WEBVTT 00:00:00.000 --> 00:00:02.740 This episode is sponsored by TeamBuildr, yet 00:00:02.740 --> 00:00:04.860 another company that's doing great things for 00:00:04.860 --> 00:00:07.679 the first responder community. As a strength 00:00:07.679 --> 00:00:09.960 and conditioning coach myself who also trains 00:00:09.960 --> 00:00:13.140 tactical athletes, dissemination of wellness 00:00:13.140 --> 00:00:15.320 information is one of the biggest challenges. 00:00:15.980 --> 00:00:18.519 Now TeamBuildr is the premier strength and conditioning 00:00:18.519 --> 00:00:21.539 software for tactical athletes and there are 00:00:21.539 --> 00:00:24.839 several features that really impress me. Firstly, 00:00:24.920 --> 00:00:27.780 there is a full exercise library. So you, the 00:00:27.780 --> 00:00:29.940 personal trainer, does not have to create that 00:00:29.940 --> 00:00:33.060 within your own department. 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To me, it's imperative 00:01:02.079 --> 00:01:05.560 that we as a profession start tracking our people 00:01:05.560 --> 00:01:09.439 from day one and then over the full span of their 00:01:09.439 --> 00:01:12.659 career, therefore catching potential wellness 00:01:12.659 --> 00:01:16.200 issues and injuries before they happen. Now, 00:01:16.200 --> 00:01:18.420 if you want to try TeamBuildr, they are offering 00:01:18.420 --> 00:01:20.760 you, the audience of the Behind the Shield podcast, 00:01:21.180 --> 00:01:25.359 a free 14 -day trial to experience all of the 00:01:25.359 --> 00:01:27.900 features. And if you want to take a deeper dive 00:01:27.900 --> 00:01:32.439 into TeamBuildr, listen to episode 1032 with 00:01:32.439 --> 00:01:36.439 Melissa Mercado or go to teambuilder .com. And 00:01:36.439 --> 00:01:37.980 I'll spell that to you because it's not as you 00:01:37.980 --> 00:01:44.579 think, T -E -A -M -B -U -I -L -D -R .com. Welcome 00:01:44.579 --> 00:01:46.239 to the Behind the Shield podcast. As always, 00:01:46.280 --> 00:01:48.060 my name is James Gearing, and this week it is 00:01:48.060 --> 00:01:50.480 my absolute honor to welcome back onto the show 00:01:50.480 --> 00:01:55.439 CRNA and the CEO of Revitalist, Catherine Walker, 00:01:55.620 --> 00:01:59.280 and this time she's joined by clinical pharmacist 00:01:59.280 --> 00:02:02.599 Nick Nowak and British military veteran David 00:02:02.599 --> 00:02:05.849 Norris. Now, in this conversation, we have three 00:02:05.849 --> 00:02:08.409 unique perspectives when it comes to the world 00:02:08.409 --> 00:02:12.129 of ketamine and mental health. So from Catherine's 00:02:12.129 --> 00:02:15.370 experience from the medical side, Nick's experience 00:02:15.370 --> 00:02:18.110 from the pharmacy side, and David's experience 00:02:18.110 --> 00:02:22.569 as a recipient, this is a very powerful, multifaceted 00:02:22.569 --> 00:02:25.930 perspective on this entire discussion. Now, before 00:02:25.930 --> 00:02:27.810 we get to this incredible conversation, as I 00:02:27.810 --> 00:02:30.870 say every week, please just take a moment. Go 00:02:30.870 --> 00:02:33.389 to whichever app you listen to this on. subscribe 00:02:33.389 --> 00:02:36.930 to the show, leave feedback and leave a rating. 00:02:37.349 --> 00:02:40.770 Every single five -star rating truly does elevate 00:02:40.770 --> 00:02:43.490 this podcast, therefore making it easier for 00:02:43.490 --> 00:02:47.050 others to find. And this is a free library of 00:02:47.050 --> 00:02:51.650 well over 1 ,000 episodes now. So all I ask in 00:02:51.650 --> 00:02:54.750 return is that you help share these incredible 00:02:54.750 --> 00:02:57.449 men and women's stories so I can get them to 00:02:57.449 --> 00:03:00.330 every single person on planet Earth who needs 00:03:00.330 --> 00:03:03.849 to hear them. So with that being said, I introduce 00:03:03.849 --> 00:03:08.469 to you Catherine Walker, Nick Nowak, and David 00:03:08.469 --> 00:03:31.969 Norris. Enjoy. Katie, David and Nick, I want 00:03:31.969 --> 00:03:34.629 to start by saying thank you so much for taking 00:03:34.629 --> 00:03:36.449 the time and coming on the Behind the Shield 00:03:36.449 --> 00:03:39.569 podcast today. Thank you. Glad we're here. James, 00:03:39.569 --> 00:03:42.750 it's a real pleasure. Yeah, thank you so much, 00:03:42.770 --> 00:03:44.789 James. Excited to kick off the conversation. 00:03:45.520 --> 00:03:47.759 Alright, so I know that we've got a shorter time 00:03:47.759 --> 00:03:51.259 frame. For people listening, Katie was on episode 00:03:51.259 --> 00:03:54.199 559 and then back on with Nick Murray on episode 00:03:54.199 --> 00:03:58.759 678. So we took deep, deep dives into the world 00:03:58.759 --> 00:04:02.020 of ketamine and Katie's your own life story. 00:04:02.759 --> 00:04:05.780 So why don't we just do a brief overview of everyone's 00:04:05.780 --> 00:04:08.719 background and then we'll dive into the problems 00:04:08.719 --> 00:04:10.780 that we're seeing and then some of the solutions 00:04:10.780 --> 00:04:12.219 that you guys are going to be bringing today. 00:04:12.699 --> 00:04:15.569 So David, let's start with you. Tell me a little 00:04:15.569 --> 00:04:17.949 bit about your kind of background, some of the 00:04:17.949 --> 00:04:21.209 uniforms that you've worn, and how you find yourself 00:04:21.209 --> 00:04:25.370 having this conversation today. James, thank 00:04:25.370 --> 00:04:27.089 you. Very embarrassing. I can't tell you that 00:04:27.089 --> 00:04:29.709 much. I served for 33 years in the British Army. 00:04:32.089 --> 00:04:36.009 Saw too much. Did quite a lot. And I ended up 00:04:36.009 --> 00:04:43.110 suffering from PTSD. And I found that the traditional 00:04:43.110 --> 00:04:47.399 approach... doesn't help i needed something different 00:04:47.399 --> 00:04:50.240 something new something that actually worked 00:04:50.240 --> 00:04:53.800 so i ended up on ending up having psychedelic 00:04:53.800 --> 00:04:55.519 assisted therapy and it gave me my life back 00:04:55.519 --> 00:04:59.579 so that's where i come from um i also back in 00:04:59.579 --> 00:05:04.399 the uk and lately internationally was heavily 00:05:04.399 --> 00:05:08.319 involved in using sport to help wounded injured 00:05:08.319 --> 00:05:11.949 and sick service men and women recover That ended 00:05:11.949 --> 00:05:14.069 up with us having a relationship with the Warrior 00:05:14.069 --> 00:05:17.389 Games in Colorado Springs and ultimately led 00:05:17.389 --> 00:05:20.410 to the birth of the Invictus Games. And the one 00:05:20.410 --> 00:05:22.709 thing that annoyed me through that journey was 00:05:22.709 --> 00:05:25.350 it was really, really simple to deal with people 00:05:25.350 --> 00:05:29.670 with visible wounds. Next to impossible to help 00:05:29.670 --> 00:05:33.430 servicemen and women with invisible wounds. So 00:05:33.430 --> 00:05:35.790 that's been a passion of mine is how do we help 00:05:35.790 --> 00:05:39.069 people with these invisible wounds? And how do, 00:05:39.089 --> 00:05:42.170 importantly, how do we move the needle from cure, 00:05:42.250 --> 00:05:44.290 our traditional approach, which doesn't really 00:05:44.290 --> 00:05:47.290 work, the individuals already hurt, their family, 00:05:47.350 --> 00:05:50.430 their friends, their work, their community, to 00:05:50.430 --> 00:05:52.470 prevent? How can we get ahead of the problem 00:05:52.470 --> 00:05:55.509 and actually help people before they've got a 00:05:55.509 --> 00:05:58.990 problem? So that's why I'm here. We've had a 00:05:58.990 --> 00:06:02.129 lot of conversations with American veterans on 00:06:02.129 --> 00:06:05.000 the show, but... Obviously, our cultures are 00:06:05.000 --> 00:06:07.720 slightly different. What is it through a British 00:06:07.720 --> 00:06:10.560 lens that you've seen that has created this stigma 00:06:10.560 --> 00:06:13.439 around the mental health when, for example, people 00:06:13.439 --> 00:06:16.160 like Mark Holmrod, who's an incredible man, I've 00:06:16.160 --> 00:06:18.459 had on him a couple of times now, like you said, 00:06:18.620 --> 00:06:21.600 they look at him like, wow, triple amputee, we 00:06:21.600 --> 00:06:24.139 need to take care of this guy. He needs prosthetics 00:06:24.139 --> 00:06:26.639 and all the things. Why is there disconnect in 00:06:26.639 --> 00:06:28.480 the British military when it comes to the mental 00:06:28.480 --> 00:06:33.800 health side? I think you can put it under a couple 00:06:33.800 --> 00:06:35.839 of things. One is we're all meant to be alpha 00:06:35.839 --> 00:06:39.420 males as soldiers. So we don't talk about our 00:06:39.420 --> 00:06:41.540 weaknesses or we don't like showing weakness. 00:06:42.319 --> 00:06:44.639 And certainly if I think of the first time that 00:06:44.639 --> 00:06:48.319 I ended up saying to people, I need help, it 00:06:48.319 --> 00:06:52.259 was still taboo. I had other people considering 00:06:52.259 --> 00:06:55.899 me weak for saying that I had a problem. And 00:06:55.899 --> 00:06:59.129 the only good news I had was I had a... He became 00:06:59.129 --> 00:07:01.610 a dear, dear friend who sadly died recently, 00:07:01.709 --> 00:07:05.750 who said, David, for speaking out is stronger 00:07:05.750 --> 00:07:08.949 than the rest of you. But I think we still have 00:07:08.949 --> 00:07:11.449 that. I think we still don't like talking about 00:07:11.449 --> 00:07:13.430 something that we don't necessarily understand. 00:07:13.689 --> 00:07:18.389 Very easy to understand an amputee. Not so easy 00:07:18.389 --> 00:07:22.970 to understand what's going on upstairs. One of 00:07:22.970 --> 00:07:25.790 the things I think that I've... that I think 00:07:25.790 --> 00:07:27.949 can help us connect with some of the naysayers, 00:07:27.949 --> 00:07:30.550 some of the still believe that kind of faux machismo 00:07:30.550 --> 00:07:35.490 version is performance. When you have a busy 00:07:35.490 --> 00:07:37.189 mind, you're not going to be able to get into 00:07:37.189 --> 00:07:38.649 the flow state. You're not going to be able to 00:07:38.649 --> 00:07:41.129 perform at the highest level. I'm making an assumption 00:07:41.129 --> 00:07:43.189 now that you worked in some high level areas 00:07:43.189 --> 00:07:46.290 of the British military. What is your perspective 00:07:46.290 --> 00:07:50.569 now? on performance with you know as you as you 00:07:50.569 --> 00:07:52.670 started struggling how that affected your performance 00:07:52.670 --> 00:07:54.490 because i think it's a different lens that gets 00:07:54.490 --> 00:07:58.050 you the same result yeah i think it is i think 00:07:58.050 --> 00:08:01.509 um if i if i look at our experience in the british 00:08:01.509 --> 00:08:03.790 military we you know we went on operations you 00:08:03.790 --> 00:08:06.329 came back you literally try to parachute you 00:08:06.329 --> 00:08:10.470 straight back home it doesn't work you're still 00:08:10.470 --> 00:08:14.670 on a high from being on operations and when you 00:08:14.670 --> 00:08:16.129 get back in your home environment they're not 00:08:17.379 --> 00:08:20.019 An operational tour for me would feel like days, 00:08:20.180 --> 00:08:23.019 not months. For my family, it would feel like 00:08:23.019 --> 00:08:27.759 years, not months. So somehow you've got to get 00:08:27.759 --> 00:08:29.839 people back down to the same level, come down 00:08:29.839 --> 00:08:34.639 off that operational high you were on, and grasp 00:08:34.639 --> 00:08:39.100 reality again. On an operational tour, you were 00:08:39.100 --> 00:08:43.019 ultra -focused on the mission at hand, and everything 00:08:43.019 --> 00:08:46.929 else was excluded. I think that's how you coped, 00:08:46.929 --> 00:08:51.049 but that didn't help you when you got home. Absolutely. 00:08:51.409 --> 00:08:53.549 All right. Well, Nick, let's move to you. I know 00:08:53.549 --> 00:08:55.590 you've got a very different background. You weren't 00:08:55.590 --> 00:08:58.789 SQL scrolling around the British Isles. So talk 00:08:58.789 --> 00:09:01.909 to me about your journey and what's brought you 00:09:01.909 --> 00:09:05.110 to this conversation. Yeah. Thanks so much, James. 00:09:06.299 --> 00:09:08.360 Yeah, interesting mix of people we have on the 00:09:08.360 --> 00:09:10.480 call. So I'm excited to see how this all goes. 00:09:11.019 --> 00:09:13.539 Yeah, my name is Nick Nowak. I'm a board certified 00:09:13.539 --> 00:09:15.980 clinical pharmacist. Most of my career has been 00:09:15.980 --> 00:09:19.600 on the clinical side. So I've worked in emergency 00:09:19.600 --> 00:09:23.720 medicine, cardiovascular ICU, including was at 00:09:23.720 --> 00:09:26.759 David Grant Medical Center, which is on Travis 00:09:26.759 --> 00:09:29.720 Airport space for about five years. And then 00:09:29.720 --> 00:09:31.659 my other portion of the clinical background is 00:09:31.659 --> 00:09:33.299 more like integrative preventative medicine. 00:09:33.870 --> 00:09:35.730 And how do we really focus on the whole health 00:09:35.730 --> 00:09:39.789 and the whole human in order to take a more proactive 00:09:39.789 --> 00:09:44.549 approach to care? And yeah, the way I guess I'm 00:09:44.549 --> 00:09:46.070 on this call is ultimately just like frustrated 00:09:46.070 --> 00:09:48.570 with the current system. So a recent founder 00:09:48.570 --> 00:09:54.470 of a company called Miko Health. Miko, we built 00:09:54.470 --> 00:09:57.690 a nationwide inclinant ketamine provider network. 00:09:58.110 --> 00:10:00.730 So we created rigorous standards for all those 00:10:00.730 --> 00:10:03.549 clinics, and we're focused on the employer benefit 00:10:03.549 --> 00:10:07.029 channel, including frontline workers, where often 00:10:07.029 --> 00:10:10.809 various mental health conditions may be more 00:10:10.809 --> 00:10:13.509 prevalent than the general population. I stepped 00:10:13.509 --> 00:10:15.870 away from that role, but still very active in 00:10:15.870 --> 00:10:20.110 the overall integrative mental health space from 00:10:20.110 --> 00:10:23.149 a political standpoint and from a support and 00:10:23.149 --> 00:10:26.470 consulting standpoint. I ask this to a lot of 00:10:26.470 --> 00:10:28.250 the physicians. It'd be interesting to get your 00:10:28.250 --> 00:10:32.090 perspective. When I ask our doctors, how much 00:10:32.090 --> 00:10:35.149 education did you get on prevention, on sleep, 00:10:35.269 --> 00:10:37.649 exercise, nutrition, time in daylight, all these 00:10:37.649 --> 00:10:40.929 things? It's very little. And they normally chuckle 00:10:40.929 --> 00:10:43.470 right before they give their answer. And you 00:10:43.470 --> 00:10:45.830 learn that a lot of these medical programs are 00:10:45.830 --> 00:10:48.029 actually funded by pharmaceutical companies. 00:10:48.889 --> 00:10:51.950 Through a pharmacist lens, what is the education 00:10:51.950 --> 00:10:58.429 on the prevention side of pharmacology? Yeah, 00:10:58.590 --> 00:11:02.009 very little. The two examples that come, that's 00:11:02.009 --> 00:11:04.110 a great question too, I love that. Because it 00:11:04.110 --> 00:11:06.429 really highlights some fundamental flaws when 00:11:06.429 --> 00:11:09.370 we go from, when we're focused on a sick care 00:11:09.370 --> 00:11:11.990 system as opposed to a healthcare system. And 00:11:11.990 --> 00:11:15.490 from a sick care mindset, I would say for mental 00:11:15.490 --> 00:11:17.889 health, it was all symptom management. Here's 00:11:17.889 --> 00:11:20.539 a pill. take the pill, the pill doesn't work, 00:11:20.659 --> 00:11:24.159 try the next pill, repeat. And that seems like 00:11:24.159 --> 00:11:27.740 silly to take a medicine for a complex human, 00:11:27.980 --> 00:11:31.059 try it for six to eight weeks, and then try the 00:11:31.059 --> 00:11:32.179 next one, and then try the next one. It's like 00:11:32.179 --> 00:11:36.039 an unscientific, unrigorous process. And so what 00:11:36.039 --> 00:11:38.960 you were touching on as well, diabetes comes 00:11:38.960 --> 00:11:42.860 to mind, right? Diet, exercise, like really putting 00:11:42.860 --> 00:11:46.120 in that effort. But clinically, what we see is 00:11:46.120 --> 00:11:48.120 you have diabetes, yeah, diet, exercise, eat 00:11:48.120 --> 00:11:50.580 some apples, but really here's your medicine. 00:11:50.960 --> 00:11:52.779 Let's focus on the medicine, let's educate on 00:11:52.779 --> 00:11:54.659 the medicine, and let's do the medicine without 00:11:54.659 --> 00:12:00.600 providing tools for just overall support and 00:12:00.600 --> 00:12:04.259 betterment of well -being. When I think of the 00:12:04.259 --> 00:12:07.159 FDA, let's remove vaccines from this conversation 00:12:07.159 --> 00:12:10.700 completely. I think of an organization that approved 00:12:10.700 --> 00:12:14.200 OxyContin. which led to the opioid crisis that 00:12:14.200 --> 00:12:16.539 we have today. And I think of the organization 00:12:16.539 --> 00:12:20.600 that just denied MDMA to be used as a psychedelic 00:12:20.600 --> 00:12:24.019 -led therapy. What is your perspective experience 00:12:24.019 --> 00:12:29.899 on either the support or the barrier to healing 00:12:29.899 --> 00:12:34.700 modalities through that organization? Yeah, oof. 00:12:34.940 --> 00:12:37.519 We could talk on that one for... for a little 00:12:37.519 --> 00:12:41.360 bit. So I did an internship at the FDA in Rockville, 00:12:41.419 --> 00:12:43.460 Maryland, a number of years ago in the Division 00:12:43.460 --> 00:12:46.399 of Bioequivalence or the generic drug arm of 00:12:46.399 --> 00:12:50.879 the FDA. And I have a really deep respect for 00:12:50.879 --> 00:12:53.960 all of the individuals within the FDA and what 00:12:53.960 --> 00:12:56.200 they are striving for. I feel like our overall 00:12:56.200 --> 00:12:59.759 infrastructure is where barriers are coming in. 00:13:01.919 --> 00:13:05.120 I don't know a clear pathway forward, but ultimately... 00:13:05.370 --> 00:13:07.730 they've helped us out in like so many facets 00:13:07.730 --> 00:13:10.070 where other drugs have been approved in other 00:13:10.070 --> 00:13:11.970 countries and then weren't approved in the US 00:13:11.970 --> 00:13:14.889 and we find they maybe have like teratogenic 00:13:14.889 --> 00:13:17.629 effects for pregnant women or other issues. So 00:13:17.629 --> 00:13:21.029 now without flaws, now without issues, we're 00:13:21.029 --> 00:13:23.190 seeing a lot of friction now as we touch on the 00:13:23.190 --> 00:13:25.250 psychedelic space. You touch on MDMA, which a 00:13:25.250 --> 00:13:30.190 synthetic molecule unfortunately was not passed 00:13:30.190 --> 00:13:36.529 on August 8th of 2024. It's still like, yeah, 00:13:36.669 --> 00:13:38.529 deep respect for the rigor. I kind of danced 00:13:38.529 --> 00:13:39.730 around the question because there's a lot of 00:13:39.730 --> 00:13:43.570 loaded aspects in there. But yeah, we took vaccines 00:13:43.570 --> 00:13:45.330 out of the picture, which also deep respect there. 00:13:46.009 --> 00:13:47.649 Well, I think, I mean, it's not a black and white 00:13:47.649 --> 00:13:50.570 conversation, but it is. I mean, it obviously 00:13:50.570 --> 00:13:55.259 is an oversight for our safety. But when corrupted 00:13:55.259 --> 00:13:58.519 by certain individuals, then it becomes a danger 00:13:58.519 --> 00:14:00.460 to the very people they're supposed to be protecting. 00:14:00.620 --> 00:14:03.580 So I think maybe kind of dissecting them and 00:14:03.580 --> 00:14:05.539 fixing the things that are broken will make the 00:14:05.539 --> 00:14:09.600 overall system safer. So here would be my MDMA 00:14:09.600 --> 00:14:12.220 stance is if there was a world where we can have 00:14:12.220 --> 00:14:15.039 approval but have a longitudinal study, so everyone 00:14:15.039 --> 00:14:18.500 who is receiving MDMA -assisted therapy and have 00:14:18.500 --> 00:14:21.320 a large cohort of individuals and still consider 00:14:21.320 --> 00:14:24.179 them as part of the research, I'd be really excited 00:14:24.179 --> 00:14:26.200 about that, where we could have rigor, we could 00:14:26.200 --> 00:14:28.820 have a process, we could have access, and it's 00:14:28.820 --> 00:14:31.059 not fully released into the wild. And we've seen 00:14:31.059 --> 00:14:33.960 that on, I think, two drug occasions, if I'm 00:14:33.960 --> 00:14:35.559 not mistaken, where it was like a tentative approval. 00:14:36.399 --> 00:14:40.220 to allow access. Yeah, that sounds great. All 00:14:40.220 --> 00:14:42.299 right, well, then let's move to Katie. Let's 00:14:42.299 --> 00:14:45.460 get your kind of origin story, Katie, your world 00:14:45.460 --> 00:14:50.899 into anesthesia and beyond. So, yeah, my background, 00:14:51.139 --> 00:14:53.700 nursing, worked in the hospital, did anesthesia 00:14:53.700 --> 00:14:57.519 for 10 years. James, I don't know, since we've 00:14:57.519 --> 00:14:59.740 talked, I went back and got my psychiatry degree 00:14:59.740 --> 00:15:03.960 too. Oh, really? Everyone said, you know, with 00:15:03.960 --> 00:15:05.539 the anesthesia that I didn't know the brain, 00:15:05.639 --> 00:15:08.100 which actually I learned way more about the brain 00:15:08.100 --> 00:15:11.139 with anesthesia than I did with psychiatry. And 00:15:11.139 --> 00:15:15.759 so the more I learn, the more I know that we 00:15:15.759 --> 00:15:18.700 don't know. And there's three things here that, 00:15:18.759 --> 00:15:22.340 like, between what David and Nick said, is seeing 00:15:22.340 --> 00:15:28.440 the invisible, right, in mental health, is knowing 00:15:28.440 --> 00:15:32.149 that it is invisible wounds. But then also what 00:15:32.149 --> 00:15:33.710 Nick was saying, you know, with the FDA, they 00:15:33.710 --> 00:15:36.570 may not be bad people, but they're fragmented. 00:15:36.929 --> 00:15:39.690 And the whole healthcare system is fragmented. 00:15:39.909 --> 00:15:42.389 So it's basically, you know, the more money that 00:15:42.389 --> 00:15:46.909 you have in this space, the more that you're 00:15:46.909 --> 00:15:50.450 paying a fragmented system to view what you want 00:15:50.450 --> 00:15:53.809 them to view. And if there's not a lot of money 00:15:53.809 --> 00:15:55.889 in the space going towards a certain product, 00:15:56.169 --> 00:15:58.529 then that product's not going to be seen in any 00:15:58.529 --> 00:16:00.889 light. And that's, you know, with ketamine, there 00:16:00.889 --> 00:16:04.929 is no money in ketamine because it's too old 00:16:04.929 --> 00:16:08.690 for anybody to own. So that's why, you know, 00:16:08.730 --> 00:16:09.850 everybody's trying to come up with these new 00:16:09.850 --> 00:16:12.730 different pieces. So honestly, like, I think 00:16:12.730 --> 00:16:18.990 that it's a really big gap in knowledge. And 00:16:18.990 --> 00:16:21.309 I think that's our biggest flaw. is in health 00:16:21.309 --> 00:16:24.850 care we're very very smart and we can't see what 00:16:24.850 --> 00:16:27.490 we don't know but we know that we know it right 00:16:27.490 --> 00:16:29.710 so you're trying to go up against these smartest 00:16:29.710 --> 00:16:32.289 people in the world and tell them well wait a 00:16:32.289 --> 00:16:35.990 minute you may not know this piece and we're 00:16:35.990 --> 00:16:37.909 like oh no I know something like I know there's 00:16:37.909 --> 00:16:39.850 a box I know there's a bubble I know we've got 00:16:39.850 --> 00:16:42.350 it all created like we can put it somewhere and 00:16:42.350 --> 00:16:46.049 what one thing I've noticed is the terminology 00:16:46.049 --> 00:16:50.080 doesn't exist yet So when David says invisible 00:16:50.080 --> 00:16:54.700 wounds, yes, they are invisible right now. But 00:16:54.700 --> 00:16:56.899 the beautiful thing with the brain and what we're 00:16:56.899 --> 00:17:00.159 seeing with psychedelics and ketamine is we can 00:17:00.159 --> 00:17:02.840 if we can learn how to define, bring the terminology 00:17:02.840 --> 00:17:06.460 to it and actually make it diagnostic, we can 00:17:06.460 --> 00:17:09.960 bring that invisible piece to light. So it'd 00:17:09.960 --> 00:17:12.039 be the same way, you know, with open heart surgery. 00:17:12.140 --> 00:17:14.920 Right. It's like that's a very known thing that 00:17:14.920 --> 00:17:17.430 we do. And we have pretty good success with it. 00:17:17.490 --> 00:17:19.650 I mean, we saw people's chests open, you know, 00:17:19.650 --> 00:17:21.410 and then we stop their heart and we bring their 00:17:21.410 --> 00:17:22.990 heart back. We put their chest back together 00:17:22.990 --> 00:17:25.069 and then they live, you know, for 20, 30, 40 00:17:25.069 --> 00:17:28.410 years afterwards. And this whole brain thing 00:17:28.410 --> 00:17:32.089 is just, you know, it's so dumbfounding to everybody 00:17:32.089 --> 00:17:34.069 that we just were just like, oh, it's too complex. 00:17:34.210 --> 00:17:37.130 It's not too complex. We've just not identified 00:17:37.130 --> 00:17:40.190 the specific patterns with all of this. So the 00:17:40.190 --> 00:17:42.730 more specifics that we can get with it, especially 00:17:42.730 --> 00:17:44.990 psychedelics are showing us there's patterns. 00:17:45.769 --> 00:17:48.490 How do we define those patterns? How do we actually 00:17:48.490 --> 00:17:50.569 bring those patterns to light through a diagnostic 00:17:50.569 --> 00:17:54.269 lens? And when I say that, I'm not saying diagnoses. 00:17:54.289 --> 00:17:56.549 We suck at those in the mental health space. 00:17:56.630 --> 00:18:01.170 We're like up to 90 % erred in some cases. But 00:18:01.170 --> 00:18:04.859 if we can start bringing like... lab reports 00:18:04.859 --> 00:18:08.440 or brain scans or heart scans and show people 00:18:08.440 --> 00:18:10.599 like oh yeah hey look when you have PTSD you 00:18:10.599 --> 00:18:12.920 have this certain electrical abnormality in your 00:18:12.920 --> 00:18:15.660 heart that's actually PTSD it's the same place 00:18:15.660 --> 00:18:18.019 in the brain you know so we're seeing that there's 00:18:18.019 --> 00:18:21.240 these little pieces that we can bring your traditional 00:18:21.240 --> 00:18:23.680 knowledge and just kind of twist it a little 00:18:23.680 --> 00:18:26.259 bit to where we can make it fit into the psychedelic 00:18:26.259 --> 00:18:29.200 sector so that's kind of where I'm at now I mean 00:18:29.200 --> 00:18:31.990 yeah I know ketamine back and forth and i treat 00:18:31.990 --> 00:18:33.970 people pretty well like from a clinical standpoint 00:18:33.970 --> 00:18:36.690 i can assess them but now i'm starting to see 00:18:36.690 --> 00:18:42.089 huge gaps and identifying the fragmentation and 00:18:42.089 --> 00:18:47.430 how do we integrate all of it and it's going 00:18:47.430 --> 00:18:49.630 to be the hardest thing that we do because psychedelics 00:18:49.630 --> 00:18:52.529 are in the core it's in the core of cardiology 00:18:52.529 --> 00:18:55.049 and neurology and psychiatry and psychology like 00:18:55.049 --> 00:18:57.609 they're in the middle and they're changing everything 00:18:58.299 --> 00:19:01.960 You know, so it's like, how do we now make this 00:19:01.960 --> 00:19:05.160 a new specialty that the traditional system can 00:19:05.160 --> 00:19:08.059 hear? And it's going to be hard because there's 00:19:08.059 --> 00:19:11.259 so many communication barriers, more than what 00:19:11.259 --> 00:19:14.660 we know. It's an interesting path you've taken 00:19:14.660 --> 00:19:16.700 into the world of psychiatry. You know, one of 00:19:16.700 --> 00:19:20.680 the biggest comments I get from our veterans 00:19:20.680 --> 00:19:24.000 here in the U .S. is I went there, they threw 00:19:24.000 --> 00:19:28.559 drugs at me and I left. When I asked Nick about 00:19:28.559 --> 00:19:31.519 the pharmacology route educationally, when you 00:19:31.519 --> 00:19:34.319 went through the psychiatric route, what was 00:19:34.319 --> 00:19:38.460 the pharmacological advice that you were given? 00:19:38.539 --> 00:19:41.579 Again, was there a prevention -heavy element, 00:19:41.700 --> 00:19:46.940 or was it more leaning into the psychiatric meds 00:19:46.940 --> 00:19:49.859 rather than even exploring some of the other 00:19:49.859 --> 00:19:51.079 options that we're going to be talking about 00:19:51.079 --> 00:19:54.619 today? that's all they talk about in psychiatry 00:19:54.619 --> 00:19:56.619 is how do you use a physician best reference? 00:19:56.759 --> 00:19:58.400 Like how do you use a PR? How do you use that? 00:19:58.400 --> 00:20:00.059 The medic, you know, the, the pharmacy, how do 00:20:00.059 --> 00:20:01.799 you use this little book to help you to prescribe? 00:20:02.319 --> 00:20:05.059 That's it basically is what you're taught, you 00:20:05.059 --> 00:20:08.579 know? And then, and then the, the advice is personally, 00:20:08.680 --> 00:20:11.140 I think horrible because, you know, it's like 00:20:11.140 --> 00:20:12.779 start somebody on a drug. Oh, well they're having 00:20:12.779 --> 00:20:15.019 an adverse effect or a side effect. And like 00:20:15.019 --> 00:20:18.059 they, it tells you in the PDR, it says like the 00:20:18.059 --> 00:20:21.240 next step is to wait. and then the next step 00:20:21.240 --> 00:20:24.019 is to wait and the next step is to wait right 00:20:24.019 --> 00:20:26.180 so you have to look at like from the anesthesia 00:20:26.180 --> 00:20:28.900 standpoint like that I'm coming from literally 00:20:28.900 --> 00:20:31.099 like if you didn't change something in the next 00:20:31.099 --> 00:20:35.240 10 seconds somebody's dead right and in anesthesia 00:20:35.240 --> 00:20:38.680 we're 99 .9 effective we get one bad outcome 00:20:38.680 --> 00:20:41.779 one person out of a hundred thousand people and 00:20:41.779 --> 00:20:45.559 then in mental health we're 30 effective if that 00:20:46.400 --> 00:20:47.940 James, I don't know if you saw the START -E trial. 00:20:48.140 --> 00:20:50.480 They're even now saying that the START -E trial, 00:20:50.740 --> 00:20:54.059 the numbers could potentially be even lower on 00:20:54.059 --> 00:20:57.240 efficacy than what they even thought. So we may 00:20:57.240 --> 00:21:00.339 not even be, we can't even see how bad the system 00:21:00.339 --> 00:21:04.019 is because the data is so skewed. It's almost 00:21:04.019 --> 00:21:07.420 like we should just go back to placebo in mental 00:21:07.420 --> 00:21:11.220 health and just start over. And that's kind of 00:21:11.220 --> 00:21:13.680 what psychedelics are letting us do. And I was 00:21:13.680 --> 00:21:15.200 telling Nick the other day, I made a really good 00:21:15.200 --> 00:21:18.960 point when I was at a talk last week. I was talking 00:21:18.960 --> 00:21:21.539 about big pharma being a multi -trillion dollar 00:21:21.539 --> 00:21:23.680 market, right? It's like the biggest market in 00:21:23.680 --> 00:21:26.460 the world. But what's the number one treatment 00:21:26.460 --> 00:21:28.680 for depression? The gold standard treatment. 00:21:28.799 --> 00:21:31.119 The gold standard treatment for depression since 00:21:31.119 --> 00:21:35.640 1950, right? So 75 years ago, the number one 00:21:35.640 --> 00:21:41.039 treatment is ECT, shock therapy. So Big Pharma, 00:21:41.059 --> 00:21:43.319 while it's become a multi -trillion dollar market, 00:21:43.619 --> 00:21:48.019 it has never been able to top us electrocuting 00:21:48.019 --> 00:21:52.519 someone's brain. But fortunately for us, psychedelics 00:21:52.519 --> 00:21:55.240 are actually showing that it's changing the electrical 00:21:55.240 --> 00:21:58.960 patterns in the brain. So, you know, so maybe 00:21:58.960 --> 00:22:01.920 if Big Pharma would have started looking at how 00:22:01.920 --> 00:22:04.839 do you auto -regulate, you know, too excited 00:22:04.839 --> 00:22:08.839 or not excited enough. electrical patterns in 00:22:08.839 --> 00:22:11.640 the brain and made drugs that way instead of 00:22:11.640 --> 00:22:13.720 looking at all these chemicals that they thought 00:22:13.720 --> 00:22:17.019 it was like then maybe we wouldn't be in as bad 00:22:17.019 --> 00:22:19.740 of a situation that we're in but it's there it's 00:22:19.740 --> 00:22:22.839 the biggest like we're fighting the biggest i 00:22:22.839 --> 00:22:26.160 don't know it's the industry i mean it's not 00:22:26.160 --> 00:22:28.539 it's not even industry it's it's it's the biggest 00:22:28.539 --> 00:22:31.160 thing in the world that we're trying to fight 00:22:31.160 --> 00:22:34.240 right now as we're trying to advocate for people 00:22:34.240 --> 00:22:36.640 who are literally dying once every 20 seconds 00:22:36.640 --> 00:22:40.500 of suicide right now. So we've got a long ways 00:22:40.500 --> 00:22:44.160 to go. Well, I think it's important to hear these 00:22:44.160 --> 00:22:45.660 perspectives. It's interesting when you talk 00:22:45.660 --> 00:22:48.160 about changing the electrical patterns. There's 00:22:48.160 --> 00:22:51.259 a technology out now that used to be a big box 00:22:51.259 --> 00:22:53.420 in high -performance rooms, whether it was NASA 00:22:53.420 --> 00:22:57.140 or the SEALs called NuCom, and the smartphones 00:22:57.140 --> 00:22:59.940 have become so advanced now, that's now an app. 00:23:00.359 --> 00:23:02.440 And that is the only one that's got the patent 00:23:02.440 --> 00:23:04.779 that it actually down regulates the brain. It's 00:23:04.779 --> 00:23:07.319 a phenomenal technology. I use it. My mom uses 00:23:07.319 --> 00:23:09.920 it. My son uses it. And it's not, you know, snake 00:23:09.920 --> 00:23:14.880 oil. It's so, so good as N -U -C -A -L -M. But 00:23:14.880 --> 00:23:17.180 just hearing about the success stories there, 00:23:17.299 --> 00:23:19.279 that makes sense. And I've heard over and over 00:23:19.279 --> 00:23:22.160 again about the lack of efficacy. And this is 00:23:22.160 --> 00:23:24.119 important for us to know, because if you're not 00:23:24.119 --> 00:23:26.740 getting any benefits, truly, but you're getting 00:23:26.740 --> 00:23:29.180 all these side effects. you know, what are you 00:23:29.180 --> 00:23:31.160 taking it for? And it's costing you, you know, 00:23:31.180 --> 00:23:33.539 thousands and thousands of dollars. So Nick, 00:23:33.660 --> 00:23:36.579 you've got a very unusual lens on this too. What 00:23:36.579 --> 00:23:40.480 are you seeing from a pharmacist lens on efficacy 00:23:40.480 --> 00:23:43.200 in this world? And what made you start leaning 00:23:43.200 --> 00:23:47.799 into the holistic space? Yeah. And holistic might 00:23:47.799 --> 00:23:51.579 be a loaded term, but we'll run with it. Yeah, 00:23:51.640 --> 00:23:54.400 it was, honestly, in pharmacy school, it was, 00:23:54.500 --> 00:23:56.799 as mentioned, symptom management, daily pill, 00:23:56.880 --> 00:23:59.259 if not working, go to the next one. And the idea, 00:23:59.519 --> 00:24:02.599 when we use the term psychedelic, just to clarify 00:24:02.599 --> 00:24:06.779 here, we're focused on ketamine therapy, which 00:24:06.779 --> 00:24:10.259 is available nationwide, all 50 states, United 00:24:10.259 --> 00:24:13.180 Nations list of essential medicines, MDMA still 00:24:13.180 --> 00:24:15.619 being researched, psilocybin outside of the country, 00:24:15.799 --> 00:24:18.660 as well as Oregon and Washington within the U 00:24:18.660 --> 00:24:22.420 .S. have it legally available, along with multiple 00:24:22.420 --> 00:24:27.819 other agents there. So my deep interest, James, 00:24:27.900 --> 00:24:30.720 is the idea that someone going to have a medicine. 00:24:30.859 --> 00:24:32.980 So if we take ketamine, for example, the half 00:24:32.980 --> 00:24:35.259 -life, we'll say about two hours. So it's out 00:24:35.259 --> 00:24:38.339 of the body in less than a day. And there's going 00:24:38.339 --> 00:24:42.240 to be intermittent doses, usually a session of 00:24:42.240 --> 00:24:45.579 six over three weeks. And potentially someone's 00:24:45.579 --> 00:24:47.740 not going to have to go back on that medicine 00:24:47.740 --> 00:24:51.619 ever again. As opposed to standard pharmacology, 00:24:51.680 --> 00:24:53.099 it's in the body. And if it's not in the body, 00:24:53.140 --> 00:24:54.779 it's not working. The idea that a medicine could 00:24:54.779 --> 00:24:58.380 be given to an individual, to a human, and they 00:24:58.380 --> 00:25:00.140 might not have to be on it. The only other things 00:25:00.140 --> 00:25:03.380 that do that are antibiotics and some chemos, 00:25:03.440 --> 00:25:07.059 some oncology agents. And otherwise, like blood 00:25:07.059 --> 00:25:09.059 pressure meds, every other med is just symptom 00:25:09.059 --> 00:25:13.039 management. Yeah. Well, I know even with MDMA, 00:25:13.079 --> 00:25:16.900 I've had years ago, Dr. Ben Sessa from Bristol 00:25:16.900 --> 00:25:20.019 University. And he was talking about it's three 00:25:20.019 --> 00:25:22.680 sessions and you're with, you know, you're with 00:25:22.680 --> 00:25:24.319 a clinician. You're not taking it out on the 00:25:24.319 --> 00:25:26.819 street, which I had fun doing that in Japan years 00:25:26.819 --> 00:25:28.259 ago. It was a blast, but that's a whole different 00:25:28.259 --> 00:25:30.619 conversation. It was just probably one of the 00:25:30.619 --> 00:25:32.180 reasons why I help. I had the mushrooms were 00:25:32.180 --> 00:25:34.240 legal in Japan, too. So maybe I self -healed 00:25:34.240 --> 00:25:36.920 without realizing it. But joking apart, you know, 00:25:36.940 --> 00:25:38.900 you're not it's not a prescription. You're not 00:25:38.900 --> 00:25:41.640 walking out. taking these pills, you're sitting 00:25:41.640 --> 00:25:44.900 with a, you know, a clinician or therapist, you're 00:25:44.900 --> 00:25:46.599 doing the first session. I think it was two weeks 00:25:46.599 --> 00:25:48.859 later, you do the second one, four weeks after 00:25:48.859 --> 00:25:51.099 that, I think was the third. And then that's 00:25:51.099 --> 00:25:53.200 it. And they just saw, you know, improvement, 00:25:53.319 --> 00:25:55.579 improvement, improvement. So as you said, it's 00:25:55.579 --> 00:26:00.119 very rare that there's an exit strategy to a 00:26:00.119 --> 00:26:01.900 prescription. I think this is what's broken in 00:26:01.900 --> 00:26:05.059 the healthcare industry. is there's no money 00:26:05.059 --> 00:26:07.380 in healthy people. There's no money in dead people. 00:26:07.539 --> 00:26:09.460 But if you can keep them on the pills for the 00:26:09.460 --> 00:26:13.140 rest of their life, then you've got a customer 00:26:13.140 --> 00:26:15.900 forever. And if you look at the way, and it's 00:26:15.900 --> 00:26:18.099 not like some evil doctor with a prescription 00:26:18.099 --> 00:26:21.759 pad, but the ethos around this, you hear it with 00:26:21.759 --> 00:26:23.660 all the men and women that take it. Yeah, I'm 00:26:23.660 --> 00:26:25.539 on these and these. Oh, when are you going to 00:26:25.539 --> 00:26:27.440 get off? How much weight have you got to lose? 00:26:27.779 --> 00:26:30.079 What have you done to change your... change your 00:26:30.079 --> 00:26:32.220 eating habits? Are you hydrating? What are you 00:26:32.220 --> 00:26:34.200 doing so that six months from now, you're not 00:26:34.200 --> 00:26:36.440 taking these pills anymore? That's not even in 00:26:36.440 --> 00:26:38.259 the conversation. They are assuming that they're 00:26:38.259 --> 00:26:40.700 going to take it till the day they die. And I 00:26:40.700 --> 00:26:43.420 think that mentality is completely broken as 00:26:43.420 --> 00:26:49.180 well. 100%. I think you nailed on that. With 00:26:49.180 --> 00:26:52.079 my time at MECO, a core tenant was really focused 00:26:52.079 --> 00:26:57.180 on agency. If we were able to have patients create 00:26:57.180 --> 00:27:00.509 a sense of self -agency to help make those decisions 00:27:00.509 --> 00:27:02.690 and to drive their, their own life path forward. 00:27:02.750 --> 00:27:06.829 Like that was our definition of success and supported 00:27:06.829 --> 00:27:09.309 by the clinics, such as Katie's being revitalists 00:27:09.309 --> 00:27:11.950 and others nationwide. They're actually doing 00:27:11.950 --> 00:27:15.269 the care delivery. So don't let me touch on James 00:27:15.269 --> 00:27:21.029 and you may the, the model here is totally different. 00:27:21.480 --> 00:27:24.940 So when you're touching on pharmacy and pharmacy 00:27:24.940 --> 00:27:28.799 benefit managers and health carriers and this 00:27:28.799 --> 00:27:31.039 whole infrastructure, there's medical benefits 00:27:31.039 --> 00:27:33.099 and there's pharmacy benefits fundamentally broken 00:27:33.099 --> 00:27:36.619 down. This is the merging of both of those, which 00:27:36.619 --> 00:27:38.599 is really the first time we're seeing that. If 00:27:38.599 --> 00:27:41.180 someone is having a medicine and they're having 00:27:41.180 --> 00:27:44.880 a psychotherapist or therapeutic support paired 00:27:44.880 --> 00:27:47.740 with the medicine. And this is like first of 00:27:47.740 --> 00:27:51.019 its kind from a U .S. standpoint, mostly driven 00:27:51.019 --> 00:27:55.920 by an organization called MAPS, Multidisciplinary 00:27:55.920 --> 00:27:57.960 Association of Psychedelic Studies. I'm sure 00:27:57.960 --> 00:27:59.740 people are familiar. And then like Michael Midhofer 00:27:59.740 --> 00:28:03.339 with MDMA Research. And Nick too, not only is 00:28:03.339 --> 00:28:05.619 it compared, it's the pharmaceutical and the 00:28:05.619 --> 00:28:07.859 medical, it's the behavioral health. So you have 00:28:07.859 --> 00:28:09.420 to look at the way healthcare, it's all three 00:28:09.420 --> 00:28:11.960 different. When I said it's core earlier, we're 00:28:11.960 --> 00:28:15.140 having to merge. And merge means we're having 00:28:15.140 --> 00:28:19.599 to break their business model. Like everyone's 00:28:19.599 --> 00:28:24.559 going to be on the same level. Yeah. Absolutely. 00:28:24.920 --> 00:28:27.220 Well, David, let's pull you back in for a second. 00:28:27.339 --> 00:28:28.819 We were talking about, you know, some of the 00:28:28.819 --> 00:28:33.460 science a little bit. Walk me through your initial 00:28:33.460 --> 00:28:35.599 kind of therapeutics that were offered to you. 00:28:35.720 --> 00:28:37.660 And then, you know, how did you find yourself 00:28:37.660 --> 00:28:41.900 using ketamine? So most of it was traditional, 00:28:42.039 --> 00:28:47.059 90 days. Speak to somebody, pop a pill, you'll 00:28:47.059 --> 00:28:49.430 be okay. If you're not okay, pop another pill. 00:28:50.650 --> 00:28:53.509 And I suppose it suppressed everything, but it 00:28:53.509 --> 00:28:57.250 didn't actually cure at all. And then it was 00:28:57.250 --> 00:28:59.150 really my journey with things like the Invictus 00:28:59.150 --> 00:29:02.109 Games and meeting Katie and meeting Nick Murray 00:29:02.109 --> 00:29:04.430 that took me into there are different things, 00:29:04.470 --> 00:29:07.029 approaches that we can do that I haven't tried. 00:29:10.049 --> 00:29:14.470 I used some psychedelic -assisted therapy with 00:29:14.470 --> 00:29:18.670 Katie and Nick, and it, yeah, brilliant. Also 00:29:18.670 --> 00:29:20.769 talking to a lot of US veterans that I know, 00:29:20.869 --> 00:29:22.809 and it's the journey that they've been on, not 00:29:22.809 --> 00:29:25.509 necessarily in the US, but overseas. And they 00:29:25.509 --> 00:29:27.150 will all tell you that it gave them their lives 00:29:27.150 --> 00:29:29.769 back. And to me, that's got to be better than 00:29:29.769 --> 00:29:34.230 our traditional approach, which numbs you, numbs 00:29:34.230 --> 00:29:36.329 the symptoms, numbs the problem, but doesn't 00:29:36.329 --> 00:29:40.430 give you a cure. Well, there's this one kind 00:29:40.430 --> 00:29:43.099 of perception that, you know, ayahuasca is the 00:29:43.099 --> 00:29:45.039 magic pill and you just do it and everything's 00:29:45.039 --> 00:29:47.039 fixed and then you you know learn to play the 00:29:47.039 --> 00:29:49.359 fiddle and ride a unicycle away into the sunset 00:29:49.359 --> 00:29:51.779 obviously there's a lot of people that actually 00:29:51.779 --> 00:29:53.460 have been through it that talk about okay this 00:29:53.460 --> 00:29:55.500 is opening the door and then you continue to 00:29:55.500 --> 00:29:57.579 unpack all the things that you need to address 00:29:57.579 --> 00:30:00.160 and there's this this kind of growth curve that 00:30:00.160 --> 00:30:02.940 you have what was your experience you know what 00:30:02.940 --> 00:30:06.559 what did that initial um exposure to psychedelics 00:30:06.559 --> 00:30:08.660 do for you and then what did you do to continue 00:30:08.660 --> 00:30:15.779 after that um okay so i'm agnostic as to which 00:30:15.779 --> 00:30:18.500 i think they all have a value they all have a 00:30:18.500 --> 00:30:20.819 part to play none of them alone are the silver 00:30:20.819 --> 00:30:23.039 bullet so i won't say one is better than the 00:30:23.039 --> 00:30:27.640 other um did i did i know what to expect not 00:30:27.640 --> 00:30:31.279 really i i do remember from my youth the film 00:30:31.279 --> 00:30:34.440 yellow submarine and it wasn't that it wasn't 00:30:34.440 --> 00:30:37.990 that kaleidoscope at all But there was a clarity 00:30:37.990 --> 00:30:40.490 and an ability to look at the things that I was 00:30:40.490 --> 00:30:43.990 beating myself up about from a different perspective 00:30:43.990 --> 00:30:47.349 and to understand them better and to stop feeling 00:30:47.349 --> 00:30:52.130 guilty. And all of it for me was a guilt that 00:30:52.130 --> 00:30:53.690 I should have done more, that we should have 00:30:53.690 --> 00:30:56.109 done more, that I could have done more. Yeah, 00:30:56.230 --> 00:31:01.250 look at it in a different perspective. But to 00:31:01.250 --> 00:31:05.049 me, it's not just that treatment. It's a continual 00:31:05.049 --> 00:31:08.039 process. So there's a community that I'm part 00:31:08.039 --> 00:31:11.359 of that I keep in touch with. There are people 00:31:11.359 --> 00:31:13.440 that I can contact when I need to, or they will 00:31:13.440 --> 00:31:19.339 check in on me. And, yep, I'm microdose. Fine. 00:31:21.579 --> 00:31:26.180 Please, jump in, Katie. Well, so one thing, thinking 00:31:26.180 --> 00:31:29.420 about this, and sorry, you all kind of highlighted 00:31:29.420 --> 00:31:31.500 on it, and I actually talked about this yesterday. 00:31:33.099 --> 00:31:37.390 The lack of training that we have as... prescribers 00:31:37.390 --> 00:31:42.130 whoever right in the medical space when somebody 00:31:42.130 --> 00:31:46.170 presents to you with mental health issues they 00:31:46.170 --> 00:31:50.069 look like they're moving so slow that they need 00:31:50.069 --> 00:31:54.910 help with learning how to move again and if you 00:31:54.910 --> 00:31:57.869 are a person who's struggling with trauma symptoms 00:31:57.869 --> 00:32:01.630 or anxiety or whatever else what's going on internally 00:32:01.630 --> 00:32:07.599 is moving so fast that all your energy is going 00:32:07.599 --> 00:32:11.240 into that. Like it's an overarching system, right? 00:32:11.339 --> 00:32:14.019 So as prescriber, we don't know, right? We're 00:32:14.019 --> 00:32:16.039 not taught like, oh no, like their brains are 00:32:16.039 --> 00:32:18.200 moving so fast. Like they can't stop. They can't 00:32:18.200 --> 00:32:20.579 slow it down. Like they can't sleep because the 00:32:20.579 --> 00:32:23.099 brain's still moving. So here as providers, what 00:32:23.099 --> 00:32:24.740 we're doing is we're trying to teach them like 00:32:24.740 --> 00:32:26.980 ADLs, right? Their activities of daily living. 00:32:27.180 --> 00:32:29.180 Here's how you should take a shower. Here's how 00:32:29.180 --> 00:32:32.000 you need to eat, right? And their brain's moving 00:32:32.000 --> 00:32:36.039 so fast. And here we are trying to teach them 00:32:36.039 --> 00:32:38.960 something. So what we have to do is to learn 00:32:38.960 --> 00:32:42.220 to auto -regulate, slow that brain down, and 00:32:42.220 --> 00:32:45.099 then there'll be more energy to do these things. 00:32:45.220 --> 00:32:47.079 And I think that's a really big piece. We're 00:32:47.079 --> 00:32:50.440 coming in and we're giving you pills. We're giving 00:32:50.440 --> 00:32:53.539 you stimulants a lot of times. Like in PTSD, 00:32:53.720 --> 00:32:56.220 they get a lot of stimulants. And so we're stimulating 00:32:56.220 --> 00:32:58.400 them to actually have more energy, but we're 00:32:58.400 --> 00:33:03.980 just feeding this beast that we can't see. psychedelics 00:33:03.980 --> 00:33:07.759 ought to regulate that that energy um to a point 00:33:07.759 --> 00:33:09.779 so when you're saying people's brains are speeding 00:33:09.779 --> 00:33:12.900 all the time people in medicine don't understand 00:33:12.900 --> 00:33:16.460 that at all right unless they're struggling with 00:33:16.460 --> 00:33:18.279 something and then we don't admit any of that 00:33:18.279 --> 00:33:23.460 so if we can teach providers and nurses and whoever 00:33:23.460 --> 00:33:25.380 else is dealing with the mental health community 00:33:25.380 --> 00:33:29.019 that when you talk to someone who's struggling 00:33:29.019 --> 00:33:31.910 to take a shower They're struggling to sleep. 00:33:32.049 --> 00:33:34.329 They're struggling to eat. They don't know the 00:33:34.329 --> 00:33:37.029 last time that they ate or that they took a shower. 00:33:37.549 --> 00:33:42.150 It's not because they're moving so slow. It's 00:33:42.150 --> 00:33:45.009 actually because their brain's moving so fast. 00:33:45.349 --> 00:33:48.990 There is no energy left to actually do these 00:33:48.990 --> 00:33:52.569 tasks. And the only thing that they want is a 00:33:52.569 --> 00:33:56.849 moment of peace in their brain to breathe. Just 00:33:56.849 --> 00:33:59.509 something. And so from a provider standpoint, 00:33:59.930 --> 00:34:03.150 we're probably, it's malpractice all the time, 00:34:03.170 --> 00:34:05.569 every day. Every day we're probably prescribing 00:34:05.569 --> 00:34:07.369 the wrong thing, giving the wrong interventions, 00:34:07.690 --> 00:34:09.989 putting the wrong strategies in place. And it's 00:34:09.989 --> 00:34:12.429 because we don't understand what's truly going 00:34:12.429 --> 00:34:15.429 on with those people. So if providers can sit 00:34:15.429 --> 00:34:17.469 down with somebody and actually have a really 00:34:17.469 --> 00:34:19.309 good conversation with someone who's struggling 00:34:19.309 --> 00:34:22.469 with anxiety or struggling with PTSD, instead 00:34:22.469 --> 00:34:23.909 of just being like, oh, I know what to do here 00:34:23.909 --> 00:34:27.099 if you've got this. Then we'll be able to start 00:34:27.099 --> 00:34:30.639 learning more about it. But until we do, we're 00:34:30.639 --> 00:34:34.380 going to continue to prescribe aired treatment 00:34:34.380 --> 00:34:36.880 regimens, which are even putting people at a 00:34:36.880 --> 00:34:42.420 higher risk of mortality. Absolutely. Well, we 00:34:42.420 --> 00:34:44.579 talked about, you know, some of the psychedelics 00:34:44.579 --> 00:34:47.599 and MDMA not being approved yet. And I hope, 00:34:47.599 --> 00:34:49.199 you know, we'll have a conversation in a couple 00:34:49.199 --> 00:34:51.659 more years and this will be. included in the 00:34:51.659 --> 00:34:53.539 toolbox for our veterans and first responders. 00:34:54.039 --> 00:34:56.760 But there is a lot of fear as far as, well, I 00:34:56.760 --> 00:34:59.960 can't take that, workplace drug tests, all the 00:34:59.960 --> 00:35:04.380 things. So talk to me about the unique element 00:35:04.380 --> 00:35:07.579 of ketamine, not only the therapeutic part, but 00:35:07.579 --> 00:35:10.480 also the legality of it as a mental health drug. 00:35:12.139 --> 00:35:14.760 That's a great question. So ketamine under a 00:35:14.760 --> 00:35:17.059 prescriber, it's under a prescriber, right? It's 00:35:17.059 --> 00:35:20.199 like you can be getting ketamine therapies and 00:35:20.199 --> 00:35:25.179 continue to work. And they cannot legally hold 00:35:25.179 --> 00:35:27.219 that against you unless they think that you're 00:35:27.219 --> 00:35:29.380 going to be altered while you're doing your job. 00:35:29.539 --> 00:35:31.300 And what Nick said earlier, it's out of your 00:35:31.300 --> 00:35:33.900 system in two days. So I actually had a really 00:35:33.900 --> 00:35:36.219 good conversation with a pilot who was with the 00:35:36.219 --> 00:35:40.079 FAA, who actually works with mental health. And 00:35:40.079 --> 00:35:43.539 he was saying that, you know, Pilots can actually 00:35:43.539 --> 00:35:46.699 be diagnosed with depression and they can still 00:35:46.699 --> 00:35:49.659 fly. They can be on antidepressants and still 00:35:49.659 --> 00:35:52.679 fly. And I didn't know that. I didn't think that 00:35:52.679 --> 00:35:55.599 they could at all. But even the FAA is looking 00:35:55.599 --> 00:35:58.960 at ketamine now, which is huge, right? So it's 00:35:58.960 --> 00:36:02.619 this long -lost intervention that we've never 00:36:02.619 --> 00:36:06.179 seen from people. So you can still get treatment. 00:36:06.239 --> 00:36:09.039 You can still work. Have we treated DEA agents? 00:36:09.219 --> 00:36:12.940 Yes. Have we treated federal agents? Yes. Have 00:36:12.940 --> 00:36:15.159 we treated veterans because ketamine is approved 00:36:15.159 --> 00:36:18.820 under the VA? Yes. You know, so it's people are 00:36:18.820 --> 00:36:21.599 afraid to get treatment because they're afraid 00:36:21.599 --> 00:36:23.340 their guns are going to be taken away, their 00:36:23.340 --> 00:36:25.780 jobs are going to be taken away, all these different 00:36:25.780 --> 00:36:28.039 pieces. And have we treated active duty police 00:36:28.039 --> 00:36:31.139 officers? Yes. Treated active duty police officers. 00:36:31.199 --> 00:36:34.019 And I have a sheriff and a deputy that are trying 00:36:34.019 --> 00:36:37.960 so hard. to get ketamine approved for their guys 00:36:37.960 --> 00:36:41.059 under their insurance plan because they said 00:36:41.059 --> 00:36:44.340 just treating one officer changed the entire 00:36:44.340 --> 00:36:48.340 environment of the whole precinct. So that's 00:36:48.340 --> 00:36:51.400 the piece. We've got to get that out there. And 00:36:51.400 --> 00:36:53.219 when you take a medicine, and Nick can talk more 00:36:53.219 --> 00:36:55.920 about this, every time you take an antidepressant, 00:36:56.250 --> 00:36:59.530 It's changing the entire landscape of your brain. 00:36:59.849 --> 00:37:03.230 Like it's like it's constantly changing all these 00:37:03.230 --> 00:37:06.250 different scenarios. Ketamine doesn't do that. 00:37:06.570 --> 00:37:08.969 It's in, turns the light switch on, turns it 00:37:08.969 --> 00:37:11.309 off, gets back out. And then your brain just 00:37:11.309 --> 00:37:14.510 starts operating on its own. Like it's a neuro 00:37:14.510 --> 00:37:17.889 regenerative piece. The brain can organically 00:37:17.889 --> 00:37:21.690 fix itself. That's what we need to hear is the 00:37:21.690 --> 00:37:23.829 brain can. And somebody said this earlier. I 00:37:23.829 --> 00:37:26.940 was speaking to a neuro engineer. which I thought 00:37:26.940 --> 00:37:29.679 was a cool degree to even get into. But he was 00:37:29.679 --> 00:37:34.619 saying the brain is an organ of learning. And 00:37:34.619 --> 00:37:38.239 he's right. It's continual learning. So if we're 00:37:38.239 --> 00:37:41.800 medicating it daily, we're teaching it other 00:37:41.800 --> 00:37:45.000 things. If we're able to do interventions, do 00:37:45.000 --> 00:37:46.980 the therapy, do the integration, whatever else, 00:37:47.039 --> 00:37:49.219 teach it peace, teach it calm, it can learn. 00:37:50.010 --> 00:37:51.750 Because that's what the brain's intended to do 00:37:51.750 --> 00:37:55.050 our entire lifespan is to learn. So how do we 00:37:55.050 --> 00:37:58.929 optimize that environment? Well, Nick, I'll throw 00:37:58.929 --> 00:38:00.429 it over to you. I just want to put one thing 00:38:00.429 --> 00:38:02.909 in before we kind of hear your thoughts on that 00:38:02.909 --> 00:38:07.530 as well. So often I've heard of people. you know, 00:38:07.570 --> 00:38:10.110 either attempted or even completed suicide. And 00:38:10.110 --> 00:38:12.530 they were on psych meds, even sadly, if you look 00:38:12.530 --> 00:38:14.590 at a lot of the school shooters, you know, psychiatric 00:38:14.590 --> 00:38:17.949 meds are involved. So talk to me about, you know, 00:38:17.949 --> 00:38:19.590 Katie just talked about the kind of changing 00:38:19.590 --> 00:38:22.409 the chemistry when it comes to being on these 00:38:22.409 --> 00:38:25.409 meds. What are the dangers? What are the side 00:38:25.409 --> 00:38:27.489 effects of some of these meds that, you know, 00:38:27.510 --> 00:38:29.670 we can actually replace with something like ketamine? 00:38:31.449 --> 00:38:33.809 That is a loaded question there, James. Where 00:38:33.809 --> 00:38:38.030 do I start? Ultimately, I think philosophically 00:38:38.030 --> 00:38:41.230 and pragmatically, each of us as human beings 00:38:41.230 --> 00:38:44.550 are unique and different with some similar characteristics. 00:38:45.070 --> 00:38:50.449 And so to pin someone on antidepressants and 00:38:50.449 --> 00:38:53.590 school shooters is like more correlation. What 00:38:53.590 --> 00:38:55.090 else was happening for that person? What type 00:38:55.090 --> 00:38:57.409 of childhood do they have? I mean, just so many 00:38:57.409 --> 00:39:00.110 questions come to mind. We need a better approach. 00:39:00.699 --> 00:39:03.239 And we need more rigor around what this looks 00:39:03.239 --> 00:39:05.920 like. Is it genetics? Are they a fast metabolizer? 00:39:06.039 --> 00:39:08.719 Are they a slow metabolizer? Do they try to stop 00:39:08.719 --> 00:39:12.440 their meds? Is it too high of a dose? I'm not 00:39:12.440 --> 00:39:15.800 educated enough to have a clear perspective on 00:39:15.800 --> 00:39:20.090 a causation. for those aspects. Yeah, and I'm 00:39:20.090 --> 00:39:21.869 just saying it's a contributing factor. It's 00:39:21.869 --> 00:39:24.449 not by no means, you know, the thing, you know, 00:39:24.449 --> 00:39:26.670 this violent video game, sleep deprivation, you 00:39:26.670 --> 00:39:28.289 know, trauma, all these other things as well. 00:39:28.550 --> 00:39:31.309 But it does seem to be one of the things on the 00:39:31.309 --> 00:39:34.050 pie chart almost every single time. And a lot 00:39:34.050 --> 00:39:36.469 of people I know that are suicidal have been 00:39:36.469 --> 00:39:38.570 on these meds. And you even, I mean, you watch 00:39:38.570 --> 00:39:41.130 the TV commercials of these meds can cause suicide 00:39:41.130 --> 00:39:43.610 ideation. Wait a second, antidepressant causes 00:39:43.610 --> 00:39:48.730 suicide ideation. This may be my red flag. Yeah, 00:39:48.730 --> 00:39:52.630 I guess here would be my perspective on that. 00:39:52.690 --> 00:39:56.070 When we consider antidepressants, which actually 00:39:56.070 --> 00:39:59.690 atypical antipsychotics work better as antidepressants 00:39:59.690 --> 00:40:03.550 than what we consider antidepressants. So antipsychotics 00:40:03.550 --> 00:40:06.809 are a preferable agent in many cases. We don't 00:40:06.809 --> 00:40:15.110 use them often. Yeah, all the side effects. So 00:40:15.110 --> 00:40:17.650 if we consider whether it be erectile dysfunction, 00:40:18.130 --> 00:40:22.389 sexual habits, sleep disturbances, increased 00:40:22.389 --> 00:40:25.769 suicidality, we try to be so reductionist in 00:40:25.769 --> 00:40:28.889 our approach in medicine and get down to a root 00:40:28.889 --> 00:40:31.030 cause of it, but I think we've missed the mark. 00:40:31.730 --> 00:40:35.530 I leveled on that. I danced a little bit. Katie, 00:40:35.610 --> 00:40:36.710 what are your thoughts there? I know you have 00:40:36.710 --> 00:40:44.510 some big feelings. I do. But yeah. Again, this 00:40:44.510 --> 00:40:47.130 is all about we've got to reframe the entire 00:40:47.130 --> 00:40:50.130 system with it. So when you talk about like ED 00:40:50.130 --> 00:40:54.230 stuff, right, it's like, you know, you get somebody 00:40:54.230 --> 00:40:57.010 who's depressed or suicidal and you put them 00:40:57.010 --> 00:41:02.030 on an antidepressant. Well, James, depression 00:41:02.030 --> 00:41:07.849 is not a direct correlator to suicide. So, you 00:41:07.849 --> 00:41:09.570 know, so it's like, why are we putting them on 00:41:09.570 --> 00:41:12.219 antidepressants when they're suicidal? Right. 00:41:12.300 --> 00:41:14.920 So, again, makes no sense. Like there's you couldn't 00:41:14.920 --> 00:41:16.579 you couldn't take somebody to court and try to 00:41:16.579 --> 00:41:19.099 rationalize what they're doing because there's 00:41:19.099 --> 00:41:22.179 no rationalization to it. But, you know, but 00:41:22.179 --> 00:41:24.119 thinking about psychedelics again and thinking 00:41:24.119 --> 00:41:25.940 about like erectile dysfunction. Right. Like 00:41:25.940 --> 00:41:28.300 that's a huge piece, like having that connection 00:41:28.300 --> 00:41:31.840 with someone. You know, especially like if that's 00:41:31.840 --> 00:41:33.960 your safety or that's your trust or whatever 00:41:33.960 --> 00:41:37.280 else. And now you can't even contribute to that 00:41:37.280 --> 00:41:39.920 connection and with that oxytocin release and 00:41:39.920 --> 00:41:42.019 all this other stuff. And that's what they're 00:41:42.019 --> 00:41:44.460 going to get. It's like, you know, we're adding 00:41:44.460 --> 00:41:48.340 to their fire again. I mean, psychedelics allow 00:41:48.340 --> 00:41:51.920 you to reconnect with yourself that allow you 00:41:51.920 --> 00:41:55.199 to see what you want to be aligned with. And 00:41:55.199 --> 00:41:58.679 people who do psychedelics, they're able to put. 00:41:59.829 --> 00:42:02.110 everything that they want back into their relationship, 00:42:02.650 --> 00:42:06.650 right, which improves all of that too. So, no, 00:42:06.730 --> 00:42:10.530 James, I'm a big, I mean, I've read all the, 00:42:10.530 --> 00:42:13.090 you know, the inserts on the antidepressants 00:42:13.090 --> 00:42:16.309 because I have a really big, I don't know if 00:42:16.309 --> 00:42:17.989 Nick wants to talk about this, but I went down 00:42:17.989 --> 00:42:20.570 a big rabbit hole one time because, you know, 00:42:20.570 --> 00:42:22.210 antidepressants, you're intended to be on them 00:42:22.210 --> 00:42:24.329 for 90 days. There's no long -term studies on 00:42:24.329 --> 00:42:26.409 antidepressants, but, you know, we've got people 00:42:26.409 --> 00:42:30.369 on them for. 10, 20, 40, 50 years. And insurance 00:42:30.369 --> 00:42:34.050 is fine to cover that all day long. But also 00:42:34.050 --> 00:42:35.949 what happens when people are on these drugs for 00:42:35.949 --> 00:42:39.170 a very long period of time, a lot of them get 00:42:39.170 --> 00:42:43.230 really atypical liver failures. And they also 00:42:43.230 --> 00:42:46.070 get diabetes and all these other different pieces 00:42:46.070 --> 00:42:49.369 that no one's telling them about. And if you 00:42:49.369 --> 00:42:53.010 look on the... the inserts to the meds, it doesn't 00:42:53.010 --> 00:42:55.449 say that it causes, you know, like fatty liver 00:42:55.449 --> 00:42:57.869 or whatever else you want to say with liver dysfunction. 00:42:58.670 --> 00:43:01.989 But it does say that it like can change, you 00:43:01.989 --> 00:43:05.690 know, the plasma or whatever levels that may 00:43:05.690 --> 00:43:09.369 contribute to liver dysfunction. So there's just, 00:43:09.409 --> 00:43:11.269 there's a lot of things here. I mean, I know 00:43:11.269 --> 00:43:13.250 people feel like crap when they're struggling 00:43:13.250 --> 00:43:16.150 and they just want something easy, something 00:43:16.150 --> 00:43:18.489 light, you know, which is just a pill. Just take 00:43:18.489 --> 00:43:20.840 this one pill. That's all you have to do. They 00:43:20.840 --> 00:43:24.300 don't see how much damage that's potentially 00:43:24.300 --> 00:43:26.900 getting ready to be done in their situation. 00:43:27.179 --> 00:43:29.380 And then they'll look back and be like, oh, my 00:43:29.380 --> 00:43:31.119 gosh, what if I would have done something else 00:43:31.119 --> 00:43:34.340 20 years ago, like another intervention, right? 00:43:34.420 --> 00:43:36.599 But now they feel so far down the track that 00:43:36.599 --> 00:43:39.940 they're lost. It's like, you know, it's us. Again, 00:43:40.079 --> 00:43:42.780 James, you talk about the opioid epidemic. This 00:43:42.780 --> 00:43:46.179 is us as prescribers in the health care field 00:43:46.179 --> 00:43:50.960 creating this crisis again. It's us. We want 00:43:50.960 --> 00:43:54.179 to help. We do. But just because we have good 00:43:54.179 --> 00:43:57.480 intentions sometimes doesn't always mean that's 00:43:57.480 --> 00:44:01.000 what should be done. We're creating a really, 00:44:01.059 --> 00:44:02.880 really bad system and it's going to get worse 00:44:02.880 --> 00:44:05.780 for a while until we can learn to create these 00:44:05.780 --> 00:44:09.380 new business models. Well, you mentioned about 00:44:09.380 --> 00:44:12.400 the insurance companies having no problem continuing 00:44:12.400 --> 00:44:15.769 to cover the psych meds. You've got this law 00:44:15.769 --> 00:44:18.590 enforcement agency fighting to get ketamine approved 00:44:18.590 --> 00:44:21.590 by their insurance. What is the barrier to entry 00:44:21.590 --> 00:44:23.869 to this therapy that's seeming to be so effective? 00:44:27.409 --> 00:44:30.409 You're all day long there, Miko. Yeah, I know, 00:44:30.489 --> 00:44:33.909 I know. Yeah, so the company that I was recently 00:44:33.909 --> 00:44:36.610 part of and founder, Miko, was trying to crack 00:44:36.610 --> 00:44:41.789 that nut. And effectively... It's an old drug 00:44:41.789 --> 00:44:45.550 that's off -label. So there's a brand name drug 00:44:45.550 --> 00:44:51.030 called Spravato, which is one portion of ketamine 00:44:51.030 --> 00:44:53.110 that's sprayed in the nose. It costs anywhere 00:44:53.110 --> 00:44:55.909 from $30 ,000 to $50 ,000 per year. But it went 00:44:55.909 --> 00:45:00.289 through the formal FDA approval pathway. Ketamine, 00:45:00.510 --> 00:45:04.190 whether it be infusion or intramuscular or trochies 00:45:04.190 --> 00:45:09.630 or other method, is... approved in 1970s. Really, 00:45:09.750 --> 00:45:12.230 it wasn't until the year 2000 when Yale published 00:45:12.230 --> 00:45:14.670 a study on depression that we really realized 00:45:14.670 --> 00:45:18.630 that there was a compelling mental health use 00:45:18.630 --> 00:45:20.230 case for ketamine. Otherwise, there's been this 00:45:20.230 --> 00:45:22.469 old drug that I've used in pediatrics in the 00:45:22.469 --> 00:45:24.989 emergency department. Katie's used it a ton in 00:45:24.989 --> 00:45:28.369 anesthesia. So like just a common old drug. And 00:45:28.369 --> 00:45:30.590 I think the pathway just comes down to it's not 00:45:30.590 --> 00:45:33.710 FDA approved. I've had like... very high up decision 00:45:33.710 --> 00:45:36.050 maker conversations. And it just came down to 00:45:36.050 --> 00:45:39.349 the fact of it's not FDA approved for that indication. 00:45:39.889 --> 00:45:42.429 So we're not doing it. And that was it. I was 00:45:42.429 --> 00:45:44.449 like, here's real world evidence. Here's studies 00:45:44.449 --> 00:45:47.530 with 10 ,000 people. Here's compelling literature. 00:45:47.989 --> 00:45:50.710 I do feel, James, if you gave me a crystal ball, 00:45:50.829 --> 00:45:54.909 within two years, maybe three, I think ketamine 00:45:54.909 --> 00:45:57.849 will be FDA approved through the FDA as the first 00:45:57.849 --> 00:46:02.289 drug to go from generic to a new on -label indication. 00:46:02.829 --> 00:46:05.289 And the pathway is built for that now. And I 00:46:05.289 --> 00:46:06.909 really think that will happen and we'll get there. 00:46:08.349 --> 00:46:12.969 And you can explain this more to James and David 00:46:12.969 --> 00:46:18.809 and maybe to me, but off -label prescribing is 00:46:18.809 --> 00:46:21.929 so common. And it's almost like 100 % of the 00:46:21.929 --> 00:46:24.789 drugs in the mental health field are off -label 00:46:24.789 --> 00:46:28.159 prescribing. And insurance will cover... off 00:46:28.159 --> 00:46:32.260 -label prescribing of these meds. And, but people 00:46:32.260 --> 00:46:34.699 like prescribers, you know, they're not, they, 00:46:34.800 --> 00:46:37.860 they are off -label prescribing all the time, 00:46:37.860 --> 00:46:41.260 all the time. And they just don't know it. They 00:46:41.260 --> 00:46:43.340 don't know that, you know, if you, if you're 00:46:43.340 --> 00:46:46.699 giving a secondary agent for depression or PTSD 00:46:46.699 --> 00:46:50.159 or anxiety, more than likely that's an off -label 00:46:50.159 --> 00:46:52.880 approach, you know, but even greater than mental 00:46:52.880 --> 00:46:56.539 health that's off -label is oncology. So if a 00:46:56.539 --> 00:46:58.400 chemotherapeutic agent, if they're given a secondary 00:46:58.400 --> 00:47:01.719 agent, which most of them do, those are all off 00:47:01.719 --> 00:47:04.900 -label prescribing and insurance covers it all 00:47:04.900 --> 00:47:08.300 the time. But there's just some type of barrier 00:47:08.300 --> 00:47:11.119 with ketamine. Oh, nope, it's off -label, not 00:47:11.119 --> 00:47:13.320 going to cover it. But they do it all the time, 00:47:13.340 --> 00:47:17.320 James. And that's the piece when I tell you there's 00:47:17.320 --> 00:47:22.340 so much education here because these people at 00:47:22.340 --> 00:47:29.400 the FDA, their world is their box so you're trying 00:47:29.400 --> 00:47:32.659 to tell 10 boxes that they're all part of a bigger 00:47:32.659 --> 00:47:36.119 box and they can't hear it and they can't see 00:47:36.119 --> 00:47:38.539 it and they've got a good paying job and they 00:47:38.539 --> 00:47:40.860 don't want to see it because it's easy now they've 00:47:40.860 --> 00:47:43.019 got a good business model but you know but what 00:47:43.019 --> 00:47:45.900 we're trying to advocate for is all this new 00:47:45.900 --> 00:47:49.079 to where it's like please just try to think outside 00:47:49.079 --> 00:47:52.320 your box just a little bit because you're doing 00:47:52.320 --> 00:47:56.960 exactly what we want you to do just for ketamine. 00:47:57.599 --> 00:47:59.699 Like you're prescribing off -label drugs all 00:47:59.699 --> 00:48:02.659 the time. But they really don't understand that. 00:48:02.800 --> 00:48:04.619 So it's almost like it's like a court system. 00:48:04.860 --> 00:48:06.699 You've got to like make the conclusion for them 00:48:06.699 --> 00:48:10.420 and then let them have that like, oh, wait a 00:48:10.420 --> 00:48:14.679 minute. Every time I prescribe Trazodone. Wait, 00:48:14.880 --> 00:48:17.039 I prescribe trazodone all the time. That's one 00:48:17.039 --> 00:48:20.280 of the most commonly used drugs in an off -label 00:48:20.280 --> 00:48:23.380 capacity that insurance continues to cover. So 00:48:23.380 --> 00:48:26.000 any prescriber who's ever prescribed trazodone, 00:48:26.019 --> 00:48:29.440 you just broke the law, basically, in their head 00:48:29.440 --> 00:48:31.539 with ketamine if they were to prescribe ketamine 00:48:31.539 --> 00:48:34.440 in an off -label capacity. So, James, it's almost 00:48:34.440 --> 00:48:36.300 like we're dealing with people that are developmentally 00:48:36.300 --> 00:48:40.110 delayed. They can only see their path, and they 00:48:40.110 --> 00:48:43.449 can't see that anybody else exists in this world 00:48:43.449 --> 00:48:47.170 except their world. And that's where we're at 00:48:47.170 --> 00:48:49.630 right now, and it sucks because people are dying 00:48:49.630 --> 00:48:53.190 because of our ignorance. Well, that mirrors 00:48:53.190 --> 00:48:55.929 the fire service. I mean, I'm trying to make 00:48:55.929 --> 00:48:58.840 the point for... a shorter work week so we can 00:48:58.840 --> 00:49:01.380 give our first responders time for rest and recovery 00:49:01.380 --> 00:49:04.219 the average firefighter works 56 hours a week 00:49:04.219 --> 00:49:06.780 you have a recruitment crisis now because of 00:49:06.780 --> 00:49:09.179 the devolution of working environments and now 00:49:09.179 --> 00:49:11.480 people don't want to do this job anymore so now 00:49:11.480 --> 00:49:14.599 one mandatory overtime one you know 7 a .m phone 00:49:14.599 --> 00:49:16.960 call you can't go home after all now it's an 00:49:16.960 --> 00:49:20.139 80 hour work week And again, all the evidence 00:49:20.139 --> 00:49:22.699 is there. Like I've said, even forget evidence. 00:49:22.900 --> 00:49:25.420 If the way we did it worked, then we would have 00:49:25.420 --> 00:49:27.880 healthy firefighters and no recruitment crisis. 00:49:28.599 --> 00:49:31.519 But, you know, they're so indoctrinated by the 00:49:31.519 --> 00:49:33.440 way they think that even the firefighters themselves 00:49:33.440 --> 00:49:36.219 push against it. And it's crazy. And again, like 00:49:36.219 --> 00:49:37.940 you said, you want to break down the walls of 00:49:37.940 --> 00:49:41.340 the box and say, look, look around you, you know, 00:49:41.340 --> 00:49:43.400 and, you know, comprehend these deaths that are 00:49:43.400 --> 00:49:44.940 happening at the same, you know, these men and 00:49:44.940 --> 00:49:48.639 women in the same uniform as you. So I see the 00:49:48.639 --> 00:49:52.199 same resistance even in my own profession in 00:49:52.199 --> 00:49:55.460 a different way, but the same issue is just the 00:49:55.460 --> 00:49:58.019 inability to critically think. But I think, again, 00:49:58.079 --> 00:50:00.820 that comes from this kind of divisive, highly 00:50:00.820 --> 00:50:03.340 stressed society that we're in now as people 00:50:03.340 --> 00:50:07.480 lack the ability to just stand back and take 00:50:07.480 --> 00:50:09.880 it in for a moment and go, does this make sense? 00:50:11.869 --> 00:50:14.230 And I think a big piece with that, right, is 00:50:14.230 --> 00:50:16.289 and that's the beautiful thing with psychedelics 00:50:16.289 --> 00:50:18.949 is it's allowing all these specialists to come 00:50:18.949 --> 00:50:21.510 in. So, like, I don't know veterans. I don't 00:50:21.510 --> 00:50:23.690 know firemen. I don't know pharmacy. But you 00:50:23.690 --> 00:50:26.170 all understand those languages. So it's almost 00:50:26.170 --> 00:50:28.690 like when we go to the FDA or we go to the DEA 00:50:28.690 --> 00:50:31.510 or whomever else, we have to sit down and be 00:50:31.510 --> 00:50:36.000 like, OK, tell me how your system works. And 00:50:36.000 --> 00:50:38.239 if we can understand how their system works, 00:50:38.340 --> 00:50:41.219 then we build what we need to put into that system. 00:50:41.400 --> 00:50:43.960 And then they'll be able to empathize with it 00:50:43.960 --> 00:50:46.400 and connect with it. So, you know, it's like 00:50:46.400 --> 00:50:48.280 if I walked in, I was like, oh, I'm an anesthesia 00:50:48.280 --> 00:50:50.039 provider. I can do all this stuff. It's like 00:50:50.039 --> 00:50:51.320 people are like, oh, whatever. You put people 00:50:51.320 --> 00:50:53.320 to sleep like like you don't know anything, you 00:50:53.320 --> 00:50:56.519 know, or if I came in and instead said, you know, 00:50:56.519 --> 00:50:59.179 like if I was, I don't know, a pediatric conference 00:50:59.179 --> 00:51:02.260 and I was like, hey, this is, you know, when 00:51:02.260 --> 00:51:04.960 I work with. children who have brain tumors this 00:51:04.960 --> 00:51:08.360 is something that we see well right there i've 00:51:08.360 --> 00:51:12.699 connected with them because they're like oh she 00:51:12.699 --> 00:51:14.659 knows about kids brain tumors and we're at a 00:51:14.659 --> 00:51:17.659 pediatric conference now all of a sudden i have 00:51:17.659 --> 00:51:21.760 broken down that communication barrier to where 00:51:21.760 --> 00:51:24.800 it's starting to be more open and people's tail 00:51:24.800 --> 00:51:27.860 feathers aren't getting stuck up kind of thing. 00:51:28.119 --> 00:51:32.500 And physicians are one of the worst. I asked 00:51:32.500 --> 00:51:36.599 my ex -husband, I asked him, I said, what is 00:51:36.599 --> 00:51:38.500 this? Like, you know, because you can't go in 00:51:38.500 --> 00:51:40.280 and say that you're going to educate a physician. 00:51:40.400 --> 00:51:42.139 And he's like, well, actually I was going to 00:51:42.139 --> 00:51:44.579 go say that. And he said, if you go in and say, 00:51:44.619 --> 00:51:47.320 you're going to educate a physician, he said, 00:51:47.360 --> 00:51:50.239 they will slam the door in your face and tell 00:51:50.239 --> 00:51:53.260 you to get out because they are the highest educated 00:51:53.260 --> 00:51:56.440 professionals in the world. If you change your 00:51:56.440 --> 00:51:59.400 terminology and say, I have new information for 00:51:59.400 --> 00:52:02.170 you to help treat your patients better. then 00:52:02.170 --> 00:52:03.650 they're going to be, oh, wow, you're going to 00:52:03.650 --> 00:52:06.010 get me better outcomes. I'm like, that's it. 00:52:06.090 --> 00:52:08.309 I'm getting you better outcomes. Right. So we're 00:52:08.309 --> 00:52:12.030 feeding their egos. So an issue that we have 00:52:12.030 --> 00:52:14.849 to realize is like, we've got to put our egos 00:52:14.849 --> 00:52:19.010 down a little bit so we can at least try to get 00:52:19.010 --> 00:52:22.590 into the door so we can feed their egos. Right. 00:52:22.650 --> 00:52:24.090 Because that's how you're going to get things 00:52:24.090 --> 00:52:28.539 passed is. How can what I'm doing help you from 00:52:28.539 --> 00:52:29.940 a political standpoint? How is it going to make 00:52:29.940 --> 00:52:31.739 you advocate for your people better? How is it 00:52:31.739 --> 00:52:33.719 going to decrease costs in the system? Like, 00:52:33.739 --> 00:52:36.719 what are they looking for? And if we can see 00:52:36.719 --> 00:52:44.860 what they're looking for, then we can learn how 00:52:44.860 --> 00:52:48.320 to negotiate better. And maybe David knows that 00:52:48.320 --> 00:52:50.460 in the veteran space. It's all about negotiation 00:52:50.460 --> 00:52:55.730 and mediation. That's what it's all about. Well, 00:52:55.750 --> 00:52:58.050 David, we talked about your healing journey. 00:52:58.130 --> 00:53:00.050 I want to get to, you know, the therapies that 00:53:00.050 --> 00:53:02.130 are offered and what you collectively are trying 00:53:02.130 --> 00:53:04.610 to do as far as, you know, moving forward and 00:53:04.610 --> 00:53:07.110 even prevention. What was it that brought you 00:53:07.110 --> 00:53:09.309 into this group to now be part of the solution 00:53:09.309 --> 00:53:15.750 for your fellow veterans? It's pretty simple. 00:53:16.309 --> 00:53:18.869 Our veterans, our first responders deserve better. 00:53:20.369 --> 00:53:23.869 We know the problems. And we know what causes 00:53:23.869 --> 00:53:27.010 the problems. If I look at Helena, if I look 00:53:27.010 --> 00:53:28.929 at deployments in Iraq, if I look at deployments 00:53:28.929 --> 00:53:31.929 in Afghanistan, if I just look at the fires in 00:53:31.929 --> 00:53:34.389 California, we know that they're going to cause 00:53:34.389 --> 00:53:37.590 problems. What we can't afford to do any longer 00:53:37.590 --> 00:53:40.869 is wait until that problem is there in front 00:53:40.869 --> 00:53:45.650 of us. We've got to get ahead of it. Curing doesn't 00:53:45.650 --> 00:53:49.110 work, but preventing will help that individual, 00:53:49.289 --> 00:53:51.269 will help their families, will help their communities. 00:53:51.929 --> 00:53:55.349 will help their businesses that's that's that's 00:53:55.349 --> 00:53:58.409 what gets me into the space is if i look at my 00:53:58.409 --> 00:54:02.989 journey it was painful hurt me and it hurt my 00:54:02.989 --> 00:54:10.670 family that's that's what drives me um and i 00:54:10.670 --> 00:54:14.190 think if i look at how do we get there one we 00:54:14.190 --> 00:54:16.889 have now got this ability with with this bot 00:54:18.889 --> 00:54:22.050 to identify your risk of having a mental health 00:54:22.050 --> 00:54:26.170 episode. That gets us ahead. I'm no longer waiting 00:54:26.170 --> 00:54:28.670 for you to have the episode. We've got an idea 00:54:28.670 --> 00:54:31.210 that you are at risk of having an episode. We 00:54:31.210 --> 00:54:33.130 can now give you help. We can give you support. 00:54:33.329 --> 00:54:35.829 We can give you treatment. And if I move into 00:54:35.829 --> 00:54:39.050 using psychedelic -assisted therapies, there's 00:54:39.050 --> 00:54:41.349 a real solution because we already are gathering 00:54:41.349 --> 00:54:44.070 the evidence that they work, that they give you 00:54:44.070 --> 00:54:49.559 your life back. So talk to me about the bot. 00:54:50.039 --> 00:54:56.880 Yeah, please. Let's open that up. Katie, go on. 00:54:58.840 --> 00:55:02.440 So James, oh, actually here, James, this is all 00:55:02.440 --> 00:55:05.260 from you, buddy. This is all from our first conversation 00:55:05.260 --> 00:55:09.599 was when I was describing ketamine and how there 00:55:09.599 --> 00:55:11.610 was a. A police officer, and I wish we could 00:55:11.610 --> 00:55:14.449 find who he was, but he was a police officer, 00:55:14.530 --> 00:55:17.210 reached out to me after our podcast because I 00:55:17.210 --> 00:55:19.650 was describing to you how ketamine works. And 00:55:19.650 --> 00:55:21.889 you said, so it kind of unfucks the brain. And 00:55:21.889 --> 00:55:25.280 I said, yeah, unfucks it. And that was when a 00:55:25.280 --> 00:55:27.179 police officer reached out and said, I listened 00:55:27.179 --> 00:55:30.320 to your podcast on James' show. And I went and 00:55:30.320 --> 00:55:32.119 got treatment. You saved my life. Thank you. 00:55:32.139 --> 00:55:34.019 If you ever made a shirt that said, unfuck it, 00:55:34.099 --> 00:55:36.579 I would buy it. So I went down this, like, category. 00:55:36.659 --> 00:55:37.980 You know, that's how I created the unit initiative 00:55:37.980 --> 00:55:40.679 and all this other stuff. But I created a scale. 00:55:41.340 --> 00:55:43.900 And my scale is five questions, and the five 00:55:43.900 --> 00:55:46.760 questions actually has been validated with over 00:55:46.760 --> 00:55:49.980 12 ,000 people, and it cross -correlates depression, 00:55:50.199 --> 00:55:53.599 anxiety, PTSD, insomnia, suicidality. And the 00:55:53.599 --> 00:55:56.219 five questions are kind because I just know when 00:55:56.219 --> 00:56:00.260 people struggle, literally that breath of wind 00:56:00.260 --> 00:56:02.780 might be the last thing that pushes them over 00:56:02.780 --> 00:56:05.719 the edge just because everything is just so hypersensitive. 00:56:06.260 --> 00:56:10.199 So I created this scale, and I called it the 00:56:10.199 --> 00:56:12.780 Federal Unit. conservative or the the federal 00:56:12.780 --> 00:56:15.420 unit conservative kinesiologic investigational 00:56:15.420 --> 00:56:18.920 task force scale which actually stands for fuck 00:56:18.920 --> 00:56:21.360 it um but we're just allowed to call it federal 00:56:21.360 --> 00:56:23.780 unit scale but just so you know it's its name 00:56:23.780 --> 00:56:26.880 was birthed through your podcast um but uh but 00:56:26.880 --> 00:56:28.380 anyway because you know there's something about 00:56:28.380 --> 00:56:30.920 controlling your own narrative um from that standpoint 00:56:30.920 --> 00:56:34.360 but We got the scale validated. That draft manuscript 00:56:34.360 --> 00:56:36.400 should be published, actually, in the Journal 00:56:36.400 --> 00:56:39.260 of Psychiatric Research soon. And then we were 00:56:39.260 --> 00:56:41.880 able to work with our science team. They made 00:56:41.880 --> 00:56:45.099 an AI bot. It's an avatar. It can actually talk 00:56:45.099 --> 00:56:48.480 to you with these five questions and go back 00:56:48.480 --> 00:56:51.000 and forth. And it gives you a number, zero bad, 00:56:51.139 --> 00:56:54.239 100 good, and whatever in between. So it's not 00:56:54.239 --> 00:56:56.519 saying, oh, James, you're bad. It's saying, oh, 00:56:56.599 --> 00:56:58.800 you're 30. Well, let's try to work to a 50 or 00:56:58.800 --> 00:57:00.460 whatever you want to work to, right? So it's 00:57:00.460 --> 00:57:03.159 all about recontexting the way that we look at 00:57:03.159 --> 00:57:05.320 mental health, realizing all of us have a score, 00:57:05.519 --> 00:57:09.519 everybody. And it might be good, it might be 00:57:09.519 --> 00:57:12.420 bad, but you can always improve it. So the bot 00:57:12.420 --> 00:57:16.780 is geared to deploy across the world to where 00:57:16.780 --> 00:57:18.800 we can start measuring people preventatively 00:57:18.800 --> 00:57:21.119 through risk mitigation because we're all at 00:57:21.119 --> 00:57:23.519 risk because we don't know what causes all this 00:57:23.519 --> 00:57:28.239 stuff yet. Thank you, James. It's not just what 00:57:28.239 --> 00:57:34.059 you say. It's how you say it. It's your facial 00:57:34.059 --> 00:57:38.139 expressions. It's how do you speak, what you 00:57:38.139 --> 00:57:41.559 do. It looks at it. It's brilliant. Absolutely 00:57:41.559 --> 00:57:44.639 brilliant. Yeah, it measures your – so believe 00:57:44.639 --> 00:57:46.679 it or not, James, we have 22 emotions in every 00:57:46.679 --> 00:57:49.710 conversation that we have. All of us right now 00:57:49.710 --> 00:57:52.510 are having 22 emotions. And she measures your, 00:57:52.550 --> 00:57:54.929 like, yeah, your facial expressions, your tone, 00:57:55.010 --> 00:57:58.210 to where after the review or after you talk to 00:57:58.210 --> 00:58:00.110 her, she gives you a summary of your conversation. 00:58:00.869 --> 00:58:03.070 And then she also shows you on a bar graph where 00:58:03.070 --> 00:58:05.449 you are with these 22 emotions. Because you may 00:58:05.449 --> 00:58:07.170 say, we may be like, hey, James, I think you've 00:58:07.170 --> 00:58:08.510 got some anger issues. And you're like, I don't 00:58:08.510 --> 00:58:10.550 have any anger issues. Like, if anything, like, 00:58:10.610 --> 00:58:12.570 I don't have anger. I suppress anger. You know, 00:58:12.590 --> 00:58:14.969 whatever. But if you're able to go and look at 00:58:14.969 --> 00:58:17.869 this review and it shows that your tiredness, 00:58:18.280 --> 00:58:21.139 is off the scale like we could be like oh yeah 00:58:21.139 --> 00:58:23.300 i'm just tired all the time if it's showing that 00:58:23.300 --> 00:58:26.199 then maybe we need to take steps in order to 00:58:26.199 --> 00:58:30.260 lower that bar graph down or to improve the joy 00:58:30.260 --> 00:58:32.199 i mean because it does like joy distress all 00:58:32.199 --> 00:58:34.440 these different pieces but it just it just gives 00:58:34.440 --> 00:58:37.599 you an analysis so if we're able to get this 00:58:37.599 --> 00:58:39.300 spot and this is something that david and nick 00:58:39.300 --> 00:58:41.440 and i are actually working on is getting the 00:58:41.440 --> 00:58:44.380 bot in the psychedelic space So it can be the 00:58:44.380 --> 00:58:47.019 one piece that analyzes everybody. It's like, 00:58:47.019 --> 00:58:48.179 I don't care if you're in the jungle, if you're 00:58:48.179 --> 00:58:50.019 in Europe, if you're in Asia, it doesn't matter. 00:58:50.059 --> 00:58:52.260 I don't care what psychedelics are doing. It's 00:58:52.260 --> 00:58:56.360 an agnostic scale and bod that's been made to 00:58:56.360 --> 00:59:00.360 advocate for you. It's not advocating for a product 00:59:00.360 --> 00:59:02.599 like the other scales are out there with medications. 00:59:03.300 --> 00:59:07.360 You are the product. So whatever you do, whether 00:59:07.360 --> 00:59:10.820 that be diet change, yoga, meditation, antidepressants, 00:59:10.820 --> 00:59:15.289 psychedelics, you are doing and that's what we 00:59:15.289 --> 00:59:18.610 missed in mental health there is nothing that's 00:59:18.610 --> 00:59:23.590 advocating for you so simple but nobody's done 00:59:23.590 --> 00:59:25.550 it right so that's the cool piece with the bot 00:59:25.550 --> 00:59:28.269 um and it is it's fascinating um so hopefully 00:59:28.269 --> 00:59:30.150 we can get that eventually approved to be an 00:59:30.150 --> 00:59:39.730 fda device nick jump in he loves it it's the 00:59:39.730 --> 00:59:43.599 best thing he's ever seen Yeah, ultimately, like 00:59:43.599 --> 00:59:46.340 high level, like where I have a deep appreciation 00:59:46.340 --> 00:59:51.960 for the bot is when I think about mental health 00:59:51.960 --> 00:59:54.239 and the way we have care delivery currently, 00:59:54.440 --> 00:59:58.940 a lot of patients are going to meet and potentially 00:59:58.940 --> 01:00:01.159 appointments are only six minutes. So there's 01:00:01.159 --> 01:00:03.679 a snapshot in time and a busy schedule. They 01:00:03.679 --> 01:00:06.019 walk right out the door. And the idea to have 01:00:06.019 --> 01:00:09.960 longitudinal information that's able to assess 01:00:09.960 --> 01:00:13.929 voice, able to assess, facial features, able 01:00:13.929 --> 01:00:18.409 to have just like a more of a video reel as opposed 01:00:18.409 --> 01:00:21.889 to just a six -minute snapshot brings a tremendous 01:00:21.889 --> 01:00:25.469 value. If someone, a therapist or psychiatrist 01:00:25.469 --> 01:00:27.989 or other mental health care provider is able 01:00:27.989 --> 01:00:32.570 to have data points before walking into a room 01:00:32.570 --> 01:00:34.389 for a patient, they're just better equipped. 01:00:35.599 --> 01:00:37.780 And like some of the technology coming out for 01:00:37.780 --> 01:00:40.579 the space is just like fascinating and really, 01:00:40.780 --> 01:00:43.760 really high value. This being one, I imagine 01:00:43.760 --> 01:00:46.159 a world as well where there's like, there's some 01:00:46.159 --> 01:00:47.820 really neat technology coming out for like with 01:00:47.820 --> 01:00:49.980 vibrations and sound. I imagine before going 01:00:49.980 --> 01:00:51.500 into appointments, there's almost like reset, 01:00:51.639 --> 01:00:54.320 no medicine involved before going into an appointment. 01:00:54.619 --> 01:00:58.260 To break that space of getting out of a car after 01:00:58.260 --> 01:01:01.099 a rushed visit during your lunch hour to like 01:01:01.099 --> 01:01:03.820 go to a therapist to talk. I'm just having like 01:01:03.820 --> 01:01:07.280 resets and continuity. It will be so vital in 01:01:07.280 --> 01:01:09.199 the upcoming years. And it could, and what we 01:01:09.199 --> 01:01:10.579 just talked about, it can make, it can address 01:01:10.579 --> 01:01:13.960 that gap of our stupidity or ignorance in the 01:01:13.960 --> 01:01:16.139 field, you know? And it would give us something 01:01:16.139 --> 01:01:18.840 like, oh, wow, look, this color's higher than 01:01:18.840 --> 01:01:21.340 this color. We should look on that one, you know? 01:01:21.380 --> 01:01:24.340 So it actually puts some tangible aspects so 01:01:24.340 --> 01:01:26.719 we can become better providers. Because again, 01:01:26.940 --> 01:01:30.309 we are not good. you know you know it'd be a 01:01:30.309 --> 01:01:32.349 really interesting and i'm curious james question 01:01:32.349 --> 01:01:35.809 back to you here um because of the individuals 01:01:35.809 --> 01:01:37.869 that you're working with in the level that you 01:01:37.869 --> 01:01:39.969 work with are you seeing anything on like the 01:01:39.969 --> 01:01:45.929 presumptive law side for for departments um so 01:01:45.929 --> 01:01:48.769 job related injury for firefighters or frontline 01:01:48.769 --> 01:01:52.429 workers what i'm seeing and it's very sad is 01:01:52.429 --> 01:01:55.170 that there are some states that have some presumptive 01:01:55.170 --> 01:01:59.000 laws um for example i know some states let's 01:01:59.000 --> 01:02:01.539 say you have a presumptive law for cancer, but 01:02:01.539 --> 01:02:04.119 if women are over a certain age, then breast 01:02:04.119 --> 01:02:06.219 cancer isn't covered. You know, even though they've 01:02:06.219 --> 01:02:09.340 worked for 20 years as a firefighter, there's 01:02:09.340 --> 01:02:11.340 some presumptive laws on the mental health side 01:02:11.340 --> 01:02:14.659 as well, PTSD. But what I've heard from many, 01:02:14.739 --> 01:02:17.000 many people is just because you have a presumptive 01:02:17.000 --> 01:02:19.000 law doesn't mean they're going to pay out. And 01:02:19.000 --> 01:02:21.780 these insurance companies will fight tooth and 01:02:21.780 --> 01:02:25.000 nail to the point where some have reported literally 01:02:25.000 --> 01:02:27.519 hearing them say, well, we'll just fight them 01:02:27.519 --> 01:02:29.619 and they'll die. They'll die before they ever 01:02:29.619 --> 01:02:32.320 get a penny. So this is kind of the landscape 01:02:32.320 --> 01:02:33.920 that we're dealing with. I'm sure there's some 01:02:33.920 --> 01:02:36.320 that are great and they just take care of their 01:02:36.320 --> 01:02:38.940 people. That's not the stories I'm hearing more 01:02:38.940 --> 01:02:44.980 often than not. Okay. David. Thanks for context 01:02:44.980 --> 01:02:47.739 on that. Yeah, I know like Maine, Florida, I 01:02:47.739 --> 01:02:49.320 think Colorado, some other states have some, 01:02:49.340 --> 01:02:52.639 but I wasn't sure about actual outcomes on implementation. 01:02:53.159 --> 01:02:55.769 Yeah, I know it's a fight. David, you mentioned 01:02:55.769 --> 01:02:58.389 about needing to close out in an hour. Did you 01:02:58.389 --> 01:03:00.929 need to, if there's anything you want to leave 01:03:00.929 --> 01:03:04.730 us with before you step out? I think, well, James, 01:03:04.869 --> 01:03:06.670 yeah, I'm very sorry that I've got to go because 01:03:06.670 --> 01:03:08.650 I think it's a great conversation. The bit for 01:03:08.650 --> 01:03:12.530 me is we've got to do better. The joy is we can 01:03:12.530 --> 01:03:19.130 do better. Absolutely. All right. Well, I wanted 01:03:19.130 --> 01:03:22.630 to get, just kind of circle around. To the comments 01:03:22.630 --> 01:03:25.389 that you guys made, when I think about being 01:03:25.389 --> 01:03:28.929 a paramedic, one of the most important concepts 01:03:28.929 --> 01:03:31.789 to me was trending. You might have someone in 01:03:31.789 --> 01:03:34.610 cardiac arrest or whatever it is, but it's over 01:03:34.610 --> 01:03:37.469 the journey in the ambulance or whatever it is, 01:03:37.530 --> 01:03:39.650 or even it's my family's health. How are they 01:03:39.650 --> 01:03:42.769 doing today, tomorrow, five days? Okay, it's 01:03:42.769 --> 01:03:44.570 looking good. We're trending upwards. That's 01:03:44.570 --> 01:03:47.750 beautiful. It seems like this AI bot that you've 01:03:47.750 --> 01:03:50.800 got. will give someone the ability to see how 01:03:50.800 --> 01:03:52.619 they are trending because it's not something 01:03:52.619 --> 01:03:54.840 you can normally annotate. So if you do have 01:03:54.840 --> 01:03:58.260 someone with depression or anxiety or, you know, 01:03:58.280 --> 01:04:01.000 God forbid, even suicide ideation, you know, 01:04:01.000 --> 01:04:02.960 is there an ability then to be, oh, well, I was 01:04:02.960 --> 01:04:05.260 a, you know, I was a 16 yesterday and now I'm 01:04:05.260 --> 01:04:07.800 a 24. I could see that would almost give them 01:04:07.800 --> 01:04:09.579 hope. And, you know, they're doing cold plunges 01:04:09.579 --> 01:04:11.159 or ketamine or whatever it is. And like, oh, 01:04:11.239 --> 01:04:14.789 this, this is working. This is working. Yes. 01:04:14.789 --> 01:04:17.630 And here's the really cool thing, James, is with 01:04:17.630 --> 01:04:20.050 this, like antidepressants have been covered, 01:04:20.110 --> 01:04:22.570 you know, 90 days. Well, here's what's happening 01:04:22.570 --> 01:04:24.690 in the psychedelic space right now. You're getting 01:04:24.690 --> 01:04:27.730 veterans, great job vets for coming out and saying, 01:04:27.829 --> 01:04:32.309 you saved my life. The FDA can't hear it. We've 01:04:32.309 --> 01:04:35.510 got to put it in the language that they can hear. 01:04:35.829 --> 01:04:39.449 And the language that they can hear is seeing 01:04:39.449 --> 01:04:44.369 data change. So if we're able to get somebody 01:04:44.369 --> 01:04:48.269 to use this bot for a year and just do psychedelics, 01:04:48.309 --> 01:04:50.349 go do ayahuasca, go do Ibogaine, go do whatever 01:04:50.349 --> 01:04:53.530 you want to do, and then do the bot once a month, 01:04:53.650 --> 01:04:56.849 and then we can have that longitudinal data to 01:04:56.849 --> 01:04:59.130 where maybe we can prove that people are in remission. 01:04:59.369 --> 01:05:01.909 And then we can give more insight. And the more 01:05:01.909 --> 01:05:04.949 insight you can give, the more that we're able 01:05:04.949 --> 01:05:10.659 to decrease that fear factor. Because people 01:05:10.659 --> 01:05:12.940 are afraid. They're afraid of all these things. 01:05:13.039 --> 01:05:15.440 But a lot of times, unfortunately, we have to 01:05:15.440 --> 01:05:18.219 hit rock bottom before we get help. And that's 01:05:18.219 --> 01:05:21.800 what we need to prevent, is to say, like, maybe 01:05:21.800 --> 01:05:24.280 the scale, if you do hit into the 30s, then you 01:05:24.280 --> 01:05:25.760 need to get help, even if you don't feel like 01:05:25.760 --> 01:05:28.460 you need to get help. You know, so it's just 01:05:28.460 --> 01:05:30.579 something. It's like your red blood cells. If 01:05:30.579 --> 01:05:32.440 your red blood cells are off, do you feel like 01:05:32.440 --> 01:05:36.139 a bad person because of it? No. You know, so 01:05:36.139 --> 01:05:38.400 if we're able to put a number there instead of 01:05:38.400 --> 01:05:40.179 being like, oh, just tell me why you feel so 01:05:40.179 --> 01:05:43.119 bad. I mean, we're using people who can't even 01:05:43.119 --> 01:05:48.420 eat or drink as the primary indicator on if they 01:05:48.420 --> 01:05:53.039 need to get help. And it's like asking a computer 01:05:53.039 --> 01:05:55.900 that's malfunctioning to fix itself or to identify 01:05:55.900 --> 01:05:59.719 why there's an issue. It can't. So we're starting 01:05:59.719 --> 01:06:01.360 off on the wrong foot with all this. So if the 01:06:01.360 --> 01:06:03.300 bot, yes, if the bot can just show these numbers 01:06:03.300 --> 01:06:06.079 over time. When are you optimally functioning? 01:06:06.280 --> 01:06:08.280 Oh, when I'm like a 65, I'm optimally functioning. 01:06:08.480 --> 01:06:11.780 Okay, great. Stay at 65. You know, but yeah, 01:06:11.820 --> 01:06:13.460 no, absolutely. I think it's going to be life 01:06:13.460 --> 01:06:15.880 changing. I really, really, really, really do. 01:06:16.619 --> 01:06:19.119 But I'll send you the draft manuscript. It's 01:06:19.119 --> 01:06:21.719 fascinating. And we got a lot of really cool 01:06:21.719 --> 01:06:24.699 people that are behind it. And they're all big 01:06:24.699 --> 01:06:27.280 Ivy League scientists. And they're doing it because 01:06:27.280 --> 01:06:31.000 they know there is better out there. They're 01:06:31.000 --> 01:06:32.820 not doing it to make a dollar. They're doing 01:06:32.820 --> 01:06:35.400 it because they see that they need to contribute 01:06:35.400 --> 01:06:39.099 to history. And this is going to be very contributing 01:06:39.099 --> 01:06:42.639 to history. I want to put something to both of 01:06:42.639 --> 01:06:45.300 you just quickly. There's a phrase I love. Don't 01:06:45.300 --> 01:06:47.239 wait for science to prove what you already know 01:06:47.239 --> 01:06:49.519 is true. And I'll give you a perfect example. 01:06:49.559 --> 01:06:52.980 Again, this resistance to changing the work week. 01:06:53.179 --> 01:06:55.420 People will tell me, oh, we need to see studies. 01:06:56.170 --> 01:06:58.829 And what they're asking is, can you show me in 01:06:58.829 --> 01:07:03.309 a laboratory study that a 42 hour work week will 01:07:03.309 --> 01:07:06.150 be healthier than a 56 hour work week? And there's 01:07:06.150 --> 01:07:08.010 a certain point where you've got to draw a line 01:07:08.010 --> 01:07:09.949 in the sand and go, we don't need a study for 01:07:09.949 --> 01:07:12.050 this. I don't need a study to know that if I 01:07:12.050 --> 01:07:14.130 stand in front of a moving bus that I'm going 01:07:14.130 --> 01:07:16.829 to get flattened. You know, where is that point 01:07:16.829 --> 01:07:20.909 of common sense? So, you know, why is it in some 01:07:20.909 --> 01:07:24.050 of these things that we're all seeing are very, 01:07:24.170 --> 01:07:27.510 very. And arguably, if we're talking about the 01:07:27.510 --> 01:07:29.949 plant medicine, really, we've got hundreds of 01:07:29.949 --> 01:07:33.070 years of studies, you know, as far as history 01:07:33.070 --> 01:07:36.670 and indigenous cultures. Why is this roadblock 01:07:36.670 --> 01:07:42.469 of studies so high in some of these areas? Nick, 01:07:42.510 --> 01:07:47.289 you want to take that one on? So many pieces 01:07:47.289 --> 01:07:49.789 there. I mean, ultimately, it comes down to DEA 01:07:49.789 --> 01:07:52.510 scheduling. If we really were to get to like 01:07:52.510 --> 01:07:55.989 a first principles aspect of regulation. So the 01:07:55.989 --> 01:08:00.230 idea that many of these medicines are in phase 01:08:00.230 --> 01:08:03.969 two or phase three clinical trials with rigorous 01:08:03.969 --> 01:08:07.489 scientific research, and there's still DEA schedule 01:08:07.489 --> 01:08:09.449 one, meaning they're restricted and there's no 01:08:09.449 --> 01:08:12.250 medical value. Marijuana being an additional 01:08:12.250 --> 01:08:15.030 component there, despite being legalized, I don't 01:08:15.030 --> 01:08:16.750 know, 30 or 40 states, I have no idea how many, 01:08:16.930 --> 01:08:20.970 is still a schedule one federal substance. And 01:08:20.970 --> 01:08:24.390 the idea that for these agents, what was the 01:08:24.390 --> 01:08:26.590 quote he said? Don't wait for science to prove 01:08:26.590 --> 01:08:29.729 what you already know. And the idea that if we 01:08:29.729 --> 01:08:33.390 took the collective voice of all of these individuals, 01:08:33.550 --> 01:08:36.770 and I only advocate for legal access, just to 01:08:36.770 --> 01:08:39.529 be clear on that. But all these individuals who 01:08:39.529 --> 01:08:41.090 maybe they're going out to the jungle and they're 01:08:41.090 --> 01:08:43.170 risking it in like some hut with some shaman 01:08:43.170 --> 01:08:45.430 or all these individuals going down to Mexico 01:08:45.430 --> 01:08:48.109 or outside of the country, even if they fought 01:08:48.109 --> 01:08:50.819 for our own country. And the collective voice 01:08:50.819 --> 01:08:55.140 is saying, this helped leaps and bounds more 01:08:55.140 --> 01:08:59.380 than what conventional insurance covered care 01:08:59.380 --> 01:09:02.899 provided for me within the US. And I took it 01:09:02.899 --> 01:09:06.000 on my own accord to leave the country to go for 01:09:06.000 --> 01:09:09.880 this. We need to listen to those people. Despite 01:09:09.880 --> 01:09:12.340 whatever our political perspective is, whatever 01:09:12.340 --> 01:09:17.579 our viewpoint is, it's proven if we listen to 01:09:17.579 --> 01:09:20.930 the voice to an extent. Where my interest and 01:09:20.930 --> 01:09:23.109 intrigue lies from a scientific lens is like, 01:09:23.149 --> 01:09:26.470 who is this working for? What type of people? 01:09:26.689 --> 01:09:29.289 Is there harm? What kind of harm? If we look 01:09:29.289 --> 01:09:33.189 at the MDMA research, 71 % are no longer diagnosable, 01:09:33.350 --> 01:09:37.630 88 % had benefit. But there's a 12 % that, if 01:09:37.630 --> 01:09:40.590 we're real, 12 % didn't have that benefit. So 01:09:40.590 --> 01:09:44.430 who are those 12 %? How do we really siphon those 01:09:44.430 --> 01:09:47.760 people out initially? we could focus on the 88%, 01:09:47.760 --> 01:09:51.800 which is massive, massive, considering that we 01:09:51.800 --> 01:09:56.159 currently have 60 % treatment resistance or drug 01:09:56.159 --> 01:09:58.680 discontinuation with our current mental health 01:09:58.680 --> 01:10:06.239 care model. Yeah, that's the direction we need 01:10:06.239 --> 01:10:08.659 to go. And I think states like Oregon and Colorado 01:10:08.659 --> 01:10:11.279 are really, really interesting case studies with... 01:10:12.119 --> 01:10:14.859 Legal access to psilocybin -assisted therapy 01:10:14.859 --> 01:10:18.560 for wellness or for mental health care. And the 01:10:18.560 --> 01:10:20.060 leading indicator that will have some really 01:10:20.060 --> 01:10:21.979 interesting data within the U .S. that we can 01:10:21.979 --> 01:10:27.720 bring to regulators. Kate, anything to add? No, 01:10:27.779 --> 01:10:29.640 I think you summed it up really, really well. 01:10:29.720 --> 01:10:32.180 But, yeah, I think we're going to look back. 01:10:32.180 --> 01:10:34.899 And what you just said, our veterans are going 01:10:34.899 --> 01:10:38.479 to other countries to get help that they need. 01:10:39.380 --> 01:10:42.739 That's an instrumental statement. And it's very, 01:10:42.779 --> 01:10:46.840 very sad. It's very sad that we, being in the 01:10:46.840 --> 01:10:49.920 United States, cannot provide that care for them. 01:10:50.500 --> 01:10:53.520 But yet, what isn't scheduled, and I mentioned 01:10:53.520 --> 01:10:57.079 this the other day with Nick, alcohol. Alcohol 01:10:57.079 --> 01:10:59.460 is a mind -altering drug. It can also be utilized 01:10:59.460 --> 01:11:03.579 as a non -regenerative psychedelic, per se. But 01:11:03.579 --> 01:11:07.739 it's not scheduled, and it's everywhere, right? 01:11:07.880 --> 01:11:09.420 I mean, if anything needs to be scheduled, one, 01:11:09.500 --> 01:11:13.220 it needs to be alcohol. But we need to de -schedule 01:11:13.220 --> 01:11:16.960 or take them out of the Schedule 1 classification 01:11:16.960 --> 01:11:20.399 with psychedelics and put them more than likely 01:11:20.399 --> 01:11:24.699 on a Schedule 3 to where we can give people access. 01:11:24.960 --> 01:11:28.720 It's like, what are we doing? And hopefully the 01:11:28.720 --> 01:11:30.500 new administration that just came in is going 01:11:30.500 --> 01:11:33.239 to help with some of this stuff because so much 01:11:33.239 --> 01:11:35.539 of this as to what we talked about today, none 01:11:35.539 --> 01:11:38.760 of it makes sense. It just doesn't make sense 01:11:38.760 --> 01:11:43.340 anymore. And we just need to change our view 01:11:43.340 --> 01:11:48.220 and build a new system. And also not making sense 01:11:48.220 --> 01:11:52.380 in the way that the app works on your phone, 01:11:52.539 --> 01:11:56.119 that your TV channel changer doesn't work properly. 01:11:56.239 --> 01:11:58.060 That doesn't make sense. That's fine. No one's 01:11:58.060 --> 01:12:00.260 dying there. But in what we're talking about 01:12:00.260 --> 01:12:02.739 today, what doesn't make sense is costing lives. 01:12:02.880 --> 01:12:04.739 And this is why it's such an important conversation. 01:12:05.960 --> 01:12:08.819 And not only is it costing lives. It's costing 01:12:08.819 --> 01:12:11.880 lives for generations to come. So when you lose 01:12:11.880 --> 01:12:13.720 your mom, when you lose your dad, when you lose 01:12:13.720 --> 01:12:17.720 your child, it has such catastrophic impact on 01:12:17.720 --> 01:12:20.880 our society that it decreases, you know, like 01:12:20.880 --> 01:12:24.720 how much people are actually able to work, how 01:12:24.720 --> 01:12:27.260 much income they're able to bring in. Like, you 01:12:27.260 --> 01:12:29.880 know, on so many different economic levels, this 01:12:29.880 --> 01:12:33.880 is having, like again, it's an impact we don't 01:12:33.880 --> 01:12:38.710 even know how bad it is. Absolutely. Well, let's 01:12:38.710 --> 01:12:41.170 just talk about solutions then. Talk to me about 01:12:41.170 --> 01:12:45.750 anyone listening now where they can access ketamine, 01:12:45.810 --> 01:12:49.090 whether it's through your own company or whether 01:12:49.090 --> 01:12:51.649 it's in other areas around the country. And then 01:12:51.649 --> 01:12:54.850 what else should we be looking for? You mentioned 01:12:54.850 --> 01:12:57.609 the AI bot. What is the next step to try and 01:12:57.609 --> 01:13:01.100 bring this solution to more people? Oh, that's 01:13:01.100 --> 01:13:03.420 a good loading question right there, Jane. So, 01:13:03.439 --> 01:13:05.739 of course, they can go to Revitalist. There's 01:13:05.739 --> 01:13:09.640 about 5 ,000, you may know, 5 ,000 -ish ketamine 01:13:09.640 --> 01:13:11.319 clinics across the United States, maybe more. 01:13:12.570 --> 01:13:14.529 Good, bad, or ugly, right? They're all different. 01:13:14.609 --> 01:13:17.109 They all have different modalities of. But one 01:13:17.109 --> 01:13:19.390 thing that we're doing, James, is, yes, we've 01:13:19.390 --> 01:13:20.989 got the AI bot, but the other piece is we're 01:13:20.989 --> 01:13:25.210 opening a lab in February to where we're drawing 01:13:25.210 --> 01:13:27.470 blood, doing brain scans, doing heart scans. 01:13:27.550 --> 01:13:29.689 So it's a four -minute EEG. It's a four -minute 01:13:29.689 --> 01:13:33.590 EKG. We're seeing the real -time electrical patterns, 01:13:33.729 --> 01:13:36.270 and we're seeing how those cross -correlate with 01:13:36.270 --> 01:13:41.119 blood based on the inflammatory cascade. So we're 01:13:41.119 --> 01:13:43.760 seeing that stress on the system causes inflammation. 01:13:44.180 --> 01:13:46.859 Inflammation causes dysfunction. And that's what 01:13:46.859 --> 01:13:50.500 we want to do is to like reverse engineer treatment 01:13:50.500 --> 01:13:53.720 so we can get up here and we can start figuring 01:13:53.720 --> 01:13:56.119 out like how do we change, how do we minimize 01:13:56.119 --> 01:13:59.260 that stress on the inflammatory cascade? And 01:13:59.260 --> 01:14:02.319 then how do we also help people to have more 01:14:02.319 --> 01:14:04.520 data to prove that their diagnoses are real? 01:14:05.100 --> 01:14:08.380 Because you shouldn't walk around with 38 diagnoses. 01:14:08.380 --> 01:14:10.659 You know what that means? You've had 38 wrong 01:14:10.659 --> 01:14:13.020 practitioners more than likely. You know, and 01:14:13.020 --> 01:14:14.640 they all have their own different lens and view 01:14:14.640 --> 01:14:17.199 and whatever else. It's like, you know, we just 01:14:17.199 --> 01:14:21.000 need to have, the brain is one. What's the brain 01:14:21.000 --> 01:14:24.359 doing wrong? And what symptoms is it giving you? 01:14:24.500 --> 01:14:28.920 And how can we reset the brain? So yeah, so then 01:14:28.920 --> 01:14:30.760 once the lab comes out, James, it's a reference 01:14:30.760 --> 01:14:33.800 lab. Anybody across the world can send us blood. 01:14:33.960 --> 01:14:36.140 Anybody can partner with us across the country 01:14:36.140 --> 01:14:39.640 and the world. So our goal is that we can have 01:14:39.640 --> 01:14:43.180 somebody come in once a year, right? Once a year 01:14:43.180 --> 01:14:45.000 you come in, you get your brain scan, your heart 01:14:45.000 --> 01:14:46.819 scan, your blood. I don't care if you feel good 01:14:46.819 --> 01:14:49.109 or bad or whatever. Just come in. We don't have 01:14:49.109 --> 01:14:51.069 to talk about childhood trauma. We don't have 01:14:51.069 --> 01:14:53.210 to talk about, you know, the trauma, whatever, 01:14:53.409 --> 01:14:54.729 right? Whatever's been in your life. We don't 01:14:54.729 --> 01:14:56.970 have to talk about that. Just come in. Let's 01:14:56.970 --> 01:14:59.329 just look at the data and let's do interventions 01:14:59.329 --> 01:15:02.130 that can treat the data because psychedelics 01:15:02.130 --> 01:15:05.430 and ketamine, they're huge anti -inflammatories 01:15:05.430 --> 01:15:07.590 and not anti -inflammatories that they're like, 01:15:07.609 --> 01:15:10.649 you know, blocking the inflammatory system. They're 01:15:10.649 --> 01:15:14.260 auto -regulating. the inflammatory system to 01:15:14.260 --> 01:15:16.420 where it's actually starting to function better. 01:15:16.600 --> 01:15:19.460 So we're trying, but I tell you, it's not an 01:15:19.460 --> 01:15:23.680 easy path at all. Well, that would affect cancer 01:15:23.680 --> 01:15:25.960 and heart disease and other areas too. And this 01:15:25.960 --> 01:15:27.560 is the thing, even with new calm, when he's down 01:15:27.560 --> 01:15:29.760 regulating with that technology, you know, he's 01:15:29.760 --> 01:15:31.819 talking about cancer. He's talking about aging. 01:15:31.920 --> 01:15:34.279 I mean, when you're carrying that trauma, as 01:15:34.279 --> 01:15:36.399 they say, the body keeps the score, it's going 01:15:36.399 --> 01:15:39.939 to affect everything. Yep. Yep. And that's a 01:15:39.939 --> 01:15:42.140 piece, right? So I've actually, when I told you, 01:15:42.159 --> 01:15:43.500 you know, we've got to give people conclusions. 01:15:43.859 --> 01:15:47.340 That's the way I set up the lab is I have actually 01:15:47.340 --> 01:15:50.340 on the, on the forms, it just has the diagnosis 01:15:50.340 --> 01:15:52.579 there. So if you have, if you're obese, if you 01:15:52.579 --> 01:15:54.960 have diabetes, if you have fibromyalgia, if you 01:15:54.960 --> 01:15:58.079 have TBIs, CTEs, depression, anxiety, insomnia, 01:15:58.119 --> 01:16:00.720 you just circle what you're feeling at that moment. 01:16:00.760 --> 01:16:03.359 And we've actually made protocols behind that. 01:16:03.380 --> 01:16:06.199 Well, that will draw all the labs behind that 01:16:06.199 --> 01:16:09.189 protocol. So that's the piece, right, is we're 01:16:09.189 --> 01:16:12.569 trying to make it, gosh, we're just trying to 01:16:12.569 --> 01:16:16.930 make it to have just a very small level of statistical 01:16:16.930 --> 01:16:20.189 error. That's the goal. Because right now, like 01:16:20.189 --> 01:16:22.869 I said, it's all error. That's all we know in 01:16:22.869 --> 01:16:26.069 the mental health system. And burnout with providers 01:16:26.069 --> 01:16:29.930 is 50 % or greater. How do we stop that? How 01:16:29.930 --> 01:16:33.590 do we give them more tools, right? And here's 01:16:33.590 --> 01:16:37.060 my analogy that I tell people. Because, again, 01:16:37.279 --> 01:16:41.279 it's like new language skills. If you break your 01:16:41.279 --> 01:16:44.159 leg and you go to the emergency room, if you 01:16:44.159 --> 01:16:45.899 think your leg's broken and you go to the emergency 01:16:45.899 --> 01:16:49.279 room, you don't go and see the orthopedic surgeon 01:16:49.279 --> 01:16:52.060 first who's looking at you like, oh, is James 01:16:52.060 --> 01:16:55.380 grimacing enough? Does his leg look swollen enough? 01:16:56.420 --> 01:16:58.060 You know, well, I guess I'm going to have to 01:16:58.060 --> 01:16:59.939 go in blindly and just cut him open and see what's 01:16:59.939 --> 01:17:03.060 in there. No, you do an x -ray. So that's where 01:17:03.060 --> 01:17:05.119 the bot will come in, that's where the lab will 01:17:05.119 --> 01:17:08.500 come in, is we can give these people data markers 01:17:08.500 --> 01:17:12.680 that they can look at, then they can look at 01:17:12.680 --> 01:17:15.039 your diagnosis. Because people are getting diagnosed 01:17:15.039 --> 01:17:17.579 in like five minutes, seven minutes, and absolutely 01:17:17.579 --> 01:17:22.939 not. It's negligence, it's malpractice, it's 01:17:22.939 --> 01:17:25.479 all the negative legal jargon we want to throw 01:17:25.479 --> 01:17:27.979 in there. But again, it's just ignorance. The 01:17:27.979 --> 01:17:31.359 system's not where it needs to be. Just reminded 01:17:31.359 --> 01:17:34.199 me, and I don't know anything about the background 01:17:34.199 --> 01:17:36.300 of this particular video, but someone was in 01:17:36.300 --> 01:17:38.220 the street and they were interviewing, I think 01:17:38.220 --> 01:17:40.760 it was psychiatrists, and they were said, how 01:17:40.760 --> 01:17:43.939 many patients have you cured? And over and over 01:17:43.939 --> 01:17:45.579 again, each of these different people were saying 01:17:45.579 --> 01:17:48.100 none. And so when you talk about the burnout 01:17:48.100 --> 01:17:51.100 being compassionate and empathetic for the provider, 01:17:51.279 --> 01:17:53.960 whether it's, you know, an ER physician or nurse, 01:17:53.979 --> 01:17:56.319 it's just seeing all these obese patients coming 01:17:56.319 --> 01:17:58.579 in and obviously us, the paramedics that are 01:17:58.579 --> 01:18:00.319 literally intubating them and defibrillating 01:18:00.319 --> 01:18:02.279 them and they die over and over and over again. 01:18:02.500 --> 01:18:05.520 That inability to improve or inability to save 01:18:05.520 --> 01:18:10.350 is incredibly. you know, detrimental to someone 01:18:10.350 --> 01:18:12.710 who wanted to serve someone who wanted to alleviate 01:18:12.710 --> 01:18:16.229 pain. So this shift, I hope helps the practitioners 01:18:16.229 --> 01:18:20.750 too. That's the goal of it, you know, and they're 01:18:20.750 --> 01:18:23.329 all in the mental health space again, because 01:18:23.329 --> 01:18:25.550 I hear things I'm like, Oh, you don't work like 01:18:25.550 --> 01:18:27.130 that. It's so different, James, they're just 01:18:27.130 --> 01:18:28.829 trained differently in the mental health space. 01:18:28.949 --> 01:18:31.029 As therapists don't have to have peer reviewed 01:18:31.029 --> 01:18:33.550 journals, they don't have them. They don't exist. 01:18:34.359 --> 01:18:36.560 In medicine, that's all we have is peer -reviewed 01:18:36.560 --> 01:18:39.039 journals. You've got to present your case, hope 01:18:39.039 --> 01:18:40.520 it gets eaten, then you draft it, then it gets 01:18:40.520 --> 01:18:42.899 eaten again, you draft it again. But therapists 01:18:42.899 --> 01:18:45.619 don't have that right now. So they're looking 01:18:45.619 --> 01:18:48.140 for a bot. They're like, oh, does your bot diagnose? 01:18:49.020 --> 01:18:50.840 No, it doesn't diagnose. Why are you calling 01:18:50.840 --> 01:18:53.500 it diagnostic marker? It's like because it's 01:18:53.500 --> 01:18:56.039 giving you data to help you diagnose because 01:18:56.039 --> 01:19:00.819 you all suck right now. And that's the piece. 01:19:00.880 --> 01:19:03.510 They're looking for a bot to diagnose. Guys, 01:19:03.609 --> 01:19:06.050 we don't even have the language on how to effectively 01:19:06.050 --> 01:19:08.850 diagnose. How are we going to make a bot that 01:19:08.850 --> 01:19:11.369 diagnoses it? Like, we don't have the large language 01:19:11.369 --> 01:19:14.850 model. We don't see it yet. And AI, in order 01:19:14.850 --> 01:19:18.989 to build AI, you have to give it a large language 01:19:18.989 --> 01:19:21.149 model. And the large language model doesn't exist. 01:19:21.710 --> 01:19:24.270 So, yeah, I'm hoping it's going to help out providers, 01:19:24.449 --> 01:19:27.329 health care, communities, schools. Here's another 01:19:27.329 --> 01:19:28.729 thing, James. I think we've talked about this 01:19:28.729 --> 01:19:31.369 before. In the school system, I asked one of 01:19:31.369 --> 01:19:33.510 the teachers. When do your kids kill themselves 01:19:33.510 --> 01:19:35.850 the most? What's the highest? What's the highest? 01:19:35.970 --> 01:19:38.069 When's the highest rate of occurrence? Oh, we 01:19:38.069 --> 01:19:41.250 don't know. It's random. No, it's not random. 01:19:41.350 --> 01:19:44.149 There's a pattern somewhere. How have you looked 01:19:44.149 --> 01:19:46.010 at the pattern? Oh, we don't know how to look 01:19:46.010 --> 01:19:48.789 at that. So if we can get the bot into schools. 01:19:49.479 --> 01:19:52.180 It can show when these children are decreasing, 01:19:52.520 --> 01:19:54.720 when we need to put more support around them. 01:19:55.000 --> 01:19:57.619 And that's how we prevent. We've got to get out 01:19:57.619 --> 01:20:00.000 there. We've got to start surveying the landscape 01:20:00.000 --> 01:20:03.439 from an agnostic viewpoint. Right now, we're 01:20:03.439 --> 01:20:05.939 only surveying the landscape when people are 01:20:05.939 --> 01:20:09.239 rock bottom or they feel stressed to ask for 01:20:09.239 --> 01:20:11.460 help or they're scared and they ask for help. 01:20:11.659 --> 01:20:15.779 So all the data that we see is very skewed. Yeah, 01:20:15.819 --> 01:20:18.460 I had a personal experience. I'm sorry, say again. 01:20:19.079 --> 01:20:20.960 I said, but I'm very hopeful for the future. 01:20:21.579 --> 01:20:23.399 Well, I think this is a good thing. A crisis 01:20:23.399 --> 01:20:25.800 is the perfect time to turn the ship around. 01:20:25.979 --> 01:20:28.079 But yeah, with the school thing, I had an issue 01:20:28.079 --> 01:20:31.199 with my son and he was, I mean, just basically 01:20:31.199 --> 01:20:34.220 malpractice of what happened to him and it traumatized 01:20:34.220 --> 01:20:35.760 him for years and years and years after that. 01:20:35.899 --> 01:20:38.220 So, you know, you're preaching to the choir there. 01:20:38.619 --> 01:20:41.180 Well, Nick, anything to add on this last kind 01:20:41.180 --> 01:20:46.079 of close out element? Great conversation, James. 01:20:46.180 --> 01:20:48.489 This was a blast. I appreciate you. Appreciate 01:20:48.489 --> 01:20:51.590 you having us all. And I think ultimately the 01:20:51.590 --> 01:20:53.989 pathway, which I feel like we're all in alignment, 01:20:54.149 --> 01:20:57.449 is first it's finding balance in life. If we 01:20:57.449 --> 01:20:59.350 go through a lab pathway, it's like, how do we 01:20:59.350 --> 01:21:01.550 balance our hormones? How do we balance our electrolytes? 01:21:01.569 --> 01:21:04.949 How do we balance our nutrition? And then there's 01:21:04.949 --> 01:21:07.569 these deeper tools available. Ketamine, we know, 01:21:07.590 --> 01:21:10.369 is effectively a therapy accelerant, available 01:21:10.369 --> 01:21:13.989 nationwide. Clinicaltrials .gov is a really, 01:21:14.069 --> 01:21:16.819 really great resource for... Individuals seeking 01:21:16.819 --> 01:21:21.939 legal access, legal regulated access for various 01:21:21.939 --> 01:21:26.640 modalities within the US. And yeah, I'm optimistic 01:21:26.640 --> 01:21:29.699 about the future. And I feel like this post -COVID 01:21:29.699 --> 01:21:32.819 trauma era has really been rough on society as 01:21:32.819 --> 01:21:37.939 a whole. So all we can do is build forward. Absolutely. 01:21:38.079 --> 01:21:40.159 Well, I want to thank you both. This has been 01:21:40.159 --> 01:21:41.720 a great conversation. We were kind of joking 01:21:41.720 --> 01:21:43.220 at the beginning. We didn't know where it was 01:21:43.220 --> 01:21:45.760 going to go as far as... the dynamic because 01:21:45.760 --> 01:21:47.539 i mean you've got these amazing concepts and 01:21:47.539 --> 01:21:50.159 we're kind of unpacking now what hopefully the 01:21:50.159 --> 01:21:52.399 future looks like but uh you know between david 01:21:52.399 --> 01:21:54.359 who's left us now so we won't be able to say 01:21:54.359 --> 01:21:57.699 goodbye to him um and uk and nick i just i want 01:21:57.699 --> 01:21:59.439 to thank you for such an amazing conversation 01:21:59.439 --> 01:22:01.880 and being part of the solution you know when 01:22:01.880 --> 01:22:04.199 we question the things that are broken that we 01:22:04.199 --> 01:22:07.220 we see do not work anymore and we're able to 01:22:07.220 --> 01:22:10.739 bring solutions into the conversation i've been 01:22:10.739 --> 01:22:13.279 calling calling out cowardice a lot recently. 01:22:13.380 --> 01:22:16.600 At what point do we stop burying our people and 01:22:16.600 --> 01:22:18.439 actually have the courage to stand up and say 01:22:18.439 --> 01:22:20.579 this needs to change? And I think this, you know, 01:22:20.600 --> 01:22:22.439 what we've discussed today, whether it's ketamine, 01:22:22.539 --> 01:22:25.279 the AI bot, or even psychedelics that we need 01:22:25.279 --> 01:22:27.479 to bring into the country, not our veterans and 01:22:27.479 --> 01:22:29.960 first responders have to leave the very soil 01:22:29.960 --> 01:22:31.819 they're protecting to get the healing that they 01:22:31.819 --> 01:22:35.100 need. I think it's extremely exciting. So I want 01:22:35.100 --> 01:22:37.579 to thank you both so much for being so generous 01:22:37.579 --> 01:22:39.500 with your time and coming on the Behind the Shield 01:22:39.500 --> 01:22:43.199 podcast today. Well, and thank you for all of 01:22:43.199 --> 01:22:46.960 your advocacy, too. You've saved a lot of lives. 01:22:48.060 --> 01:22:48.420 Absolutely.