Cancer Makes This Chiropractor a Better Doctor with Bobby Maybee, DC

[0:00] Kathy: Have you ever almost died? I mean, I’ve done burpees, so spiritually, yes. Okay, well, today’s guest actually almost died. Like, hospital every day, specialist on speed dial, almost died. And here’s the wild part, he’s a chiropractor. Like, no chiropractor ever has ever almost died before. So, he’s lying there, totally at the mercy of nurses and doctors and techs, and he has this massive epiphany about what it actually feels like to be a patient. And spoiler alert, it’s not all

[0:30] about outcomes. It’s actually about whether your provider can find the vein on the first try. Oh, that’s where we’re going today. Yes, we’re going there. Because if you think your patients care most about your technique or your fancy diploma on the wall, you might be dead wrong. Pun intended. Okay, here we go. This is the PTCH. What happens when a chiropractor and a physical therapist get together to make a health and wellness podcast? But chiropractors and physical therapists don’t like each other. Oh, think again. I’m Dr. Kathy Lynch,

[1:00] physical therapist who likes to help people move and get stronger. I’m Dr. Jason Young, an evidence-based chiropractor who uses humor just as much as adjustments to help people get better. Welcome to the PTCH Podcast. Remember, there’s no I in PTCH. Uh-oh, here we go. We’re back. Welcome to the PTCH Podcast. Jason: I’m Dr. Jason Young. Kathy: Dr. Kathy Lynch. Yes, and I want to introduce our guest today. This is Dr. Bobby Maybe.

[1:30] Bobby: Hello. Jason: Yes, as mentioned, he is a chiropractor. And spoiler alert, he lived. Bobby: I did. Jason: He lived. Yes. Second spoiler, doctors are awesome. Now, we’re really glad to have Bobby. Bobby’s been a friend of mine for a long time, couple of decades, I would say. Very well respected in the profession by good people. And the bad people don’t respect him. So. Bobby: Simple as that. Jason: Yeah, pretty much. Sometimes

[2:01] that’s just the whole scorecard, right? Is who respects you and who doesn’t. Well, let me tell you a little bit about him. Bobby, where are you from? I should have asked that first. Bobby: San Luis Obispo, California. Jason: Oh, yes, okay. Another Californian. San Luis Obispo, California. No, okay, very good. Yeah, you know, I think that there’s two types of Oregonians. There’s native Oregonians, which are actually born here, and then there’s what I call true Oregonians, which — that’s you and I — we’re people from California who live here. No, Jason, there are native Oregonians, and there

[2:32] was a thing called the Oregon Trail. Everyone that comes after that. Yeah, it was actually a video game. I’ve heard of that. Well, let me tell you a little about Bobby. Like I said, he’s a chiropractor, you’re practicing up in Portland, yes? Bobby: Yes, sir. Jason: And what’s the name of your practice up there? Bobby: It’s Bobby Maybe DC. Jason: Bobby Maybe DC. What a crazy name for a practice. Original practice name was Wellness in Motion, and before that Middle Path Medicine, my partner was Gary Forseman, MD, a

[3:02] integrative oncologist, by the way. Jason: Oh, really? Bobby: Internal medicine specialist. Jason: Wow, no kidding. Bobby: Yes, we ran an integrative clinic. Jason: Yeah, sweet. I love it. So, he is also a basketball referee. Bobby: I am. Yes. Official for high school, hopefully soon college, and wheelchair basketball. Jason: All right, that’s good. So, hey, maybe I could play basketball then. One of these days. One of these days, yeah, I’ll finally be able to block somebody. Okay, and you’re a veteran. Bobby: Yes. Jason: Thank

[3:34] you for your service. All right, also you’re smart, you joined the Air Force. Bobby: The Chair Force. Jason: The Chair Force, right. You deployed mops and things like that. Bobby: I deployed equipment around the hospital, and yeah. Jason: Awesome. Files and charts and intense. That’s good. And let’s see, practicing for 20 years. Actually first met you when we were in chiropractic school. You were just finishing up as I was starting. Yeah. And so, that was about all I remember. I was just watching you

[4:05] walk away. Well, the whole thing’s a blur, right? It is, yeah. Kathy: How about PT education, a blur as well? Yes. I mean, while I was in school, I felt like it was 10 years while in school, and it was only three. I’ve been out for 10 years, and I’m like, boy, this has gone by quickly. Jason: Yeah, it’s like — the thing that I think about when I think about how overwhelming it is — I remember when we got to Western States Chiropractic College. Kathy: Yes. Jason: I couldn’t work, so we had to go get

[4:36] food stamps, and my wife sent me, because she didn’t want to go get food stamps. So, I sat down, and I was talking to the lady, and she’s like, so, why aren’t you working? I was like, oh, because I’m in school, and I can’t have a job and do school at the same time. She’s like, well, you should — lots of people have a job and go to school. I was like, no, I worked full time when I was doing undergrad, but here I have like 30 credits. She’s like, no, you can’t have 30 credits, because

[5:06] no school allows that. And I was like, well, here’s my — I happen to have my schedule. This is my schedule. So, she said, what you should do is you should drop out of school and support your family, sir. Yeah. That will be the plan. Yeah, and so, it’s a blur, because it’s pretty intense. And I will apologize in advance, because I have my own podcast, so I might interview you guys on there. Bobby: Oh, yes. Yes, and we want you to plug your podcast, too. Forward Thinking Chiropractic Alliance with Dr. Bobby

[5:36] Maybe. Bobby: Nice. I know that guy. On Spotify. Jason: Sweet. We’re going to link it in the show notes. It won’t do you any good, because nobody reads the show notes. But on the outside chance — it’s a two-way street, no one’s listening there, either. Yeah, sweet. We just listen to each other’s podcasts all day. We should actually queue it up and just play it right now in the background. Get double plays. Yeah, oh gosh, I’m

[6:06] actually remembering I’ve been on your podcast before. That was a long time ago. Changed my life. Look for the email. It’s very memorable, it sounds like. Yeah, she has an NDA, so she can’t. No, I’m just All right, we’re working our way through your bio here. Okay, so, chiropractor, referee, veteran, wife, five children. Yes. Okay, and probably one of the coolest things about you, one of the most unique things about you, is that you started

[6:37] a movement. It’s not really an association, it is an organization, but more than anything it’s kind of a movement, I would call it. Probably so, yeah. Yeah, the Forward Thinking Chiropractic Alliance. It was a time and place thing, but it stuck. So, the Lindy effect is in effect, it’s been around for more than a decade, so it stuck. Okay, is that what the Lindy effect is? The Lindy effect is the longer something sticks around, the more likely it’s going to last. All right, nice. That’s good. You got a good piece of furniture that hasn’t broken in the first two years,

[7:07] it’s probably going to last you a fair while. Does not apply to old people. No, the Lindy effect does not apply to biological species at all. Damn, even chiropractors. Even chiropractors. Does it apply to podcasts? I don’t know. It can, yeah, well, absolutely. There comes a point when you run out of money. Well, so, the Forward Thinking Chiropractic Alliance, I was trying to put it into perspective for Kathy, because I think it’s best known for it’s

[7:39] got a Facebook group. And now that people have heard this, you’re probably going to get five people that want to join. Yeah. I hope so, it’s going to blow up big. Yeah. So, but it’s a huge Facebook group. Like, a lot of people, if you’re like in some moms’ kids Facebook group, it’s like 500 people. Your Facebook group has over 10,000 people in it. Close to 12, yeah. Yeah, well, okay, and there’s 70,000 chiropractors. Which isn’t unusual, I mean, there are other chiropractic

[8:09] Facebook groups that have 10,000, 12,000, or whatever, but they’re not as traffic heavy. Yeah, and it’s 75% bots. Yeah, one of the reasons is we get rid of all the nonsense. Yes, it’s highly curated. People can talk about whatever they want, but you have to fit within a certain boundary. And we don’t let spammers in, and we don’t let nonsense conversations happen. Right. And yeah, when there’s sort of a jerk — Mhm. — in the group, we just, you know,

[8:40] you can find somewhere else to do that stuff. Yeah, so it’s moderated pretty nicely. And that’s one of the things that’s nice about it. And the thing is, I think one of the things that’s impressive about it is there’s people that think that it’s like, oh, it’s all about your philosophy, and that’s what gets you kicked out — and that’s not true, because there’s people in there that have different philosophical views. It is about your behavior, because I think that there’s even people who philosophically, you know, we align with, but they can’t behave themselves, and so it’s like, hasta la bye-bye. Well, you have to also

[9:10] remember, like I said, this group has been around for over a decade. 12 years going on 13 now. When I first started, it was very split on that sort of philosophy. It was an escape or a safe place for evidence-based chiropractors to have a conversation without the straight chiropractors coming in and blowing up the conversation. Put down your vaccines. Yeah, you’d want to — random vaccine talks, or you would even just be talking about a concept in rehabilitation, you’d be like, why are

[9:40] you talking about rehab? All you have to do is adjust C1, and — Yeah. — that takes care of everything. So, it was a little more pedantic and like serious in the beginning as far as the party lines. But I met this guy named Greg Cook. Have you ever met him, Kathy? I’ve never met him, but I know who he is. We had breakfast because he spoke at one of our Forward Thinking events. And he’s a physical therapist, yeah. Yes, physical therapist. And I had breakfast with him every morning. It was kind of like my extra bonus treat for inviting him along. Mhm. And he kind of knew about the

[10:11] FTCA and what it was doing. He knew I was kind of like trying to fight the bad guys. And I use these in air quotes because they’re not bad guys. They’re just a really dumb old philosophy from the 1800s, right? And on the way out on his last day, our last breakfast together, he’s like, “Bobby, I got—” He’s got his southern drawl, you know. It’s like, “I got to catch a flight, but I just want to let you know something before I leave. You can fight evil if you want to. But you’re going to get some on you.” Oh. And then he winked and he walked off. Like just walked off like a space cowboy. There you go.

[10:41] Okay. And he knew Gray. Yeah. And if he knew Gray, you think that — I’m picturing him walking away and he’s got a guitar. And he’s got a glint in his eye. He’s like, “I got it.” And I knew then like, “All right. We have to be a little bit more diplomatic about what we’re doing here.” Mhm. Yeah. And allow people who maybe don’t agree with what we’re doing to at least hear what we’re saying. Right. And then if they can find a place and behave, Yes. they’re going to get — more

[11:11] people are going to hear this conversation from a sort of a positive angle. Yeah. And then we also learned that some of the evidence-based chiropractors are kind of jerks, too. Like — Yeah. — and they’ve got their own pedantic things that they go on about and are intolerant as well. And so those folks had to go, too. Yeah. So it’s nice because it’s heavily curated and it is a love-hate thing. You love it or you hate it. I love it. I’ve gotten a lot out of it. So, and I’m being paid very well to say that.

[11:42] It’s deep pockets, huh? Well, that thing gave me cancer, so Yeah, and you know, we should talk about that because I think that — well, I’ll tell you about this from a groupie’s standpoint. Like, you weren’t really public about this until you were. Until you had to be, really. And I think that to a lot of people it just really came as a shock. It was like, “Whoa,

[12:13] holy crap. Like something’s wrong with Bobby?” Because at the same time we had also in that group we’d taken some hits. Yeah, we lost two greats. Kathy: Yeah. Two greats. Chuck and Greg Friedman. Yeah. Just amazing people. Jason: They passed away. Same thing. Cancer, yeah. Wow. And they were very stoic and silent about their— Kathy: Mhm. Jason: —illness and their struggles, yeah. Kathy: Yes. And there was mixed feelings about that, which it’s okay to have mixed feelings about it because it’s their business. They can do it however they want. But there was some people that

[12:43] were like, “Whoa, wait. What? You’re— you’re gone?” And it just— it hit a little harder. So it was scary to find out that you were— you were dealing with this. And then to kind of see you go through that. And the thing that really kind of was like, “Holy crap. I got to get Bobby on right now,” was you sent out an amazing email about your experience and I sent it to Kathy. Kathy: Yeah. Oh, yeah. And yeah. So why don’t you just kind of walk us through like the beginning parts about that? Like how do you even find out that you have cancer? Sure. Well, you know,

[13:15] and then in retrospect I’m looking back at that email and I’m like, “Oh, this looks like one of those horrible LinkedIn articles where— Jason: Bobby: —like five things cancer taught me about network marketing.” Jason: Bobby: But there were like three main points I took away. But we can go to the beginning for sure. Yeah. It’s not like what you read in the textbook as a provider. Kathy: Mhm. Bobby: That someone’s going to show up with these certain cardinal things and you’re just going to go, “Oh.” Oh. Although that has happened in my career where someone’s walked in with the cardinal signs. Yeah. Night sweats,

[13:46] unexplained weight loss and all that stuff and you go, “Oh, I know what this is.” Right. When you’re a provider or supposed to be a smart person, you actually don’t figure it out that quickly. Like Occam’s razor takes control. Jason: Sure. Bobby: It’s going to be the most obvious thing because I’m youngish and I’m— I’m healthyish. And I’ve never had cancer. So how would I— how would I get it? Right. And it’s not in my family. It’s not like a thing. And so— we came home from— it was before a family

[14:18] vacation to Mexico. Just wasn’t feeling good. Kathy: Mhm. Bobby: Not that big of a deal. And it was after an ACA convention, which those people— I’m just joking. I’m— I’m the Oregon representative for the American Chiropractic Association. But after coming back from the convention you always feel a little ragged. You’re like, “It’s an ulcer.” Jason: Bobby: It’s those people. It’s indigestion. So like malaise. And then when you’re on vacation you should be having a good time. I was not having a good time. Coming back from the vacation, it felt like a little bit of back pain.

[14:48] Not that big of a deal. I’ve had back pain. I’m going to do all my things. We’ll do all the things I know how to do. Right. Jason: Didn’t get better. Wait, the foam roller didn’t fix anything? Bobby: My foam roller did the trick. Kathy: Yeah, did the foam roller vibrate though? Bobby: The foam— roller— He didn’t try it. I didn’t have one of those. That’s probably— that was probably the difference. Jason: That’s the difference. That was probably it. Yeah. Bobby: All the things didn’t kind of work. I was consulting my little AI chatbot thing. What do you think it is? Give me some

[15:18] differentials. That’s a mistake and I want to say that right now for everybody. Jason: Bobby: Everybody out there who’s listening— both of you, listen up. Jason: Kathy: We know their names. Do you want me to call them by name? Bobby: Don’t use AI for your possible healthcare conditions. Jason: No. Bobby: Even if you think you know what you’re doing or even if you trust it, it’s probably going to be wrong diagnostically. Jason: Right. Bobby: It’s probably going to tell you the thing you want to hear. Kathy: Yes. Bobby: And so it told me all the Occam’s razor things. Kathy: Mhm. Bobby: Oh, it’s

[15:48] you know, indigestion. Kathy: Mhm. Bobby: Kidney stones. Jason: So take a supplement. Bobby: Mhm. Oh, it’s kidney stones. So take a little cranberry juice. Maybe you should see your doctor. All these sort of things. It got to the point— and I was walking. I did go to PT for back pain. Kathy: Mhm. Bobby: And it helped with some of the back pain, because I actually was having some back pain because I couldn’t sleep. Jason: Yeah. Bobby: And this was the weird part. If you’ve got pain that you don’t understand, Kathy: Mhm. Bobby: have somebody figure out what it is, because my back pain wasn’t

[16:18] pain. It was like I would lay down on my back and feel this tremendous anxiety. Jason: Oh, interesting. Bobby: Don’t lay in this position. Kathy: Oh, wow. Bobby: It was weird. Yeah. And then I would just lay in a different position and sleep. But as the tumor progressed I would get onto my side and then I would get the same sensation. No, no, no, don’t lay that way. So I was slowly and surely like encased in this— only one position I could ever sleep in— and I was almost like sitting up in a chair. Jason: Interesting. Kathy: This is where— yeah. Bobby: you should sort of

[16:48] be like, “Something’s going on here.” Jason: Yeah. How long did that last? Bobby: So— back to the AI chatbot. That period was actually pretty short. So we’re talking May, June, July is the period where all the things were developing. Now in that time I was seeking healthcare. They just weren’t finding it. Kathy: Okay. Bobby: And you don’t always get the mnemonic words from your patient of like, “Oh, I— I have unexplained weight loss.” Jason: Yeah. Bobby: I have intractable pain. Jason:

[17:18] Bobby: I was actually losing weight on purpose at the same time. Kathy: Okay. Bobby: So a lot of this stuff overlays, right? Yeah. My A1C was 10 when this started. And that’s absurd. Jason: Yeah, it’s very high. Bobby: Like the normal range is five, five and a half. Yeah. And then after I started my walking it was back to 5, 5.5 or whatever. So we’ll just take that as an aside. It was probably a tumor-induced hyperglycemia. But we’re not going to go there right now. But they were like, “Your— your A1C is

[17:48] 10. That’s ridiculous. You’re diabetic.” I’m like, “Shh. Not me, you know.” Yeah. And I was right. It’s not me. Something was wrong, but they didn’t want to go beyond the yeah— easy to find diabetes diagnosis. Jason: Right. Well, and do you think that there’s a piece of it where— because I don’t know if your providers know that you’re a healthcare provider. But I sometimes worry that I’m looking for the most favorable diagnosis because I don’t want to have that conversation with the healthcare provider— there’s something really wrong. Right? Do you

[18:18] Think that — do you think that that played into it at all?

Jason: To be really honest — and I’ve got an example of this as well. I tried to be really honest with my symptoms and my conditions and not try to frame it in a way that would be favorable, cuz I knew that I would do that. I knew that I would have bias. I did want — by the time I went to the doctor, I wanted him to figure it out. Yeah. And by the time I went to the doctor, it was the ER, cuz I had not slept for two days. My normal routine was to go on a little walk —

Kathy: Yeah.

Jason: — and I would feel a little better, and then I’d be able to

[18:48] sleep after some moving and stretching and all that stuff. After I would go to pee, I would feel much better and go to sleep.

Kathy: Interesting.

Jason: And you know, when you’re a physician or a healthcare provider and you’re listening to all these — sort of like listening to me say these things — you’re like, “Oh, well, of course. Of course. Sure. Of course.” When you’re living them, it’s not “of course.” It makes sense. When I would start to then do my walk in the middle of the night — I would have to do it in the middle of the night with a little lamp on —

Kathy: Mhm.

Jason: — because that’s when the pain was the worst. I would go out into the bushes and just hurl into the bushes to get relief, and then come

[19:19] back home and go to sleep. That’s when I’m going to the doctor. Yeah. And the night instigated it the most, cuz I did think it was kidney stones, but I thought they would sort of pass. Sure, yeah. I passed a stone or whatever. That’s not right, but I never said I was smart.

Kathy: Yeah. Well, it’s — I mean, one of them is cognitive dissonance.

Jason: Yeah. Not a kidney stone — cognitive dissonance. Yeah. Yeah, absolutely. It’s just like this — it can’t be. And there’s other people that are very talented and

[19:49] they think that everything’s wrong. But so I went to the emergency department.

Kathy: Mhm.

Jason: And I thought I was going to be very open with my symptoms. I said, I’m going to lay it all — everything that I’ve experienced — I’m going to lay out to this doctor. So I’m going to say so many of the right words, she’s going to get it and she’s going to solve this. And I gave her all the words and I laid it out there, and she was like, “So you have pain when you’re laying down on your back?” Well, yeah, at nighttime, but it’s not pain — it’s more like an anxiety. She

[20:20] goes, “Anxiety?” Like, well, yeah, but it’s also like — it’s like — it’s hard to describe, which should be the sort of like a factor. Like she’s like, “Have you heard of Prozac?” And that’s where we’re going. And probably — she probably did the worst physical exam you could possibly imagine. No one will ever know her name, and she never got beat up for this, so no one is ever going to know who it was — and we almost said her name.

Nobody’s going to know that her name is Dr. Jill — no, no. But she said, “I, you know, I think you just have anxiety around your pain,

[20:51] and you need some trazodone or whatever. To sleep.”

Kathy: To sleep.

Jason: And I’m like, yeah, lady, I do have some anxiety around my pain.

You’re right about that. I was like, are you serious? You know where I am? Are you serious? And I’m looking at — she’s like, “Bye,” you know, and I can hear her in the next room over talking to that patient: “I think you just have anxiety for your pain, so here’s some trazodone or whatever.” Yeah. And I’m like, oh no. So I went home and told my wife, and

[21:21] my wife was like — that’s garbage. I’m — all these with your PG-13, man.

Kathy: I know, we have to tell them it’s a PG-13 show. I don’t want any cuss words out here.

Jason: But I called my primary care provider — so that was nonsense, I want more investigation here. But that took 3 weeks to get in.

Kathy: Of course.

Jason: So that was the big delay. In the 3 weeks — that’s pretty quick. Walked in, told my primary care provider the exact stuff. She was like, “Oh, CT right away.”

[21:51] By the time I got home, they were already on the phone like, “Come back, go to the ER.” And I just looked at my wife and I’m like, that can never be good.

That’s not a kidney stone. It’s like — it’s a hangnail, dang it. And I gave her a hug, and that was it. And they were like, “You’ve got a massive tumor in your tummy.” They said “tummy,” but —

— you’ve got a massive tumor in your tummy that has encased your aorta and is constricting it. And so we’re taking you upstairs right now.

Kathy: Yes, yes you are.

Jason: I was like, what’s upstairs? Hopefully not the

[22:22] morgue.

Kathy: No, that’s — that’s where it is. Typically that’s in the basement or right behind the ER, yeah.

Jason: There we go. So that’s when it all started. And during that scenario, I only had empathy for the doctor in the ER who had to tell me. I didn’t have empathy for myself — I mean, it was a shock, of course.

But I’m like, man, I feel bad for you that you have to say that.

Kathy: Gosh, I can’t even imagine.

Jason: So — giant cell tumor — oh sorry, germ cell tumor. I always call them giant cell tumor. Germ cell tumor, retroperitoneal,

[22:54] right in between the aorta and the kidney. But they’re not balls — some people think of tumors as balls; they’re more like amorphous things that are taking up space. And it was filling up space around the aorta, pushing on the kidneys — that’s why it felt like a kidney stone. Yeah. And they were like — I mean, germ cell tumors do not go to like the stage four where they kill you per se, but they can, cuz they take up so much space. They suffocate you, basically.

[23:24] Kathy: Weird question — did you name it?

Jason: Once again, you’ve got a PG-13 —

— so the answer is yes. I had a couple names for it. Yeah, I had a couple names for it. You mother —

— squeezing your aorta. And you didn’t really have a

ton of pain symptoms.

Kathy: No, and — you know, vascular surgeons checked it out. I think it visually looked like it was compressing the aorta, but it wasn’t actually structurally, physically, or physiologically.

[23:57] Kathy: Okay.

Jason: Your brain

knew it was there, and that’s where the anxiety was, I think. I mean, in my estimation — it feels like, in retrospect, everything always makes sense. I had — we haven’t discussed yet, but I’m a basketball official — so this was happening around June of last year, and that’s summer league and summer camps and things. I did all summer league and camps all the way — I mean — to the end of June. There was a 3-week period where it just got extremely worse. Within those 3 weeks. So I was perfectly

[24:28] physically active. I mean there are some signs where if I look back like, oh no I wasn’t doing that good. And my wife was like, no you could see in your eyes that you were sick somehow but no one knew what it was. And obviously I wasn’t sleeping but like 2 hours a night on any given night but none of that stuff like really sort of clicked. And I do want to say there are three phases to this process. The first phase and this is for anybody who’s not gone through this

[24:58] who hasn’t had a family member who’s had serious illness or cancer, someone who hasn’t had it themselves. The first phase is when they’re trying to figure out what’s going on. And that might be the worst — is when nobody really knows what it is, because a retroperitoneal tumor can be a number of things. One of them, the worst case scenario, is probably lymphoma, which has a very poor survival rate, and that’s what they thought it was. So I thought I was gone — I was a goner.

[25:28] That’s number one on the differential list. Number two would be these germ cell tumors, and there were some other stuff further down — these IGF type of inflammatory diseases — and they were kind of like, we hope it’s that, because that’s the one you kind of want. And I’m looking at the doctor, the inpatient doctor, and I was like, but it’s not that, is it? She’s like, no it’s not that. We’re going to — we’re going to — we’re going to look anyway. It’s not that. She was very — she was very awesome, because I’m like, I didn’t want the CT scans. I’m still sort of in the

[25:59] naturalistic fallacy type of mindset — like I don’t want tons of imaging, like stop wanting to keep scanning me and scanning me — and she’s like, look, dude, you’re going to do all this stuff. You’ve got little kids. You’re going to do all of it. You’re going to do everything you need to do. You’re going to get all the scans because you have to. You got the family and the kids. You want to win. You got to do all the things. The second phase is when you need the treatment. So whatever the treatment is.

[26:29] And in my case it was chemotherapy. For germ cell tumors they can also do retroperitoneal lymph node dissection, because it’s usually a lymph node that’s blown out, and they’ll go in and they’ll take the other lymph nodes out, usually with a robot. Like a four-pronged robot will go in and laser them out. And then there’s some other therapies as well. I mean, obviously with men, germ cell tumors are typically testicular cancer and they’re going to

[26:59] take out — take one of your boys in the process — and all that stuff. And so you’ve got to go through that treatment process, which is its own different hell, and we’ll talk about that. And then the final third piece of hell is after. Like, what is the rest of my life like? Does it come back? What are the consequences of chemotherapy, which are actually the most

[27:29] annoying thing of the whole process. And it’s not free, is it? It costs some money to beat cancer. Blessings in place — — this was all done through the Department of Veterans Affairs and the VA hospital, and I received some of the best care I could have possibly imagined in my entire life. When people kind of poo-poo on the VA quite a bit — the most top-notch. Now, in Oregon we have an advantage: they’re right next door to OHSU and they work hand in hand together, and

[28:00] OHSU works very closely — they have experts in germ cell tumors and managing these types of cancers — so I was in the best hands, probably on earth, in this case. And the almost-died part — it was the treatment phase. I wasn’t going to die because germ cell tumors are very chemo-sensitive and I had a 95% survival rate. When the oncologist was like,

[28:30] you know, 98% chance — you know, we’re going to cure this — this is curable. He didn’t say it was not that big of a deal, definitely, because if you do nothing it’s still a 98% cure rate. And I’m like, what do you — what’s cure? What do you mean by cure? What is a cure here? Like, I live another 5 years? The 5-year survival rate — you’re considered cured if you’ve made it to 5 years, then you’ve been cured. But he’s like, no, you’ll live a normal life.

[29:01] Okay. What a relief, right? And then he said, but the chemotherapy program we’re going to put you through is probably one of the worst ones you can ever imagine. Because of how big it got and how many rounds I had to go through — four rounds — it’s going to be close. And chemotherapy is a game of — you guys remember The Price Is Right? Where you had to like make a bid — like, how close can you get to the dollar without going over? Chemotherapy is how close can we get to

[29:31] killing you without going over? And that’s — it was that. Well, and I’ll tell you, so October, right — I see you at this conference, and what is that, 6 months ago by this recording time? Yeah, 6 months ago. And you’re simultaneously like my hero but you’re an idiot. Because we — you organized this big conference in Portland, and you know there’s hundreds of people and there’s

[30:03] dozens of speakers, and you’re there, right? And I showed up at the school and I see the president of the school walking around, I see an administrator of the school walking around, they’re walking around with this old guy, and I don’t know who he is, and I’m like, where’s Bobby? And they’re coming down the stairs and I’m like, oh crap, that’s Bobby, right? And so like, they took you to the brink — you had to leave. I did. After that I got admitted the next day. Yeah. Yeah, I mean halfway through the

[30:33] conference you’re in the hospital, because that took a lot out of you. And watching you work through this — like, you just were — you weren’t even at the conference the whole time when you were at the conference. And so My wife and two daughters did most of the work. Yeah, they were — and they were amazing. A 12-year-old and a 9-year-old and my wife did most of the work. Yeah, they were — it was insane. They were so, like, totally over the top. You have an amazing family. But the thing — so first of all,

[31:05] thank you for your dedication, because you definitely should not have been there, but also if you’re not there, important things don’t happen in the profession. So that’s a huge thing. Before I even had any idea of what was going on. Yeah. I don’t quit. And nobody — nobody would have faulted — be a theme later on in this podcast. Good, good, yes. Yeah, and nobody would have faulted you for saying, look, guys, I’ve got cancer, I’m not going to — I’m not going to have your conference. That’s why I took the second day off. You can take the second day off. If

[31:36] Jason: You can’t pull the cancer card — what card can you pull? Well, I didn’t know that. Like, I didn’t know that. Like, I’ve never — I’ve never been like forgiving of myself. You know, or giving myself the grace to sort of stop and be like, I’m tired, I’m hurting, I’m burnt out, or whatever. And this whole thing was like — I’ve never been cared for, you know. They always say a man never gets — A man gets his first bouquet of flowers at his funeral. Right. Yeah. I never had people be like, you need to take care of yourself, you

[32:06] need to stop and just — my wife — we — we just — Jason, you’re going to hate this — my son enrolled in the University of Oregon.

Kathy: Jeez. I shut up right here. Right here.

Jason: He’s like, no, that’s not the hard thing.

Kathy: See, I knew it. You were doing the O the whole time. You liar.

Jason: That little — broke the third wall. Jeez. Okay. So that left a bedroom open in the house, and my wife made it like a hermetically sealed, silent, dark place

[32:36] for me just to go and sleep. Okay. And you know, that was huge — to have a place to go. Right, just disappear. And yeah, because — I hear — we were flying to Mexico this year for our vacation, to celebrate life and all.

Kathy: Yeah! Hey, look at us.

Jason: And the kids wanted pancakes at the McDonald’s that’s in the airport. It’s like the only thing that was open in the morning. Or — no, that’s — only — they — they love McDonald’s. What are we talking about? Those hotcakes are something else. But the dude that was working the McDonald’s stand — like, his other buddies

[33:06] at the airport was like, hey, what’s wrong with you, Hector? What’s wrong — like, you look jacked up. So yeah, I got cancer, bro. I got testicular cancer, man. What? I just had chemo, so I lost all my hair. And they’re like, what are you doing here? He’s like, I got to work, bro, I got to work. And I was like — friend — because I — I couldn’t move it at all. I mean, I couldn’t even do — those events are all — the work is in the planning. Yeah. The showing up part is just to make sure everyone’s having a good time and everything kind of flows. Yeah. I could barely walk. Yeah. He might not have had — he might not

[33:37] have been into his fourth round of chemo. Yeah. But just the things that people do to keep fighting — and this is — I’ll just say it at the point now — if there’s patients listening. Yeah. Or if you ever become a patient, there were times on the chemo infusion ward — — you know, I would be up there four or five days a week. And I saw people quit a lot. Just — I don’t want to do it anymore, I made my decision, this is over, I’m not doing this stuff anymore, blah blah blah.

[34:08] Or whining. So remember, this is VA healthcare, so a lot of this stuff is free to a lot of these folks. And they would whine a lot about what they were giving. You know, the dollar signs are running through my mind. My goodness. Yeah. And the whiners and the quitters never made it. It’s not that they disappeared and went off home — they died. Yeah. And I mean, even if you’re just a PT or a chiro patient, you’ve got a disc. Yeah. You’ve got a

[34:38] tendon rupture, or you’ve got pain from a car accident — the whiners and the quitters don’t make it. Be a good patient and don’t be a whiner or a quitter. And that might be tough — yeah, or tough love or whatever — but those folks never make it through their health conditions. Do you remember — jeez, what was this guy’s — the — the doctor who — he was the attending at the Burnside Clinic?

Kathy: Oh, Owen?

Jason: Yeah, I love that guy. Yeah. Yeah, Owen — I want to say Owen Wilson, but

[35:08] that’s the actor. No, but he was amazing.

Kathy: My guy. Yeah. I always worked at that Burnside Clinic because you could get all of your patient visit credits. Yeah, totally. You can bank them real quick. And it — it was so — it had to deal with some urine. Urine and prostitutes. Yeah. So it was the free clinic downtown Portland on Burnside Avenue, and it was like one of those kind of like no-questions-asked clinics — you got something, you need help — and it was

[35:41] interesting because we did not — you get nothing, you get your hands and you get your mind and you get your skills, and that’s it. There’s no electrostim, there’s no extensive treatment plan or anything like that. You just —

Jason: No vibrating foam roller.

Kathy: No, no. Yeah. Not even a regular foam roller. But the attending doctor there — man, I feel so bad that I can’t remember — he’s not listening anyway — but he was amazing because, man, he just cared so much. Yeah. And he was a guy who refused to let

[36:12] people quit, but he refused to let them quit through accountability, rather than like, oh, please, please don’t quit, please don’t quit. I remember I had a patient who — this guy — I don’t know if he thought we were going to give him drugs or whatever if he complained enough. He’s like, oh, oh my — oh my — I’m bone — I’m bone and my back is broken and I can’t — I can’t do that. So he walked in — he’s like, your back hurts? And he’s like, yeah, it’s killing me. He’s like, so what happens if you fall off that chiropractic table? He’s like, I

[36:42] don’t know. And then the guy slides off the table onto the floor. He’s like, so what are you going to do now? And he’s like, I just need help, I need help. And he’s like, are you just going to lay on my floor forever? And he’s like, well — he’s like, get off the floor. The guy’s like, what? He’s like, get off the floor. And so then the guy like pushes himself off the floor. He’s like, stand on your feet. So he stands on his feet and the guy is like, oh, my back. He’s like, get back on the floor. And so the guy like gets back on the floor. And so he had this guy doing get-ups.

[37:14] And he’s like, look — he’s like, you can do that. He said, you’re going to do whatever it is that you want to do, you just need to quit the whining and everything and get it done. And I was like — so every once in a while I have to flip that switch in my clinic. I’m telling you, he’s my guy. I’m not lying that I used that same exact thing with patients in my own clinic, but I learned from the doctor whose name I can’t remember. There’s an Owen in there. We love you, Owen. He’s the best. Yeah. Patient slid off the

[37:44] table and his wife. Owen Lynch — it’s not that we don’t forget the name, it’s that it just takes time to register. Absolutely. It’s been a veritable — it’s been a myriad of names. It’s been a sea of names. These 20 years. Yeah. Patient slid off the table, and yeah, wife was screaming like, “You going to help him up? Help!” I told him not to get on the table like that or he might slide off. Well, what are you going to do now? I’m going to watch him get up. Yeah. You’re not going to pick him up — what are you going to do? I’m not doing anything. I’m also not going to drive to his house when that happens and pick him up there

[38:15] either. And he’s not going to expect me to, you know. And so I think that that’s a really important point though, is it doesn’t matter — big problems, little problems, whatever it is — it’s like you have to make a decision not to quit. Yeah. So, can you talk a little bit about the providers — like I want to, I want to read this portion of — Yeah, the nuts and bolts of why we’re even here talking. Yeah, you — that intro was very — that’s the intro we just got. Yeah, we’re just starting.

[38:45] And now. So, you said — ‘cause this letter that you wrote was aimed at chiropractors, and kind of encouraging us to just be better. Let me see — I hope I’m reading the right part. I lived it. I lived it. I’m going to — yeah, I’m going to see — I’m reading it for the benefit of everybody else. I’m going to go through two paragraphs. One of the things I observed, which isn’t earth-shattering, is that healthcare providers have a varying level of skills

[39:17] and competencies. Not everyone you encounter in healthcare has their stuff together. This is all the way up and down the line — physicians, nurses, technicians, and oof, chiropractors. However, when your life is on the line, or your spine, or some other health issue that you value very much, the competency of the provider becomes a very high-priority concern. As a patient on these daily trips to the hospital, I began to know who on duty had their stuff together and

[39:47] who didn’t. And the anxiety that could be felt when I was assigned an incompetent was significant. I wrote that. You did. Dang, that was pretty good, yeah. It’s beautiful. Yeah. It’s — it’s everything. Yeah. So, I’ve never been a patient like that, so it could just be everyone like, yeah, no duh. Yeah. ‘Cause I’ve never been a patient like that. But I think there’s a lot of young PTs and chiros — Mhm. — who are young and active and strong, and you know, they’re adjusting people that don’t need to be adjusted in clinic because they’re all

[40:17] rubber and bouncy and active, and it’s like they’ve never been a patient of that caliber where you have to walk in and you’re like, I sure hope this person knows what they’re doing. Now, the highest scale of that, of course, is like a surgeon. Yeah. Yeah, that — that would be the highest I can imagine. Brain surgeon — I sure hope the neurosurgeon knows what they’re doing. But it goes all the — the anxiety would then be on a spectrum, right? And there’s still an anxiety that exists in the — what would you call this? The physical rehabilitative world.

[40:48] Manual medicine. And as you know, there are some people who carry more anxiety than others. So, they come into our office even if it is just manual therapy, rehab, and all that, with a very high level of anxiety — like, I sure hope this person knows what they’re going to do and they’re not going to break my neck, right? Or rip my shoulder out of its socket or whatever. And you would be able to identify specifically who was working that you knew they could get it done, and you knew you were going to have a good day on the chemotherapy ward that day.

[41:18] And you knew the ones that, you know, they just didn’t have it. And you knew they were going to miss. So, there’s a thing you get — it’s called a power port. They keep it in you for like nine months to a year, just in case. Just in case, just in case, you know. Thanks for reminding me of this thing, you know. But I’ve got this thing sticking out of my chest. It is extremely pain— it’s a very large — like, I don’t know — the size of the needle: 20-gauge, 2-inch-long needle, because this thing’s attached to my inferior vena cava.

[41:49] So, they jam that thing into your skin every time they want to do a lot of IV therapy, so that they don’t fry your veins in your arms. There are some nurses that can get in there and you don’t feel anything. Yeah. And there’s some — it is like — it’s like getting stabbed. Yeah, it’s like you’re at a Mexican cockfight and you made a wrong bet, you know, and someone just put one right in your chest. And they just keep poking you. From what I’ve heard. How would you know? And then it hurts just as bad pulling

[42:19] out. Yeah. And so, there’s a lot of anxiety just going into the clinic that day — like, is someone going to be a tear-jerker or what? So, competency is huge. And my epiphany was that this competency is all the way up and down the road. Yeah. And if you can manage that competency, you get a long way in building patient trust. And of course, as we know, patient trust is the gold standard here for building a great relationship clinically. And — and I think that you were talking about competency not just from the

[42:49] standpoint of technique. Right? No, right. Exactly. That matters. Yeah. So, in our case — in the chiropractor’s case — delivering the adjustment. You do have to deliver a comfortable, effective, non-anxiety-building, non-painful adjustment. I like to refer to it as a good crispy adjustment. Yeah, right. Nice and crisp. Crispy and smooth. You only want to be a terrorist within like a millimeter. You don’t want to terrorize the patient throughout the whole range of motion.

[43:19] Absolutely. But just in the whole process — the greeting process, Yeah. the patient experience process, the managing expectations process, Mhm. how you handle your instrumentation, how you perform an examination, if you take radiographs in your clinic — like how you prepare the patient, gowning, effective communication, respecting their cultural differences compared to yours — like all these things

[43:49] Jason: translate into a patient like, this person knows what they’re doing. They care that I’m here, and I’m in good hands. In a medical setting, it could be as simple as like, yes, how they do the injection. Yeah. I definitely remember nurses fumbling things and dropping them on the ground. And me watching out the corner of my eye, are they going to pick it up and throw it away or are they going to use it on me? And things like that. Fortunately, they picked it up and they licked it off. Right? You don’t want to go in dirty. Whether

[44:20] they were like, after they’ve got you going on your IV and they’re off doing their other thing, or they’re just talking about their next vacation in the next room over, they’re chatting with the other nurses, or they’re on their game and they’re focused on what’s going on. Like, all that stuff can be picked up by a patient. And it was just like the feeling of being at complete and total mercy of whether they were competent or not was horrifying. Yeah. And it made me really understand a patient who comes into my own office and like, how can I make sure that they

[44:50] are not horrified by any perceived incompetence. Kathy: That’s a great point. It’s like when I get on airplanes. When I get on an airplane, I want somebody who only has gray hair. Yeah. If there’s any color in your hair, or if you’re bald, that’s also acceptable. Right. Men, women, I don’t care. If you’re a bald lady, I will accept that, right? But man, if you look younger than me, then that makes me nervous, right?

[45:20] Jason: Everyone has their biases, right? And some of them are completely inappropriate, but they happen. But you know, like I wouldn’t want my pilot to show up in Crocs. Yeah. Right? I have scorned other chiropractors in the past when they show up in like bowling shirts or wearing shorts. You know, and they have their own justifications like, why I wear shorts to the practice. Yeah, but that’s for you. Your own personal comfort, or you were an active person and you wanted to show you’re active. The person coming off the street is

[45:50] making judgment calls immediately based on all these little things that you want to decide for yourself versus deciding for them. And you know, it all ultimately comes down to the question, why are you here? You here for them or for you? Yeah. Kathy: Being a patient, you’re so vulnerable. You’re in such a vulnerable position. And plus, you come in and you’re on guard for everything. You’re looking around. I mean, even the presentation of the office or the hospital. The shape of the room,

[46:20] of the room. Yeah, is this place been maintained? You know, does this need a — yeah. Is this paint job — this place is chipping everywhere, like what’s going on here? Now, your name’s Kathy. I’m not going to assume you’re a woman, but maybe I am going to assume you’re a woman. Yes, I am. Maybe I could have just asked, how do you identify? I could have just asked. Yeah. Yeah. But there’s a book, Why Women Buy. Yeah. And it outlines a lot of these things about how women make decisions like

[46:52] buying decisions, but health care is a buying decision, and what they’re looking at. And a lot of times male clinicians don’t even think about this stuff, like you’ve got a bagel — still got schmear on your shirt. Yeah. Or you’re making off-color jokes that have no place. Or you know, chiropractors and PTs, we get a lot of patients that have been run through the mill by the time they get to us. And can you disarm a patient appropriately so that you can then get to the work that needs to be done. Jason: Well, and you spend a significant amount of time cleaning up after other

[47:22] providers, right? Where it’s like, oh jeez, I went to this place and man, for some reason, they were just talking about the Bible the whole time. And then, oh, I went over to this place and it smells like Ben-Gay and feet. So it’s like, part of it is you have to kind of reset their expectation around the clinical experience that they’re going to have. Kathy: So, I had three lessons that I can pass on that I learned about this —

[47:54] notes. Because they’re not committed to memory. They’re probably in that email that I sent. We could probably find that and send it to people if they wanted. But yeah, you know what? If it’s okay with you, I will include the email in the show notes. Yeah, it was really very impactful. Lesson one we’ve already covered: the patients feel dependent on your competence, and they’re at the mercy of your competence. Which leads into the second lesson we haven’t quite discussed yet, but maybe danced around in, that your competence has to be visible.

[48:25] Jason: Mhm. So, people actually have to see the competence. You know you’re competent. Yeah. Like all your colleagues know you’re competent. You’ve got all the letters after your name to say you’re competent. But it’s actually a little bit of showmanship. There’s a performative function to what you’re doing to show the competency. And most of us are not performers. But if you can make your examina— I’m not saying like B.J. Palmer where he was like adjusting in the — yeah, the hair goes flying —

[48:55] we’re not talking like that. We’re not talking circus sideshow performative, but there’s got to be a dance that you put on Kathy: Sure. for these folks that shows that you’re working, you’re thinking, you’ve got them in mind. Jason: It’s about them. Handle your instruments appropriately. As a basketball official, we practice our signs in the mirror. Like, how much do us clinical people practice what we’re doing in a mirror? Like we used to in adjusting class, look in it — it looks kind of like — but practice your wink before you —

[49:25] Kathy: If you’re demonstrating certain rehabilitative moves, how do you actually know what it looks like to a patient? Like, is it something that they can lock into their mind and say, when I go home, I’ll remember how the doc was moving. Jason: And you better be able to do it. Yeah. At least one — at least one good rep. One good rep. At least one. Three would be ideal. And all that leads into trust. So, lesson three is that the perception that you’ve passed on affects the patient experience. And when you gain the trust, that’s when you really win. That’s when they really win. Patient wins, too. Yeah. Yeah,

[49:55] Absolutely. Yeah, those are — I think all those things really — I’ve been watching: have you seen that show, The Pit? No. Okay. Jason: I’m one of those people where you mention a show and I’ve — I’m too cool — I’ve never watched a certain — I don’t watch movies. I don’t watch TV. Kathy: I think you would like it. It’s about an ER in Pittsburgh. Okay. And it’s kind of like real time. So, it’s 15 episodes and it’s 15 hours in one day. Jeez. And I have learned so much from

[50:27] watching that show, actually. And part of the reason I started watching it was I would see, you know, various doctors, nurses, and things like that talking and they’re like, “Holy crap, this is so realistic. It’s not like ER or Grey’s Anatomy.” So, it’s doctor approved. Yeah, it is doctor approved. Yeah. And they use all the lingo. They do. And one of the things that I am obsessed with is how the doctors present themselves to patients and the way that they communicate with them. Because you get

[50:57] to see the whole thing, you know, they’re in there with the people and everything. And then you also get to see them interacting with their colleagues and having their own personal life and — you know, there’s somebody gets attacked or there’s this problem — and they’re going room to room to room. And every single time, like one of the chief skills that they have is getting so honed in on that situation. And you get to see people do it really well and you get to see people do it really poorly. That’s changed the way that I practice. End scene. Yes. Going into this room and I’m going to

[51:27] absolutely. Pretty much. To think about that in practice — back in like — we weren’t around in the ’80s, but like the tail end, the early 2000s. When we were still really, really busy with a lot of patients, I would think like, “Okay, I’m going in here. This is what I’m going to do. This is how I’m going to — and go.” Right. And then I would go in. This being the VA — it’s a teaching hospital. So, you would have younger docs coming in, like hospitalists who were admitted and

[51:58] osteopaths who were trying to learn the MD side of things and they’re getting their residency. So, you’d see residents and stuff. And it was always hilarious to see the different personas they try to put on, Yeah, because they think they need to do that to be the doc. Mister maybe — this is Doctor Jones. How are you doing today? Yeah. You don’t have to do the authoritarian — like, I get it, I know that you look 14, but I also know that you’re the doctor. You don’t have to — chill — you don’t have to do the thing. You don’t have to parkour. Just talk to me. Okay. Okay, sir. Yeah, all right. Okay.

[52:28] Okay. Yeah, and you know, that’s a — I think it kind of is a double-edged sword with chiropractic because I think people who pay a lot of attention to that and they’re trying very hard to be very professional, I think that they get mocked a lot. Especially if you’re trying to project that — yeah, well, I think even if you’re trying to project that on social media. For example, you’ll see a chiropractor and

[52:58] maybe he’s got on his white coat. Wears a white coat when you practice — there’s no problem with that. And they put on the white coat to do a video. People are like, “What are you wearing a white coat for?” Blah blah blah. And my thing is like, he’s wearing a white coat for the same reason that a medical doctor doing a video has her stethoscope on while they’re doing it. It’s not because they’re going to listen to the heartbeat of everybody watching the video. They’re trying to project that image. Yeah. Is that the right thing to do? Yes. Yes, it is the right thing to do. The coat is a symbol and white has got symbolism, too. Purity,

[53:29] honesty, straightforwardness. Yeah. But some people — all they see is — put it to modern chiropractors that understand any bit of symbolism about anything. Yeah. It’s all very practical. Yeah. And but then even outside of chiropractic, people are like, “That person’s trying to be a doctor.” And so they mock it. And so it’s difficult because I just want to tell chiropractors, do not get beat down by people who are mocking you trying to be professional. Always just try and be professional.

[54:00] Mock the ones that are trying to unprofessionalize themselves. Yes, who are making softcore porn trying to adjust people. Okay. Yeah. You need to watch some of these videos, guys. Videos, yeah. Yeah. Videos are bad. Yeah. And like — there’s this one horrible video of a chiropractor. He’s in Africa and he’s just — he’s walking down the road and there’s all these little African children. They’re like, “Oh, hey.” You know, and I’m sure — I don’t know what they’re saying. They’re speaking — African. I don’t speak African

[54:31] for some reason. Is African even a language? Yeah, it’s Africanese, I think. Yeah. But they’re like running along and he’s walking and as he’s walking, he’ll just go up to a kid and freaking adjust his neck. And they’re like, “Oh my gosh, like what?” And then all the other kids — how do you say consent in Africanese? Yeah, right. Exactly. So, he’s going along and he’s just adjusting these kids. And I’m sure that he’s just having this wonderful amazing time just bestowing innate intelligence upon all these savages. You know, and it’s just

[55:01] like — yeah, and it’s just like, whoa, dude. God bless — Kathy: Yeah, absolutely. And so that is, I think, the other end of that spectrum where it’s like you have to become comfortable projecting that persona, being professional despite mockery. And it’s not just chiropractors, though, because people don’t want to talk about it, but medical doctors face that too. Sure. You know, there is tremendous distrust of medical doctors, which is unwarranted, and people mock them trying

[55:33] to be professional. And I think it’s so hard to be a healthcare provider right now because of what you mentioned earlier — that freaking chatbot. Yeah. Yeah. Yeah. Another one I think has a tremendous amount of challenges — PTs. The modern PT profession — like the PTs I saw in the VA — so much compulsion to not touch the patient. Yeah. And I don’t know how you guys pull that off. Well, I do know how, but the amount of this skill, the trust-building skill and professionalism skill to be able to use

[56:04] basically only verbal cues. Mhm. To get a patient to do anything at all without any touch input. Mhm. Or even therapeutic touch at all is pretty impressive, but it’s also like, how can you tie one hand behind your back like that?

Kathy: Is that a thing, Kathy?

Jason: It is a thing.

Kathy: Really?

Jason: It’s — that’s the big fight in our profession is manual therapy over exercise, you know, which one is better? Just like, you know, which is better, cardio or strength training?

Kathy: Yeah, that — hmm. We should do a show about that.

Jason: About that. And so there’s a really strong, you

[56:35] know, it’s like a political divide. Like, you know, “manual therapy is just placebo, it’s not going to do any good, so you should just make the person exercise.” And then obviously there’s the manual therapists like, “you can’t do exercise unless they have mobility,” and so on and so forth. So yeah, that is a big fight within our profession. And of course, neither side — it takes a good blend of both.

Kathy: Yeah. I would say maybe manual therapy with an

[57:05] attempt to be therapeutic, and you can have your objective questions about it.

Jason: Yes. But touching people to build clinical competency and trust within the patient —

Kathy: 100%. Because some of the therapists I experienced, and some therapists believe in actually not touching the patient at all.

Jason: Yeah. And if I wasn’t touched during my journey — mhm — like if some nurse didn’t come up and be like, “You know, you’re going to be okay. This is going to — it’s good to see you

[57:35] here. You’re doing good.” I think there would have been some issues.

Kathy: Sure. Yeah.

Jason: I’m not saying I would have quit, but — right — no one really gives a darn about me.

Kathy: Yeah. Healthcare is intimate. Yeah. Which is tricky because you also need boundaries. You need to be like a basketball referee. You need to be on the court.

Jason: Yes. And part of the game, but not part of the game whatsoever.

Kathy: Yeah, it’s a good point. You just — you don’t inject yourself into their game, but you make sure the game goes smoothly and it’s played

[58:06] within the respect and honor of the game. And then everybody can have some fun.

Jason: Yeah. Except for the losing team. They’re not going to have any fun. They learn lessons.

Kathy: Yeah. This is so profound. I think that this is so good for providers to listen to. I know I’m getting a lot out of it. I think it’s good for patients to listen to also. I think hopefully it helps them to have a little more grace for who’s on the other side of that equation. Hopefully it allows them also

[58:37] to have a little more courage in terms of what they’re capable of, what they can be doing, what they should be doing.

Jason: Yeah, I do want to put that as an asterisk. Like, patients, if you’re listening — your doctor, your provider, even if they seem incompetent, like they’re fumbling their words or they’ve got a little coffee stain on their shirt, they’re actually most likely probably quite competent. They’re actually probably good at what they’re

[59:07] doing. There’s going to be a percentage that are just horrible, and they’re bad, and they might even be illegal or whatever. Give the provider some grace and be a good patient. Show up. Go through the plan that they’ve outlined for you. And then ask yourself what you got at the end. Did you get what you wanted? It’s called the Dan Sullivan question, and I ask some young chiropractors to do this with a new patient when they meet them. What do you want out of this? If we do the

[59:37] plan as I have outlined here, what do you expect the results to be? How would you like this to look at the end? And if the patient’s like, “I want to fly on a unicorn to Mars,” you’re like, okay, well, that’s not realistic. You need to come to Body of Health Chiropractic in Corvallis, Oregon. Yeah, no. So then you get an opportunity to manage expectations, right? And then your provider will not be able to sell you a line of fluff.

Kathy: Yes. And you can tell them exactly what you want. And as

[60:07] the provider, you can write down, “This is exactly what they want. I better be honest — can I deliver it or not?” And then that’s where that goes. I think this is one of my favorite questions that I ask in an intake. I ask people, what does a good outcome look like?

Jason: Yeah. And it’s surprising how many people haven’t even thought about that coming in. Like, oh, good question. Yeah, and for some of them — because you can

[60:37] tell — like I do the Start Back, right? So I know that’s a person I’m not going to want to dwell on pain. Or, you know, when you look at their intake and it’s just pain, pain, pain, pain, pain, pain, pain, pain, pain, right? I know that’s somebody I’m not going to talk about a lot of pain with. So sometimes I have to phrase it, “I know that you want less pain. Outside of that, what does a good outcome look like?” And I think that that is a great question for getting people on the same team, because yeah, you can manage expectations. And also,

[61:09] a weird thing about healthcare is that most people who have a good expectation out of their healthcare experience are going to have a good experience. So that’s a winner. So much easier to be an oncologist. “What do you hope to get out of this?”

Kathy: Yeah. Not die.

Jason: Five years. Yeah, so when you respond with, “What do you see yourself doing in five years?” Well, Bobby, we have a tradition where

[61:40] we like to play a game with people. We’re going to do something actually pretty similar. I have developed a game here called Good Doc, Bad Doc. And I’m going to put you up against the PT. All right. Now, this one’s actually going to be kind of fun, all right? I am going to read a complaint from a patient, right? And then I’m just going to randomly say like a physical complaint, right?

[62:12] And then I’m going to pick one — good doc or bad doc. And then you just chime in and you let me know what does a good doc say, what does a bad doc say? We can have a little fun with this too, okay? Because games are fun. All right? You ready? Complaint number one — this is the Desk Jockey Disaster. “I’ve been working from home at my kitchen table for two years. My neck and upper back are on fire by 3:00 p.m. My solution so far has been more coffee and occasional

[62:42] profanity. Bad doc. What does bad doc say? Just jump in. We’ll take some x-rays before we ask any other questions. Try some Red Bull. There you go. Switch out that coffee for Red Bull. Okay. Complaint number two, the weekend warrior wreck. I play pickup basketball once a week, pull my calf or tweak my low back every other game, and my current treatment plan is an ice pack, Advil, and I swear I’ll start

[63:14] stretching someday. What does good doc say? Tell me what else you do in your life. That’s it. That’s good. You just start a conversation. What does good doc say to that? Yeah, what does good doc say to that guy? Good doc says, how’s that working out for you? I like that. Very good. Yeah, that’s the problem here. I don’t see a problem. Wait, that’s bad doc.

[63:44] Orthopedic. He got the generic stuff. Okay, very good. Complaint number three, the phone neck fiasco. My neck and between the shoulder blades area ache every night because I scroll my phone in bed until midnight, and I’m convinced the real issue is that I just need to be cracked. What does bad doc say? I agree. Let’s check your insurance first, but I agree.

[64:14] Yeah, good PT says, oh, I got this friend, he’s a chiropractor. Yeah. Send you over there. Good doc says, I don’t think that’s your problem. What’s missing in your life? I like that. That’s good. And then does the patient just look at you like you’re weird? What’s missing in my life? You might not — yeah, you might want to not start that with your first — your first. Just crack me. I just came for the crack. All right, how about this? The car commute crunch. I drive 45 minutes each

[64:45] way to work. My low back and hips start burning halfway there, and I’ve tried fixing it by shifting around the seat and turning the heated seats on to lava. What does good doc say? What do you like to do for exercise? What — yeah, what do you do when you get out of the car? Oh, yeah, good. Good. Why don’t you quit your job? Move closer. Just move closer. Yeah, because a 45-minute

[65:15] drive — I mean, you can’t really suggest, hey, why don’t you ride your bike? Unless you’re in LA, because then you’re probably two miles away. Take the bus. Last one, the gym hero hamstring. I sit all day, and twice a week I go straight into heavy squats and deadlifts cold. My hamstrings are like guitar strings, and I keep blaming it on being almost 40 now. What does bad doc say? Sounds like you’re getting old.

[65:46] We have some supplements for you. You have the hamstrings of a 90-year-old. Yeah, that’s — — it. You’ve deteriorated at this moment. It’s called degenerative hamstring syndrome. I don’t know, what is your — what is your bad doc — oh, you just make up an acronym. I love it. You’re the fifth good doc, bad doc patient I’ve had today with a — — repetitive postural syndrome. Yeah, exactly. Yeah. You know what you need? You need magnesium.

[66:16] I’ve got some in my lobby. That’s right. Not just any magnesium, you need colloidal magnesium. Depends — what did your — I’m the only person who sells it. What did your AI chatbot tell you? You know what I love to do is, like, whenever I’m getting through with the exam and putting everything in the computer and people are like, what are you doing? I’m like, I’m asking ChatGPT what’s wrong with you. What’s the next thing to do here? So. That’s sad. We only have like four things to diagnose.

[66:47] Right? And that’s the crazy thing. But this has been really, really eye-opening. I think — see, we’re on our second year of this podcast, and you are definitely the top guest of the second year. You’re also the first guest of the second year. Not that I’ve ever heard that, and they always put me up first to like set the precedent for everyone else. This podcast just keeps getting better and better. You know, I really feel like everybody

[67:17] else is screwed. I really feel like that. Yeah, this was some good information, and I really, really hope — and I suspect — this is my takeaway. We’re starting takeaways. I’ll do — I hope and I suspect that one day, maybe not this week, but maybe one day somebody is going to listen to your story and what you shared, and it’s going to have a huge impact on their life. Right? They’re going to need what you said for their own personal struggle. Maybe on the

[67:48] patient side, maybe on the provider side, but I hope — and that’s part of the reason we wanted to have you on this — to amplify this message because it can do so much for so many people. Cancer touches everybody’s life if you just stick around long enough. You know, I lost my mom to it. We’ve lost friends to it. And there’s so much good about what you shared. I’m sorry that you had to experience this, but I’m so grateful for that

[68:19] gift that you’re giving to other people. And you get this conversation. Yeah. Right? And so real blessing to have you. I’m so glad that you’re well, my friend. So. It’s my takeaway, too. You know, I do a podcast that no one listens to as well. But I know — but she set up a chatbot that makes them listen to each other. You guys will hear this eventually at some point. You’ll hear the — we listen, we think it’s great, or that guest was great, or whatever. Someday you’re going to get a message from someone that says, I would have quit

[68:50] if it wasn’t for what you’re saying. You might get messages like I’ve got from the FTCA and what we’ve done there, where people said, I would have killed myself. I was going there if that group didn’t exist. Some of these things we do, like FTCA, my podcast — no one’s buying a boat. No one’s making a career out of it. But like you said, I know somebody is going to hear it at some point, and it’s more fun for me to be in this position, and I don’t care if there’s anything to gain from it for me personally, but someone’s going to hear something that’s going to move them

[69:20] along, and that’s that’s what it is. I mean, that’s that’s my takeaway. I do this because I feel like we’re humans, and we should have human moments not clinician moments. Yes. And and people aren’t alone. Even when you feel really really lonely. Yeah. You just got to know that there’s there’s people out there that that are there for you. So. People would have been sad if I died and that’s pretty cool. That’s good to know. You know, hey. People kind of like like you.

[69:50] Jason: Kathy, what do you got? Uh, one — advocate for yourself. Yeah. Right. I mean that’s what you did. Absolutely. Early on you didn’t just take, you know, the first whole journey. Yes. Still. Still. Still advocating. Yes. Trust our health system. We do have some — we’re very well educated. Our doctors are competent but at the same time trust but verify, right? That’s right. Yeah. And give give each other grace. Give yourself grace. I feel like I heard that from you. Is that — I maybe learned to give myself grace

[70:21] through this. Yeah, there was that celebrity — I never, cuz I don’t watch TV. The one that was on — he recently passed away. Very young. Chuck Norris? No. No. Uh, not like Schitt’s Creek. Not — it’s — that’s the name of the show. I didn’t say a bad word. One of those younger guys. And then as he was dying they were like what did you learn? Oh yeah yeah yeah. Dawson’s Creek. Yes. Dawson’s Creek. Yeah. Dawson’s Creek. Dawson’s Creek. It was Van der Beek. James Van der Beek. And it was uh — is that how you say it? And I’m going to get it wrong. Other people can look it up but

[70:51] he said you know what I learned is that I’m okay and I can love myself. Yes. The the real — I’m I’m perfect the way I am even if I’m dying. Mhm. It’s beautiful. Yes. And when I read that he had said that I’m like oh. Yeah. Yeah. All of the feels. Because I had come to that conclusion on my own. Nothing’s on your own. Something something happened — I was like somewhere in my my journey. Mhm. I learned grace

[71:22] and I’m worth loving or being sad about this or whatever and it worked. Yeah. And it’s an amazing thing. I remember having this thought when my mom was was dying from cancer and it was a thought that you can have cancer — you can have terminal cancer and you can be healthy. Yeah. Right? So you can — not have — like your body can be failing you but you can be a healthy person. You can be whole, and

[71:53] and that’s just such a weird thought to me. You don’t have to have all the parts working for you to be a healthy person. So. You can also die a normal healthy death, whatever you want to call that. The longevity. And be completely sick on the inside. Facts. Not not get there. Yeah. Totally. So my goal is that everyone gets there. Yeah. Yeah. Just everybody get healthy. So. Well I think there’s one more thing that we got to add, Kathy. That’s that there’s no I in PTCH.

[72:26]