This episode is sponsored by TeamBuildr, yet
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if you want to try Teambuildr, they are offering
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I'll spell that to you because it's not as you
think, T -E -A -M -B -U -I -L -D -R .com. Welcome
to the Behind the Shield podcast. As always,
my name is James Geering, and this week it is
my absolute honor to welcome on the show 25 -year
U .S. Army veteran, physician's assistant, and
one of the founders of Frontline Mobile Health,
Mike Connor. Now, in this conversation, we discuss
a host of topics, from his journey into the military,
the creation of the Physician Assistant Program
for Military Transition, trauma medicine, working
with the first responder community, fitness standards,
entry requirements, blood panels, psych evaluations,
and so much more. Now, before we get to this
incredible conversation, as I say every week,
please just take a moment, go to whichever app
you listen to this on, subscribe to the show,
leave feedback, and leave a rating. Every single
five -star rating truly does elevate this podcast,
therefore making it easier for others to find.
And this is a free library of well over 1 ,100
episodes now. So all I ask in return is that
you help share these incredible men and women's
stories so I can get them to every single person
on planet Earth who needs to hear them. So with
that being said, I introduce to you Mike Connor.
Enjoy. Well, Mike, I want to start by saying
two things. Firstly, thank you to our mutual
friend Trevor for making this connection. And
secondly, to welcome you onto the Behind the
Shield podcast today. Oh, hey, thank you very
much for having me. Trevor's a powerhouse and
such a solid guy and vocal advocate for firefighter
health and safety. And I love him to death. He's
a good dude. All those people, honestly, out
there at Pflugerville are just amazing people.
Yeah, he blew me away. We came across each other
after social media, but watching this lunatic
doing Tough Mudders in full firefighting gear,
I'm like, okay, I got to talk to this bloke.
And yeah, now he's the force of nature in a different
way. Yeah. All right. Well, then first question,
where on planet Earth are we finding you today?
So today I'm in beautiful Colorado Springs, Colorado.
It's where my wife graduated from high school
and where I promised her I'd get her back to
after. after some time in Texas with me. Well,
this is an interesting kind of side conversation
because Colorado Springs is where the National
Fallen Firefighter Memorial is. It is. We're
going to be talking about how to improve those
odds today. No, absolutely. I look forward to
it. All right. Well, let's start at the very
beginning of your journey. So tell me where you
were born and tell me a little bit about your
family dynamic, what your parents did and how
many siblings. Yeah. So I am an only child. I
had a very interesting childhood. I grew up in
Hawaii, but I was born in the Philippines. So
my dad was a Navy guy, married a Filipino gal,
moved to Hawaii. And then I was raised by a single
mom who was presented with a lot of challenges
growing up because Hawaii is not a cheap place
to live. And we lived on the bad side of the
island. And people are always like, what do you
mean bad side of the island? There's no such
thing as a bad side of the island. So we lived
on the west side. We lived in Waianae. Lately,
Waianae has gotten a lot of attention because
of a UFC fighter named Max Holloway. He's from
Waianae, Hawaii. He's done a lot of great things
out there, and I love watching him grow. But
it's a very rough part of the island. My mom
usually works two or three jobs, no siblings.
And I got into a lot of trouble. So I got shipped
out to go to live with my grandmother for a couple
of years and then came back home. And then and
then for my senior year of high school, we moved
to Las Vegas. And then I joined the military
from there because, well, I'd screwed off so
much in school and didn't really feel like I
had a purpose and didn't know what I was going
to do. Um, shipped off to the army right after
I graduated, uh, my senior year. Um, I did a
short, a short, like about a four, a little over
four year enlistment went, uh, along the way.
They're like, Hey, you're really smart. You should
try going to college. And so I went to college.
Uh, I found a passion for, um, science and in
particular medicine, wanted to go to a medical
school. And then my senior year. of, of, uh,
of college. Um, I was getting ready on the end
of my bed, brushing my teeth, watching a Matt
Lauer interview somebody. And then the camera
switched over, uh, to a plane flying into the
Royal trade center. Um, and when it first happened,
I was just like, Oh my God, what happened? And
then shortly after that, the second plane came
in and I, and, and, and I just kind of knew,
and I said, okay, well, it looks like, um, It
looks like we're probably going to go to war.
So I'm going to shelf some of these aspirations
for further education. Came back in the military,
served as an infantry officer, did a variety
of jobs there through company command, deployed
multiple times to combat. And yeah, and then
I kind of got tired of that. Um, and was looking
back at my college, you know, career and, you
know, just thinking to myself, like, you know,
I really wanted to go into medicine and the army
has this amazing program. Um, it's the interservice
physician assistant program. It's affectionately
called IPAP, Navy, Coast Guard, Marines, Air
Force, Army, all go through the program and you
become a PA, uh, amazing program, incredibly
hard to get into. Um, and just some. really top
notch, you know, special operators, combat medics,
infantry guys like me, rangers, like all of these
people that, you know, show an aptitude for medicine
and a passion for taking care of soldiers really
get into that program. And I was fortunate enough
to get in. So I was able to. do that. And then
I started my medicine career in the military
and that, and that brought me out to like 2018
where I took care of soldiers and aviators and
yeah. So that's kind of me in a nutshell up until,
up until retirement in 2018. Well, let's go all
the way back to earlier. Firstly, I'm married
to a woman who is half Filipino. So I've been
exposed to that culture. So talk to me about
some of the beautiful things about Filipino culture
that most people aren't aware of as you were
progressing through your childhood. Man, family
is so important. Family, you know, my my mom
was so busy and. working all the time, but she
brought her sister and her mom over from the
Philippines after a while. And so they stepped
in and they like, just like I was one of their
kids, you know, and my mom's baby sister was
really only 15 years older than me. So, you know,
she wasn't much older than me, you know, in the
terms of lifespan. And, you know, there's a lot
of respect, you know, in the culture, right.
You know, a lot of deference to age and wisdom.
Sometimes not so good, but for the most part
with good intentions. The food is amazing. You
know, I'm married, you know, I'm married to a
gal who grew up in Colorado in the Midwest. And
she's learned how to cook like chicken adobo
and lumpia and pancit. You know, she learned
from my mom. uh and in in just this kind of you
know i didn't have a big family growing up now
i have a big family i've got a very large family
um but it it really emphasized the importance
of like taking care of your family and and being
there for each other and that's that's probably
the most impressive thing i got out of growing
up as a child I heard, God, I'm blanking on Theo
Vaughn. That's who it was. There was a clip that
came. Happy people. Yeah, exactly. So what is
it when you reflect about that culture that creates
that? Because that's what we're missing, isn't
it? It's that gratitude. It's that community.
Yes. Yeah. My Aunt Evelyn had the best laugh
and the most infectious laugh. And I'll probably
share this with her daughter because. When I
got older and we moved to Vegas, I actually lived
with Evelyn because her and her husband worked
different shifts. And so I would take care of
Carrie Ann, my little cousin, who was only 16
years younger than me. So it's kind of the same
age gap. So it's like it did come full circle
and I was happy to do it. And Carrie Ann's probably
one of the closest relatives that I have that
I love and adore. And I feel the same way about
her that her mom felt about me. So what is it
about the culture, though, do you think that
creates that happy people element? I mean, because
even cruising, there's a lot of Filipino people
that work on cruise lines. And it's kind of sad
because they're away from their family for like
eight months, but they're sending money back.
Eight months, yeah. I just experienced that.
We were on a cruise recently and people look
at me and I look Latino. And I talk to my babies
in Tagalog all the time. I was fortunate enough
that growing up, I learned it and I spoke it.
which really messes with people when I meet Filipinos
and they speak and they just kind of look at
me and they just kind of do a dance. Why is this
Latino guy speaking to me in Tagalog? But no,
I, yeah, it's, I don't know what it is about
the culture. I think it's just the, something
in the DNA, man. You know, like there's just
something about those people that they're just
so happy and they're so loving and they're so
generous too. like they will just give you the
shirt off of their backs like anytime i when
we first moved to colorado springs we we put
our boys in tutoring and and like the the lady
at the at the at the center that we was was doing
the tutoring um you know Found out I was Filipino
and we started talking and she was like, oh,
here, you got to contact this person. You know,
this is a restaurant and like these people will
take care of you and all these other things.
And I just absolutely loved it. It was it was
awesome. But, yeah, I don't know what it is about
the people. I think it's honestly just this village
kind of culture that this tribal kind of culture
that we've gotten away from, especially with
like these types of things, you know. um there's
a great book by sebastian younger called tribe
um i you know you're smiling because you've probably
read it yeah he's been on the show five times
now i think oh that's right i saw that yeah i
saw that he's amazing and um and that yeah i
i love that book and it and it it tells such
a beautiful picture of you know and it's the
same thing in the military and in the fire service
you know right like those your houses are tight
Right. Like, you know, shifts are tight. Right.
There's always this inner shift competition.
Same thing in the military platoon versus platoon
company versus company. A lot of that is free
decor and loyalty and lifting each other up.
And it helps you. It helps build resiliency,
which he describes so beautifully in that book.
So I think it really has a lot to do with that
kind of that tribal or village culture that a
lot of Filipinos. find themselves in in their
families you know because filipino families man
like they're huge right like my mom had like
seven sisters right or six sisters and a brother
and um and each of them have like six kids each
right so we have like these massive families
that are just like you know tunnel and dichos
running around and later south of manila um but
yeah it's it's it's bonkers but i do really think
it boils back to that kind of that tribal village
kind of culture yeah 100%. The other thing is
the aging. My wife is already six years younger
than me and she's half Filipino. So, you know,
we joke that people think that I'm some creepy
old dude that got her in a catalog. And that's
actually the opposite. I'm the immigrant and
she got me from a catalog. It's awesome, man.
Yeah. All right. Well, then you mentioned about
your father not being in the picture. You know,
so many of us have struggles. in our early life
and that sends us into uniform. When you reflect
back now, because usually there seems to be a
common denominator with when people find themselves
on the good path, despite some challenges when
they were younger, there often is a mentor or
several mentors that were able to steer them
the right way. When you reflect back now, were
there those key figures in your upbringing? Man.
So, yeah, you know, there was a guy named Mike
Baker that that was really influential in my
life. My mom, my mom was with him for a while
and, you know, they split up eventually. But
he, you know, taught me how to work on cars,
taught me how to swing a hammer, taught me about
discipline. He was a he was an entrepreneur.
You know, he had a patent for a device for a
Harley Davidson so that you could check your
oil without having to like, you know, pop the
bolt off the oil pan and like check it manually.
He was just always thinking and always working
hard. And I always thought to myself, like, man,
that guy. that guy has it together you know he's
he's getting his stuff done he's very disciplined
worked really hard he was an electrician he worked
in trades um and yeah so when when i think about
positive male role models he's the first person
that i think about that taught me a lot about
you know the grind right like just getting up
in the morning going um you know, doing what
you said you do, getting, you know, finishing
projects on time, that sort of stuff, that really
impressed me as a kid growing up. And when I've
had a chance to reflect on that, he has been
the person that really comes to mind. Well, going
back to, you know, what you're talking about
with Filipino culture, you know, this is what
we're missing now. And, you know, Sebastian's
book is absolutely spot on. And there's a lot
of... judgmental narrative when it comes to young
people that aren't headed in the right direction.
It's always these broken families. It's like,
well, those children didn't get to choose the
fact that their families are broken. So the solution
is the mentors then. So for each one of us that
are in our homes, hopefully we've been able to
be good parents and good loving husbands or wives.
The next step is to step outside your front door.
and be that mentor for someone else in your community,
whether you're a sports coach or, you know, a
firefighter or whatever it is, fill that gap
rather than standing on an ivory tower saying,
well, that family's, you know, disintegrated.
That's why that child is a problem. Yeah. Pointing
fingers at problems never like that does nothing.
Right. Like it does absolutely nothing if you
have to get involved in these sorts of things.
Right. And, you know, my wife and I, we try to
support in each way that we can. You know, we've
we've we've looked at or we've applied to becoming
like a cadet sponsor for the Air Force Academy
out here so that they have a family. You know,
we we try to get involved as much as we can.
you know before we moved here and the company
got too big i used to coach jiu jitsu and judo
for my last gym um and specifically the kids
right because i i like kids are so malleable
and they're so impressionable and you know one
of the things i would always try to work on with
them is like hey you know your parent brought
you here make sure you tell them thanks right
because it takes a lot of time out of their day
um and and yeah i know i wholeheartedly agree
like getting involved Rather than pointing a
finger, you know, kind of helps us progress forward
as opposed to just kind of sitting around. And
like you said, sitting in an ivory tower and
it's like, well, that's why it's all messed up.
Right. Exactly. Well, speaking of sports, what
were you playing and doing in the school ages?
Oh, man. So a lot of basketball, as most Filipinos
do. Right. People don't think about it. Right.
But like, you know, Filipinos love to ball. And
they're good, man. They've got a wicked crossover.
They can shoot from the outside. They drive through
the paint. So played a lot of basketball, surfed
and boogie boarded a lot. And that was really
it. You know, I didn't do a lot of team sports.
I remember being young and asking my mom if I
could do a team sport. And it required a physical.
And her biggest concern was that I would get
injured. and and break something and we didn't
have insurance growing up so that was always
the fear so that was it you know it wasn't to
me it wasn't a fight worth fighting so i would
just play streetball right i'd always i'd go
surf or do something like that um so yeah those
were the things that i did i skateboarded a lot
man i skateboarded so much course that's like
the natural thing to do when you grow up in hawaii
right like you surf you skateboard you do all
those things i don't know if skateboarding is
safer than basketball though yeah yeah yeah i
don't know well you mentioned about you know
joining the military you know you're in this
medical program and then the towers yeah so kind
of walk me through what that looked like through
your eyes then um i had plans you know i wanted
to I was looking at going to medical school,
possibly doing a combined PhD program because
I was enjoying research as a senior in college.
I worked in a forensics lab my senior year. Throughout
college, I did a ton of odd jobs. I bartended.
I waited tables. The old GI Bill was not nearly
as robust as the post -9 -11 GI Bill. I think
it got like $250 a month. Um, and then I took
a scholarship from the university, uh, that was
a campus -based ROTC scholarship. Um, but so
you still had to work and survive, right? Like
it wasn't, you know, it wasn't like the new,
you know, the new GI Bill, which is fantastic.
And I think it's a great program for veterans.
Um, so yeah, I had all these plans and then watching
all of that happen, kind of, um, you know, you,
you go through this shock, right? You, you go
through this. really kind of helplessness um
and then you know as you as you span the emotions
and you go through it you you you think to yourself
okay well i have to contribute i have i have
to give back um i want i want to do more and
so that's kind of where i was and that's kind
of that was my thought process as it happened
and then um and then yeah you know um These invisible
strings just tug us to different locations as
we go through the motions of our careers. And
you meet people along the way and they influence
your career and you meet another person, influence
your career. Yeah. So where did you find yourself
deployed? Iraq and Afghanistan. So the initial
push into Iraq. Hang on real quick. The initial
push into Iraq for. uh the first democratic re
-elections um then you know deploy refit deploy
military schools along the way um pa school afghanistan
um and then uh after afghanistan I honestly thought
I was in the free and clear until I retired because
they were doing these redeployment cycles. And
then they hit me one more time. They're like,
hey, you need to go to Korea. So I went to Korea
one last time just before I retired. But yeah,
just Iraq and Afghanistan. Baghdad, outside of
Baghdad nearby. And then Afghanistan at Fob Fenty
on the eastern side of Afghanistan. A kind of
reoccurring theme for people that went to Iraq
early was initially they were received really
well by the locals. And it seems to be the longer
we stayed, the more people changed. So what was
your kind of perception of that reception? So
one thing I was not mad about with regards to
changes was how the living conditions improved.
it did take a quick change right like you know
we we went from like this big push into an insurgency
um and the insurgency got really dicey right
they you know they weren't you know quote unquote
playing by the rules anymore um this became a
counter -insurgency fight as opposed to you know
what we had spent everything after the gulf war
was still focused on these big peer -to -peer
fights and now you're fighting this war where
you know Some dude in pajamas could come around
the corner and, you know, light you up or trigger
an IED and you wouldn't even know it. So, yeah,
it was it was it was a big change. I think the
people, the people who were there that wanted
to embrace the regime change really enjoyed it.
Um, and we're really supportive of what we were
doing as we came in, but the longer our presence
lingered without, and, you know, I'm not a strategist,
right? Like, so I'm, and you know, I wasn't in
the rooms making these decisions, but the longer
we stayed, the more we got ourselves involved,
the, the, the less our presence was tolerated.
It's just, I think it's an important conversation.
It's the same with COVID, you know, I, during
the whole. COVID period, everything I was putting
out was how can an individual improve their own
health? That's the one truth, whether you choose
to have a vaccine and your response to that immunization,
whether you choose not to, your natural immunity,
the healthier the people, the higher the chance
of a healthy outcome. And the end of the COVID.
No one wanted to learn any lessons. They swept
it under the rug and they would just want to
pretend it never happened, you know, and then
move on. And it's the same with war. After 20
years, it's important that we do have these conversations
and hearing. Yeah. Yeah. How do you prevent future
mistakes? Exactly. Yeah. Yeah. I mean, even with
Afghanistan, you know, the number of people that
said, well, you know, A, we should have gone
in with SFSO. communities you know be kind of
surgical with our our you know strikes remove
the key people remove the training areas and
then get out and the same with with iraq um and
uh so yeah and it just it makes perfect sense
to a complete ding dong like me that's never
been in the military that yeah the longer you
stay the more it feels like an occupation for
those people the more enemies you're now creating
Yeah, yeah, yeah. And then you're telling them
how to run their government, right? Like you're
not giving them the autonomy that they want to
have. You're influencing policy and you're changing
generations of learned behavior and hoping that
they're just going to embrace it. So odds are
they're not. Yeah. Well, even with Afghanistan,
one thing I heard over and over again was also
the tribalism. There was a misunderstanding that
it wasn't a country. It was a group of tribes
that weren't necessarily communicating with each
other. Yeah. Yeah. Yeah. I mean, to a degree
they do. Right. But like, who's the one doing
the communicating to, right? Like that's, that's
the other thing, right? It's, it's not, people
have a hard time understanding the world over
there when, you know, I can walk outside and
do whatever with my cell phone, right? Like I
can surf Facebook, Instagram, you know, call
my cousin in Alaska and get an update, you know,
call friends in Hawaii and see how the tsunami
is over there in real time. But that's not accessible
to everybody. We've made things so accessible
in Western society that we've gotten used to
receiving information at such a fast rate that
we can make a little bit better or informed decisions.
But over there, that tribalism, they may still
be sending messages by freaking courier, right?
Or they have cell phones set up, but there's
only key individuals with cell phones. That's
a question I always ask anyone who was deployed,
excuse me, deployed during combat. And the reason
being, when you look at American media, you get
a very polarized, you know, kind of feed when
it comes to war. Either, you know, the one extreme
is kill them all, let God sort them out, stack
in bodies. The other side is they're all baby
killers. And in the middle are the men and women
that we send overseas, you know, wearing our
flag on their shoulder, you know, to protect
the people that they're serving. So the first
is a two part question. The first part, regardless
of the politics, regardless of the information
that sent you into these countries, were there
moments where you realize that within those nations,
there were some horrific people that did need
to be addressed? Oh, yeah. Yeah. Oh, yeah. Yeah.
No, I mean, what comes to mind was a police station
bombing that like, you know, killed dozens of
innocent people that were bystanders. um, you
know, like it's your own countrymen, right? Like
it's your neighborhood potentially, and you're
doing things like that. And you just have to
really ask, you just really scratch your head.
Like what compels a person in, in that area to
do things like that, right? Like, um, yeah, no,
I, I totally agree there. There were some very
evil people with an agenda that had the power
that did not want to lose the power. And we're
grasping at straws and doing things that were
unconscionable just to get those things done.
What was the contrast for you between Iraq and
the way that civilization was and Afghanistan?
Man, you know, in a lot of ways, Iraq was a lot
more modern than the area of Afghanistan that
we were in, you know. You know, accessibility
was really a big issue, too. You know, like you
don't have the terrain obstacles that you do
in Iraq than you do in regions of Afghanistan,
at least the area that I was in. Right. Like,
I mean, we you know, it wasn't traveling through
mountainsides on frickin, you know. barely six
feet wide trails you know i mean i would go and
visit some of our medics on another fob because
they were kind of isolated and some of our people
on another fob and i would take you know we shuttle
aircraft over there like i just take a helicopter
right over the mountain ridge and then come back
otherwise it'd be a forever ride right down an
area that could be potentially riddled with ieds
but uh you know it's to me it was the geography
and um you know probably i feel like that geography
probably played a lot in terms of that tribalism
that you were discussing earlier right like as
if it's over the mountain and this is your plot
of land you should you know probably not too
worried about the other side of the mountain
yeah it's interesting i've never never even thought
about that but that makes a lot of sense What
about kindness and compassion? This is the other
side that we don't hear on the media, which is
whether it's the kindness and compassion of our
own military or whether it's the indigenous people
that we're working with. I was very rarely met
with people that were not kind or compassionate,
giving you gifts, having dinners with leaders.
with very lavish like food organization. Right.
And, um, yeah, I mean, the, the people there
were really kind and, and, and, and that same
token, like, you know, the guys that I was over
there with too, were just as kind to, you know,
sharing MRE candy, sharing candies with kids
and, you know, you know, like the, the little
kids in Iraq running up to you going, Mr. Mr.
Chocolate. chocolate mister you know like asking
you for chocolate and stuff um yeah so i mean
it just became one of those things that are normal
now you know there were other times you go out
on patrol it'd be like a little i remember sewing
up a kid who got who took a rock to the face
you know because he's sitting in the back of
his patrol vehicle like driving down the street
and like you know some little some little badass
kid just like chucks a rock at his vehicle and
it hits him in the face And, you know, the amount
of restraint required to handle that too, when
you're 19 years old and you're behind a gun system
is pretty incredible. But, you know, you see
both ends of the spectrum, I guess is what I'm
trying to say. But I think for the most part,
we saw more kindness than we did, you know, ill
intent, especially from the younger kids. Not,
you know, I... I can't say, I can't, I don't
know that I can say that about some of the adults
that we ran into. Yeah. It's an important perspective
for people to hear though, because again, you
know, they're painting as the boogeyman, you
know, and you hear so many of these stories and,
you know, these, these families, you know, dad's
fixing the car and mom's in this particular case,
making dinner and the kids are out kicking a
football. And that could be England. That could
be America. It could be anywhere else on the
planet. Yeah. Yeah. No, I, I, I totally agree.
Right. Like what would happen if, if we were
suddenly invaded and occupied? Yeah. A hundred
percent. Well, you mentioned Korea as well. So
talk to me about some of the interesting elements
of the Korean culture you're exposed to. And,
you know, if any threat. Super, super friendly
people, very active people. I was always impressed.
So my, my last, you know, I was there from 2016
to 2017. And I was with a good group of guys.
I worked in the division surgeon's office and
we would hike something every weekend. And man,
Koreans just have the most amazing trail management
system. And you would see like people in their
70s and 80s just cruising up these massive mountains,
you know, in the middle of summer, in the middle
of winter. always friendly, always greeting you
with a smile, happy to see you on, on the road
with them. Um, you know, they're, they're not
big on a personal space, right? So you get on
a subway and like, you'll be crammed like sardines.
And I remember, you know, a couple of my buddies
were just like, God, they're so close. Like it's
a culture, man. Right. Like this is, this is,
this is normal for them. Right. Great public
transportation system, amazing food. Um, lots
of, uh, just lots of like kindness and, you know,
a lot to me, a lot like, you know, Filipinos
are pretty kind and happy to engage. If you,
if you made an attempt to converse with them
in, in Korean, they would just be over the moon.
You know, they just like, Oh, you're trying,
you know, like here, let me feed you. I mean,
let me do some stuff for you. Just really, really
good people. And I never had a bad experience
during my time there the entire year. Like it
was just amazing. It sounds a lot like Japanese.
I lived in Japan for 15 months. And yeah, if
you go to Tokyo or somewhere where the dudes
with the white gloves are pushing you all onto
the train. Yeah. Yeah. What about the potential
threat? I think this is what's so sad about Korea
is, you know, again, like Germany was, you know,
you've got this. country that's cleaved free
nation in the bottom and then these indoctrinated
you know brainwashing in the north from what
we understand from the messages that we're getting
at least so what was the conversation about differences
and even the threats from up north uh no they
took them very seriously you know it wasn't you
know the further north you go in korea the less
sparse you know the the less populated it becomes,
right? Because everybody knows that that area
of Korea is just a giant speed bump before they
get to Seoul, right? If they were to ever make
a very large push down, they just know that all
of those areas up front, it's kind of like our
forward line of defense just becomes a speed
bump for that push on the way down. So the threat's
very real. You know, they take it seriously.
You know, we, you know, we did exercises all
the time in Korea just to kind of prepare war
game, you know, medical readiness. Like, what
was your, you know, you know, medical readiness
was huge over there, which is, you know, part
of how I feel like what we do as an organization.
is different than what other organizations do
is because we just kind of understand like it's
really important that you understand who's fit
to fight who's ready for war um because it's
not you know as the saying goes you don't get
to fight the army you want you fight the army
you have um and so medical readiness is a key
component um up there and played a big portion
of that that job that's an interesting aside
because you mentioned you know the the kind of
overall fitness of the nation. And when I think
of a Korean populace, I think of a pretty fit
group, even their fire service. And then you
contrast conversations I've had with Dan Bernstein
and some of these other people about the struggle
to find candidates for the military in the US.
And you look at the fact that we are 70 % obese
or overweight as a nation. There's this kind
of mythology that regardless, you're just going
to dip into your gun collection and be, you know.
billy badass when the when the ruskies come or
whatever happens but the reality is the the more
unfit the nation the more vulnerable they are
to attacks from other nations well the the what
is it the the joint chiefs penned a paper back
in was it 2012 2014 i can't remember when but
they identified it as a threat to national security
growing the growing obesity the growing childhood
obesity rate and it's the truth and we talked
about it you know at the last international physical
employment standards conference we had which
was out at oklahoma state university that i attended
um it's not you know it's not just a us problem
it's a problem in the uk it's a problem in australia
um you know one of the one of the folks talking
there rob had mentioned not only is it a Is it
a like obesity problem? It's really a physical
fitness problem. You're getting recruits that
are coming in who've never run, who've never
played sport because it's not mandatory or not
required. And so just moving their body is challenging,
right? You have these like biomechanical disadvantages
because most of their life has been sedentary.
Was that Rob Wilkins speaking? No, it was Rob
Orr out of Bond University. Okay, yeah. Yeah.
Rob's a very, very prolific author. Lots of research
on load carriage and just all around great human
being. That's someone I need to get on. Wasn't
he one of the first people that was kind of focusing
on the whole tactical athlete concept too? Yes.
Yeah. Him and Jay Dawes. Yeah. Him and Jay Dawes
are big tactical athlete guys. I've been talking
with Rob a lot and Ben Schramm and Elisa Canetti
down there. I'm looking forward to working with
them more. Fantastic. Well, let's talk transition
then. Firstly, the PEA program, if I'm not mistaken,
it's amazing how much I've learned just doing
a podcast. Yeah. Wasn't that specifically, firstly,
it was a military program that then ended up
in the civilian side. Wasn't it also to set you
guys up for transition? Have I got that right?
You're absolutely right, man. It's great that
you know that. That's the history of the PA profession
was founded by a physician who recognized you
had a group of hospital corpsmen and combat medics
coming back from Vietnam who were able to sustain
combat casualties that would be beyond definitive
care and sustain them for, in some cases, days.
And it was just a skill. you know and and these
guys were coming back and there was nothing for
them once they got back right like once they
got back if you told somebody you're a combat
medic you couldn't even get a job at a hospital
right i was like okay that's nice cool um so
he started the first pa program at duke university
and uh and that that was the the birthplace of
our profession as pas and then um you know the
military obviously you know they they have a
They have a tendency to kind of lead the way
in terms of like combat casualty care and trauma
medicine and some of that stuff. So they quickly
adopted that program and that's how it came about.
But you're absolutely right. It was initially
started as a transition program for medical extension
of services for physicians. I actually got my
degree in University of Florida and it gave me
all the prereqs for the PA program, but I didn't
go ahead because I... Ended up having a podcast.
It took me a completely different route. If I
was going to come out of the fire service, that
probably would have been what I would have done.
Well, then talk to me about the transition itself
then. A lot of people, you know, they struggle
with that and going back to Sebastian, you know,
the loss of purpose, tribe, you know, identity,
et cetera. How was your transition and did that
PA program improve that transition process? I
think it absolutely would have, right? Because
otherwise, I probably honestly might still be
in if I didn't transition to becoming a PA. Because
I was doing fairly well as an infantry officer
in the Army. I held a lot of good key positions.
But I knew I was fortunate enough to have the
foresight, I think, that after I... Um, I, one,
I wanted to get back to something I was passionate
about, which is medicine and science. And then
two, um, I, you know, I, I don't know that I
could write a desk for the rest of my life. I
see that as I spend most of my time behind a
desk now. Um, but so the, the transition really
did help, right. Because after I, after I got
out, um, shortly after I got out my, uh, my business
partner, um, you know, offered me ownership in
the company and, um, some purpose and, and also
like dealing with essentially the same population
of patients. Um, firefighters are a lot like,
you know, service members, right. They, you know,
they, uh, you know, they just, they just want
to do firefighter stuff and, you know, they just
need to be cleared and you have to talk to them
a particular way. Um, can't bullshit them. Right.
Like they know bullshit when they see it. So
that's kind of a, it's kind of a core corporate
quality that we have in the organizations. Like
don't bullshit your patients, right? Be honest
with them. And yeah, you know, it's just, and
it's, and typically, typically they're willing
to listen and implement things. you know i didn't
have the same experience working in civilian
medicine when i did work in civilian medicine
i would moonlight sometimes and go work urgent
cares or primary cares i spent quite a bit of
time as a neurosurgical pa um and you know you'd
have conversations with people and you could
just tell us like in one near out the other right
but if you talk to a firefighter about improving
their health about you know showing them like
hey these are the steps you need to take you're
able to take time with them they're a lot more
open that conversation than you know the gen
pop i feel so give me the origin story of frontline
mobile health then that's a good one so it's
really weird right so i talked to you about these
invisible strings so they just kind of tug you
into different places um so you know i became
a pa uh i after i got back from afghanistan as
a pa I needed to do a career change. And so you
look for different types of job opportunities.
I was interested in aviation medicine. I wanted
to be a medevac PA and work in a medevac unit.
And so I started working towards that. And I
had a boss. along the way who told me he was
supportive but behind my back from one of my
buddies i found out uh he was kind of shutting
up shutting down my opportunities so i had a
comp so i was supposed to move to the unit like
six months ahead of time but i never did because
i had this person in the way and i probably wouldn't
have met my business partner right if i'd have
gotten there earlier so fast forward i finally
get to the aviation unit Go to aviation medicine
course. My roommate, who's supposed to be my
roommate, can't get his funding memo done in
time. So Ross ends up being my roommate just
by chance. And we hit it off, right? Like we
get along really well. He's such a likable person
and he's so passionate about medicine. And he's
just he's just a good dude. And so I bring him
into our unit. Right. And one night. As he's
moving to Fort Hood, getting his family settled,
his wife wants to make friends. And so he has
a dinner conversation with some new friends.
And one of them is a battalion chief at a fire
department. He's like, hey, what do you do? And
Russ is like, oh, I'm an aviation medicine PA.
I work with aviators. And he's like, hey, what
do you do? He's like, I'm a battalion chief at
a fire department out here, right? So AJ and
Russ have this conversation. And AJ, you know,
Russ explains like, hey, so what we do is like
we just essentially clear aviators for flight.
Right. Like we make sure that they're healthy,
they're safe, they can perform all their functions.
They've got no disease. We do a screening on
them annually. And AJ's ears kind of perk up
and he says, hey, you ever thought about doing
that for the fire service? And, you know, Russ
was like, no, I never even considered it. Right.
Like I'm a flight PA. Why would I even consider
that? And then shortly after that, like Russ
gives me a call and I swear it was like, you
know, he was in a panic or somebody said, hey,
meet me at Alamo Drafthouse. I got an idea for
a business. I want you to like I want to talk
about it with you and I'm going to need your
help. So he tells me about this idea. And this
is like right at the time. And I'm going to Korea
for one of my terminal assignments. And I have
to tell him, I say, hey, man, I'd love to help
you, but I can't because I'm going to Korea.
So obviously Russ and I keep in contact throughout
that time. And then I get done with the military
and I retire. I'm out of the military in like
July. I go on like this crazy climbing trip with
a buddy of mine. And we just hang out like, you
know, in Colorado and Washington and British
Columbia climbing. And then I finally get back
to Texas, settle down. And Russ says, hey, why
don't you come to the clinic? you know about
that place i was telling you about so i can talk
to you so i watched him do a physical for a firefighter
we chat afterwards and that's how i got roped
in to uh to working with frontline because ross
was going to go to afghanistan in about nine
months and i needed to run the company while
he was gone um so the timing was actually perfect
right like again those invisible strings in the
meantime like during that time i was actually
going to go work for an orthopedic company doing
ortho trauma But I decided not to because I wanted
to take a chance on Frontline and it seemed more
appealing to me, working with firefighters and
chatting with people and being in the community.
What were some of the misconceptions that you
had about my profession that were kind of myth
busted when you started seeing the people walk
through the door? Y 'all are healthy. probably
probably the first one right probably the first
because the first thing people think about whenever
you say you're a firefighter is those damn calendars
right exactly six pack yeah those damn calendars
and uh and no you couldn't be further from the
truth in some cases right like there's some pretty
unhealthy people um and uh so that was probably
the first one um the second one is that uh you
know, you guys are fighting a fire every day.
And it's like hard -ass work, hustling all the
time. And I'm not saying that you don't, right?
Like I don't want people in the audience to send
me hate mail or anything like that. I'm just
saying that like you go through these undulating
phases. And, you know, and I think that's where
health really plays a important role in physical
and mental resiliency. Um, because when you hit
those high points of operational tempo, you have
to have the physiologic reserve to manage those
high points. And the only way to do that is by
staying healthy. Right. Um, so that was, this
was number one, healthy. Number two, like you
guys were always hustling and like, you know,
doing all kinds of crazy stuff. And then number
three, I think the biggest one was, uh, all you
do is fight fires, right? Fight fires and like
take care of the motor vehicle accident stuff.
Like the amount of ridiculous stories I've heard
from firefighters for calls that they go on has,
yeah, mind boggling, right? Like the utilization
of EMS services is almost like pitiful in terms
of like what, you know, what firefighters get
called out to do sometimes. And I feel bad for
y 'all for that. One of my. You know, funniest
slash most frustrating calls I ever ran on. And
there was a slight psych element to this, but
it was one of our frequent fires. And he called
because he just got new dentures and he didn't
like the taste of them. And then he starts being
belligerent. So not only do I have to take him
to the hospital because he requested to go to
the hospital, I have to take a rider to another
firefighter. He was a big lad. Because if he
loses his shit, then we got to, you know, tie
him down and drug him. Yeah, restraints, right?
Do him with a B -52 or something. Exactly, exactly.
So the magic cocktail. Yeah. So, well, then what
about as far as, as you started talking to them,
understanding the kind of work week, the shift
cycle, the magnitude of their work versus, you
know, again, all they do is sit around and, you
know, smoke cigarettes and play cards. Yeah.
So that's like, that's probably the thing that
I've noticed across, you know, taking care of
firefighters in multiple states is that, man,
y 'all, you don't have, so, okay, let me break
this down. So number one, the schedules are crazy
to me, right? you know west coast schedule kelly
schedules 24 48 48 96 is um you know modified
kelly whatever you want to call it um it does
not long term there's consequence right there
is there is consequence to these things and when
you're young and you're physically resilient
because you have great physiologic reserve you're
probably going to handle it fine. Right. But
you know, it's like radiation, right? Like it's
not, it's not the first dose. It's the accumulation
of doses over time that start to really break
people down and, um, where their health really
starts to fall apart. Right. And we see it, we
see it, right? I think there's, there's tons
of literature out there that talk about cardiovascular
disease and cancer rates and, and, and, you know,
in public safety. And, um, And I think the shift
thing is really a big component of it. And I
don't have a good answer for it. You know, you
can talk about 24 -72s, right? You know, that
might be a healthier option for people. But I
think that's also kind of situationally dependent
too, right? You know, we've got a paper brewing
right now. looking at 2448 transitioning to a
4896. And for this particular department, it
improved their systolic blood pressure whenever
we looked at the analysis and it didn't really
affect anything else. And they had some mild
improvements in their sleep, but it's a small
department, right? So single station department
and their average overnight call rate is 0 .9.
you know so that's not bad right like that's
not but that's not going to work for a large
metro department who's getting called out twice
in the middle of the night um twice that's a
good shift yeah yeah yeah great shit so but but
you get my point right like i i think i think
sleep is the slow ticking time bomb um that impacts
a number of things and then and then the environment
right like Because if you get into an environment
where like, hey, we're going to go to Whataburger
for breakfast, lunch and dinner, probably not
a good idea. If you get in an environment where
like, you know, fitness isn't a priority and
that's where policy kind of comes into place,
right? Where fitness isn't a priority, you know,
it's just going to, you know, it's just going
to keep chopping legs out from underneath you
in terms of building, you know, some physiologic
resiliency. Yeah, I mean, the one study, I don't
know if it was the Joel Billings study that you're
talking about or if you're doing your own, but
what they found with the 4896, what Joel found,
the same exact thing, you know, tiny department,
less than one call a night. So basically zero
a lot of times. And the actual benefits were
that second 24 of the 48 and where they were
comparing it is because when you got up to go
to work. You were sleep deprived because you're
getting up at 5 a .m. Like a lot of us do to
get to the station on time because we don't live
anywhere near where we work. We can't afford
it. Yeah. So that is mitigated for free by changing
the start time. Because if you do it. Yeah. I
talked about this before. I've talked about this
before. Why don't you start in the evenings?
Well, not even think about this midday. Yeah.
I mean, any any point where you can complete
like, you know, the requisite sleep cycles and
get your requisite rest, you know. i i i've always
thought to myself like midday or afternoons are
great because like you come in right you do your
checks do your shift change and then you go to
bed right like you you know you go to bed if
you ever sleep cycle over and then you get off
shift get home you're able to be with your family
for dinner and You know, those those things,
those types of things make the most sense to
me. Just altering the time at which you do your
shift change would be great. I know some departments
that we've worked with have recently changed
that. And by some, I mean like a very small percentage
because they have they have kind of noticed that
and they've listened. But, you know, those it's
little things like that that can improve, I feel
like, you know, the overall health of organizations.
Yeah. I mean, the. if you did it at 11 a .m 12
you know because i don't know if other people
listening have the same if i've got to work in
the evening i can't relax that day because i
know i'm going to go to work so but you missed
rush hour you actually get to wake up you know
with your family have breakfast take your kids
to school whatever and then you go to work and
then if you're off going you don't have to wake
up at 7 a .m for shift change you can sleep if
you if you had three or four calls at night sleep
till 10. everything's checked out if you don't
get a call now you don't end up being a smear
on the side of the freeway when you're trying
to drive home and you end up wrecking your car
so it's yeah it's a win -win and then with the
2472 you know it really boils down to you know
a lot of departments do run so that right hands
down is the best one the quiet ones it's like
you know military members in you know a hospital
clinic No one's complaining that they're not
taking grenades and RPGs at work. That's what
happens. But each of them deserves to be at home
with their family the same amount of time. So
even if you are a quiet department, why does
a banker go home after 40 hours and the firefighter
has to work 56? So I think that's... That's the
answer. If you're quiet, awesome. Then you'll
be training more and you'll be holding that fitness
standard. But I think that one of the biggest
mistakes we make in the fire service is we hold
the number of calls that we went to as a metric
of our worth when if you're quiet, then you're
just offsetting that with training to be prepared
because, for example, how many of those horrific
school shootings happened in very, very sleepy,
small towns? Yeah. Yeah, no, those are, I mean,
those are great. Those are great statements.
And I totally agree. You just have to, you know,
it's a, you're, you're having to change a lot
of, you know, what I call like generational dogma,
right? Like they're just this thought in place
that like, no, we can't do this. We can't do
that because this is going to happen. It's like,
well, now we're in this big age of collecting
data, right? Like, well, let's collect the data,
right? Run a trial run. Right. Like, I mean,
there's nothing wrong with that. Run a trial
run and see how your members feel. See how, you
know, things shake out after that. And the problem
is always funding, you know, but there are sources
for grants. There are sources out there that
just take some work to get to. um that you can
do those types of things well what's interesting
with most departments is because we're in a recruitment
crisis the money's already there but it's downstream
it's the overtime it's the lack of retention
it's the workman comp claims it's the you know
the lawsuits so it's a it's a short -sighted
fiscal you know and how do you mitigate that
right like it's it's this vicious cycle really
right like you talked about it right it's the
overtime it's the workman's comp right well why
is overtime and workman's comp happening it's
because you have an unhealthy force that's getting
injured um that's probably tired but if you implement
some of these changes ahead of time that stuff
starts to trickle back into the budget, right?
Like you have fewer days off because of workman's
comp, right? Like, you know, annual health and
wellness screenings, right? The biggest obstacle
to all of this is funding some of those things.
But when you're able to paint a clear picture
to the risk management people, because those
are really ones that are holding the purse strings,
right? It's all the risk management people. Whenever
you're really able to like, paint this clear
picture of like hey this is how we can reduce
our time right like people also talk about like
embedded strength and conditioning specialists
for departments you know like man those are those
are worthwhile investments that pay big dollars
in the long term you know when when you look
at large organizations that are spending millions
of dollars on work comp and staffing um man those
millions of dollars can be used in other areas
just just allocate a little bit of that and just
you know bet on the program and run it and then
do an analysis afterwards and be able to prepare
that data for risk management cd council so those
things can get approved like hey look this is
how many work days we saved compared to last
year because we implemented this program and
then you know you know when when it's black and
white like that when it's objective information
it's hard to refute When it's a gut feeling,
people will poo -poo the idea all day long. It's
interesting. I was just talking with a guest
yesterday about this. There was a news article
recently, and multiple agencies have reported
on this. The LAFD, over three years, their overtime
budget, this is FIRE specifically, overtime budget
was a billion dollars with a B, over three years.
So when you look at the recruitment crisis, you
know, there's a reason why young people aren't
becoming firefighters anymore. And it's what
we're talking about. These young people have
access to all things health, all things mental
health. They understand the importance of relationships,
being home. So when you start addressing that,
because it's only 10 years ago where we were
testing against thousands and thousands of people
for 10, 20, in my case, it was 30 jobs, a thousand
people at the written test, the 30 jobs. So it's
not like, you know, it was recent that we had
that kind of demand. We've just screwed, you
know, by not changing everything, you know, with
this information age exploding. And it was interesting
because I just did an AI search the other day
on the 2472. And for the first time, AI starts
talking about all the health benefits, all the
financial benefits. So this is what, and if you
Google, is it healthy to be a firefighter? Everything
that comes up is all the things that we die from.
So when you talk about data. I mean, you know,
just look at any firefighters Facebook or Instagram
feed. It's nothing but black bands on, you know,
Florian. So, you know, there's such a beautiful
opportunity to turn it around. And most agencies,
the money is already there, but it's downstream.
And what baffles me is why those financial gurus
in cities and counties aren't the ones coming
to the fire departments and saying, what is going
on with this overtime? There must be a better
way of doing this. But it's the checks. Yeah,
there's hats on, cutting checks, right? Like,
yeah. And I think, you know, one of the proposed
changes that was discussed at IPES, the International
Physical Employment Center, I'll just call it
IPES from now on, that, you know, we had like
these group conversations like, hey, how do you
fix this recruitment for the tactical athlete
population, for the military, for the fire service,
for police? And, you know, like the smartest
idea I heard that came out is that like you need
to have a pre -academy academy. Like, you need
to have a conditioning phase before they get
there, right? Like, you need to show them how
to move their bodies, how to lift properly, you
know, shed some pounds, right? To get them to
be capable of joining. You know, culturally,
we probably just need to encourage our children
to move more. You know, like, my boys, you know,
my kids. they can't be in the house all day like
i'm kicking them out hey go get on your bike
go to the store like go fishing at the lake down
the road um get outside get some sun you know
keep your phone on you so like i know i can get
a hold of you if i need to get a hold of you
um and there's nothing wrong with that right
like that's just something that for some reason
we've just kind of gotten away from and uh and
we need more of it like they need to run they
need to play and then that slowly starts to mitigate
these issues that we're having in recruitment
right it's just that you have to introduce it
now to this generation so that in you know the
next generation isn't struggling through it again
um because yeah we've we've sort of created a
mess in terms of the recruitment pool at the
moment uh, by not focusing on these things that,
you know, guys from, you know, I, I hate sounding
like a crabby old fart, but like, you know, back
in our day, right. Like drinking from the hose
and running around the neighborhood and, you
know, staying out. So the, you know, streetlights
came on was totally a normal thing. Yep. Yeah.
And this, uh, watching my son, um, he ran cross
country, then he ran track. He did JROTC, but
there are some phenomenal. young people that
would be incredible firefighters police officers
and they i've talked about this several times
on here that i think it was a wall street journal
did a piece on how gen z is going into the trades
because the same way they're learning about how
shit it is to be a firefighter at the moment
not the job the working environment i adore i
adore the profession it's the same with with
university they're like wait a second you know
sixty thousand dollars in debt for a piece of
paper that doesn't guarantee me a job That's
ridiculous. I'm going to go learn to be a welder
or I'm going to go to PA school or whatever it
is. So that's fantastic. They're there. You know,
a lot of them are in good shape. There are great
mentorship programs, the one locally here for
firefighters, where you do take a diverse population
and challenge them to, to reach the bar, to be
a firefighter. But yeah, so, so the, the. They
are out there, but we have to show them as employers,
as firefighters, that we will take care of you.
If you're going to leave your family for 24 hours
at a time and possibly die, that we're at least
going to give you an environment that sets you
up for success and hopefully a long retirement.
Yeah, the Explorers program is such a great program
for, you know, budding firefighters for high
schools and stuff. And I think that's such a
great thing that you can really kind of open
someone's eyes to. yeah but yeah and and then
you know I think what we also need to do too
is we probably need to just um take care of firefighters
better uh and and you know screen heavily and
work hard on um you know just making that making
it normal right like normalizing it right like
hey after Checks are complete, like we're all
going to do PT together as a crew because that's
what our schedule says, right? Like that's what
our policy says. Those types of things need to
be kind of normalized. I know lots of organizations
where that is normalized and I know lots of organizations
where it's not. Were you surprised when you started
diving in a little deeper that... a profession
where lives are at stake, where we carry a lot
of gear and sometimes have to perform at a very
high level of exertion, that there are no fitness
standards in this profession? Yeah. So, you know,
there's WFI, which has some of these things.
What I was really surprised was how policy was
just kind of all over the place. in terms of
like fitness testing, occupational performance
testing, medical testing. You know, there's a
big guideline, right? So like 1580 recently took
like WFI and 1582 and kind of mashed it all together.
And, you know, hey, this is your guide. You can
use this. But organizations need to have these
policies to themselves, right? You just can't
point back at the book and then not know what
the book says. Like you have to have your own
way of like normalizing it and having culture.
I think I was more surprised by how like one
organization in particular that we work with,
like they've got like pack walk. They've got
like occupational consumption testing. They've
got a physical fitness test and they've got a
medical test. And that's great. Right. And they've
got a policy that says on shift, you're going
to do PT for an hour. Right. And then you go
to another organization. It's like we do medical
physicals and that's it. It doesn't tell you
anything else. So once a year, you might crash
diet and freaking work out a ton just before
your physical so you know you can pass as opposed
to just normalizing the standard. And this is
part of where I think that the fire service could
maybe look to the military for some guidance
on some of these things. We had MOS tasks that
we had to complete on an annual basis, ranges.
had to shoot your weapon, had to operate those
things where you had occupational testing. You
had a physical fitness test that you had to pass
twice a year. And then you had a medical annual
physical exam that you had to do, you know, depending
on the community that you worked in at least
once a year. And if you wanted to go to a special
school, like dive or, you know, smoke jumping
or whatever, right? Like you had to pass an additional
physical, right? It was a special skills physical.
And you just don't see that in the fire service.
You know, in a lot of institutions, it's just
kind of all over the place. And I'm not saying
it needs to all be the same. I'm just saying
it needs to be captured and consistent. Well,
I think we have an opportunity to all be the
same. The reason I say that, unlike, for example,
even law enforcement, when you talk about, you
know, what would a physical fitness standard
look like? I'm talking about the occupational
tasks part of this. I mean, the CPAT, the fire
sled version of the CPAT, the FPAT, I think they
call it, you know, when you're moving hoses and
ladders and dummies that are equivalent of a
human being and climbing stairs with load, no
one can say that's not fair. It doesn't matter
if you're male or female. No, absolutely. Yeah,
it's the Canadian Physical Assessment Test, I
think is what it's called. That's what Pflugerville
uses. And it's a great test, right? Because you're...
moving a ladder, you're simulating a breach,
you're dragging a rescue randy, you're dragging
a charge line, you're moving up and down a ladder.
So you're hitting all of these things that are
occupationally uniform, right? And it's one of
those things where you can just say without a
doubt that like, hey, if I can do these things
and this person can do these things with under
these time constraints. then I can trust them
to get the job done, right? Like there's no doubt
as to the capability of that person. Yeah. And
where I get, you know, not pushed back so much
because I don't, you know, ask people in the
first place. Yeah. You know, it's a non -conversational
topic, in my opinion. But where the water gets
muddy is when people go, well, we'll do a max
vert test and a max deadlift, you know, and they
start inventing these things. Like, no, no, no.
Because if you just go to the tools that we just
talked about, that's exactly what you were required
to do in Fire Academy. So then any of this, oh,
it's not fair. You're trying to take our jobs
bullshit. It's like, well, no, because at the
front door, you knew exactly what was expected
of you. Yeah. So I don't want to hear it. If
you don't want to do this anymore, that's absolutely
fine. Go to fire prevention, go check extinguishers.
But you have no business being on a fire engine
anymore. Yeah. Yeah. No, I, I do think, you know,
pre -academy, there are certain tests and I do
think it's interesting to understand just from
a, a research and probably like a, just kind
of put it to bed understanding, like what are
the physiologic, what are the physiologic characteristics
of someone who will be physically and mentally
resilient through academy training and then throughout
a career in the fire service, right? Like what
does body fat look like? What does skeletal muscle
mass look like? What does VO2 like absolute or
relative look like? You know, maybe throw in
a grit questionnaire like they did at West Point.
And what does that look like in terms of, you
know, how can you assess? And, you know, identify
who's going to be the injury risk that isn't
going to make it through academy, right? And
that's kind of like some stuff I'm working on
in the background with a couple of labs at Oklahoma
State. And I've talked to Mark Abel at UK about
this. It'd be nice to know because these tests
are relatively quick and simple, right? Like
an IMTP is you just freaking. yank on a bar for
as hard as you can for a few seconds to generate
power. And, you know, depending upon where you
land on the scale, like where, where, where is
that number that shows that like, Hey, you're
going to be an injury risk and you need special
attention before you start the academy, right?
Like these are things that you need to work on
and that could help out with this. this problem
that we've got right now with recruitment because
it's not just recruitment because we end up recruiting
somebody what's the fallout rate for the people
that have poor physiologic characteristics you
know but they're still meeting the minimum standard
on the 1 .5 mile run the other stuff or the c
-pad even right um so and and that's some stuff
that we're gathering data on the background with
some of our larger organizations and some of
our more historic organizations in central texas
i think this and we talked about this i think
when we spoke a few weeks ago but this is the
other portion of this recruitment demand issue
that we have at the moment when this is mixed
and this is happening in florida the department
sort of gone to the 24 72 literally their hr
phones are ringing off the hooks now people wanting
to work for them so now you've got that large
list and you know arguably now you start selecting
the self -start. You can select, right? Right.
Like you have an OML now, right? Like, Hey, you
did well on this test and you're physically fit.
And like, you've got great job history and no
criminal record. Hey, you're the top of our OML.
Yeah. Yeah. I mean, it's, it's, you know, it's
essentially recruitment, right? It's like, you
know, it's like the combine, right? Like you
just, you, you, you pick your, you pick your
workhorses and you pick your racehorses and then
you go. Exactly. Yeah. But if you are scraping
the bottom of the barrel, then you're taking
almost everyone. Then now the chances of injuries
down the road. And then again, no disrespect
to the people that are prone to injury. But when
I was testing. I was working an office job when
I was going to the fire academy. I was working
out on my lunch hours. I was running in the evenings.
I was doing all the things because it was very,
very competitive. So I made sure I was physically
resilient when I entered the academy. Now you
take away that demand where they're going into
high schools and begging them to let them go
attend the fire academy. As you mentioned, with
this young group, you're going to have the athletes
who are going to do incredibly well, but you're
going to have the kids that have been playing
Xbox for the last 10 years. And what are the
chances of them, you know, having strains, sprains,
etc. So even in this, you know, the higher we
set the bar for recruitment, you know, the more
chance there is of that group of people that
you have being the right kind of physical candidate.
So the chance of injury is much lower. Yeah.
And really, it's about like not just like making
sure they get through the academy fine, but also
like how they thrive throughout their career.
Right. And then there's maintenance. Right. Like
there is there's quite a degree of maintenance
that needs to occur if you're going to be on
the job. Right. So you have to, you know, I affectionately
call it chopping wood and carrying water. Right.
You just have to chop wood and carry water. It's
part of the job. You know, it was that way in
the military. And it's that way in the fire service
and, you know, any other really public safety
position. So let's kind of go into, you know,
all the different elements that you offer at
Frontline Mobile Health. Yeah, sure. Yeah, so,
you know, we like to distinguish ourselves because,
you know, we have kind of listened to our fire
chiefs. You know, that was probably the first
thing that we did was like, hey, what do you
need, right? And they threw us a copy of 1582.
It was 1582 at the time. And it was funny because
1582 reads just like a military manual for performing
annual exams for service members. So it was easy
to read, easy to pick up. Where we saw where
it fell kind of short and we knew that there
was a need was there was this particular iteration,
you know, kind of lightly touched on behavioral
health stuff and lightly touched on cancer screening.
And then the cardiovascular testing was really
considering the risk, right? Like, so I ran the
numbers for a paper that we're pushing through
right now. I looked at the U .S. Fire Administrator's
website of the line of duty deaths collected
from 91 to 2021. And when you look at the number
of people who have succumbed on duty, or consider
line of duty death from cardiovascular event
98 over 98 of them were over the age of 30 right
um and the old standard which i thought was actually
okay um had you know had cut off points of eight
ten and twelve mets right you know vo2 wise that's
like you know 32 35 and 42 mets um in terms of
your cutoffs you're being cleared for duty And
the recent iteration, you know, this is kind
of going into our cardiovascular screening while
I'm talking about it. You know, now it's, you
know, it's a lot easier for you to pass as an
older guy than it is for you to pass as a younger
guy, which is kind of opposite because age is
really the biggest risk factor. So we do a lot
of cardiovascular screening. We do that through
advanced labs like LP little a, APOB. It's not
something that you would typically get at your
primary care in an annual physical. And we do
that because we know that those identify genetic
risk and those are the real numbers that allow
you to understand, you know, what your cardiovascular
risk is. And then we do something called a cardiopulmonary
exercise test, which is where we hook you up
to a mask and we're directly measuring your VO2.
We're looking at your heart rate. We're looking
at your ECG tracings as you go through. So we're
just making sure that, you know, when we redline
the engine in a controlled environment. that
we don't see anything that's going to concern
us, right? Because where you want to redline
the engine is in a controlled environment and
observe it. You don't want to redline the engine
on scene and have a mayday. So that's kind of
how we run the cardiovascular stuff. Cancer screening,
you know, we do solid organ ultrasounds from
the neck all the way down to the scrotum and
just looking for, you know, things that aren't
supposed to be there. You know, we offer, you
know, We're looking at, you know, kidney function
labs, liver function labs, PSAs, stuff that you
wouldn't normally order in someone in their 20s
and 30s. But because of, you know, the occupational
exposure risk over time just kind of predisposes
you to having a higher hazard ratio in terms
of like developing cancer in the profession.
And then behavioral health, right? Generationally,
you and I come from the same timeline, right?
Like, you know, put it in a box and shove it
in the back, right? Is kind of what we've been
told for most of our careers. And, you know,
again, it's like radiation, right? It's not the
first dose. It's the accumulation of doses that
slowly erode and chip away. So we focus on a
lot of screening tool questionnaires that...
You know, you probably wouldn't get if you go
to your annual health and wellness physical,
right? Like they're not going to ask you about
PTSD. They're not going to ask you about your
sleep quality unless you have a particular complaint
about your sleep. But we ask all of them sleep,
anxiety, depression, PTSD, burnout, compassion,
fatigue, secondary stress. Some of the things
that really affect the profession that people
don't really talk about. Our big one is sleep.
We talk a lot about sleep hygiene, especially
off shift. Sleep hygiene off shift is like so
important. And, you know, we've got, you know,
I feel like the fire service has some bad habits,
but that's just part of coping, right? Like when
you work a 24 -48 or a 48 -96 or a Kelly shift.
Um, those are the things that you have to do
to kind of give you that second bump for the
afternoon. And then the next day, you know, you're
habituated by it, right? So you just kind of
continue the, the, that, that product. So we,
we do a lot of that screening. Um, and then we
spend quite a bit of time with our patients.
You know, we don't, you know, it's not like an
urgent care visit where the doc just kind of
pokes his head around the corner and gives you
like five minutes to talk to him and asks you
if you're still at the pharmacy around the corner
from your house. he leaves and then you never
see him again for another year like we we try
to spend a lot of quality time with the patients
each each patient's allotted like 45 minutes
because there's a lot to cover with what we do
and we want to be able to give you know our patients
an opportunity to talk about it and then and
then at the end of it all we summarize all of
it we de -identify all of it and then we share
it with the fire chiefs because that's their
ammunition to go back to the city for continued
funding or nutrition classes or perhaps some
resiliency classes or some equipment for their
stations um and so that's kind of our you know
kind of our big thing is that we just we we share
all of our data it's the department's data and
we want to make sure that they get it they get
it in time and manner and then they're able to
have these conversations with you know, districts
or cities in terms of funding. What about the
information you were talking about, you know,
everything from the sleep disruption to the compassion
fatigue to the depression, PTSD, et cetera? What
is happening with that data? So can you clarify
what's happening? Is the organization responding
to that? Is there a treatment plan based on how
they report? Oh, yeah. We give it to them so
that they can use it to, you know, we've got
one department that shares it with their organizational
psychologist that offers classes and treatment.
Some of them use it to bring in resiliency specialists
or partner with resiliency teams that, you know,
they have these types of things available to
them. Some of them, you know, I can't remember
which department it was, but one department in
particular, whenever we started seeing all these
sleep scores. you know, people were complaining
about beds. And so we told the department and
so the department bought new beds. And so like,
it's, it's stuff like that that allows us to
kind of give feedback to department leadership.
Cause you know, I don't feel like, you know,
the people in the ivory tower are there to, you
know, you know, make shit up so that they can
make their, their members miserable. They, they
genuinely want to care for their members in most
cases. And They just, you know, lack the awareness.
They're not getting this feedback that allows
them to have the understanding of what's going
on at the small unit level, really, right? But
the more that they have this understanding, the
better, right? It's been interesting kind of
listening to all the different departments and
all the pushback, you know, when it comes to
changing the work week, for example. One of the
departments I worked for was a 56 No Kelly 2448.
They brought in, and I'm sure it was probably
volunteered by some university, but they did
a sleep study. And, you know, the outcome was,
yeah, your firefighters are chronically sleep
deprived. That was it. The end. All right. Thanks.
Bye. And what's crazy. Yeah. So, you know. They
got data. I did nothing with it. And what's crazy
is if you look at the firefighter cancer conversation,
they'll talk about the carcinogens in our gear,
which, you know, as you mentioned, we don't go
to fires all the time. At least I don't work
now, but even in my career, I watched it start
to decline over the years. You know, but there's
no conversation about sleep deprivation and shift
work is a known carcinogen. When you look at
the mental health conversation, you know, they'll
talk about peer support teams and, oh, it's what
James saw with that decapitated three -year -old.
but they won't look at the sleep, you know, the
work week when that's a direct correlation to
all things mental ill health to the point where,
you know, if you're going to SF selection, they're
going to deliberately sleep deprive you for a
few days to try and get you to type out. Yeah,
that's part of the job, right? You go to see
her, that's part of it, right? Exactly. So this
is where I get frustrated and it's happening
now. This revolution has taken off. So fire service,
brace yourself because if you don't want to change
your work week. It's going to happen to all the
departments around you, and you're going to have
to change anyway if you want to hire anyone.
Yeah, top three behavioral health issues that
we see in our practice, sleep, number one, and
then compassion, fatigue, and burnout. Yeah,
exactly. So if you're buying new beds, that's
awesome. again is that really fixing the solution
or oh i don't know maybe they need more sleep
you know what i mean so yeah this is what's exciting
because all these metrics then are going to improve
and then you add these other layers to it imagine
if you got a well -rested responder who then
goes to a counselor yeah we we have found that
if you have a clinically significant impairment
in sleep you are greater than 50 more likely
to have an impairment in some other aspect of
your behavioral health yeah and then testosterone
another huge metric how many young guys you come
across who should be in the 800s and they're
in the two holy dude it is bonkers man and well
the amount of testosterone use in the fire service
is crazy but like you mean you can do i mean
when is testosterone made right it's made when
you sleep exactly right so yeah of course of
course people are going to be low because their
sleep's terrible and they're going to be supplementing
and the part part about supplementing and this
is where i'm going to get on my soapbox is that
like You know, the TRT in some cases really isn't
TRT, it's TR optimization. And, you know, it's
a billion dollar industry and it does come with
risk, right? So we need to be aware of that,
especially if you're a firefighter. It does come
with a lot of risk and you need to be managed
tightly. You need to be managed so tightly, right?
And that requires you to take ownership of your
health. Absolutely. There's a company that I
love, veteran owned company. They've got a full
nonprofit arm called Transcend. And they, because
I, this is an issue I've had, you know, when
you listen to Kirk Parsley talking about sleep
10 years ago, maybe see an old term position.
He was on the show. He told this story. The original
scale, you and I would go into the doctor and
it'd be like, well, Mike, your T is 300. You're
fine because the range is 250 to 950. Well, that
was an Ivy League school study where the 250
was an 80 -year -old that lived in his recliner
and the 950 was the high school athlete. So then
the pendulum swung all the way the other way
where now these men's clinics popped up. And
yet I've got lots of young firefighter friends
that are on TRT and they were not told about.
the infertility the hair loss the um you know
the tits all the other things the back knee yeah
all the stuff that comes with it right like you
know there's there's a lot to come i mean never
mind that like mismanagement can cause you to
have like you know a higher blood count that
higher blood count predisposes you to dehydrating
a lot faster right and what do you do as a profession
you put on a shitload of gear and you go into
a hot building excuse me so yeah there's just
you have to be aware of some of these things
and and it just it with trepidation you shouldn't
you should do it right try to fix as much as
you can before you decide to rely on it exactly
so yeah one more 24 hour period between shifts
to sleep is a huge one exercise nutrition but
then peptides there's a there's a few that stimulate
your body to make a little bit more of its own
testosterone i have done that one um the end
of my career when I just was like 14 years of
not sleeping, it had to have taken a toll. So
I did it for, I did peptides for about a year
and then came off and it wasn't a huge gain by
any means, but it was like about 10, 12 pounds
on, and I was, I would arguably underweight when
I was working and it sustained and it stayed
on and everything's good and libido is good.
So that's that other middle piece is if you are
working shifts and you just can't quite get the
holistic approach to get everything completely
in line. With a company like Transcend, this
isn't a sales pitch. I just truly trust them.
You can use peptides just to tweak your body
a little bit. That's very different than exogenous
testosterone with TRT. Yeah. So great tool as
well. Well, you mentioned VO2 max. Let's go back
to aerobic capacity, the decline of the standards
and how that applies to our readiness to perform
on a worst case scenario on a call. Yeah. So
this is my soapbox, right? You're going to hear
me say this over and over again. One job, one
standard, right? We know that certain tasks,
right, thanks to people like Mark Abel, Emily
Langford, some of the smart folks that have done
a lot of robot capacity research with firefighters
specifically, we know that some of these tasks
require a met level in the range of 9 to 11,
right? Victim rescue, hose drag. you know, bundle
carries upstairs, that kind of stuff. And, you
know, so the 8, 10, and 12 standard was really
good, right? It was uniform. It didn't matter
if you're male, female, didn't matter if you're
like, whatever, right? This was the standard
period. And then in late 2023, the new standard
became, hey, we're going to follow the ACSM guidelines,
which acknowledge that as you get older, your
vo2 changes um females inherently have a lower
vo2 than males and so we started watching this
and paying attention to really alex did my or
lead ex -phys and and then he shared this with
me one day and and we looked at the percentage
of passes on the old standard by decade of age
compared to the new standard right so the percentage
of passing in the old standard, which is that
8, 10, and 12 was, you know, higher in the younger
groups in the 20s and 30s. And it would, it would
start to taper off, right? Because as you got
older, you know, and it's not just a matter of
like, as you get older, your VO2 decreases. As
you get older and you've been in the fire service
for a decade or two, you've probably gotten out
of shape, right? So some of these bad habits
have accumulated. And then we looked at We used
the same amount of data and we looked at the
we looked at the pass rates by decade of age
starting in the 20s, according to the new ACSM
standard. And, you know, it's it was staggering.
Right. So if you were in your 20s, you know,
you had a a very significant fail rate and then.
But the minute you became 30, your pass rate
went way up. And then same thing for 40s, 50s,
and 60s in our data. 6 ,000 tests. When we analyzed
and we compared 6 ,000 tests, when we compared
30 -year -olds, 40 -year -olds, 50 -year -olds
to 20 -year -olds, if you were 30, you were 27
times more likely, not 2 .7 times, 27 times.
more likely to pass your aerobic capacity standard
test than you were if you're in your 20s if you're
in your 40s and beyond it got anywhere between
to 32 to 37 times more likely right so what is
the translation what does that mean well it means
that medically and you know according to the
wfi standard which is your capacity standard
if you're older you're going to have an easier
time to pass your test Because your standard's
lower. If you just look at going from 20s to
30s, if it's on a treadmill for aerobic capacity
testing, it's like 20%. If it's on a cycle ergometer,
it's like 30%. Just more likely difference. And
you don't drop that much in that decade of age.
And then you have to bring into question, what
do you tell somebody who's 29 who's taking his
test that next year he's going to be 27 times
more likely to pass his test? So it just it really
was it really was just staggering. And, you know,
it's it's in review right now. The paper is going
to come out. It's in review right now. But it
really just kind of goes to show you that I think
the intention was good. Right. Like the intention
was that, hey, we have a lot of institutional
knowledge. We're trying to make sure that, you
know, we don't lose this institutional knowledge.
And so we're going to, you know, make sure that
the guys who were failing before are able to
continue in the profession. But what you've done,
right, what you've done is, you know, the greatest
risk, the greatest risk that is, you know, outside
of our control for cardiovascular disease is
age, right? But what you've done is you've made
it easier for people who have been on the job
for decades to pass that test compared to someone
who's in their 20s. And it doesn't make sense,
right? Because like the people with the greatest
risk, right? That example I cited earlier, 98
% of the firefighter fatalities occurred over
the age of 30, over a 30 -year period. Those
are the people who have the easiest time to pass
now. Those are the people who are going to be
probably working a lot harder than the younger
person with a lot more physiologic reserve. So
it was really kind of shocking and eye -opening,
and we just decided that we're just going to
release it in a peer -reviewed paper so that
we can kind of bring it to light. stimulate some
change right like hey this was a great idea but
like you need to understand the impact and the
risk that it's going to have on um on people
right like you know in our in our conversation
a few weeks ago you kind of made the comments
and i've recycled it You know, when you go out
on a fire ground and you see someone working
a fire and they're in their bunker gear and their
SCBA on and their helmets on, like, I can't tell
if that's a 50 -year -old guy or a 20 -year -old
gal or a 30 -year -old dude, right? They're a
firefighter, right? They're all doing the same
job. They're pulling hose, they're breaching,
they're, you know, defense, offense, attacks,
whatever. They're doing the same job. So why
is there such a big disparity in the standard
to which you can pass? Yeah, I agree 100%. And
to give an example, and to preface this, I have
never been the fittest, strongest, fastest anywhere
ever. So what I'm about to say is not coming
from someone that was an Olympic athlete or something,
just a normal guy that tried to be the best version
of himself as a firefighter. Building next to
my last fire station, which was one that very,
very, very rarely ever run a fire, was a 30 -story
hotel. Now, for me, on my then 168 pounds, six
foot tall, skinny ass, had to strap 100 pounds
of gear. So I had the air bottles, the hose and
the tools to do what I would need to do on the
30th floor. And it was a hotel. So there was
a good chance that you'd be actually making a
rescue way up there. So then you climb a hundred,
sorry, excuse me, you climb 30 floors with a
hundred pounds of gear and then you start working.
So to contrast that at 48, when I just left the
fire service and I was running out of money,
waiting for a sponsorship, I was preparing myself
to go back in, you know, if I needed to. And
so I went and did a CPAT as part of the kind
of, you know, hiring thing that you did called
fire teams. And at 48 years old, no, sorry, 46
years old, I got a, I did the CPAT in seven minutes,
20 seconds. And again, I don't say that to sound
like, oh, it's amazing, but just simply state
the fact 46 years old, 720 CPAT. So this is my
point is no one cares if it's old James with
his fucked up knees from years of stunts, martial
arts and firefighting, or if it's an 18 year
old recruit. All they care about is can that
person make it to the top with the gear and get
my child out of that burning hotel room. So to
lower the standards and get the violin out because
poor old James is in his fourth decade of his
life is bullshit. It really is. Now, if you want
to have that in a corporate setting or like you
said, in a military where maybe you're in the
drone control unit where you're actually not
required to do anything, I understand that. Fire
prevention. But if you are on a fire engine,
on a truck, on a rescue, in a battalion chief
vehicle, and you're responding to an incident
that could be a shooting or an explosion or a
hurricane, and you're going to have to be a physically
active member of that team, then you should be
held to the same standard, period, point blank.
That's my opinion. I totally agree, right? Like
there's, you'll never, yeah. It's something that
me and some of the folks I do research with,
you know, Jake and I talk about this a lot. You
know, nobody cares, right? You know, it's a great
Cam Haines saying, right? No one cares, work
harder. You just have to do it. There's a standard.
Yeah, I have a similar story. I did a consumption
test with one of our departments in Central Texas,
and I was able to crank out. a little over four
rounds on a bottle, on a 45 minute bottle and
squeak out like 29 minutes of air doing a bunch
of random tasks. And, you know, compared to the
recruits that were in that class, like I ran
circles around them and I'm an untrained person,
right? Like, and like you, I'm not phenomenal,
right? Like I'm not like this, you know, decathlete
or Olympian or anything like that, right? Like
I just, I take care of myself and I know how
to push through things and I had a career in
the military. But it's important, right? Like,
you know, there is a shield, right, in the fire
service, and that shield is your fitness level
that's going to carry you in terms of your health.
Well, I think the other thing that's frustrating
about this conversation is the same with the
work week. Like, there are literally no downsides
because even as you mentioned, the financial
element, the money is there. Now you're becoming
a more fiscally sound organization. The only
challenge is having the courage to actually do
it. step up, advocate for it. But it's the same
with fitness standards, which I think will go
hand in hand. You create an environment that
allows these people to thrive. Now is the perfect
time to then put fitness standards in. But not
only are you asking people to perform at a higher
level, not only are you doing the things that
are needed to minimize the chance of injury,
for example, but also you're forging longevity
in retirement. So you're extending their lifespan.
So there is no downside unless, as one of my
guests said, and I think it was such a beautiful,
beautifully put, unless you're scared of getting
tired. And if you're scared of getting tired,
then you shouldn't be a firefighter in the first
place. Because that's all fitness is, is just
being uncomfortable, being hot, sweaty, tired,
muscles burning for a short amount of time, three,
four times a week. That's it. So we've got to
get back to putting our big boy pants on and
saying, look, no one's saying. that you need
to be fit if you want to be a plumber or an accountant
then you do you but if you want to join this
profession then you need to be fit you need to
be strong you need to be mobile and you need
to understand what working as a team is so i
think any union or organization that's opposed
fitness standards is partly responsible for the
premature deaths of their people and i find that
unacceptable my thing with our staff is that
i really encourage them you know, to go through
flashover training, to go through a consumption
drill, to do all of these things that give them
an idea of what it's like to put on bunker gear,
walk around, right? Like drag a rescue Randy,
see what that feels like. So you have a better
appreciation for kind of what we're asking our
patients to do and what we're clearing them for.
Because, you know, when you've done it yourself,
you have a better appreciation of like why, you
know, strength. and why aerobic capacity is so
important right the only difference between you
know me and that group of recruits on that you
know on that consumption testing field was that
like i knew my vo2 was good and i know like you
know just because of years in the military and
some of the sports that i've participated in
like i know how to tap into that dark space right
like i can get uncomfortable i'm okay with getting
tired well it was i mean when he reframed it
that way It really made me think because if you've
got a person on your crew that is afraid of being
tired. then what does that mean when the shit
hits the fan in a fire? What does that mean if
you hear gunfire? I'm not talking about running
towards a gunman, but you've been told it's a
warm zone now, PD haven't cornered, and you're
going to go in and start dragging people out.
We have to ask ourselves, it's uncomfortable
going to the gym, it's uncomfortable getting
tired. Sometimes you do even tweak things or
whatever, but if that scares you, if that in
your mind is something that you will shy away
from, How far have you come from that excited
young fire recruit that was chomping at the bit
to do these exercises? So it's not about shaming
people. It's not about, oh, they need to be thrown
out today. It's the opposite. These people have
strayed from where they should be. There's two
options. Let's help them get and give them the
tools back to where they need to be, which will
allow them to perform, allow them to retire healthily.
Or have you got to the point where in your heart
of hearts, you don't want to do that anymore?
Okay, that's great. transition to a different
department in the fire service it doesn't involve
you being on the front line man i'm so happy
you said that right because that's like our big
thing whenever we talk to you know unions ahead
of time or organizations ahead of time we we
talk about like hey we're not here to be the
boogeyman and take your job right like we're
here to help you get back on the path to wellness
right because our goal is that number one you
can retire on your own terms right you're not
retiring because you can't do the job anymore
You're retiring because you've decided like,
hey, I want to retire. This is me saying I want
to retire. And then number two, the number two
and most important thing probably is that after
you retire, like you can give back time to your
loved ones and you can drain that retirement
that you've been putting into for your entire
career. Right. And so I think where you know
what you're talking about is, you know, like
these. This isn't shaming, right? It's the same
thing with us. We're not coming in here and talking
to you about how your body fat impacts your VO2
and how your CPET's risky and you've got all
these cardiovascular problems. We're trying to
guide you and get you the right people so that
you can take ownership of those things. One of
my favorite sayings is we don't rise to the level
of our expectations. We follow the level of our
training. And it's the truth, right? And it applies
towards your mental health, your physical health,
and your medical health, right? Like if you're
not taking care of those pillars, you're not
taking care of those things because you're not
training yourself by taking care of yourself,
eating right, getting good sleep, practicing
whatever it is you need to practice for your
spiritual needs, then you're going to have problems,
right? And they start to stack up. And when you
have those different shields in place, they allow
you to kind of become a little bit more resilient.
And then like you discussed, retire on your own
terms and then, you know, drain that bucket.
One more area before we kind of close out and
let everyone know where they can find you. Where
I'm very excited as this revolution begins in
Florida and they're moving to this healthy work
week and now there's vacant spots are being filled
by the right kind of people. The next conversation
is not only fitness standards. is also performance.
And when I talk to your community, SFSO, et cetera,
et cetera, when you have strength and conditioning
coaches and nutritionists and sports psychologists,
they're forging performance. They're trying to
get you to operate at a higher level. At the
moment, when those same professionals come into
the fire service, the conversation is ultimately,
let's try and get you to die less. So there's
this massive void. And then you look at the SF
program, the Thor 3 program. Thor 3, yeah. getting
warfighters back on their feet, rehabilitated,
the prevention side, the performance side, I
think that's the next phase. Once we get a healthy
work week and a fitness standard and the competitive
recruitment where we're getting the right kind
of person and then mitigate some of the fallback
from some of our more seasoned professionals.
The next step, I think, which is really exciting,
is in how can we use sports science to then advance
the firefighter to be able to make them operate
at a higher level? Yeah. And there are so many
there are so many professionals out there just
chomping at the bit to get involved with this
community, because, number one, right, like.
Like, why wouldn't you want to work with first
responders, right? Like they're there, you know,
they're in the profession, you know, they're
going to be. potentially helping you on your
worst day. And then number two, you know, there's
just so much potential there, right? Like how
much it's an organization that's never had this
type of a resource before. And there's great
environments where we can show that like the
proof has kind of really paid itself out, right?
Like South Metro in Colorado, you know. I always
point back to Pflugerville. They've got Vanessa.
She's a great, you know, strength and conditioning
specialist for that organization. And, you know,
and they've grown with them over the years, right?
Like she's gone from, you know, when they were
under 100 people to now they're over 200 people.
And, you know, they're running academies now
and, you know, injury rates are falling down
and the people are healthier. And it's just by
implementing these things. I think what's really
important though, is that whenever you have these
policy implementations or these These interventions
that you're going to introduce is, you know,
you can't just come at organizations with a hammer
right away. Right. Like you have to collect data
when you collect that data. Right. In terms of
your fitness benchmarks or your health benchmarks,
then you need to set a new goal. Right. Like,
OK, this is the average. Let's bump the average
up to this. And then you just and you just keep
moving it. until you reach a stopping point,
right? And then you normalize that. And then
when you normalize that, that's where you really
start to see the big benefit, probably the biggest
in terms of like cost reduction when you look
back retrospectively from a risk management side.
Absolutely. Well, I want to throw some quick
closing questions at you before I let you go.
Yeah. The first one I love to ask, is there a
book or are there books that you love to recommend?
I'm sure Tribe is one of them. It can be related
to our conversation today or completely unrelated.
Yeah, so Tribe is definitely one of my favorite
books. We have it. It's funny. We have it in
our Dallas clinic. And I forgot that one of our
design people asked me, like, hey, what's the
books that you would recommend? And, you know,
Tribe, The Daily Stoic by Ryan Holiday. I really
enjoy The Daily Stoic. I've been reading it for
six, eight. nine years, uh, no eight years. Um,
so the daily stoic is a great book. Um, and then,
uh, trying to think, uh, like if you're an organizational
leader, it's, it's, you know, it's kind of one
of those basic ones, but good to great. I really,
I really love that book. Um, I reread it again
recently as when I took over as a CEO of the
company, um, good to great was another book that
I think is really powerful for organizational
leaders. Fantastic. What about films and documentaries?
Oh, man. You know, I love trash movies. I am
a, you know, I'm a science fiction and fantasy
guy. I kind of grew up in terms of that like
escapism. So I don't have any good recommendations
in terms of science or not science, but films
and documentaries. I did enjoy. um uh the pacific
and um oh man the big tom hanks documentary on
world war ii um documentary you said uh it was
it was a story it was about um the hundred and
three private ryan or the band of brothers band
of brothers yeah band of brothers i i've i've
always enjoyed that um that holds a special place
in my heart because of the connection to the
military and you know unit cohesion and like
the trials of war. So, yeah. I had, I worked
with Captain Dale Dye when I was a stuntman.
Did you really? A couple of times. And then Shane,
who played the medic in Band of Brothers, he
was on the show too. Yeah. Yeah. No, great, great,
great series. I really enjoyed that one. Absolutely.
All right. Well, the next question, is there
a person you'd recommend to come on this podcast
as a guest to speak to the first responders,
military and associated professions of the world?
We already had Alan on there, so I was going
to say Alan. Alan Shabarro is a longtime friend.
Man, Tim Sendelbach, probably. Tim Sendelbach's
a chief out here. Tim Sendelbach or Nick Perkins,
one of those two guys. They are both, you know,
quietly and not so quietly sometimes, really
pushing for change and taking care of their people.
And sometimes fighting against the community,
which is bonkers to me, to extend services like
that. That is probably the craziest fight that
I've ever heard a leader have to do is to fight
a community that they are serving for resources,
which, yeah, I don't know. But those two those
two fellows are exceptional leaders with a vision.
um that that is very firefighter centric and
firefighter health centric um and they're they're
just amazing human beings brilliant i appreciate
that all right well the last question before
we make sure everyone knows where to find you
and the company what do you do to decompress
oh man what do i do to decompress i uh i um i
do a lot of jujitsu So I like choking people
and bending limbs the way they're not supposed
to bend. It's always been a fun hobby for the
past five and a half years. I'll also climb.
I haven't done much that lately, though, just
because work has been really busy. And it takes,
you know, you have to take a whole day or day
or two off to go do that. But those are the two
probably favorite things. Decompress, other than,
you know, other than obviously being with my
family, but I've got toddlers at home. Um, so
that's hard to decompress and you've got toddlers
running around. Absolutely. I was doing murder
yoga this morning. That's my new favorite pastime
too. Oh man. Yeah. That's my favorite. Yeah.
I've unfortunately, because it's been so busy
here this week, no practice in this week. Um,
so I'm hoping to try and get in tomorrow. Brilliant.
All right. Well, for people listening, where
can they find Frontline Mobile Health? And if
you want to just, again, give an overview of
what you offer, and then we'll talk about where
we can find you specifically as well. Yeah. So
Frontline Mobile Health is a specialty occupational
health clinic. And I say specialty because we
just deal with public safety. So fire and police,
large majority of our customers are fire. We're
at frontlinemobilehealth .com. That's all one
word. We offer annual, new hire, fit for duty.
and medical and psych screening. And yeah, we've
really grown by word of mouth, you know, just
fire chief to fire chief. We've started doing
shows here recently. We'll be at FRI. So if you're
going to be out at FRI, we're going to have a
very large booth out. And yeah, we're in 12 states,
big presence in Texas, Colorado, and Georgia,
but we're expanding into other locations as well.
Even though we just closed out, I got one more
question because you said psych screening. As
I progressed through this nine years and learned
from all these experts and I reflect back to
the psych tests I had to do four times to four
different departments, I discovered that the
one I did, which was the multiple, multiple,
multiple choice, you know, the hundreds and hundreds
of questions. 350 questions, the MPSS probably.
Yeah, MSPSS. It was the MMPI. So the psychology,
psychiatry world basically educated me that that
was never meant to be used as a standalone test
to determine if someone was going to be a first
responder or not. So which screening do you use
and why? So I'd have to defer to Rebecca because
she kind of runs late on that. She's our lead
psychologist. But it's only that's only one aspect
of four tests, four different tests that we do
to include receiving background packets from
the hiring committee and a relatively lengthy
interview once we get the results back in. So
it's not it's not a one dimensional test. The
MMPI should not be used as a single source screening.
And then sometimes, you know. over -reporting
and under -reporting occurs, as you know, on
some of these testing, so that can kind of skew
results. And that's why you need, it really should
be evaluated by a forensic psychologist, which
is who we staff on our teams. We use forensic
psychologists. We don't just, not that a psychologist
isn't a bad person, but forensic psychologists
are specifically trained to do this type of work.
And Rebecca has, you know, has a pretty extensive
background in that. Brilliant. well one last
thing for you specifically if you want to reach
out to you where are the best places online or
social media yeah so i'm on linkedin you can
just look up uh michael connor on linkedin and
you'll see that i'm i'm there on frontline um
i keep my my i keep my uh my facebook and my
um instagram pretty private because that's typically
my family but you know you can you can always
find me on linkedin and i'm always posting stuff
about some of the research that we're doing some
of the shows that we're at and that kind of stuff
beautiful well i want to say thank you again
to trevor but also to you i mean again coming
from the background that you have and you know
the medical element of the military and then
Transitioning out into help in our community,
I think it's phenomenal. And it sounds like all
these elements that you've talked about from
the types of blood screening that you do to the
psych evaluations, it's one of those organizations
that people definitely need to look into. So
I want to thank you so much for being so generous
with your time and coming on the Behind the Shield
podcast today. Hey, it was a pleasure being here.
Thank you so much for having me, James.