Program Director, Abdominal Pain, Kelly Sketchy discussed on The Peter Attia Drive


So you trained in internal medicine when you finished at Stanford. What was the first job? You took isn't attending. So I'll be honest with you about your two of my residency. I wanted to GI always intellectually interested. Your dad is a guest on just isn't actually a primary care doc who also trained in pulmonary. Oh, I just for some reason, I always love GI physiology. Love hepatitis C. I loved the way that digestion works and the mind body gut connection. I thought was fascinating I loved irritable bowel syndrome because I thought how interesting that the mind can influence what we send in our in our gut when we get butterflies coming. So second year, though, I did the rotation had terrible mentor. It was just scoping routinely doing kalanick's copies and EG dis. And it was horrible the idea that that could scale for career was mind numbing too. Because when I hear someone saying I wanna go into GI. I assume they mean they wanna be in. They want to go because that's the most lucrative prodigy. I right, but you are more interested. And in like, the medical part of GI. I like the medical part of it and even hepatic was a little too much. But I wanted to scope that was cool that was video games in people's buttocks. Awesome. Great. But I like talking to patients I like the relationship, and I like the physiology of it talking to people about their issues because abdominal pain chronic abdominal pain constipation, nausea, vomiting a lot of times. These are these are deeply connected to the mindset. And so I that's what I loved. But then when I saw the scoping part of it was like, I hate this. I hate it. And this is most of how I make a living. It was repetitive. Mindless to me. It didn't sit with me. Plus I was starting to get disillusioned in general with medicine because most of what we did seem like bullshit. Most of what we did either harm people or wasn't thought out. You know, it's half baked in the thing is that caused the kind of moral distress. So is like forget it was burned out. It was tired. So by third year. I remember my program director to pull me in. And he's like, you're a bad influence on the interns is one thing to be burned out and tired. It's another thing to to. To model that for the younger, and it changed me. Totally then I became the great teacher and got focused on that. As a way to have self warn. What were you doing at about sarcasm or like the humor gone too far? Like, what was it? The humor got very dark. It became more of a wall, then a coping mechanism. So it was more. Like, how can I mentally victimize? Everyone around me by throwing blame to build a wall around myself. The fact that I feel morally bereft doing this job. So, you know, calling patients Gummer's, you know, the slang stand for it stands for get outta. My ER comes when the book house of God. Yes. And so I would use every haven't heard that in the long time because it's a horrible thing residents. But we heard it all the time. I just had forgotten. Not only do you hear it all the time. I had conjugated every form of that. So I was like that guys. Go out he's in status quo Mattis. You know, this guy's preparing to gome. He's like protocol home. He's got serious. Go mafi every version of Gomer I could use and it came from this black hole in my in my center where it was like, I'm a bad person. Right. I'm a worthless. Poor that's burn out really moral injury. So because of that I decided I was taking I told our program director Kelly sketchy knows the story of toll public. I said Kelly. I can't no I'm not going to match. I'm not going to do a fellowship. And I'm not going to practice medicine. I'm going to go into tech..

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