- You're now three years out of residency.
You've worked urgent cares, primary care offices,
semi-hospitalist positions,
was the juice worth the squeeze?
(sighs loudly)
Hey guys.
Welcome to another episode of the Wednesday check up.
As promised, I have my special guest here, Dr. Luis Espina.
- Hello.
- Dr. Luis Espina's quite the special character.
We did residency together.
Even though we're a few years apart.
Do you want to say how many years apart
or we're not gonna do that here?
- I'm almost old enough to be your dad.
Yeah, so we're kind of a few years apart.
- A few years apart.
I'm putting it nicely.
I'm trying to be as kind as possible.
- You are kind.
- Because ageism is a thing.
- Ageism is a thing.
I joke about my age.
It doesn't really bother me.
- In my last responding to comments video, someone asked,
should they pursue medicine
as a second career in their mid-life?
And I thought to myself, who do I know in their mid-life,
- Hopefully.
- That went into medicine?
And my mind went to no other person
than this lovely doctor by my side
who actually was my senior resident.
- [Luis] I was.
- He was a second year when I came in as a first year
and he was my, quote on quote, buddy, when I was an intern.
And the buddies are second years
that help out the first years.
And then when I was a second year and he was a third year
and we both happened to be on call, we would hang out a lot.
- Yeah.
- Talk about life.
- Yeah, we were roommates for a while.
It was like going away to summer camp, it was a lot of fun.
- Well, you would have to be hanging out in the room
to be roommates, we were running around the hospital.
Especially you.
- Yeah, we didn't do much hanging around, truth be told.
We ran around the hospital.
- What was your career prior to medicine?
- So that's a...
So I was an engineer
I guess I still am an engineer.
I don't have to give that one back.
I was a mechanical engineer first.
Did that for a number of years.
And then ended up doing...
I have a master in biomedical engineering
and I worked for a medical device company.
- Just casually a biomedical engineering degree
- And then here I am.
- Now wait, to me, you told me you used to work on planes.
- So that was before I was ever an engineer.
I went to...
- This guy had 48 jobs prior to becoming a doctor.
- I did, I did.
- I want to figure out how you go from working on planes
to getting biomedical engineering degree,
to then waking up,
working in a prestigious company and saying,
"I want to go back and be a scrub in medical school."
How old were you by the way?
- When I started medical school, I was 37 years old.
A friend of the family's was over to visit.
And my mother was behind me, the lady was down the stairs
at the front steps of my house
and I was walking down the stairs
to help her with something to the car.
And she kind of offhandedly asked, "Luisito," you know...
My dad's Luis and I'm Luisito.
- I call him Papasito.
- He calls me Papasito.
So the friend of the family turns around and she says,
"You know, Luisito,
what do you think you're gonna do for a living?
What do you think you're gonna do?"
And I said, well you know,
I've been thinking about biomedical engineering
and I can still hear my mothers voice over my shoulder.
She says, "Metika, the day he realizes
he has a doctor in his heart, he'll be happy.
He'll be free."
The process started.
Dr. Amartrano, who was my Anatomy and Physiology professor
made me fall in love with the anatomy and the physiology,
and the chemistry classes, and the organic classes,
and biology.
And I just kept falling deeper and deeper in love.
And then I financially, it was just me and my mom.
You know, I was like, "you know what,
maybe I need to get to work and stop with this
nonsense of four more years of school."
So I was like, "we'll do the engineering and we'll get out."
And as time went on, I finished engineering,
I didn't go to school for a year or two.
And then I went to grad school while I was working
and got my masters in medical.
And then at that point it just bit me, you know.
I just really wanted to be a doctor.
I ended up doing grad classes at UMDnJ.
- What was the day
that you say, "I'm applying to med school"?
- Do you remember the day?
- Yeah, I remember applying.
And I remember that--
- Did you tell your wife before you applied?
- Yeah.
Well, we weren't even married yet.
We weren't even married yet.
- Well, I'm gonna call her your wife.
- Gosh, yes, we've been married forever.
But we were dating still at the time.
And she knew what I was doing.
- Did she say you were crazy?
- No.
Jennifer's always been
for some bizarre reason, the woman's always believed in me.
And she just, in her mind,
she knew it might be messy, but it would get done.
We were talking about getting married.
Buying a house and everything else.
- But instead, you're like,
"I wanna do the $275,000 in debt
and eight more years of education."
- Yeah.
- Because you really wanted to meet me in the future.
- I did.
I did. - Was that it?
Man, you were the cherry on top.
- I hate making this channel about me,
but I feel like that what it was.
Just be honest. - It really was.
- It was all about him.
I knew that he was coming out of his diapers at this time.
But, yes. (Dr. Mike chuckles)
For me, among the things
that I love about being a physician,
when I'm at work, I never have to justify
to myself, what it is that I do.
I'm a very simple guy.
I'm not a complex person.
I need to just be able to very quickly tell myself,
"okay, you're doing this for this reason."
So, when I walk in to the room and I close the door.
And it's me and the patient
that's why I'm doing it.
- What's the biggest surprise
starting third or four year of clerkships,
when you're actually at the hospital that shocked you?
- A lot of things shock you.
Fatigue shocks you.
Exhaustion shocks you.
- To me it was paperwork.
- Well, that didn't shock me as much
because I... - You have more experience.
pay more attention to it.
The other thing that I will tell you,
that I still, to this day,
I've come to terms with it,
but it is something that I deal on a daily basis,
which is I wrap my arms around my own ignorance.
- Okay.
- The greatest thing that I learn in medicine
is how much you don't know.
And how much you have to constantly read and study
and read and study.
There is no "oh I graduated and it's over."
It's everyday of your life.
Just now we were talking about something.
It drives me so crazy that I have to look it up right away.
And read about it.
And what is it.
And refresh your memory.
And I say that's part of the charm.
- You're always learning.
- If you love to learn and you're like a nerd like me.
- Like us, can you throw me in?
- You are, you are, man. Like us.
- You speak nerd fluently. Okay, good.
- And that's a good thing.
The drive basically comes from that.
It's that combination
of the most beautiful things you can imagine.
Science with all its beauty.
Technology nowadays is incredible the things that we can do.
And then you add a human element.
And that is honestly, one of the most beautiful parts of it.
If not, the most beautiful part.
When you close the door in that exam room.
And it's you and the patient,
it's a dance.
A lot of times the patient comes in
and the chief complaint
written down by the MA is sore throat.
And you walk in the door
and before this visit is out,
this patient is crying their eyes out
telling you their deepest fears
and things they've experienced
and pains that they're having.
Things that they were terrified of.
They told the nurse that they had a sore throat.
But you have that moment and you make that connection.
And to have the privilege
of walking that mile with that patient
is something kind of heady and kind of big.
I, you know, I would complain about being tired,
I would complain about the paperwork endlessly,
my son will just look at me when I work on something,
and he goes, "ugh, notes."
- Electronic health record.
- It's agony EMR.
- Prior authorizations, all these things, they're crazy.
And it's the price you pay for the privilege of the dance.
- He's so much more poetic than I.
I make my video about med school.
And I keep it super practical.
This guy comes in
and makes an analogy of medicine as a dance.
- Don't let him kid you.
- (chuckles) This guy.
- One of the things about this experience
as I said is the people.
So when I first find out who my buddy's gonna be.
(Dr. Mike laughing)
I see this guy's picture and I'm like,
"oh, who's this young, pretty boy,
I am not gonna deal with this kid."
So one night, I was sitting in my cubicle,
he was sitting at his cubicle.
And it's really the first time we've ever exchanged words.
'Cause he was on other rotations.
In the first few hours that I knew this young man,
I knew that I'd met another brother
in this walk through life.
And I realized the depth and breadth of life
that one can experience in such a short time.
And it was another reminder
of don't ever judge the book by the cover.
Get to know the story.
Find out what's going on.
Because you have an opportunity to meet amazing people.
And do beautiful things.
And learn and experience.
And that's something I've gotten from him.
- What is the biggest challenge
that you had as a almost 40-year-old
in comparison to your 20-year-old colleagues?
- Fear.
- What fear is that? Fear.
- What were you afraid of?
- Fear.
I was afraid of everything.
I was afraid of making the wrong decision.
I was afraid of not knowing enough.
I was afraid of...
When you're 20, you look at the patient
as them and you are us.
And this is game.
And it's A, A, up stick, up stick, right trigger.
- He knows what that is.
I'm impressed already.
Can you do it a little bit more realistic?
- Right, so you know, A, A,
up stick, up stick, right trigger.
- There's no A on the Play Station controller.
That's Xbox.
- I'm not saying that they don't care.
I'm not saying they're not empathetic.
I've met young, young people, that care.
It's just, there is a separation.
I was that young once.
And you look at a 40, 50-year-old, and you go,
"God, never."
I look at you guys and I'm like, this was last week.
What the hell happened to me?
Where's my hair?
What's with the gray?
When I would see a patient,
it wasn't "holy cow, you have this disease," it was like,
"my god, man, we have this disease!
"what are we gonna do?"
You know, it was that fear.
It was the fear of making the wrong decision
about residency.
It was the fear of studying for the test wrong
and studying frequently wrong for the test.
- Is that because the family is on your par?
- Yeah, 'cause the stakes were so high
it was any mistake that I made,
I felt like I was failing my wife, my son.
- So how did you deal with that pressure?
- Badly.
I internalized a lot of it.
I used to smoke like a bloody chimney.
- As a doctor.
- I remember the first time that I saw in anatomy lab
that I saw lungs from a smoker it made me so nervous,
I went outside and had a cigarette.
- Don't do that.
- It wasn't until the end of medical school
that I actually stopped.
And it was, you know, stressed, and bad sleep
and I wish that I could say that my age and maturity
contributed to smooth sailing and everything is beautiful,
the truth is, it was not that.
It was a road of many falls.
And picking yourself again and facing it again.
And again.
And feeling like you don't deserve to be here.
And getting up and facing it again.
And that constant feeling of fear
and self-anger and loathing for your inadequacies.
And even with the patients, when you don't know the answers,
when the attending ask you any question,
you feel less than.
And I've seen that a lot in older students.
There's that commonality that there's that pressure of like
"my god, my husband's gonna kill me,
"my wife's gonna kill me, my partner's gonna kill me.
"I gotta do this."
And you know, it adds another element.
- Positive.
What advantages did you have being nearly 40 in med school
with colleagues, like myself, in 20's.
- That you would have to kill me to make me quit.
You would have to kill me to make me quit.
They were gonna take out a graduate
or they were gonna take a cadaver out of that school.
(Dr. Mike laughs)
They was no other way it was gonna go.
- Now, what about life experiences?
Didn't that help?
- I've always been a guy
who could talk to anyone.
And it's useful.
Because those experiences are valuable.
When somebody's in pain, and they're showing up,
and they're in pain and they're terrified,
you need to be able to connect to that person schnap.
- Quickly.
- And if your perspective is very limited,
you've only had certain experiences in life,
these are your circle of friends,
these are the only people you know,
you haven't failed in life,
you haven't had a bad day,
you haven't, you know, had these things.
It's harder to connect.
It's harder.
I've seen people do it.
It's harder.
- Well that's why diversity in medicine is important.
And not just sex, religion, race,
but also of ideas, all of this needs to be.
- Absolutely.
- I was 24 when I started residency.
Everyone would look at me and be like,
"are you...what are you?
"You can't be my doctor."
So there was some preconceived notion to being young.
Did it help being an older presence in the room?
A more mature presence, sorry.
(Dr. Luis stutters)
(chuckles) Don't hit me.
It does.
It helped.
It's certainly an advantage.
The negative is the fear.
The positive is you bring to the table all these things.
- Yeah.
- And the other thing that I also saw a lot
with the older students was you'd have to kill them.
They would not quit.
- On the day of your residency graduation,
which I was fortunate enough to attend,
here's some cute pictures of it.
Me and little Loui.
- [Dr. Luis] That's my boy.
- [Dr. Mike] What did your wife tell you?
- My wife and I don't really have to talk too much anymore.
She can just look at me and tell me a story.
Sometimes just the way she'll touch my hand,
I know what she's thinking.
And it was just a long, long, long, long hard road.
And it's not over.
What I always feel from her,
and I'm eternally grateful for it, is her support.
And I feel her love, I feel all of that,
but my wife and I, we've been together a long time.
And we've done a lot of things together,
we scuba dive together,
we've gone mountain climbing together,
camping, kayaking,
she's my partner-in-crime,
she's my best friends,
we do everything together.
So there's a lot of communication
that goes between us without words.
- Okay.
- 'Cause she's been my partner throughout all of this.
She doesn't have to say too much.
She just kinda have to look at me and tell me you know,
she's proud.
- What did her look like?
- She was proud.
She was proud and that every once in a while, she's like,
"the old man can still keep going.
"so you know, he's doing all right."
- You're now three years out of residency.
You've worked urgent cares, primary care offices,
semi-hospitalist positions
was the juice worth the squeeze?
(Dr. Luis sighs)
- Yes.
Yes.
Now, I reserve the right to complain.
(Dr. Mike chuckles)
I love being a physician.
If you ask the engineer, "did this make sense?"
The answer, logically, would be no.
The opportunity cost to get into medical school,
and to be in medical school is so high.
The debt is daunting.
And you have a family, and you know, it's daunting.
It really is daunting.
That being said, you know sometimes I joke
and I call medicine my mistress.
You know, she takes my money,
she keeps me away from my family,
(Dr. Mike chuckles)
she runs me ragged and treats me bad.
(chuckles) But I love her and I keep coming back.
I don't know how else to say it.
It's a beautiful experience to care for your patients.
It's so beautiful.
But you are putting your family through a lot of sacrifices.
You are putting yourself through a lot of sacrifices.
So my advice to anybody who's gonna do this,
if you are doing this because you wanna drive a Maserati,
and you wanna have nice clothes, you wanna live,
you might achieve that.
If that's your reason,
I think you would be better served doing something else.
You have to love the science.
You have to love the learning.
You have to want the ball.
Again, old movie, winners want the ball.
You gotta be that person.
You want the ball.
You always want to be the one.
And if that's you, come on down.
I think there's no better way to end that.
- Yeah.
- We have to hug it out.
- Alright.
- Guys, thank you so much for watching.
If you wanna see this gentleman again.
Come back on Sunday.
We're gonna do a Grey's Anatomy review.
If you wanna see more reviews, medical drama reviews,
Adam ruins everything reviews,
click here down below.
And as always, stay happy and
- And healthy.
- You know it.
(bopping music)