up just a very dangerous precedent .

I forgot exactly where I was going with this . Now you kept talking and I forgot .

Were we wrong ? Were we off base ? Do you agree ? Let us know what you think . And I guess by the time we come back on our next episode , renee will remember what she wanted to discuss . I have to remember .