Heroes of Healthcare
Heroes of Healthcare

Episode · 1 year ago

Mental Health: Treating Trauma and PTSD in Veterans

ABOUT THIS EPISODE


Psychiatry is about as damning a pathology as you can imagine. You’re dealing with patients suffering from depression, anxiety, and PTSD brought on by unthinkable trauma.

But for Dr. Michael Massa, it’s a calling that brings immense fulfillment. Dr. Massa has treated veterans and the underserved around the world enabling them to live their lives to the fullest. In this episode, I talk with him about:

  • Finding fulfillment and purpose in medicine
  • Getting knighted by the Vatican and working in a Catholic convent in Jordan
  • Treating veterans with the Wounded Warrior Project
  • Approaching treatments for patients with PTSD
  • The psychological trauma of COVID-19

Heroes of Healthcare is hosted by Ted Weyn.

To hear this interview and more like it, subscribe to Heroes of Healthcare on Apple Podcasts, Spotify, or wherever you listen to podcasts.

You're listening to heroes of healthcare, the podcast that highlights bold, selfless professionals in the healthcare industry focused on transforming lives in their communities. Let's get into the show. Welcome to the heroes of healthcare podcast. I'm your host, Ted Wayne. As we've discussed on the show several times before, we want to continue to give equal airtime to not only the clinical and physical health and those heroes that are serving them, but also for the mental health as well. So I'm very excited today to have Dr Michael Massa join us. Dr Massa did his undergraduate work at the University of Virginia, attended medical school at the University of South Carolina and then returned back to the University of Virginia to do his residency. For over twenty five years, Dr Massa has served his country in various medical endeavors, which include serving as a medical director and senior staff at Lundsville Regional Medical Center, treating our wounded warriors returning from Iraq and Afghanistan. As a captain in the Air Force for several years, he spent time treating the developmentally disabled and was a soul psychiatric consultant for the State of California at the Northern Cal Developmental Disability facility. Currently, Dr Massa is treating patients at a large Catholic hospital system in California where he resides with his wife and his daughter. Dr Mass has been knighted by the Vatican as he has treated patients at a Catholic convent in Jordan for those who were fleeing the Syrian regime. It is my pleasure, and I'm thankful for his service, to have Dr Massa join us on the heroes of healthcare podcast today. Welcome to the heroes of healthcare podcast, Dr Massa. Thank you for joining us. Thank you too, very happy to be here. Yeah, we're excited, as we always continue to want to focus on mental health. We've had some great stories and some great conversations with folks and all around the physical side of things and the doctorate side of things, on the clinical and talking about setting up makeshift hospitals in New York City and things like that, dealing with covid but we know that mental health is as if not more, or equally important to the physical side of things, so we want to continue to bring a spotlight on it. So we thank you for joining us today. Looks Happen, and I agree with what you said about the role of psychiatry plays and all US sects occur. Yep, great, so I always want to jump in. If you don't mind, tell us a little bit. The audience always loves to hear a little bit about the person on the other side, and so tell me a little bit about your background, where you grew up. I know you have a unique story and I'd love for you to share a little bit of your story of how you got here and what excited you about getting into psychiatry and what gotch into healthcare. Sure it was born in New Jersey. My father was an air force aviator, who's the Air Force officer for day case, and we moved around a bit and that included time spent in Germany, which I would eventually go back to. Get to that a few seconds, and I think before I would ever watch talk about myself, I would want to talk about the fact that I am a husband of thirty years, I'm a father of a libberfolks may two year old Chiljan, and after finishing high school, my parents were very open minded in terms of what career I could go into. As long as I was going into the United States air force and anything else. That another time perhaps, but was commissioned out of the University of Virginia and I worked in a non medical field for about six years and I remember one time being at my parents house and chatting with my wife and I was in the Air Force in a field that had a lot to do with Warsaw pack things like that, and it was over. The glory days were over. I mean we want the Cold War, which is a great thing, and I said, what are we going to do? And my wife and I decided. I remember exactly where we...

...were in the house. She decided to go to law school. I decided to go to medical school, which was the easiest part about that decision. Getting into medical school and stay in medical school successfully was about story. Artist back and that took me to the Medical University of South Carolina and and then I went back to Uba for residency, and I think in this is interesting. We bring this up because I was talking with my daughter about what motivates you a certain careers, because she's at that age, verse's twenty two, interest thinking about these things, and I said, you know, one of the key features is you have to have a sense of not only do I like doing this, I mean we all like eating lobster right, but you can't do that as a career. But I say, what is it going to fulfill you? What is going to make you feel good about who you are? And I think for that reason I found medicine really alluring because at the end of the day, he got to feel content about who you are and what you're doing, and in medicine, on a good day, provides that. On a bad day it's certainly what, quite frankly, provides it as well. So that's not a bad deal. And from there I wanted to psychiatry, because psychiatry is the combination of a very medical, real science that combines the art of medicine with some commitment to understanding. Everything's not black and white in terms of diagnosis and treatment, and I would say that, next to certain illnesses like cancer, childhood cancers, psychiatry is about as dark as you can get. It's about as damning epathology as you can imagine, and if you can alleviate that suffering, I think you've done a good job. And I would go one step further and say if I can talk about this in terms of what I did to same pure at some future day I think I'm going to be okay and a nut show. That's it mom. So one of the questions that I had in terms of your experience in your background, I'd love to talk a little bit more about is, as I mentioned in the in the biography, knighted by the Vatican treating patients and Catholic convent in Jordan fleeing Syria, the Syrian regime. I'm sure that was quite an experience. Can you tell the listeners a little bit more about that? How did that opportunity come about and what was that experience like? Sure, a number of years ago my wife and I be fortunate enough to get into some volunteer work with Catholic groups. My wife helped out with establishing trust for the development only disabled, so you don't have nine cousins coming out of the woodwork with the parents passed work and I started doing work with Catholic charities in Chicago and I spent about two years writing a clinic and eventually things moved forward and there were a couple of other things I did that it kind of knows. There's something about now and we got knighted by the Vatican in terms of being in the equestry in order of the holy suffctor, which has a very large commitment to serving Christians in the hollow wood, and I know what it is. I know the other thing we did now and I decided that the best way for me to share with the question in order, which is a Franciscan order. What I do was to do a couple of clinics and the holy way and it's in a Moan Jordan. In Jordan's a great place. I called Jordan land of unbridled hospitality. Super Quick Story. You go to Jordan, you meet someone super friendly the first five minutes. Five minutes later you're asked to have dinner out their house, and fifteen minutes later, well, actually, once you're at the house, they ask how come you have to leave after three hours. That's what you're the JORDAANS are like. They're trying people. They have diplomatic relations with all the countries, including Israel.

It's a different place, very a lot of respect for the Jordavians. Anyway. So I'm at the convent in I'm on and I'm working with the really really ill I'm going to tell you two stories, and the first one was right before I left and I'm, you know, I'm going over on British share, I'm going into from Chicago to Geneva and then I'm taking the flight until I'm on and I'm speaking with the woman who runs the clinics. She's like the administrator, and it was right around Mother's Day and I said well, happy Mother's Day and she said, well, I'm a consecrated virgin still, but she's said all these children here, I see them as my being their mother, and I thought that was really cool. So it was in not, I know she was in none. And then when I got there we were dealing with and this is the great thing about it, and it makes you feel good, I'll be direct, because you feel good to be a Catholic. Ninety nine percent of the people do not speak English, they speak Arabic. Ninety five percent of them are Islamic. They're not Christian, but they're all appreciative and you're not just dealing with psychiatry, because you can't say well, look what you see, a good friend of mine, he's a intern. It still help you. Ought we do everything, but it was predominantly dealing with the developmentally disabled, who had a lot of neurologic and psychiatric pathologies, and the best story I have about this and to this day can bring the material of my eye. I'm trying to explain, with my translator, to this woman why the child is not able to nurse the breast and the child, this is hard for me even to the stays and hears has a significant developmental disability. And I'm with the translator, I'm trying to explain this and you're trying to avoid return mentally retarded. But the child unfortunately suffers from severe intellectual or that her clear and I finally said, and this is what made her get I said sorry, Sot Aar. I said God likes you and me, but he loves your child. And then she got it. So that to me, wow, just in a nutshell, is what it's all about. And then again, you know, and then lest your Danian's, Oh my God, you have to say notice seven dinner invitations and your at this Catholic con where Pope Francis would eventually go to, Pope Benedict went to and they do such good work. And again it's beautiful. Most of these people aren't Christian there might be two Catholics there, but your servant it's like Jesus want to be asking what we're religion. Are you and I can't understand because you're not speaking the king's English. But it was just absolutely wonder and they took me out. Yeah, so that that was really my favorite story. And then actually it made it was even made better when my daughter came with me and I told her I wanted to ask you about that too. Yeah, yeah, so if you want to like, I can tell you now. We can wait, whatever you want to do. Tell that now. Got and go ahead. Tell me about the experience with your honor laying in Europe. I'm treating our wounded warriors with my team in Germany and my wife and daughter art in Rome and my daughter's dad wouldn't we go. WHAT ARE WE gonna go? What are we going to go? And I said, okay, fine, called to Danian Royal, Jordanian air, will see if they'll give us a discount, because this is going to get expensive. So we got a little bit of a break, like seventy five bucks. We fly into him on and my daughter was I think are like first year, Secondar of high school. That was thanksgiving, and she did. She was like a medical student. She really worked at it, doing the blood pressures, charting everything, getting the meds and at one point a little boy urinated on her because he had a Seesar and I said to her, you're such a cool chick. You're the only cheerleader. I know...

...who I'm thanksgiving. Got Urinated on because you wanted to be her. You could have been doing a million other things, right, a million other things, and here you are Enjordan with me. We're sleeping in the convent. You know, this is not the Ritz Carlton, this is not the four seasons, but here you are with me and as if you're a cool chick. And that was me. That's a very ful film experience for me. Well, and I'm and I'm sure to this day she remembers that expression, you know, when she use a cool chick. It's amazing how those experiences you become foundational and then in who we are and and what we do and and all of that. But that's really well, quod test, I agree. That's you really articulate that well. You're absolutely correct. Right, yeah, but you know what the what's the expression where the sum total of our experiences. Yeah, so, so you touched on it. So let's talk about some of the wounded warriors work that you did too, and love to hear a little bit more about that. Another place where my heart goes to a times is that that you're in and they're underserved and and how do we continue to increase that? But I'd love to hear about some of the work you were doing in Europe with them and what were some of the things you were seeing and how were you guys treating them and what was some of the keys to having success? I was overseas. I was assigned to Land Still Regional Medical Center. I became the director of the Psychiatry Department. Under get this. I was actually in the Department of surgery in ours thesiology as a psychiatrist and they had ender the Department of ates thesiology. My boss was Kad of that. We had a division for treating chronic pain, because these are soldiers who got back from Iraq and Afghanistan a lot of violence coming their way. IEEDS, parachutes, that kind of work, but when a parachute kind of works, it really doesn't work right and there was a lot of physical and psychiatric trump. So what we found was that a lot of these service members were at the point where they were going to leave the military, they were going to no longer be considered medically able to serve. So the services came up with this three week program. We would say, look, let's see if we can get you conditioned again, and we did interventional treatments like radio frequency ablations for pain, and they were pretty good. And then we did my program and it consisted of pets, Otis my seeing them individually as the physician, seeing them with the groups, and also really big. I had a spiritual component where we would have a session on how does your spiritual life help navigate you to another point in time, get you better and write. We ran that for two years and you would take soldiers who were exploded, were in their humbies that got rolled over, were damaged and we got them back and we had like a ninety five, hundred, ninety seven, ninety eight percent success rate. So we had guys who couldn't tie their shoes again. Are horrendous pain. I've seen things no one else should ever see in their lives and by the time we ran them through this program of getting the moving, getting their psychiatric physical needs, which are really the same thing, all treated. We got them back into service and you know, in terms of the OPIOID epidemic, are O br u straight for chronic pain was three percent, which is unheard of. I heard of any of your listeners could say, anyone who can say, well, I'm doing better any other physicians? I would say I need to learn further. So that is great. These guys got back and to the service. They didn't have to retire...

...and write every iteration. I would have to give the graduation speech. You can really get choked up. He's you're not dealing with people living and Beautiful Santa Barber California who came from Santa Barbara with trust and hedge funds. These are people from towns you haven't heard of, what they call the flyover states, which is an insult to these people, and there are serving their nation and they're serving sometimes because they had no option. But if it wasn't an option, it's what they also wanted to do and they were giving their lives in more and we treated these people with the respect. The efforts that they had come to them and they deserved every bit of our care. These are really good people, really good people. Well, obviously they're sacrificing a lot, so we need to give them everything we can. So let's talk. I want to touch on a little bit. You know. So you talked about the low opioid thing. What do you attribute that too? So if you said, if somebody said it is lower, I want to know how. So if I said you know that to you, how you how did you attribute it? What was a combination of things that made that so successful? Effective treatment? Not? We didn't get these people hooked on opiods. They would come in, they couldn't even smoke. If we tested them for nicotine and we said you, that rule was join physical therapy. You couldn't say I can't more than three times. You could get kicked out of program. They never really got kicked out program right, but they had the support of something bigger than themselves. Now, look, I've been practice in medicine was twenty five years. The Camaraderie you have in the military is just different. It's just different. So there was a real sense of viewer here, you are part of the team, you are serving your nation. You are member of the United States, aren't you? Usually was army. Sometimes there course, occasionally. Maybe you are part of this bigger group. You have people here to support you and you will come through. You're going to go through PET OT. You meet Dr Massa individually, you're meeting for all these groups that would run and you're all part of the team and you will succeed and you're going to get the best interventional care. As I said, Radio Frequency ablations where you go in and you basically destroy the sensory gangleon so those inputs aren't felt and you're going to start moving again and you just had the real wrap around here and commitment that, quite frankly, you don't have. I've not seen it. I'll s work now. And that was a significant difference. And these guys got better and they were able to still I had to sign off where they were still eligible to be in the military at the end of this week program and I had to go through and make that decision and I maybe two or three times they said no and it was usually what they wanted anyway. But you know, all things being equal, if you tried, you got to stay in. As far as sir, wow, that's great, and knowing really not much at all about PTSD and you know, dealing with patients who have gone through unspeakable experiences and seen unspeakable things. You know the expression, I can't UN see that right at once. I've seen it, it's in my mind. So, psychiatrically, is it really about how to cope with that? Is it teaching them how to cope with those things, those feelings, those emotions that have come from those, you know, difficult situations? Now I'm going to go one step further. I'm going to say it's defeating it. There's only three types of illnesses and medicine untreatable, treatable and curable, and I strive for curable when it all possible and will do with these. I'm going to give you a story and it has a lot to do with support and returning to baseline and not politicizing this pathology. So I'll tell you the best story I have about PTSD. I had what's called an NCOI see, it's not commission officer in charge, and...

...they're like the administrator and they deal and most of the folks there were enlisted. So we have very few officers because, quite frankly, officers matters violence. The enlisted engaged. So I had this NCOI se who is down range. When they say down range, that means on the ground. So he tells me the story of his truth, and this is intense. So he's I think he was an Afghanistan and he had this like nineteen year old who was guarding the perimeter of the fourth the base, and he comes up to him, he tells me, and starts getting in his face, screaming at him because he says you got to get shut when you do your perimeter patrol. You can't walk in a straight line. He gotta Weed, he gotta stop. You moved to the side, you move forward. You just can't be a steady moving target. And he's hollering out the guy and as he's telling this guy these things to save his life, I mean by the best interest, and he's right up. You know, this is the military. They're not saying well, but I would suggest you know. He's an in from his nose with his price puffed out and read. All the sun in this round goes right through the soldiers h the guy is holler now because they were sitting still and the brains of this first soldier went over my Ncoi sees body. So that's PTSD. All right, wow, that's what we're dealing with, and I sometimes think, you know, I said we don't. I don't want to ever politicize the diagnosis, but there's such a thing as real patison, and then sometimes I think we over diagnosed that. But these guys, this is what we were working this guy, this is such a cool story about this and COOC this is some Fella North Carolina who talked like he was from North Carolina, look like it was some Bubba from North Carolina, and then you find out that he and his wife have adopted like three African kids from like when they were an Ethiopia, and you think it what a saint. This guy did not come across like Angelina Jolie with the sixteen kids or all people magazine that she's adopted. I found out like six seven months later. I say she'll me picture of your kids, and I'm thinking, I'm not sure those are your Bila children, and they were all from like Ethiopia, and I thought, man, you're a saint. No one would ever talk in too you think you're this fellow, and I thought maybe that's why. Well, it certainly is a you know, we kind of cover here on the podcast, you know, but it's clear right we don't. We don't know. You know, compassion is required for everybody all the time. We never know what somebody's been going through. Just recently on one of the podcast linkedin chats we were talking about that, about the wearing of masks, and you know, you don't know what the you know just because you don't think you want to wear a mask. You know the person. You don't know what the person next you is going through. Maybe they have a very compromise system and they're trying to protect themselves and you know, as you know, that's what just struck me when you talked about that story. Right here was the person and persona that you saw from the external cover. You just never know, and what a story, you know he had and what an unfortunate experience he had to go through. Yeah, and this guy, he was just everyone in the hospital wanted him to be in charge of their troops. I mean this guy was just amazing. And then I had another shellman for the Philippines who one point we had this old, gruff and listed fellow comes in who was like one rank below and he says that I can't understand that China, because we had a Korean member of our team who's actually in the United States Army, and this guy said you will never use that term again, and I thought, Whoa, Whoa, that is so cool. This guy got called out like that. I'm thinking, you know, he said that man might be responsible for saving your life one day and...

...we're speaking with terms like that and it's pretty cool. Yeah, I don't have to do a thing. I mean I said, you want me to handle this, and he said, sir, I got it, but you can do a better job than I, because I would have started. You know, look, maybe that's not the way people can really engage in community, this guy and none of that so anyway, because it's got he was going to shut it down fast. Yeah, quick before we transition to some of the current things today that you and I've talked about prior to our connection today. So when you talk about the curing of the PTSD, that's in just thing to me and I like to understand that a little bit better, because I wouldn't have thought that that's something that you can quote cure. I would think that it is only a coping mechanism. It's how do we deal with it. So can you explain to myself and the listeners a little bit more about from the psychiatric approach, how do we go about that? And then how do we declare that that is cured? And I would think, you know, if I've got a cut and it's better, it's cured right, or if I've got a cold and I feel better, it's cured psychiatrically, Psychiatry Wise, how do you know that the person's cure? Okay, that's a wonderful question, because it gets too I think, a bigger question. Psychiatric illnesses only exists as long as they can disrupt or ability to live, love and work to the false and that's the metric we use. So if you have a cut, it is preventing you from holding a test record throwing a baseball, it's a current illness. But if that cut heals itself, you might see the you know, maybe a train, a little bit of Starchiss or something healing, but you can still throw a baseball or hit a forehand as well as you ever could. It ceases to be quite frankly, in all those you can you're living with PTSD is an anxiety disort anxiety disorders part treatable and I believe, quite frankly, they can be curable. They cease to be curable and they cease to be treatable when we make it into a cottage industry where we have these patients coming back forever, enabling the pathology and not the patient, and that's a distinction that I think is crucial. I want to let the patient know that their identity is infinitely more than their illness, and that is something I don't think we would do in the field of medicine and certainly stucture. And there are various ways you can get to that endpoint. And the best thing about PTSD's with time, which is quite an effective feeler for a lot of things. The symptomatology does minimize but by engaging these patients with the realistic expectation that it doesn't what it occurred does not have to predict their future abilities, you give them a framework of an endpoint which is inherently healthy and attainable. How you do that? Well, that's an hour and have discussion, but when that's exposure therapy, whether it's desensitization, whether it's providing them re engagement, those are key things and quite frankly, I think it is a combination of medicine, cognitive behavior therapy, support, time and probably the biggest therapy I think that works is gradual and graduated exposure and these people can have productive lives and if their lives are no longer encumbered to the point that it doesn't affect their ability to live, love and work to the fullest, that's secure and that's a win. But sometimes we set expectations where we wish to fulfill our comfort with the people who are treating them instead of the people were treating. And every time I've ever been in a discussion about this, always remind my medical students, nursing staff and...

...team that the comfort level that I'm interested it's not my own ideally, and I hope I truly not just like that. It's not. There's as much it is the patient, and that's what we're reading for and generally most people are very receptive to that from and for the most part that's why it's people like yourself and others got into this line of business, in the line of work and what you do because, as you said earlier, in the whole in the in our conversation, it's really about finding purpose in life that keeps US fulfilled. It's when we identify that purpose. Today, some of the younger generation, and I'm old so I can say this, will say it's it's what I'm passionate about, but I think it's the same thing. What you find is purpose. That gives you purpose, is what you where your passion lies, and that would that's what gives us the motivation to get up every day and do what we do. Yeah, I would agree with you. I think it's nuance in terms of how we phrase it, but I think a sense of fulfillment and what makes this whole is actually more important than passion, because passion is driven by what we're achieving. Fulfillment, I think, in the end, is what we've achieved for others. I think that's really good distinction actually that I just came up with doing the talk. They go you better coin that we get a coin. So let's transition if we if we can. We're so as we're starting ahead to the, as they say, the home stretch of our conversation. So let's talk a little bit about PTSD, or stress anxiety, as the numbers are starting to come down, as we hear here, we are recording this in, you know, early March, of the anniversary. I think we're right. We're recording this on the anniversary of the WHO's proclamation that this was a pandemic. Hard to believe a year a year ago, that's that's what happened. But so we're recording it on this day and we're seeing numbers coming down, vaccination numbers are coming out and we won't debate whether that's fast enough or slow enough or anything like that, but there's hope on the horizon. We're seeing some things coming back to whatever we want to describe as normalcy. But obviously there's a lot that we've talked about and we're seeing in the in the news, that there's going to be a post traumatic stress from this, or there is a belief that there is going to be. Talk if you don't mind, talk to us a little bit about what you think that is, what you think that will be, how will it manifest itself and again, what can we do to help? All Right, let me start off by saying covid the coronavirus, is a very real deal. When you have four hundred and something thousand deaths, we must have five hundredzero. Yeah, I think we, I mean domestically, we it's it's around five hundred million, five hundred thousand. No one can say that's not real. And I've heard people say, well, you know, maybe server Dignos, let's say it is. Let's say it's form with thousand. Let's say the people who had it might have had other complications. Well, you can argue three hundredzero is acceptable. So covid is very real. This needs to also to be emphasized. It's getting better. In My hospital, at one point a hundred of our four hundred beds at Covid were down to thirty three. People Are Getting Vac to me, you brought up a point. You could argue whether the vaccines are getting up quickly and not for not. Here's the deal. They're not until everyone's been vaccinate. But this is America. We need to be doing way better, I think, and again you're not asking me political questions, but my God, this is the country that defeated Nazism. We put him in on the moon. We don't have a good lookistic supplot. We can't handle that. So the vaccine needs to get out and people need to take it and for those who don't believe in vaccines. What's the psychiatric term? You're crazy. You got to take your vaccine. You got to be a big boy and girl. The needle hurts a little bit, you'll live, period, you'll literally and you'll be better. Yeah, exact. There we go. So...

...now, as for the PT SD element, I think the PTSD element will be unfortunately, sure, by those who lost loved ones. I think there has to be a real proximal relationship because we don't want to explode this diagnosis and make it a diagnosis because of ascertation bias as cirtation biases. I mean no, I'm going to find it out there, and we do find it out there. I just want to stop you for a second say that again, because I don't know that I understand what that is. That what I know what biases are, but I didn't what wells that as certation bias is an illness predominantly held by medical doctors who wish to prove something, and your enthusiasm getting to that point is sometimes blinding you to other evidence which much suggest others. Thank you've got it. Okay, I think I kee praised forehand on the planet. Other people look at me and say you don't have the greatest for hand on the planet, but I'm thinking, all, yes, I do, look out. Well, you get it, I got it. Yeah. So there are people who lost loved ones, who witnessed that traumatic loss. But there's another element out there, and this is where we kind of lose truck of this this Chris us. There are a lot of restaurants in the town I live. There were a lot of people on the play and I thought, I don't think they're gonna be a lot of Christmas tree sales and I don't think they're gonna be a lot of presents under the tree for children who very really get for us. And there's going to be a lot of unemployment. Is going to be a lot of economic disparity, there's going to be a lot of lonely people, there's going to be an increase in depression. WOULD IT BE NECESSARILY PTSD? Quite frankly, I'm not prepared to go there. But you're going to have any time you have an economic turn down, you have an increase in depression and anxiety. Very, very robotical and that's what concerns me. And providing safety and the return of economic stability are crucial and if someone said to me, what did covid do? But took lives, it took people's financial sense of I can pay my bills and in the end it left people with a lot of depression, anxiety and significant work and that, to me, is the biggest immediate concern I see coming out of this. So, if I understand you right, so if the and again commemorating the day, were on the I think last night they voted to pass this new stimulus bill which is going to infuse a lot of different revenue and capital back into the system. So if, if that achieves this the success that they hope it will, it bridges the gap that you said, a financial downturn, hardship on the on the lives, hardships on the people, and that elevates that. If I understand you're right, what you're implying is that that will lessen the psychiatric challenges, the anxiety challenges that society may achieve, so that they're beyond the just the economic. Let's get the economy going again. There's a real mental health value to this. Okay, I paid my mortgage. By the lack of hope, kindness and general sense of things are going okay, on the planet. Seventy percent of my mortgage is probably paid by people being mean to each other and then that creates depressure, that creates societies and you know, drug abuse is the entire thing does with it. And if you then add on the stresser of you're not employee for six months, you're staying at home, you can't go to work as you got to be there with your kids, I have a missed a day of work. I guess I appreciate this, but I'm not experiencing it and that's an infinitely different perspective. I've got a order and you know,...

...their economy stuff for her. She's doing okay. I have missed a day of work really, so I can't say I understand what these people are going through. I hope I appreciate it, but it's hellish. It's really good. You know, we minimize, I think, the degree of isolation and loneliness place and people's lives and without that sense of you know you're going to work, seeing people you know, being able to come home and literally I thought they're all give me a little bit please. We're gonna have a damn thing to put into the tree for their kids and that's tough. Yeah, so, yeah, I think it's it's a very real illness that moves beyond just a inflammatory, pulminary response people don't want. So on the on the glass half full side, what does the pandemic give us psychologically? Do we come out of this appreciating things better? Do we love each other better? Do we realize what we you know, so, if here I am, as you talked about Christmas, on them over the holidays and I'm saying look, I'm sitting around with my family and last year I couldn't do that, I mean does that get lost on the psyche of people? Does that have an IM lasting impression, or do we say wow, this is great, we're back to the old ways and human nature just goes back to doing what it was doing? Is there? Is there something comes out of us? Hopefully sometimes. I've been around a lot of things. I think that made me think that's not possible. I would like it to do, but I don't think so. perferently, I know you think human nature goes back to human nature. Yeah, and don't get me wrong, there's a lot of good things about human nature. Yeah, that's not all that. It's not a bad guy. As a siddle back, I would like it to be the case. I would like people to be nicer to each other. I like people be kind to each other. I would like us to understand that, you know, we have a pandemic. It's very real and we have leaders in this is a vocal statement. Who appreciate that? HMM. I would like people to understand that the greatest moving of the block and tackles done by the poor. You know, I live in a very nice area and when they close one of the hotels, I thought it's always nice to have an ocean view. For the people who have to clean the toilets, they don't know a job. Yeah, and for the people, you know in the hospital who are removing all the hazardous material, those are the people. They're working hard. They work hard, I work hard, they work hard sure. So I appreciate you share are your time with us today. I appreciate your service to the veterans, your service to the underserved and around the world and your passion for compassion. And as I warned you, and I told you, he always kind of closed my episodes with the question, as we're running at a time, who's your hero? who was your hero growing up? Who's you hero today? Who are the heroes of Dr Mass Has World? I'm going to I'll do that by talking about our talk health care heroes. What about? Sixteen years ago, I got to me and I'm not going to give you their name, I met a priest who was married. He's a Catholic priest, is married, but he's part of this eastern rite where Rome said, okay, in one thousand, three hundred and eighty six, you guys can get married. So He's married. He's easy to write, Catholic, his wife is an. He's a hospital Chapan. They have four children and I kind of live in the atmosphere. What, especially when my darrow's younger, what private school is your kid going to get into? What private high schools your kid going to get into? Who knows who on the special little committees? And you know this problem with that. It has a lot of giant emptiness. It's going to come full circle, don't worry. So my friend, the Catholic priest, his wife the RN, but from another country. Now they're practicing America. They are four children, as I mentioned, and two of them are crannially conjoined. Full cognitive...

...development, but they're currently can joined the official development. Full fishing development, but they're currently can joined. And I thought, well, they can teach me a few things about being a better parent, about being a better husband, being a better father, being a better individual, and maybe I can learn a few things about being a better, more compassionate, kinder, nicer position. I thought, there you go sometimes and these people have been to my house, SOPs, my daughter's friends with my wife. We're friends and we were involved in helping them with some of their healthcare. We tried our best in terms of producing a surgical action with some of the people do these things and their healthcare. Girls. They know they're not healthcare heros. That's a mistake. Let's just go with heroes. There it is. That's great. Yeah, you know, is as you say. It's the people doing the things that are just hard, but they just do it because they feel compassionate around it and they feel purpose around it and everything like that. So well, I thank you for sharing that story. I thank you for sharing the stories that you did for today. It's been fun to catch some time together and just thank you for being part of this journey that we're on. Then we call the heroes of healthcare podcast. This has been this is good therapy for me too, is you express things that are sometimes we be dark. Well, if we helped you at all, a little bit, we're happy that it works out that way. So again, thank you to us. Yeah, well, thanks so much for being a part of our show and we just look forward to talking to you some more down the road. Thanks a lot, Dr Massa. Thank you. Cheers. You've been listening to heroes of healthcare. For more, subscribe to the show in your favorite podcast player or visit us at heroes of healthcare podcastcom.

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