Hello inside. Great Minds, listeners, I am excited to introduce to you today our guest. Dr, Terry Ann Samuels. Dr, Terry Ann Samuels is a good friend of mine, and I was excited to have her on our podcast for many reasons. One, she's an innovator in medicine as a practitioner and a urogynecologist. She studied in London as an gynecologist in OB. She got to experience the medicine, medical practice in Europe. Through that lens, she came to the States. She's had
worked for another practice. She started her own practice. She has a testosterone clinic. She works with both men and women on hormones, but also practices as a private care urogynecologist, and she just has a great perspective on medicine and her story of how growing up in Jamaica, what that was like inside of a very academic family, and then her transition to her professional focus in medicine is an exciting journey, and we get to hear a little bit of the innovations that are
occurring in medicine today. So I think you'll really enjoy this episode from a different perspective, a different take from a business owner and also from a medical practitioner. And so without further ado, I'm excited to introduce you to Dr Terry and Samuels. You came stateside from Jamaica, and that's where you were raised and grew up until. How old? How old were you? Dr Samuels, when you first moved, oh,
it's interesting. I moved and then moved back. So I actually, I actually went to boarding school in Toronto, and then moved back to Jamaica after I finished med school to work for a bit, and then I moved. Then I moved stateside. So I've kind of moved around quite a bit in terms of my my own development. But yeah, Jamaica is really culturally where I, you know,
where my my family's from, where I blossomed, where I matured. So it's probably, probably out of all the countries I've lived in, probably carries the most culturally weight in terms of my development, where did you get your sense of humor? Was that Canadian A No, I mean, again, the that's, that's my prescription now and forever. Laughter is the best medicine. I don't care what aspect you practice, and having a sense of humor is the only way
you get through this thing called life. So I want to say it was inherited. But there's nothing I love to do more than love. So the first time we sat down, I thought, you know, Dr Samuel just could be serious and get down to the brass tacks and have no time. And you were, I literally confused you for stand up comedian. I mean, is this something that runs through your whole family? Yeah. Or is this just, is this just you? That's the comedian and the
family. I mean, I think I probably get the light. I probably the lightest, but I think they, you know, I think, and also, you know, we, I've been talking about this a lot in terms of social, different types of socialization, but I think the there is some social clout for good storytelling, right? So you look forward to getting together with other people, because you want to tell the story that makes everybody
laugh, that's that's the that's the life of the party. And so you just get in the habit of gathering those, those anecdotes as you go through life, and so and, you know, and you present them at it, and no holds barred, right? So being around people you're comfortable enough to do that with, and keeping life really simple and making sure you laugh as much as possible.
I think that is a great prescription for for many, many people, one that I fully believe in what what is so a lot of people I run into Doctor is something that they've made a mental decision in when they were quite young, like they, you know, it's kind of when you're starting to do the doctor role play as a little kid, and then that's what they wanted to do for life. What was the journey in uncovering that education and medicine, and then your specific focus came about. How did that?
How did that happen? How many, how much time do we have? Oh, the thing is, I think I, you know, I had, I had desires to practice medicine when I was younger, and then they got reinforced, I think by parenting. You know, if that's what you want to do, then we'll support you. So I think that it's just the need to help. You know, as cliche as it sounds, but again, the need to. Leave things better than you found them combined with, you know, you know, strong academic
background. And I think it just was the obvious choice. My pediatrician was probably the biggest influence. And, I mean, in Toronto, you know, it's not, it's, it's a national it's the national service. So, but I had this pediatrician who had her office out of her garage, right? And so I never went into this growing up. I never went when I was little. I didn't go into this office with tons of people in there. It was this very individualized service where you felt you were the only people
there. And I remember feeling, you know, you know, you know, the schedule was always open, and you know, we were able to go almost anytime, if any of the kids were sick. And I remember that feeling, and I remember wanting to be just like Dr Kent. You know, she was light and she was bubbly, and, you know, she was an older, older, older lady. And I thought, This is what I want to do. And then fast forward, you get through academics. You know, the support came from parents who kind of
said, well, this is what you want to do. This is what you got to start doing now, right? Like you can't, you can't get up, you know, 10 years from now and decide you want to do medicine, the habits have to start now, and getting into good, good study habits, etc, and watching them manifest throughout, throughout my academic career, and then getting into went to boarding school. I know, right, I didn't go to boarding school because they thought I was, they sent you away. Yeah, I ended up
going to boarding school. And, you know, the lesson from that was, you know, to be to really be focused on what you want to do, because I got to boarding school. Now, boarding school was the end of high school, so I did a couple extra years of high school because I graduated from high school a little bit early. I was 16 when I graduated, and my parents were like, you're not
going to college. So they sent me to boarding school for two years, and I got there, and my, you know, my my seniors, my advisors, especially Mrs. Robson, Old English woman, she said to me, you know, what do you want to do? I'd gotten a scholarship to Queen's University. I, you know, had all this stuff, you know, no tuition. And then she's like, Well, what do you want to study? Because, you know, you have to get this first degree. And I was like, I don't want to study
anything else. Like, I don't want to do biochemistry. I don't do physics, kinesiology, not interested. What do I was like, I don't know what to do, but I do not want to do any of that. And she just came to me and she said, Just go that. Go and do medicine. And I was like, I don't understand what you're talking about. She's like then apply in England, because you don't have to do a first degree. Your first degree is a
bachelor's in medicine surgery, and I'm in Toronto. I hadn't been to I'd gone to England as a two year old, and I was like, but this woman believed in me enough to like, you can do this, like, just put the application, see what happens through the application out there. Got called for an interview and and there I was, you know, starting med school, and I'm on my 18th birthday. Wow. So again, that's where the journey began. Had a
fantastic time there training, and then came out. Do you want to keep going? Yeah, no, this is great. Well, and I'm thinking that you're probably going to share this component of it. The you know, your family is are kind of medical practitioners, largely, right? I mean, it wasn't just you that decided to pursue that track, but that's not true. My there are, I'm the first physician. You were the first physician, and then everybody followed in
your footsteps? Well, my, my siblings are both dentists, so we can start that argument if you want. Oh, I see, I see, versus doctor. Well, so this is actually what maybe brings me to my question. So my apologize, my apology for conflating the dentist with Doc, but your, your pursuit is very unique in your family, like, what, what was it that, when did you have that moment of wanting to pursue your particular focus?
You mean in terms of medicine or in terms of my sub specialty, your sub specialty? I don't know. So I felt like, I think one of the things that I personally value is the responsibility of people's stories, right? And I in high school, I kind of considered myself a little bit of a kind of like an ombudsman, like everybody, people would tell me things, and people would confide
in me. So I had relationships all grades across my grade, and I just had these, and to this day, these relationships have have survived, but I remember feeling that sense of responsibility, and that manifested when I got into med school I was lauded for i. Uh, being able to get the most information out of a patient, in terms of, you know, when you're taking a history and you have to report back and trying to make a diagnosis and get information, and those are things that I had
been lauded for. And so, you know, combine that with wanting to do surgery. And so I then I ended up in this OBGYN realm, right? Because a lot of it is about patients stories and the responsibility that comes with it. You're such an integral part of their lives, you know, for the best day of their life, right? Which can be glorious on one end or disastrous, and you can be a part of that change. And I thought, this is, this is me. This is what I want to do. And then, you know, I got, I was
in England. And of course, you know, you're in England, and you're like, Oh, my God, this is exciting. We deliver babies. So of course, everybody loves the baby part, right? But in England, the catch is this, so you as a consultant, right? Where you're following the medical side. We England has a lot of midwives. So really, the day to day deliveries are done by midwives. You swoop in like Superman, right? If something's going wrong, and you do the C section, or you get that
difficult delivery done, right? So it's kind of like this, you know, this hero motive, you know. And then I came to United States, and I remember starting my internship. I mean, I didn't do any research in terms of, in those days, we didn't have all this internet stuff going on. So, I mean, I didn't do, you know, and of course, this was two years ago, but I didn't do all this research. And so I remember starting, and my senior said to me, okay, go in and push with that patient. And I was
like, What are you talking about? I said, No, hold on a second. Wait, I'm a physician. I don't push with patients, and I'm in there, and this woman is like, push, push. And then she put her foot up on my hip. And I was like, What is going on? This is crazy. So it was the realization that OB GYN in America actually, like, deliver all babies, normal, abnormal. And so I remember, I remember I was like a second year resident,
and I remember one of my mentors who was doing pelvic surgery. He I was up at like two o'clock in the morning pushing with this patient. I remember, like tears streaming down my face, and I remember him going, do you really want to do this for the rest of your life? So Oh, two o'clock in the morning, and I was like, I can't see straight. I'm exhausted. And he, I mean, by the grace of God, he, I mean, he changed my life. He somehow got the administration to let me go to Kenya with him to do a
medical mission to repair fistula. And so I ended up, in the middle of my residency, which is unheard of, I got a week to go and operate on the Bucha tribe in in Kenya, right? So now here's someone who thinks I have good surgical hands and not going to Africa to do this medical mission, and my life completely changed. And that's how I started getting into urogynecology. The fellowship had just started. We we did the
application. So a year after that, I applied and got into Mount Sinai, and that's where I started my fellowship in Uruguay. So that's kind of how I got into this super sub, specialized and you're a guy, and just for so people understand your gynecology is a cross between urology and gynecology. But you know, permission to speak openly, the focus tends to be on women. There are three holes. Ladies,
if you don't know that, there are three holes. Gents, if you don't know there are three holes, front, middle, back, and so we quarterback all three holes, yeah, got it, yes. And so going forward again, then the specialty, and then in terms of getting out and seeing things, then we've kind of evolved a
little bit. So mostly I came from an intimate, you know, barn door, academic, interventionalist, surgical approach, you know, into into private practice where you're talking a little bit more about holistic approach to the patient. So then the patients that were happiest in my practice, and I was selfishly getting the best surgical results, were the patients with the best tissue. The patients with the best tissue were the patients who had their hormones
addressed. And so I'm not only that these patients were happier. Like, why are you so happy? And so that's where the interest started to get into menopausal medicine. And hormones, the menopausal medicine patients, the females, were coming and going, Yeah, I feel better. Life is better. Oh, my husband is interested. And so then I started getting into the male testosterone, because it was the partners of my patients. So that's how this whole thing has kind of evolved, you
know. And I want to definitely hear more about these practices and what you've come to understand, you know, are the ramifications of taking care of that part of your life before we go into that. I mean, it just would love to hear this like mentors seem to have played. I. Uh, some pretty major roles. I mean, you mentioned two of them already in your story, and maybe you wouldn't call them mentors as much as, like, momentary
decisions they helped you make. But I would love to know more, like, who would you say you viewed as mentors in your journey and in how did some of those people help you in processing some of the decisions and directions that you've made, and maybe you say there were no mentors, there were some facilitated decisions that were helpful from people who cared. Right? How would you describe those people in your life and what they did?
I think the, I think the respect for people's story and for people, being able to offer you things that you need from every walk of life allows you to understand that listening and being present is probably the most important thing. Because I
think if I if I look back at the people who have been mentors. I think sometimes I'm so surprised at the fact that they were my mentors, right, that it was these momentary things that happened, that Synchro, Destiny, that energy, that, you know, they saw something in me and I saw something in them, that kind of but being open to that right along the journey I think is super important. And I know I sound super vague when I say that, but it definitely when I it that's in contrast to when we
talk about mentorship in medicine, right? You know, get somebody who wants to do to do this particular specialty and wants to do it this way, and so you seek that person and make sure, you know, I could give you parameters, like, you know, if it's a female, you seek a female surgeon, because they'll understand the family dynamics and this, that and the other,
and yes, and that's all well and good and ideal. But I think in my journey, and in other journeys that I've talked in other people I've spoken to, it's those surprise people that come out of left field, and you think to yourself, if I didn't stop and listen for a second, if I didn't have a cup of coffee with that person, if I didn't trip over that, that, you know, that curb and and they caught me there, and then we ended up in this conversation. My entire life trajectory would have been
different. So I think, you know, I think mentor is, for lack of better terms, it's the people that have, the people that have been sent to, kind of, you know, gage your journey, but you can't hear them, and you can't see them unless you're open to it. Yeah, I love that. That's a great way to look at it. What do you think also has helped you be more and maybe this is me superimposing
what I see, but more creative in your approach in this field. And maybe, maybe the words open minded, like, what are some of the values or principles that you that maybe distinguish you from some of your colleagues or peers in the industry that have helped you take your path and take maybe the path that's a little less travel, right? I think it's, I think it's, it's change. I think it's the ability to deal
with change. And I think, you know, you talk we you know you'd asked a question about being the things that have been pivotal, or forks in the road, and like little things, and I think those are more meaningful to me now as a parent. And one example would be I was, you know, when I were moving from Jamaica. We're moving now from Toronto to Jamaica. I'm six years old, and I moved with my dad first, and my mom and my sister came a little bit later, and the the school system is an English
school system. The British system is a little bit tougher on kids in elementary and so, you know, my dad was determined. He had been raised in Jamaica, but he was determined, yeah, he's an engineer, but he was determined that I start, I be with my peers at my age group, right? Because I was a little bit behind. And so we had this summer where, before the start of first grade, where this guy was on me, right? He was like, we're doing a test every day. We're doing academics. I'm at
the table crying. My mom is feeling sorry for me. And you know, they're like, Why are you pushing her so hard? And I'm like, Dad, I can't take this anymore, right? And he is, and he's just every day, right? We're gonna, we're gonna do more problems. We're gonna do and then I get into first grade. I start, I'm very quiet. I'm learning this new. I mean, my parents speak in with a Jamaican accent, but now the entire class, right? I'm learning lingo, and and again, new kid,
new kid on the block, right? These kids have been together for the two years prior, and by the end of the year, I am number one in math, and I'm getting all this clout. And I remember, and you know, I remember thinking to myself, I said, I remember, even at age six, thinking, if I work really hard. At something, if I work really hard at it, right, I can do it, right? I there's, there's, I just have, I may have to take a different approach,
right? The other kids probably didn't work all summer, and it was not easy. But I love this feeling, and I love the feeling of winning. So, so, so why not? And I the change was hard, but here, here I am. I'm able to deal with the change because I was able to achieve what I wanted to achieve. And so that kind of stuck with me to this day, the ability to that, that we're all in evolution, and just because we start one way doesn't
mean we have to finish that way. It might not be where you're supposed to be. You know, when I think of my interactions with you, I think,
yeah, for sure, that competitive drive. I think your your humor for sure, and you know, you telling your story, it makes me think that I wonder if a little bit of your humor, because I've seen this in others, or even in myself, where you create humor early in your life to cope with the change of schools and new relationships that you have to form like it's it's like a superpower if you can break the ice and break people down and
get them to laugh. And so I could see maybe that being part of your journey as well, absolutely, absolutely. Again, laughter is the best medicine, and you can always find a perspective to laugh about in the worst. And I've been I've learned that. I mean, I've learned that from patients, right? I you know, you deal with people who are in a horrible situations. And again, as a
young doc, majority of them are horrific. And then you meet that one patient who is the most in the most horrible situation, right? Who can look at it and knows they're going to die in a month and still find humor and make you laugh and bring joy to everyone around them, and you're like, how do you do this? Right? They can find that sliver of humor in all the disaster, and you learn from them. You know, you learn from them. That's
a great example. Comedians have that ability to take, you know, the really traumatic moment and very quickly turn it into a bit for comedy, right? And you've, it's a it's a special ability, and it makes, I think, life probably a little bit more enjoyable, enjoyable. But you definitely have that. That's I
think you need to you. And then the third thing I've noticed, I think, from your story, and then what you've chosen to do, because I, you know, and I'm sharing a little bit because of of me seeing a little piece of your journey here in Houston.
You know your risk tolerance, and I know that there are, there are plenty, I'm sure, plenty of medical practitioners that have some risk tolerance, but it's easy once you get into and maybe I shouldn't say easy, but you get into a habit, you start your practice, or you go into practice, and there's a rhythm to it, and you can see that rhythm for 2030, years. You know, insurance, to some degrees, covers the lead generation for your practice. So you're really focused, and
you've made a choice to step out of insurance based medicine. And I mean, in the medical world, for my understanding, that is a very big risk to take. There's a whole new thing you have to learn to build a practice when it's not based on insurance based, right, right? Yeah. So we're like, how did you get comfortable with risk like that? Ooh, that's hard. And I think it's multiple. I think it's
multiple that's, that's a that's very multifaceted. The risk, I think the risk was based on, you know, the thought of losing what I love, which is, which is medicine. And I think medicine practiced in the way that that I think it should be practiced. I remember I said I started my journey with this little old lady who was Doctor Kent, who had a tiny who made me feel so special, right? Yeah, and that's what I know was good medicine. And again, it's the risk to to to really preserve what you
love, which is really taking care of the whole patient. And you cannot based on the economics of medicine and the way insurance is going, and the value that they they and the way they devalue physicians for economic gain. The you know, I cannot. The reality is the time that I can in order to keep practices open, docs are seeing patients every 15 minutes, and you cannot do what I do. You cannot make a difference in somebody's trajectory. 15 minutes. You need time. You need
time spent. You need to put that half, half of the diagnostics, half of what I do, half, more than half, is hearing and processing your story. And if I can't hear it, if I don't have the time, you know. And I just got to a point where I can't sleep at night and I can't leave this planet half assing this
career the way it's going right now. And so it was the risk to preserve what I thought I prefer to just, you know, I prefer to take the dive and fail than continue to lose love for something that has been the center of my world for so many years. So, so that's where the the drive came from, to to make that switch. And then, you know, I, you know, again life challenges. My greatest life challenge was, my by by far, was
losing my sister. And you know, I remember, before she passed away, she said to me, she was like, you know, she's like, What are you going to be afraid of? What? Why are you afraid? Right? What do you have to lose? You're here, if you're here, then do something with it, right? Because tomorrow's not promised. I'm here to tell you that. And I was like, Okay, I got my walk in orders make it happen.
Yeah, it's saying this is like the risk. It's almost like a risk to what is there's a risk to doing the status quo, because it's, you know, maybe again, easy is not the right word, but it's, it's, there's a pattern, and it's set out before you right, and it's been done 100 times, but, but there's also risk in doing that, because you're not, in your mind, able to provide the right level of service to the patient. And so there's a risk in staying in the status quo, and that's a that's
the risk of regret. And so you can get as a that I want to take the risk where I try and do it the right way and fail in the process, because that's what makes life worth living. Yeah, I love that. I love that. I want just a little detour and then bring it, bring it a little bit back to your current practice, the detours that you know, we're in this middle of this election cycle. And every time you're in an election cycle, insurance and
health care comes up as a as a main item. And I love having conversations with people on all the different from all the
different angles of you know. And I'm not going to put you in a weird political position, but I'm just curious almost, because you've had exposure between, you know, the trip you took to Kenya to doing some of your study in the UK to, you know, living in Canada, and then in the US, you've had a more global perspective on medicine In real life than a lot of people who've been through our medical system here, what's your perspective on
how things are run? And you know, what's what's out there and what's available, right? I mean, I think what's going to be the long the the short answer is, I think that we're going to have to come up with a bit of a hybrid system, because right now, the way insurance is structured, it's for profit, again, the the bottom line is healthcare, which is life or death. And you know, attaching
economics to it is just always going to be dangerous. And right now, we're in a situation where insurance is a great idea, but right now, the cost of it, in terms of what the patient has to pay and what they're getting out of it, adding in really high deductibles, it's almost unattainable in many ways. So I think that the long, the long you know, the economics don't make sense on the physicians. On the physician side, economics don't make sense on the patient side, on the insurance side, it
makes sense, right? And so I think, and they've it's ingenious, right? It's you. You an insurance company. You pit the physician against the patient. And so let them, let them battle it out, and they stand by and just collect from both sides, right? They collect on this side and then they don't pay the other side. I mean, it's, it's ingenious, but it's not sustainable. You know people poopoo national you know that.
You know, you know socialized healthcare. But the flip side of socialized health care is that your your your baby's appendectomy for a pen acute appendicitis won't bankrupt you, whereas in this country it may right. And so I think that it's to have a healthy population, the services need to be accessible. Control, okay, but at the same time it's, it's being your your ability and access is being controlled by a non medical entity, right? Current companies is telling us
what we can and can't do. So it has to, it has to collapse before, and it has to be rebuilt. Yeah, yeah. Yeah. That's a that's an interesting, interesting perspective. I, you know, I grew up in Germany for seven, eight years of my life, and so I had some, you know, European upbringing in my early childhood. And I often think about the every culture is different, and that plays a little bit of role in how things operate. Germans are very follow the rule book, culturally speaking, overall, and so
certain things work really well for them. That might not work over here as well, but, but, yeah, I always wonder, you know that if we had a little bit more perspective on how other systems operated across the world, if we could find something maybe there is, there is definitely, there is definitely room for cross pollination. And then that's, that's where my frustration is, when people are like, we can't go to a
socialized system, or we can't do this. But my The problem is, is that then talk to me, get some cloak, get some get some, some information. Let's have a discussion, right? And I just don't think there's enough cross pollination in terms of development of a sturdy healthcare so could you do? You need a healthy population. But again, part of that is you need
to reward and reward physicians for preventative care. Right? We need to right and and then as a population, we need to take responsibility in terms of, now that we have the information, how do we defer disease? How do we prevent things from happening? And if we start doing that, then the cost of health care will start going down, right? And then, and then we can make better decisions, but like, it's still, like, it's just, it's just a it's a
mess. It is a mess. Yeah, that's, that's one thing we can all agree on, right? But, yeah, we could have a glass of wine and talk about that for like, four hours. But, you know, you know, talk to me about going into a practice where it is a private pay model, like, what's been terrifying and challenging about that, what's been rewarding and freeing about that. What's that path been like for you? Whoo, again, that was a very hard coming. I was, I was trained in socialized
healthcare, right access for all. So that was a very, very difficult, difficult position to be in, but watching the reimbursement go down in terms of what the insurance companies are paying. I mean, docs are barely, barely, and I need people to understand this. There was a time when I used to, you
know, look up to docs ahead of me. And I, I will just say this, that I've had my 21st medical school reunion, so I've been this game for a little while, where these guys used to drive Ferraris, these guys used to do very well, or apparently did very well economically, those days are very much over, right? The surgeries that you think are people are getting tons of
money. The docs aren't getting tons of money from it, right? So the mute they so for me, it was very the the decision the business side was, I ended up doing a business course to get ready for the private practice, and had to really start to calculate the, how many patients would I have to see to cover my light bill, to cover my and then you're starting, you mean it, it was, I had to grieve, right? I had to grieve that I could not sustain an insurance based model and provide the kind of care
that I wanted to care. And I had to just take some time, meditate that away, pray about it, and be like, Alright, look, this is not it. But the flip side of it is the deductibles were ridiculously high. Most patients are not even meeting them, so
they're giving the money away of any anyway, right? So, and then looking at where it is in terms of where we are for health maintenance, and understanding there's this group of patients that are really interested in their health care, in terms of aging, well, in terms of staying on the right side of disease, ie away from disease. And so that population has started to grow, has started to grow. So it was a combination of all those factors
that I could serve as people. And yes, there's so economics involved, but as I've done it, it's been less and less. It's really about people who want to invest in themselves, right? They they want the best possible care, and they know that I'm going to fight for them, and so, you know, they bring their pennies to me, and I will do everything in my power to make sure that they're the best way they can be right and under. But that really had to manifest before I really started to
believe that this was possible. So the nice thing is though, though is that because it's small, like I knew all my patients, and I get a chance to really spend time with them, I get to. Learn from them. We we do shoe shopping in the in the console. We have, we have a really, you know, my guy and I were talking about football. I mean, we really have a wonderful and I look at my schedule, and I love coming to work every single day. Love, love, love, the other aspect of of things I believe
in. I told you I started this journey going on medical missions, and that's something I've continued to this day right now, we go to Guatemala every year to do free surgery. And you know, there was, you know, the year before last, I couldn't go because I couldn't afford to go. And I was like, I'm not giving up this aspect of my life because an insurance company has decided this is the value I'm going to put on all that you do. And so that was kind of pivotal for me in terms of, like, right?
I'm going to give this a go. Where's the can happen is that it fails, but I have the most amazing patients, and they have also been a huge source of encouragement, so I just one day at a time, yeah, and then this last piece of it is that I'm so fascinated in is that you're able to witness the cutting edge development of how technology has implications for cost and impact and health. And you've you are kind of on some of the pioneering side of that.
What I would say more so, right? And that, you know, what I heard from you, and we were eating breakfast the other day, is, you were talking about the testosterone clinics. And, well, you know, I think you could say 5% of the population might have known about testosterone as a form of treatment for maybe five years to a decade, but, like variety of people probably still don't really know what that means. So I thought for our listeners, it might be interesting for you to kind of
describe this like, How did you arrive? You already shared a little bit of that from the women that you worked with, float over to the men, but how did, how did the conversation of testosterone and what did you learn about it that caused you to go, oh, we need clinics for this. Well, okay, so let's take it back a second. I'm going to just when the the whi came and we took every woman off hormones. It was a huge dilemma, because now, okay, well, what do we do
now with these women going through menopause? And then, you know, we were quick, one of the number one surgeries in America is hysterectomy with removal of ovaries, right? And we were doing those a dime a dozen, right? Probably the most common surgery that existed beyond C section. And now they were like, Oh, my gosh. Well, we can't give them hormone replacement. So
now, now you know what? Now, what do we do? Do we leave the well, the argument became, leave the ovaries in because it continues to produce testosterone even after menopause. Oh, when? When did we start talking about testosterone in women? Right? But this is, this was the Forgotten hormone. So we knew that this was part of their well being in terms of
going into the menopause transition. And we would cut that short by taking all the ovaries fast forward and recognizing when I, when I started getting into, you know, studying menopause medicine and hormone management, that, again, this is a source of our well being and and testosterone so important in terms of our transition and in terms of our state of well being, and it all has other, all other health benefits, of which we need a little bit, and y'all need a
lot, alright, but flip side, flip side, we need a lot more estrogen. But my men still have, they have estradiol, and they need to have a little bit, right? You gotta balance them out. Everybody is a yin and yang thing. And so flip to, you know, these patients, these women, are starting to do better in terms of their their hormone management, and then their partner's like, hold on a second. You look better, you
sound better, you feel better. You know, where's, Where's, where's my piece of the pie, and then really getting into understanding how testosterone works in men, almost very similarly to how it works in women and and again, we're very comfortable with menopause. We're very comfortable with the fact that there comes a time in a woman's life the overs just say, stop. We're done, right? We're comfortable with that idea. We're getting better, right? Super comfortable with
puberty, just getting comfortable with menopause. But we're comfortable with the idea that this stops for men. It's a slow decline, right? Over time and again. When we talk about menopause replacement, and we talk about states of well being and hot flashes. And this is it's it's about their quality of life, right? In terms of this essential hormone to being female is necessary at certain levels for me to operate. Okay? So flip it to the men, and now we're talking about
understanding in that slow decline that your. Main hormone needs to be in certain levels for good quality of life, right? So getting away from this concept of testosterone and my penis, right? If my penis works, then I don't need testosterone, right? That is only part of it. Your testosterone receptors are where they're in your muscle, right? They're in your brain. They're in your brain. They're in your brain. They're in they're right. They're in in terms. They're in your skin.
It's, it's everywhere, it's, it's what makes you a man, right? So we know that decline. So for men that are struggling with these certain symptomatology, brain fog, fatigue, you know the they are. It's if, if their numbers come back below a certain threshold, they're just running out of messengers at a, at a, at a slower rate. When we it happens to us suddenly. Yeah. So understanding that it's this is in in my mind, and then we talk about, you know, this is part of
aging, okay? I mean, there are a lot of things that are part of aging, right, but understanding that, if you can make a decision in terms of how that trajectory is, because we know that you're running out of messengers, the question is, do we put give you more messengers so you function better? Yeah,
it's so interesting. I mean, I had a good friend who, you know, married, had a, you know, a little baby girl, he's in his 40s, and he, he told me, he's like, Yeah, I've been doing testosterone treatment because I've just been so exhausted in my like, I never thought that was going to be the solution, but that the doctor I was visiting with suggested I explore it, and we did an assessment, and my my count was
like horrendously low, right? And so it's interesting, but that kind of opened my eyes that, like fatigue may or may not, it may or may not, correlate, right? But it very well could that fatigue, low energy, brain fog and men can have a correlation with your testosterone levels, especially, what are kind of the age markers for when that becomes more symptomatic, I guess? Well, I mean, most of the time we kind of focus on men in their 50s, right, okay, but the reality is, the more aware
people become, right? Men, men are now more open, in their 40s, even late 30s, to understanding if their testosterone is low that they may not be functioning as optimally, right? The idea, I mean, yes, what's, what's a little brain fog or fatigue, right? Go, what? So why don't you stop in the middle of the day and go take a nap? Right? No, you cannot do that. You have to work. You have to provide. You have all these things to do, right? So therefore, how do you optimize your production? Right?
In, in my opinion, the most natural way possible, right? Because I can give you a bunch of things for brain fog, right? I can give you Ritalin, I can give you I'm tricking your body. I can give you Ritalin. I can give you cocaine. I mean, you know, they're all right, they're all these things, true sugar, there are these things. They'll give it will it will give you energy, right? I'm not saying, let's just caveat, I'm not prescribing cocaine to anybody, and you should not take it people. I think
you said a cookie. I was like, give me cookie. I could give you a cookie too. I'm gonna give you a cookie, a special cookie. No, I'm kidding. Um, but, but, no, I'm not prescribing cocaine. But you there are a number of drugs, right, legal and illegal that you can, you can take to mitigate your symptoms, right? Yes, the challenge I put before people is that if I, if I give you a testosterone molecule,
your body knows I don't have to trick it, process it. Your body knows what to their receptors that have a big T on it, and your body goes, I know exactly what to do, right? And I'm not. You don't want super physical, physiologic levels, right? You're I don't want you raging out of here like Hercules or the Hulk, right? You want a nice, even amount, right? And it doesn't take big doses to make you feel, to make you feel better over a longer period of time?
Yeah, yeah. I'm so it's very intriguing to, you know, we don't have, like the whole time to really explore all the science behind it, but I find that you become more interested the older you get, in the science behind these things, absolutely and and in in particular, you know, you think of all the advancements we've made in the last 10 years, of how things impact our energy and our health and and then, you know, testosterone is kind of this, this period we're in. It's
another solution to, like you said, aging and energy. And you. You know, I think a good amount of my energy as a man right now is probably expended on my two and a half year old. I thought
about this after our conversation. We have an assessment in our company called the culture index, and this assessment measures in people behavior profile, but they also measure their energy units, is what they pull it, and they have a pretty good way of defining, like, how big your gas tank is, and it's a variable thing that changes over the course of time. And they suggested that, like, Hey, if you have little kids, you know, your energy unit, gas tank may have shrunk a little
bit the way you take investment, right? Yes, but it made me think that how important energy is in our lives, or especially for business owners and entrepreneurs to be able to maintain, you know, a rigorous workload, and being a dad and balancing all these things so it's Well, well, we, we you. If you think about the number, you make more decisions between 9am and 12pm than someone in 1901, would make
in a week, right? Yes. So, you know, we talk about, or I talk a lot about, decision making capacity, right, the ability to, from the moment your alarm goes off in the morning, you're making decisions, should I get up? Should I stay asleep? Should I get up? Should I go jog? You know, it's this so you are mentally right, doing more than than human beings have done ever. Okay? The other issue is that, you know, you, like me, are a more mature parent. Yes, right. I mean, twice, right? Wise, that's
right, wiser parents. But like, you know, we should, we should really, physiologically, anthropologically, we should be grandparents right now, right? We should be right our kids. We should have had kids at 19, right? Yeah, and then we should be sitting back in our rocking chair taking care of some
grandchildren. This is not how we've evolved. So the demands on us are actually much, much greater, and people need to recognize that, that this is not, we're not naturally built for this, so some level of positive supplementation is going to be necessary to do all the things that we do. Yeah, love that. You know, I know we're coming up on time at two quick questions that are maybe like more lightning
roundish. One is, you know, what are some of the books you've read here over the last, like, six to eight months that you're just think we're really fascinating. Like, these were some, I think my mantra is discipline equals freedom. Okay, so I think anything that you discipline, you will then create. That's the only way to truly create freedom, right? Whether it's your exercise, whether it's your academics, whatever you do it's
It's whatever you put discipline too. So atomic habits has been a by James clear has been a game changer for me, just reinforcing that, especially going into this transition, the one book that I've read three times is the alchemist, which I absolutely adore and and I loved recently because he talks a lot of his Deepak Chopra's, the fulfillment, the spontaneous fulfillment of desire, which is talks a lot about Synchro destiny, in terms of energy and energy between people and your
frequency. And you know that life is really there are no coincidences, that everything is on purpose and a result of what you put out there. And again, you can choose to take that in, but don't, don't ignore, don't ignore, and don't, not celebrate even the littlest things that you think it is part of your journey, and it's how to keep things light and joyful. So that book was awesome for me. So those are the three that's those are great. I mean, I haven't read the last one
Alchemist. I love atomic habits. I love good that's a good series of book recommendations, all very different but, but great focus points. You know, one of the last things I'll share, and then I'll ask my final question is, you have, you know, you a cross section of what we found make great minds work on this podcast is curiosity and curiosity. You know, you can hear it in your voice of what you've that's taken you down this path of research with women and men's health in a different
light. It's taking to reading books. It's taken you to England to study. Curiosity is something I hear a lot from you, because you're always peeling back the layers of the onion to figure out. The next thing I mean you even you know, the way you and I met was you engaged in coaching at a time period when you were transitioning to private pay because you were curious about how you can build a. Practice. And I just love, I love that your curiosity has been also a big driving force, I think, in
your your career. Thank you. Last thing would be this, what, what advice might you give to a 21 year old that was just Terry Samuels was a doctor. Terry, well, I guess maybe you were a doctor by that we'll say, like an 18 year what advice would you 19 year old Terry Samuels pre doctor? Well, I'd remind her that her, your discipline thus far has given you the freedom to make, to give options, right? I remind you. I'd remind her that again, you know, everything is
scalable, right? And everything is is, is doable. So you know, school is your job. It's a game. Find out how to play it. Find out the rules circumnavigate. There is no get over those humps to get to what you want. And definitively, I would tell her, that's the fear, because on the other side, it's everything that you want. Because again, the you know, you growing up, and the fear can be paralyzing. And so you know, I would remind her,
you know, lady, just push past it. Just yeah, have the courage. Don't just do it, and don't be afraid of failure, because, again, it's never really, truly failure, right? What it truly is is that nugget of information that you needed for the next thing. And I've watched that manifest over the years, so I've now, so I would, I would remind her, you know, being fearless, I think is, is not what I mean. Because you want to be able to sit in the fear you you want the adrenaline, you want the ability
to kind of make those decisions, right? So you don't want to be fearless, but you want to be able to kind of step over it like, all right. Oh, felt it fine, yeah. Let's go, yeah. And the relationship to failure. I just had this thought in my mind that, you know, just in the world of medicine and organic chemistry and biology, I mean, failure is the pathway of human evolution to begin with, right? I mean, it's all breakage and failure as a as a learning mechanism for growth, and that's
for a product to that. So what a good note to end on. Terry dr. Terry Samuels, thank you so much for giving us a little bit of your time and wisdom, and maybe we'll do a second part or here in the near future to hear more about cutting edge medicine that you're practicing we can learn from don't get me started. Don't get me started. You.