Intro, tale of two doctors

[00:00:00] 

Preston: So, welcome to How to Be Patient. I'm Preston, a psychiatry resident. 

Margaret: And I'm Margaret, also a psychiatry resident. 

Preston: And we are here to talk today about our story and really the genesis for why we wanted to make this podcast. Um, I think I, I was drawn to make it because I had this vision of a med student somewhere off in the ether.

In space, who's sitting there with a patient and they're trying to comfort them. You know that moment like someone's hopeless or they're forlorn and they are going through really hard time and you're like, I just can't find the words. Have you ever experienced something like that, Margaret? 

Margaret: I sure have.

And I have been that med student and also been with that med student. 

Preston: That's what, I can't picture you being like that [00:01:00] because I think. In the time I've known you, you've always been this, like, almost perfect, put together, empathetic person. 

Margaret: Oh, well, that's, that's something we'll slowly unpack over season two.

Not season one. But yes, I think that space of, like, actually being real in medicine. 

Preston: So do you think that these skills are something that can be taught or are people born with them? 

Margaret: I think that, I mean, which skills, I guess, is the first question. 

Preston: How to talk to someone. 

Margaret: I think that people have different ways of relating, including talking.

And I think that there's a lot of things that get in the way of people connecting in a real way that feels genuine both to who they are and that other people can understand. And I definitely think it's something that can grow. What do you think? 

Preston: Yeah, I agree it's something that can grow. I think I had this idea that, uh, because I like was stumbling through my first patient interaction that, I was doomed, like, I don't have that X factor, you know, like, whatever, 

[music]: I'm not a pop star.

No, 

Preston: seriously, like, in, [00:02:00] in the clinic room, I thought they were going to be like, I don't know what it is, but he's got it 

Margaret: and I 

Preston: did not got it. 

Margaret: Is this in med school? Or is this like today? It was in med school. So I, 

Preston: so my first ever like patient interaction, um, it was like an OSCE, it was like day one of medical school.

I went to UNC and they really care about primary care and I walk into the room and all I could ever say was like, And anything else? And they're like, nope, I'm just tired. And like, okay, anything else? I told you I'm tired. And I kind of like looked at the guy next to me, and he was like an ENT. And he's like, bro, I got nothing.

And then I remember we, we like, kind of just like told him to drink water. We're like, awesome. And then the OSCE report was like, both were very nervous, like audibly shaking and all this stuff. And I was like, damn, I'm never gonna be. 

Margaret: Which is surprising, given what you do on TikTok, where you notably do talk, and I notably do not talk.

So interesting that you struggled with that. 

Preston: Right, right. Yeah. Now, now I'm perceived by a million people. I think I had one TikTok video where I had [00:03:00] a booger, like a bat in a cave. Then I got 1. 2 million views. Within 

Margaret: minute five of this vlog. 

Preston: Yeah. So, so now I can tolerate the embarrassment of being, I can't even comprehend.

An entire Rolls bowl worth of people seeing this gross thing in my notes. And the video is still up. I'm just dealing with it at this point. But the reason why I brought that up is because these skills, like. Sitting with someone, being patient with someone, being empathetic, a big aspect of them is that they can be learned.

And I think that's what I hope to give someone with this podcast to kind of sit with psychiatry residents who are learning this stuff themselves and have come a long way from when they were and still have a long way to go. And join us on this journey of what it means to be present with someone in that moment.

Whether it's at 2am or on the inpatient unit or in the clinic, finding the right words to say is one thing, but knowing how to imagine someone else's experience, it's hard. And also it can be learned. [00:04:00] 

Margaret: I think that's right. I think that there's also a fair bit, and we'll get more into this, I'm sure, over the course of the podcast of different metaphors or different ways of how we view our work.

But I think even with this, right, that there's Skills that I totally agree with you can be learned and deepened even when they seem like they're abstract skills or we've been taught that they're like just things you have or you don't, the it factor that you have or don't have, um, and There's so much again that like is kind of the obstacles that I think get in the way of people's quote unquote like true self, but they're like feeling like they can genuinely show up and sometimes just hearing some of these concepts or kind of psychoeducation and hearing people be real about it and talk about how it's a struggle and no one's perfect with it can help people kind of unlock and uncover The part of themself that ultimately, I don't know if you found this, but as someone, as someone in my fourth year, I find each, like, year of training, I get closer to talking to myself.

Like myself with patients like each year it's like more and [00:05:00] more close to who I am and who I am is it like a doctor or a therapist and so I think there's also the part of it of like Recognizing the good that someone already is and like how that looks like when they're trying on the white coat for the first time 

Preston: In a lot of ways, it's like learning how to unify your identity with that identity of being a doctor.

Because a lot of times I feel like I was cosplaying as a doctor, I'm like stepping into this costume. But as you progress in training, those two spheres kind of merge and you're like, wait, I can be myself and be a doctor. 

Margaret: Right. Well, and I think that's a good place to ask you. You know, how old were you?

Let's talk, we're going to talk about our stories of how we ended up in medicine. And I always, I like asking people, like, when was the first time you were like, maybe I'll be a doctor? Like, how old were you when that thought first crossed your mind? 

Preston: Oh, man, I was pretty little. And so it's funny because One, five?

Probably five. So, yeah, it's on a dark, cold, dark, stormy night. Preston was like, what about the MCATs? Like, no. Um, [00:06:00] so, um, My older sister actually wanted to be a doctor and I remember I was always her patient because she was three years older than me. Shout out to Heidi. She's now a crit care attending and she practices evidence based medicine now, but she didn't when she was six.

So I remember she would like cut me, not 

Margaret: cut me. She couldn't afford the journals at that point. 

Preston: We would do normal adolescent activities and I would get cut. During the process. And then she's like, Oh, I have just the thing, some milk weed that we're going to rub all over this cut and it's going to make it feel better.

Yeah. It turns out I'm like pretty hyper allergic to just about every type of like weed in Colorado. 

Margaret: Well, 

Preston: it was really an eosinophil T cell problem if you want to get down to it. So anyways, I get these like huge rashes from this milkweed and then she'd be like, Oh no, guess we have to get you more treatment.

So we'd take me inside and like give me Benadryl and other things like that. So I was always exposed to this kind of like push pull dynamic with my sister like playing doctor and then me kind of being patient. So I had this like. [00:07:00] I think the first time I really thought like, maybe I could do this, I think I was like, I was watching Scrubs, I think.

Margaret: Nice. Yeah. 

Preston: And I think I really like resonated with this character in JD who was able to use humor as this prism to navigate the hospital and his own thoughts and his own emotions. And I was like, I do that. Like I go off into these fantasies when I'm at school or I'm doing math or in soccer practice.

And then I felt connected to this character. And 

Margaret: then 

Preston: it was interesting to me how he would then use his fantasies, his, his imaginative state to the, to then assume the position of the patient and became a tool of empathy for him. So, and, and it was funny. 

Margaret: That's it. And he was a cool guy. 

Preston: Yeah. And who doesn't want to be JD?

So that kind of like had it floating around, but these weren't like solid plans at all. 

Margaret: Was there anything you ever wanted to do instead? Like, was there ever a [00:08:00] point when you were like, 7th grade, like, I'm gonna be a chef? 

Preston: I wanted to be an architect. And I wanted to be I think actually, yeah. 

Margaret: I think we've talked about this.

Yeah. Go, continue. 

Preston: I would tell my mom, I'm like, Mom, I'm just gonna build a skyscraper in the backyard. And she'd be like, okay, honey. You're sure not. That's nice. Go prep 

Margaret: some Yeah. Go take some vitadryl for your milkweed reaction. Be quiet. You've been 

Preston: overdosing on milkweed, Preston. So, we had a lot of construction around the house, and there was like always a scaffolding or something, so I was really inspired by the construction workers, but I also wanted to, I also wanted to be a movie director, so I, like, I, in retrospect, this is just like hyperactivity, but I had like so much energy as a kid that they would like lock me in the basement, and they were like, okay, Preston, like run around for two hours, and I called it my chuh chuh time.

Margaret: That makes sense to me. 

Preston: And I would just, there was like an exercise ball and I'm just like, I'd run as fast as I could and jump on the exercise ball and bounce off of it. And I'd create these like different scenes in my head. And I'd be like, wow, like I could create movies someday. Like this would be so cool.

So I had this idea that I [00:09:00] wanted to tell a story and I wanted to make something in my head and then manifest it on the screen. And this, there was this like part of me that, It never felt like I got to act that out. And then when I got to high school, I thought, being a movie director is that's not a safe journey.

I have to do something that's safe. And so when I had that tension between cool guy, JD scrubs, movie director locked in the basement running around with my head cut off, I like shoved down that movie director part of myself. And so when it when it first reemerged was actually when I started the TikTok journey.

Which, yeah, I think makes sense. Years later. Yeah. Yeah. Yeah. 

Margaret: And so then at that point, like in high school, were you like, I'm going to try and go to college and then go to med school and become a doctor? Or were you like 

Preston: No. 

Margaret: You're laughing. Yeah, I'm like, what? What is that? 

Preston: So, so we're kind of, to bring us back here, now Preston has these like different ideas floating around in his head, and the one thing that I was good at was soccer at the time.

So a lot of my social activities was, they were mediated by [00:10:00] my ability in sports. So my mom puts me on the soccer team, Arsenal Gold in Fort Collins, which is the highest tier of youth soccer at the time. And there was a bunch of pressure on us. They were treating us like a semi bro team. I remember like I remember going home from practice crying and I was pouring all of my self worth into my like value as like a striker on this team with all these other 11 year olds.

So because I'm like trying so hard to fit in with these kids, we would like go home after practice or after a game and we're all like chilling, hanging out. And everyone's like, Oh, you know, let's go to the mall and see if we can pick up chicks. And I'd be like, yeah, or we can Go to the Asian store and see if they have any cool dragon statues and everyone's like, pressing what?

That's the stupidest thing I've ever heard. I was like, oh, you guys don't like dragons? Like, oh, okay. 

Margaret: Now who's laughing? House of the Dragon. 

Preston: Yeah. Not 

Margaret: sponsored. HBO, if you want to sponsor us, we're open. 

Preston: Yeah. Now dragons are cool. dragons are cool. Yeah. So I like, I took [00:11:00] all these other parts of my identity, like this, this, this, this, Architect, construction, obsessed with dragons, Egyptology is also in there somewhere.

Um, I really liked maps, so I had these like, every type of map you can imagine was around my room. And, like, I remember I had, like, the river basins of, like, the southeastern U. S. I don't know why that was there, I just thought it was cool, and I would try to go make these field guides of my neighborhood, like I was some kind of explorer.

Anyways, I was like, this version of myself is not going to be accepted by the youth. So like, I like came home. I was like, sorry, Matt Preston, but you're dead. And so I immediately tried to conform to them. And that kind of stuck with me for the rest of high school. I was trying to be this like kind of Cocky, jock, prototype, and as a part of that, my career aligned with it.

So I wanted to go to a business school and I wanted to make a ton of connections from my frat. And then I would like, then I would totally, yeah, network my way. No, no. Oh, 

Margaret: okay. I went to a 

Preston: military academy, which is like a giant frat. I was 

Margaret: [00:12:00] like, in a way, in a sort. 

Preston: I think Alpha Gamma Alpha is what we called it because it looks kind of like AFA they would try to They would try to like sell the frat thing, but it feels a little more like a cult.

It's a brotherhood 

Margaret: You know 

Preston: brother. Yeah, 

Margaret: it's a brotherhood. You're there. You're ready to do business. You're ready for synergy. You're ready to connect network 

Preston: Exactly. I'm on this pipeline. So I'm a junior in high school. I've got my sights set on college I'm like UNC Chapel Hill I can get in state tuition because my dad lives there.

Shout out to my mom and dad for being happily divorced. And it gives me, it gives me two opportunities to get into a different, um, state school. And then my mom gets into this big accident, where my junior year of high school. So she was this bicyclist, uh, she was so into bike riding, she had this thing that she wanted to be 50 and fit.

And as a part of that, she like retook up road cycling and was doing these century rides, which is a hundred miles in a bike ride. And we're, so we live in like Northern Colorado and she would bike up all the way into the mountain [00:13:00] passes. 

Margaret: Wow. 

Preston: Like go to the Continental Divide and back. Like a 13 hour bike ride and she'd just come home and be like, wow, mom, like, 

[music]: did 

Preston: you go to Utah for lunch?

And she's like, well, technically it was Arizona. I'm like, what? Like, this is like a 16 hour drive. How are you doing this in a weekend? She was, she was really good. And so my junior of high school, I was visiting my dad in North Carolina and she used that time with the kids being gone to go do a ride. And another cyclist hit her and sent her off into a ravine.

And she fractured her spine, um, at about T4, which is kind of right in the diaphragm under that kind of V in your ribs. And that's important because it means she couldn't use her, her abs at all. After that, it was really high break. So it was a pretty traumatic event. Um, she actually landed in a creek and the creek was so cold that it kept her spine from expanding or kept her spinal cord from swelling.

And actually that's what they think What the neurosurgeons thought kept her alive. 'cause she was, her time to surgery was been like eight to 10 hours. It [00:14:00] took a long time to get, because they had to like find where she was and then they had to like discover the extent of her injuries and then like try to helicopter her out of there.

So that's where I now had this new tension. I was trying to fit in all these like. For lack of a better word, douchey soccer types. And now my mom at home, excuse me, now my mom at home is, has this life changing injury. 

Margaret: Which I think also like having something like that happen is another like sort of isolating thing.

I think it can also be something that looks like you never wish the pain or grief or loss that people have, but it also makes you start thinking about things very 16 year olds might have thought. And thinking like you're forced to think differently. 

Preston: Yeah, and, and I think I had this idea that all things happen for a reason, and I, and I think I, I struggled, like this pretty much destroyed my entire belief framework of what reason could be for this.

And then, and then I [00:15:00] had this kind of guilt around it because I resolved to stop fighting with my mom because she was in this accident, I just wanted to be helpful to her, and I was seeing myself develop these new adaptive positive behaviors, and I thought, oh my God, what if the reason is that it makes me a better person.

And then I thought, oh, now, now I'm like a good person at the, at the expense of my mom's accident. So it led to like a lot of like really conflicted ideologies in this like poor 16 year old's head. 

Margaret: Right, right. That's what they say. It's like you're a 16 year old boy trying to figure out 

Preston: what does this 

Margaret: mean?

Preston: I'm like, I'm like, what does my identity mean? I'm a good person. And then, you know, throwing that's like, yeah. So it took me a long time to really acknowledge that, like, this thing is awful. And I wouldn't wish it on anyone. And also there are positive things that came out of it. And that kind of complex relationship with emotion doesn't come easy to you when you're 16 years old.

Margaret: So, 

Preston: Part of what made me want to pursue [00:16:00] medicine was this idea that I needed to, like, make the world better for other people and I wasn't doing that. Getting these connections, pursuing business, going to Manhattan to work in a financial firm. Right. Um. So that's kind of where this initial inspiration for medicine came from.

Margaret: Yeah, so like how I need to like do something and be there, like kind of like how do I make sense of the pain and that it turned you not maybe from your personal experience with like being helpful with your mom and at home, but also like. What matters And like, making sense of that with the 16-year-old brain is Yeah.

Preston: Like I, I go back and I like read some of my tweets from that time and 

Margaret: I like, I mean in between like all the worst pearls like Travis needs you've 

Preston: seen Yeah. , I'm like, oh, I was really little Wayne, I guess into the podcast. Yeah. So I, one of the tweets that stood out to me was like, you don't know what a real, what problems are until you get a real one.

Hmm. And I remember. [00:17:00] The state of mind I was in when I wrote that, and I was just I think I had trivialized everything else in my life. I'm like, why did I care who came to Chipotle with me during lunch when I now have this problem waiting for me at home? So yeah, the solution to that was Preston, Preston has absolutely no control over this problem he has at home.

So he's going to take control and solve every problem in the world. 

Margaret: And you did. And that's how we ended up here. 

Preston: And, and, and scene. So actually, there's no more medicine after this. Preston solved every problem ever. No one 

Margaret: needs psychiatry. We don't need help. We're good. We don't even need 

Preston: cardiothoracic surgery, actually.

You're welcome, world. I'll be waiting for my PayPal deposit anytime. Yeah, I, it was, it was a lot. Um, but. It was a good redirection, I think. So now I'm in college, I want to be a doctor, and I was also like, what if I become a pilot? Because we're at the Air Force Academy. 

Margaret: Right. Well, do you think you wouldn't be a pilot at the Air Force Academy?

I [00:18:00] feel like that would be my first thought, like when I'm like heading off to college, I'm going to the Air Force Academy. I'd be like, I'm probably going to fly a plane. Is that not included? 

Preston: It's a pretty normal belief. to think that you'd fly a plane going to the Air Force Academy. It was designed to create pilots.

They recruited me to run track and I was so enchanted by the idea of like being wanted by someone that I was like, I'll do anything. Just like, I was like the One of those kids at like a halftime show in a basketball game, like an NBA game, like put, put a bat on my forehead, spin me around, throw a pen in my hand and tell me where to sign as long as like, are you guys sure you want me for the team?

They're like, hell yeah, we do. And I was like, okay, so I like dragons 

Margaret: and maps. 

Preston: Yeah, so, so next thing I know I'm in um, basic training and I'm like, Oh my God, what did I sign up for? And, and I'm being spoon fed all this propaganda about being a pilot. Like we'd go sit in the auditorium and they would just play Thunderstruck over the loudspeaker and then there'd just be a [00:19:00] montage of F 16s dropping bombs on mountains.

And just play Top 

Margaret: Gun over and over and like rip tape off of you if you look away. 

Preston: Yeah. So it's funny you should say that. Top Gun. Yeah. is Navy, so they get a little offended if you say that. Uh oh, 

Margaret: cut that, can we cut that from the podcast? Cancel. 

Preston: Somebody wore a Top Gun shirt to basic training and they got destroyed because they're like, Do you even know what branch this is?

Oh man, that's an F 14. That, that takes off of an, they're like, actually takes off of an aircraft carrier. All of ours are land based. I'm like, oh, okay. Like these guys are insufferable. 

Margaret: I apologize to every, every, um, subsection of those serving our country. 

Preston: Don't, don't worry, chat. I forgive her on behalf of, uh, other military members.

Yeah. At least it wasn't during November. So Um, I, I was kind of weighing both of those cause F 16 go fast, you know, and it was loud and they played Thunderstruck and Auditorium, [00:20:00] so I'm like, yeah, I'm like, it's like my own dragon, but instead of like breathing fire and sitting in a lair, I can just go drop a 500 

Margaret: pound bomb.

Chicks are going to love 

Preston: this, unlike dragons. Yeah, exactly. And I can name it a dragon. So around my junior year in college, I was diagnosed with asthma. And that's like a, do not pass go, do not become a pilot kind of thing. So I went through a bit of an existential crisis, but also I had this decision made for me.

I'm going to go into medicine. 

Margaret: Hmm. So you have, so to confirm, you're not a pilot. 

Preston: I am not a pilot for legal reasons. 

Margaret: I'm not a pilot. My lungs are not strong enough. Um. 

Preston: Yeah. Yeah. Well, I mean, they are strong enough, it's just if I have any kind of like bronchospasm in the air, then I'm not, I'm not reliable, 

Margaret: I could have a 

Preston: hypoxic event and crash the billion dollar aircraft, so, 

Margaret: allegedly, 

Preston: what, yeah, whatever, um, it's discrimination if you ask me.

Margaret: Lung [00:21:00] discrimination. Okay. It's, 

Preston: it's rigged. Yeah. Yeah. So this decision is made for me. I'm going to be a doctor. And then during this time at the Academy, I had a lot of insecurities, I guess is how I'll put it. So in, in the backdrop of all this stuff that we're talking about, um, Preston's sense of self, not, not fitting in or feeling like I belonged.

I think I, when I wanted to be a physician, I also like wanted to kind of. Prove myself and that's the part that I think a lot of people are reluctant to even share was a part of their path to medicine Everyone is so ready to jump on the altruism bandwagon that I was just so passionate about squamous cell carcinoma of the skin in situ that And like the first time I saw a character in Pearl, I just like, I 

Margaret: cried.

Yeah, 

Preston: it, it was an emotional experience. And I knew from that moment, I was going to be a doctor. I'm like, come on, dude. [00:22:00] When, when it comes down to it, if you ask someone, why didn't you become a nurse? Why didn't you become a PA? Why didn't you become a CRNA? It's power. And I think that's something that you can't avoid talking about.

And so just like right out the gate, I had this desire to prove myself and that's kind of, it stemmed from this insecurity, insecurity of a young college student, and then I think it kind of transformed into a more healthy relationship with what it means to have that power in medicine. So. I kind of went, spent a lot of time chasing after these accolades in college, like I went to the Rhodes Scholar interview, like I was like a finalist in District 13.

Margaret: Okay, Hunger Games. Yeah. Let's go. They were, 

Preston: they made those jokes. They were like, they were like, District 13 is going to be the district that saves the world. And, you know, all, I was like, oh my god, I'm gonna go to Oxford and I made up a whole narrative three weeks before about how everything I've been doing up to that point somehow made sense for this dream I had to go study [00:23:00] like infectious disease in Africa, uh, which I think was my pitch to them.

And, uh, they, they, like, lined us up all, um, what do you call it, Miss America style in front of this table and, like, announced, 

Margaret: announced, like, we were all wearing bikinis. It was this whole thing. 

Preston: Yeah, there's, there's other metaphors that could be used, but I, but I felt like, I have actually and their, her swimsuit scene is in San Antonio and I walk, I actually run past that stage every other day, every weekend.

Yeah, 

Margaret: okay. Cool. 

Preston: Well, I actually forget about the Alamo as I pass the stage and then I remember it again just because Miss Congeniality takes over my entire hippocampus and my memory bank. I'm constantly 

Margaret: remembering Sandra Bullock in every role. 

Preston: Yeah, so I, I had this, um, this need to prove myself and it came from this like kind of desire to have power in addition to all the, those altruistic aspects.

And then that's kind of how like [00:24:00] that happened. The journey to like med school started you you have these like conflicted feelings and you have this almost Hesitancy to even acknowledge that you can have self serving reasons for pursuing something I think I remember all the pre meds like gather around the table.

Like why do you want to do medicine? They're like, oh I want to do medicine because and then they dump an entire trauma history that you're like, oh god I can't compete with that. Like I Like, I'm like, my mom is paralyzed and they're like, well, my mom and my dad and my cat are all paralyzed, actually. And my grandpa has paper skin and he drinks everything through a straw and you're like, oh, dang, you're so much more deserving of medicine than I am.

And then, and then they also are so much more passionate about science and all these other things, and so everyone would be like avoiding saying that one thing, like, I, I want to say that I'm enough. 

Margaret: Yeah, and meanwhile, probably you were acting and people were perceiving that in, in you too. 

Preston: Oh, oh yeah. 

Margaret: And like all of us kind [00:25:00] of worsen this sort of idioculture of medicine of like, I actually don't have feelings and I have perfect motivation and I, I'm going to burn you at the stake if you tell me that you care if you can pay your loans off.

That is, that's what I talked about. I said, I'm going to, 

Preston: money, I'm going to have Preston's dragon 

Margaret: start the fire. 

Preston: Yeah, you'd see it. Yeah, I'm worried about my student loans. They're like, I didn't even realize we were getting paid. That's how much I care about medicine. 

Margaret: I actually, I just wear a paper bag to the hospital.

I'm, I'm paid in the gratitude of privilege that I feel to be working in healthcare. 

Preston: My, my entire salary is just direct deposited to the nearest soup kitchen. I don't see a cent of it. Oh my god. Kant would be so proud of us. The categorical imperative lives on, in Margaret only. 

Margaret: Um, I lost our thread. 

Preston: Yeah, so basically [00:26:00] I was, basically I'm a saint.

I'm Mother Teresa, Brother Teresa, I guess, going into medicine and then, um, now I'm in med school. And that, like, need to prove myself was still there, but what do you do if you're already in medical school trying to be a doctor? Yeah, better a 

Margaret: doctor, 

Preston: but not for a 

Margaret: patient. 

Preston: Is it satisfied? Absolutely not, like, time to go for the most competitive specialty ever.

Margaret: You're like, I'm about to ride this car till the wheels fall. I'm 

Preston: like, yeah, I'm like, well, wait, then I have to realize that I might be worthy outside of my job. And I was like, nah, time to spam, like, high step score specialties possible. 

Margaret: You're like, Google, www. whatwillgivemeworth. com. That was you in med school.

Preston: It's actually called whichdoctorsarepaidthemost. com. Yeah, so I just googled that and I was like A foolproof 

Margaret: plan that has never not fixed someone's self esteem issue. 

Preston: So the next day at school I'm like, yeah, it's just [00:27:00] weird. It was a school. It's like a high school. I know 

Margaret: it was school. So can you like coming in with your like lunchbox, 11 year old view is back.

Preston: I'm like, yeah, I just, you know, I don't know. I can't decide between like the skin or the bones. They're just both so interesting. I love 

Margaret: collagen. Oh, 

Preston: yeah. And then me, me who doesn't know the difference between between like an emollient and a cream or like an oil. I still, that was like a question on our exam.

I was like, Oh God, maybe I'm not passionate about the skin, but I told everyone I was. And also like orthopedics, it just, I'm an athlete. It speaks to me. And the other thing, I think I might be interested in how the heart pumps, but I'm not sure if it's from like a surgical perspective or a medical perspective.

I'm still trying to figure that out. You know, and really your face is what defines your humanity. So let's sprinkle in some plastic surgery. 

Margaret: The tangentiality, the refusal to recognize what the common thread is, is awesome. 

Preston: And I'm like, what are the odds that I'm interested in all these different specialties?

Margaret: You're a high [00:28:00] value man, Preston. Um, and 

Preston: then the best part of this is I go to people, I'm like, Oh man, like my friend Cheryl, um, Shoutout to Cheryl, I'd be like, Cheryl, I wish I was like you and just had this interest in family medicine. I 

Margaret: actually hate you. I, we would have not been friends. That's all I've been like, you can choke.

Preston: You're like, oh. I'm like, okay, plastic 

Margaret: surgery. 

Preston: I'm just so interested in orthopedic surgery. Or, orthopedic surgery. And so as I'm like reconciling all of these things, I landed on ENT and I want to say like I came to it with like a sound conclusion, but really it was like, um, you ever go, you ever go to the fair and they put you in that, that phone booth with all the dollars and the wind blaster?

Yes, well I've never done 

Margaret: that, but yes. But you 

Preston: see people do it, right? I've seen it, 

Margaret: mostly on TV, but yes. That was 

Preston: me grabbing my specialty that I decided I wanted to pursue. There's all these dollars floating around. I was like, 

Margaret: ENT! Got em. This is so me. 

Preston: Yeah, so, [00:29:00] so the way I I, I bat reverse engineered it was I have this philosophical desire to communicate.

I'm like, I really want to see the bridge between human minds. Mm-hmm . I really wanna understand what makes us tick and what better way to do that than a lymph node dissection in your neck. 

Margaret: So true. 

Preston: I'm just kidding. I, I was actually, I pitched the throat. I was like, if you can give someone their voice back, you're giving someone their ability to share their thoughts.

True. If you give true, if you give someone their hearing back. They can, like, listen to a conversation again. And that made so much sense in my room. And then when I was in a 12 hour case getting pimped on the, like, lymph anatomy on the different triangles in the neck, I was like, this does not feel like an 

Margaret: assessment of personhood.

Yeah. 

Preston: I think, I think I may have made a mistake. 

Margaret: In the OR, retracting, just recognizing in that moment. 

Preston: So I remember I had a head and neck attending. I was retracting and I would try to look to see [00:30:00] what's even going on in the neck. And he would get mad because every time I looked, my wrist shifted a little bit.

Margaret: Yeah. 

Preston: So he was like, no more looking. I'm like, what do you mean? He's like, look at something else. So I just looked at the ceiling tile for the rest of the case, like three hours. 

Margaret: You're like, I'm having so much fun right now. 

Preston: I'm like. And I just couldn't hide it anymore. You go back to the, the work room and all the med students are like, I had the best time today.

And I'm like, am I being gaslit? This is not fun. We stared at a ceiling tile for three hours. 

Margaret: Different stories in terms of like, I literally walked into my first rotation was pediatric surgery and I looked at them and I go, I'm doing psych. I want to be helpful. Um, work with that. And they were like, so you're willing to do this, Scott?

And I was like, I would love to. I would like the least amount of time in the OR as possible. Love that there are surgeons. Love you guys. Could never do your job. Uh, and I will never be one. If you want someone to talk to patients, I'm gonna go talk to them. I'm gonna go chat them up. 

Preston: Dang, Margaret, if only I had [00:31:00] your insight at that time.

But then you wouldn't have had, you wouldn't have gotten the fun experiences I would have got, that I got. Which are? Like counting ceiling tiles. You know how many? I still had to do 

Margaret: that, I 

Preston: will say. 

Margaret: I couldn't pretend that I was like, this is towards the greater good. I was like, this is um, an experience and I welcome all experience into my life, I guess.

Oh my god, 

Preston: that's so mature. 

Margaret: It's not. I was like, I want to go to sleep. 

Preston: I re Did you ever make out, like, little scenes in the ceiling tiles, like the patterns of the dots? I'd try, I'd be like, oh, it's like a constellation. I forget. No, I feel like I 

Margaret: blocked any time in the OR. First of all, not that much time in the OR, because I was allowed to do, for instance, of an ortho month, I was allowed to do rheumatology for two weeks and two weeks of PM& R.

And I almost switched to PM& R from psychiatry, um, but I did it minimal OR time, minimal. So I don't remember anything I did to try and get through it. 

Preston: Okay. So, um, anyways, I, I, the, the punchline is I was miserable and I came to this realization [00:32:00] that I, I didn't like anything I was doing. I was involved in research.

I was gunning for a high STEP score. I was like splitting hairs over every little grade I got on a rotation. I just, I think I like broke down one day. It was like, it was like a small PEDS quiz. And just, just that, like, a bad grade on that small quiz was enough to make me like I'm just not having fun.

Like I was just like, I'm like crying on a Thursday night after this, like, grade. I'm like, why do I care so much about this? You know, this is awful. And then I had a, And we're gonna talk with Cheryl again. Shout out to Cheryl. 

Margaret: Cheryl, shout out. You sound awesome. 

Preston: Yeah, who I'd tell, I wish I was interested in family medicine like you are.

I wish that I 

Margaret: cared a bit. Yeah, 

Preston: yeah, exactly. I wish I could 

Margaret: do such a low paying specialty like you are, is what you were saying. 

Preston: I know, and she kind of knocked some sense into me. And she was like, well, what do you think actually makes you happy? And yeah. That hit hard and I kind of took a step back and said like, well, I [00:33:00] think there may have been some connection between my desire to do plastics and ortho and derm and neurosurgery and ENT.

They're all competitive. Whoa, Whoa. Where'd that come from three years in? And then. I take a step back and say, okay, well, what if I just remove this factor of competitiveness from it? And then all of a sudden, like the interest I did have in those surgical specialties, because I did have them, it didn't go away.

But now all of a sudden I was able to be interested in all the other specialties that I'd written off that didn't have that little gold star of approval of being like competitive or high earning. And then now all of a sudden psychiatry is really cool. And I was really happy the whole time I was in psych.

Like, I, I loved talking with the patients. I would stay late to learn more didactics. I would ask to take on interviews and the psychiatrist would be like, Hey Preston, you're pretty good at this. You should consider doing psychiatry. And at the time I was like, thanks for the compliment chump, but I'm actually doing it.

You're 

Margaret: like, Oh, you can eat my shorts, but [00:34:00] that's part of the Simpson shout out. 

Preston: I was like, I was like in your dreams, losers. In 

Margaret: your dreams. Just did this and walked away slowly and then flexed and left. 

Preston: Yeah, exactly. I just, I just backed double bicep in the door and then I walked out. And then six months later, you, like a single email from me, like an all lowercase, like please take me back.

Margaret: Sorry. That was rude. 

Preston: Remember? Remember me from earlier? Remember the 

Margaret: first 90 percent of our interactions? 

Preston: So something hilarious happened, and I no longer want to pursue this specialty, it believes. So I sat down with the clerkship director, um, Dr. Molloy, shout out to Dr. Molloy. 

Margaret: Shout out. 

Preston: And she said, okay, Preston, we get a lot of 12 hour applicants really trying to switch at the last second.

And those are, it's hard 

[music]: because 

Preston: a lot of people want to switch to the psych. You're an 11th hour applicant. And I was like, so she was like, so you can probably do a pretty good job. I was like,[00:35:00] 

so 11th hour, I had my entire schedule like set up for ENT and I just ripped it up and replaced it with psych rotations. And then I loved it. 

Margaret: And you 

Preston: were like, let's get this show 

Margaret: on the road. 

Preston: And then I was like, Oh, I don't have to look back 

Margaret: at this point. The next chapter is now where will 

Preston: my self worth go?

Exactly. So, so now we're trying to reel it back in from a performance on social media and we're going to channel it into you. 

Margaret: We're going to channel it 

Preston: into Margaret's approval of me. I think I think we should not do that. My dream 

Margaret: is that we do not do that. 

Preston: Yeah. So we're, we're working on that right now.

Um, this, this morning, I think I had it. as being like a good person so it land on that for a bit and we're working on that in therapy and i was had my appointment with my psychiatrist this morning and he was like are you going to therapy i was like yeah i am i'm like trying to disconnect my self worth from like helping others you know like i think i have this maladaptive core belief that i'm a good person because other people don't get hurt around [00:36:00] me and that's like pretty inflexible And then there was a pause.

He was like, Oh, shit. I think I have that too. Did he say that? Yeah, he did say that. I was like, what were you really 

[music]: mad 

Preston: for? He was like, maybe I should go into therapy. I'm like, look at us, just two psychiatrists having a chat. Guys being dudes, 

Margaret: being guys, having feelings. You know, what's better than that?

Preston: Yeah, me in this big old, like, sofa, sitting 12 feet across from you in this big old sofa, your hokas, laptop. Love, hokas, shout out. Not a cell phone in sight. 

Margaret: Just hokas, you know? 

Preston: Yeah. So, so now I'm That's your 

Margaret: journey. 

Preston: Yeah, now I'm here and I want to kind of find a way to help people navigate their own journey.

And then when I had the idea to start the podcast, I was trying to find someone who I wanted to host this through and I came across Margaret. So we're going to take a quick break and when we get back we're going to talk about how I met Margaret and more on Margaret's story. 

Margaret: And a little on dragons. [00:37:00] 

Preston: And also Miss Congeniality.

Margaret: And a little bit about Sandra Bullock. 

Preston: Sandra Bullock. 

Margaret: Welcome

Preston: back. And let's get into Margaret. 

Margaret: Where should we start? So 

Preston: where do we begin? When I first met Margaret was when you reached out to me under your alias BadArtEveryDay on TikTok. And 

Margaret: behavior, if you will. Yeah. 

Preston: I was like, this is weird because the art is not actually bad. And it's not every day. 

Margaret: Well, it's many days.

Preston: It is many days. And so it was weird. I think it was like the diction and the syntax of your email. I don't know how you did this, but you evoked a lot of personality. And I remember like the words you said, but I was like, I don't know why the other, this nameless profile feels so human to me. And you wanted me to come to the zoom call to just talk to other med students at your med school about like what it was like to, [00:38:00] Beyond a presence on social media.

Margaret: Yeah. Yeah. 

Preston: So I remember I came to the call and it was actually the first thing I did as a celebrity, like a pseudo pseudo celebrity. Yeah. The first time I had like made a public appearance and talked about myself in a professional capacity as Presro, not just like Preston, the med student. 

[music]: And 

Preston: so I think I was.

I was actually really nervous, and I kind of tried to play it off, like, as a joke, like I do. You've actually never made a joke, so 

Margaret: that's, that's really tough, but yeah, 

Preston: hopefully saw them landed. So, it's funny, because as the, like, the session ended up going really well, and then Margaret and I just ended up keeping going.

You kept talking because I would have some idea that popped in my head that extended fruitfully from the conversation we had, um, during the chat. I think I was, I was talking about how it's been challenging for me to navigate both my professional identity and [00:39:00] my, um, like social media identity. And I was like, how do you navigate this?

And you're like, Oh, well, like, you know, I have more of like a psychodynamic approach. So you're a bit more of a, like a, a blank slate. And I was like, Oh, I was really fascinated by that. And so I think in a lot of ways I felt seen by you because you're the only other person I knew who was a psychiatrist, was managing social media, and I think thought in a way that was similar to me.

So I was like, Oh, there's this other person who I can confide in. And then I think that's kind of how our friendship started. But I don't know you on like a personal level. Like, I'm not, I haven't been friends with you for a long time. And a lot of this is kind of just been a huge leap of faith saying like, I, I And I know they'd be a great co host, but the rest of your story is a mystery.

Yeah, exactly. 

[music]: So 

Preston: I'm hoping we can shed some light on that mystery and learn about what your [00:40:00] story is. 

Margaret: Yeah. Um, should we start at the beginning? A very good place to start. Yes. Okay. 

Preston: Yeah. At the beginning. I'll ask you this question. When was the first time you thought you were going to be a doctor? 

Margaret: I think it was like in the water.

So I come from a medical family. My dad was primary care. Um, and I was like, and then a couple, two of my three siblings are doctors. So I, it was kind of there. So it's hard for me to say, like, when did I first think of it? Um, I think probably when I was like in junior high, it was like kind of, Watch my siblings who are doctors are four and six years older than me, so like as they were starting to like come go to college and come home from college and be like, I'm going to do this, I'm going to apply to med school, like you absorb that, right?

And I'm the youngest of four. And so I think it was always there. And I actually had the reaction of like, I don't want to do this. Like, I don't want to be a doctor because I had this view of medicine as like, like, I was like the creative one in my family in some ways, not always, but like, that was kind of [00:41:00] the kind of insecure, I guess, interpretation I had of like, I like English and history and like, I want to follow that thread and, you know, do something.

Preston: Your creativity wouldn't be stifled by the, the trudge into medicine. Yeah. Yeah. 

Margaret: And kind of like an ability to stay with like the hard sciences just was like, did not, it, I could do it, but it wasn't like something that felt sustainable or it was something I had to actively like work really hard at.

Whereas like English and history and like theology classes, even in like high school were naturally kind of Drew me to them. 

Preston: How did your family react when you told them this? 

Margaret: Well, I mean, I wasn't give 

Preston: it off. 

Margaret: I wasn't ever like, I hate your guys's careers. Like, I still went into college being like, I should not rule it out.

So I was never like, I definitely am never, ever going to do this as much as I was like, this part of me won't make sense in it and that will be painful. 

Preston: You didn't have that Disney movie scene in the doorway where you're like, it's your dream dad, not mine. Um, you mean Troy Bolton and [00:42:00] his dad? 

Margaret: Uh, sadly I did not.

Um, I think similarly to you though, there was something about when I tried to, like, I think I had these kind of, Really super, because right, I grew up with health care being discussed at the kitchen table. I am a Nepo baby, unfortunately, recognize that, sadly, um, in terms of medicine, uh, but, so I knew actually, like, what was hard, especially in, like, my dad's primary care, right?

So I knew what was hard about medicine. I also did know what was, like, joyful in this very particular kind of model of medicine in, like, a college sized town in the Midwest, right? Um, And I knew that and the other careers that I couldn't see at home were like, I could romanticize them sort of as like this idea of, oh, like vaguely like being creative and what that would feel like or like what working in like business or like really like advertising might look like and like marketing, like I was, there's like an image in my mind of that.

Um, but then [00:43:00] when I got to college, 

Preston: so I have a question, what, what was hard and what was joyful about it that you saw growing up 

Margaret: about health care? I mean, I think like. Seeing someone in primary care in general is like, there's so many questions that I think we don't really see or we don't talk about or know how to talk about in med school and then in residency we start to see the systems question and I don't think it's a controversial thing for me to say that like, a lot falls to primary care and it's not necessarily rewarded Uh, for the type of work that they do in the current payer model.

Preston: And that's been true. You saw that burden landing on your parents growing up as a kid. 

Margaret: Dad, yeah. Well, I think I saw like him trying to do really good care and that sometimes that was really possible and he was able to impact the system really positively. And sometimes the system just like overall in healthcare, like makes it.

Makes it hard for you to, like, care for [00:44:00] patients well and maintain, like, a boundary around yourself and being able to rest and be present with your family and do all of these things, and that's, that's difficult. 

Preston: Like a zero sum game. 

Margaret: Yeah, just that it's, it's a lot. And also if you're someone who likes Who went into medicine, right, because you want to be helpful or because you're like, I can see a way for us to organize this and do it better.

It can be really frustrating. And I think like medicine changes so much decade after decade. Um, and he was practicing from like 19, like the, like early 80s through 2017. So like a lot changed in healthcare in that time. Um, But anyway, so I'm in college and I started like pre med and poli sci because I was like I like history in English and like maybe I'll go to law school or something because my mom, uh, was, my mom is a lawyer.

Um, and so I was like maybe that's like the Englishy history side of me. Again, that same thing of like kind of [00:45:00] like being a drawn to prestige I think. Um, but also I think drawn like that's sort of the shadow side of it. I think there's also a positive side of it of like, wanting to have the ability to impact change because I had seen like, who, like, where is their power?

Because it can be really frustrating to be somewhere where you don't have the ability to, to change something for the better. 

Preston: I think, like, I saw power as this ladder to raise me out of my current socioeconomic status. And I think you were exposed to it in a healthy way and saw that your dad with that power as a primary care doctor can, you know, impact real positive change can can exact real change the same with your mom.

So like, it's a healthy description of power that I'm seeing. It's cool that you could appreciate that so early in college. 

Margaret: Cool is an interesting word, but yeah, I mean, there's insecurity there too, I'm sure. But yeah, but I switched from poli sci because it made me feel really, really dark and scary about the world.

And that was in like, what, 2013 or 2014. And I switched to theology. [00:46:00] And one of the things that I think was, I really drew me to that was This, like, kind of just these existential questions, like, how do we talk about what matters with people? Certainly, theology and religion is a mixed bag in terms of its impact, but it's a place that historically has been where people talk about things that are important and what they value in life.

And I think that combined with kind of a view on, What would it mean if it was like each person that you ever met was kind of sacred and individual and unique and non repeatable? Um, and I think that that is, that combination of things led me to work in ministry in between summers in college. Uh, and in doing that work, I had a lot of conversations with people about like what was important to them.

Obviously in that context, it was related to God, religion, but also it was a lot of things that like, I worked with high schoolers and it was like, what does it mean to be a good friend? What does it mean to like? Be a good like to like be a daughter and a sister and also [00:47:00] yourself when there's this like dissonance, um, and it just it meant a lot to me to just be able to be with people asking themselves that question, especially even though I was just in college, like, People in adolescence or young adults who are like, yeah, how do we make a more beautiful world in some way?

So it 

Preston: was important for you to be present with people. Yes, as they try to answer Life's hardest and in a way simplest questions. 

Margaret: Yeah And from that I was like, I had stayed pre med and I was, and I, then I, in college I like loved organic chemistry and was like, wait, so that kind of shifted my identity of like, like, I don't, don't get me wrong, I definitely struggled with organic chemistry, but there was some beauty to it that I hadn't had in my prior like, Physical science classes and that I saw a video chemistry like 

Preston: Legos.

Margaret: Yeah, yeah, yeah. . Yeah. Um, and so I, there felt like there was something creative about it. And I think this combination of things and then seeing like working in ministry, like. Oh, I want to have these conversations, but I also want to [00:48:00] have other tools, like I want to be able to help people with medication or therapy, um, and be with them in a really real way, and, um, not from a religious angle even necessarily, it was more just like, oh, I see how medicine and being in psychiatry could fit with this.

Preston: Yeah, I think it's, it's one thing to have the conversations about the challenging questions, but it's another thing to be in the room at the bedside. 

Margaret: Yeah. 

Preston: You know, and, and in a lot of ways, medicine is the staircase to get into that room to talk with a patient about what's really important to them.

[music]: Right. 

Preston: Because without that, otherwise, you're just some person on the street, and even if you try to have that conversation with them, it doesn't resonate the same because you don't understand all the nuances of their condition, so I resonate a lot with that. 

Margaret: And I think that's, I think it's true and not true.

I think we also tend to underestimate these other areas outside of like the current modern like healthcare system of what, how healing happens in community, [00:49:00] but yeah, that there was like, I think it also like, right, I'm like loving organic, my year of organic chemistry, I'm still like liking my theology and kind of philosophy classes.

And it was like, Oh, what if I could put these two parts of my brain together and kind of enjoy maybe nerding out on some of the science parts of healthcare, but then also be able to actually like concretize or bring into like incarnate, that's again, religious language, but like, right, have the abstract become something concrete.

That looks like paying really good attention, even if it's just choosing the right antidepressant for someone. Like, having that, that movement between the two ways of thinking is really satisfying 

Preston: to me. Weaving in actionable items with this important rumination and contemplation of these hard ideas.

Yeah, there's a beauty to that. It's like a dance. Mm 

Margaret: hmm. Mm hmm. Yeah. So, then I decided to go to med school, um, [00:50:00] and ended up in med school, still struggled, and I think the story for me of med school and some of residency has been the integration and the kind of like what can belong from in me, like what belongs in medicine and what has to be sort of like cut out and put in the other parts of your life, like what matters to be a good doctor.

I think I still some have struggled with the view of like a good doctor is like, you know, In love with science and like kind of things you were saying, right? Like a hundred percent, just no questions. Invested in, like, the science and research side, and I've never been, like, a research, like, a hard science researcher, um, and so making sense of, like, well, what do I do with the part of me that still, like, likes writing, like, fiction, like, or likes making TikToks now, if that's the question, that wasn't the question, obviously, like, five years ago, and can there be a way for these parts of me to not be at odds with, like, I don't want to be disjointed, I want these to all be integrated together.

Most of [00:51:00] med school was me being like, that's not possible and I think towards the end of med school and then definitely in residency, more of an integration of these parts has been possible and really like personally fulfilling for me. 

Preston: So, so you, instead of this continuum of Margaret, who's the scientist, the theologist, the lover of arts, you had separated into like almost two separate spheres.

Yeah. 

Margaret: And there was like shame about wanting those other parts or feeling something missing by not being able to engage with them. 

Preston: Interesting. So when did you start Bad Art Every Day? 

Margaret: My intern year. Because I was on the medicine half and I was like, I am not having fun. It's February in Boston. I mean, I like loved the people I was working with and I actually didn't mind the medicine, but it was like.

You know, like an intern year and shout out to everyone who's other specialties and not psychs. They're not working. The February 

Preston: intern. Yeah. 

Margaret: Yeah, so and I was like, so my psych program is like half the year you're in psych and half the year you're in like the medicine part. Mine's like that too, yeah.

And so I'm like with like [00:52:00] basically seven month interns in pediatrics, some child track psychiatry. And I come in and it's like February. I get to the hospital. It's dark. I leave the hospital. It's dark. It's dark. And it was just like, where's the creative part of me? Because when I was in psychiatry, I felt like I had access to it.

And so I started it then based mainly on like, how do I, like, kind of for myself as like, I think I started honestly talking about Taylor Swift's album, Lover, which is like pink and pretty and it's based on the idea for me of like, wow, February can be a very depressing month. What is special about it?

It's these like sludgy, trudgy months of, uh, of winter that you're just like, what is like able to be romanticized about this? And like, Taylor Swift is the answer, but choosing, and this is like what my account has now been for the last three years, is like, how do you actually stay with something that resonates and like a hyper consumer of content culture and like let it [00:53:00] impact you?

Like not just consume and consume and consume and have nothing matter to you. How do you say, wow, I really love this album or this movie or this moment in pop culture? How can I make myself get creative and imaginative with why I like it and then also with making my daily life special based on it? 

Preston: I think that's where I came across you and you're already, I think, well in that rhythm of reflecting on why you like these pieces of art.

[music]: Mm hmm. 

Preston: And I was like, wow, she has this great following and people are really into it. And, and it was, it was cool for me. I, it feels like this hyper consumerism that you're describing feels like this like hustle and bustle and then you find your way to your page and it just kind of feels like a stop, like a, like an airport lounge.

To use a more capitalist metaphor, no, it's like, it's like an oasis in a bit of a desert. So I think in a lot of ways, my content is, it's choppy, it can be fast, and I'm contributing to the noise, the hyper consumerism, and I'm just adding a [00:54:00] comedic twist to a lot of it. 

Margaret: Yeah. 

Preston: And yours, like, what's yours?

Changes the frequency. 

Margaret: Thank you. Yeah, I think my favorite comment I get, and I, I get it not infrequently from people is that I'm there, like the quote, like you're my comfort creator. Um, and I think that there's like a, you know, a shadow, again, a shadow side to that kind of space where you don't acknowledge like what's not rosy.

And I try to actively not do that to an extent of like being like, Hey, here's the laundry I haven't been able to do because I've been on call and like just not feeling it. And that's a small thing, but to recognize that like not everything is, should be romanticized. Um, But yeah, it's also just been like, again, with this question of like, how do you integrate the two?

So much of what I'm writing about is like a combination of pop culture and whatever like therapy modality or history of psychiatry I'm learning, like so much, like when I was first learning acceptance and commitment therapy, I think if someone who does ACT looked at my page, those like first few months I was learning it, it was just like saturated with ACT concepts, just said in a different way.

And 

Preston: ACT is acceptance, commitment, therapy, just the acronym. 

Margaret: Yes. [00:55:00] Yeah, so I think that it's, again, it's this place where there can be an integration and that's been like a really kind of fun way for me during residency to learn not by accident, honestly. 

Preston: Yeah, it's, it's hard. I think I felt that a lot too, this other side of myself that I was trying to put to So, uh, when I, when I started Presro, I was lifting content during my.

Fourth, year. 

Margaret: Yeah, exactly. 

Preston: I wanted to show myself bench pressing and like take on this identity of like this bro who had been an athlete, his whole life, I think a lot of, That, that aspect of 13 year old Preston wanting to get accepted by his soccer friends. I didn't want to just be a doctor. I didn't want my whole identity to be a white coat and treat everything like it was an extension of the clinic.

I wanted to have like a playground for myself. So it's interesting to me how we both kind of had the same inspiration for it as this like outlet for self expression. And then, In time, I had the same [00:56:00] problem. I was like, well, if I only promote myself as this weightlifter, there's so many more facets to Preston.

And then I just kind of started making videos about anything I felt like. Do you, are there parts that you think you may be holding back from with bad art every day that it seems like you, you're intentionally filtering out? Are there other aspects of yourself that you think may be introduced at some point?

Margaret: Well, I think doing this podcast with you and actually talking on video is, is my step, is my exposure, uh. It's a huge 

Preston: step, yeah. 

Margaret: Yeah, that's my step outside of my comfort zone. Um, I think showing up as like a woman online is always an interesting balance of things. Um, and it, it hasn't been the form, I don't know, it's not the form I know how to make.

And so that's why I kind of stay, despite what TikTok monetizes, like, I just, it feels so much more like, I don't know how to do it. Maybe there's part of me that is like, it is more vulnerable to put yourself talking on, on camera, um, than it is to write on things. [00:57:00] But also that, like. I feel really authentic when I'm writing, and it also feels so much less intrusive on my life and what I'm talking about, especially given that like my form's not talking about like healthcare, talking about something specific in that way, um, and so it just, it feels more like a compliment to my life and less like I need to think about TikTok, um, but I definitely have a fear and avoidance of talking in a camera and talking in general online, and so this, this is how I'm growing, just not directly on my TikTok page.

Preston: Well, glad to 

Margaret: serve 

Preston: you as we serve the audience. Yeah. I mean, everybody wins. There's no way out. It's funny because I think I had trouble just seeing TikTok as a compliment to myself. I almost wanted it to merge with my identity. Um, I, I think I found myself So, I was kind of hoping to be more like Preston, but I struggled because I also didn't want to [00:58:00] be vulnerable.

Right. And it's one thing to be vulnerable in front of your friends, it's another thing to do it online, and it kind of comes in steps. So, like you're able to hide behind, or even not hide behind, but use your writing as this kind of buffer between yourself and the audience. I would use characters to do that.

So, yeah. The first four or five months. All I ever did was satire and I was like, POV, I'm a character of somebody else, but I'm never Preston. I'm a psychiatry resident, or I'm an anesthesia resident, or I'm a surgery resident, but when people would attack me, they would attack my character or my interpretation of the character, but they were never like attacking Preston.

[music]: Right. 

Preston: So, The, the part that like felt most vulnerable was when probably about like almost like eight months in when I started talking as me 

[music]: and 

Preston: then now when people are criticizing it, they're like attacking my, my own person and it's a, it's a hard feeling and it's tough to deal with that. Those, those wounds hit a lot harder.

Margaret: Right. Right. Yeah. I mean, I can imagine so. And I think. For me, there's like, there's the fear [00:59:00] part, but I think, honestly, bigger than that, and I know we've talked about this off, like offline, but part of it is that I don't think, I think there are parts of me that are You know, like if there are parts of anyone like this that are kind of intimate and sacred and special and, and I, I don't want to share them with everyone.

Um, and that that feels right for me. Um, and I think 

Preston: they don't need to be shared with everyone. It's, it's just about finding And I'm going to be talking about the techniques you have to live your life in the way that you're most comfortable and having this hard introspection, which is in a lot of ways, I think what made me want to start this podcast and what it's ultimately about is helping someone navigate these difficult conversations with the right people.

Two people have some practice staring at themselves in the mirror and then saying, how do I use this to be present with someone? 

Margaret: Yeah. Yeah. 

Preston: Because if, if I don't understand my own [01:00:00] emotions and my own emotional reactions, it's really challenging to try to help someone else navigate their own. 

Margaret: Right. I think, I think another thing, like with this podcast and what you're saying too, is.

One, we know there's an access problem with mental health and like, being able to actually get good mental health information, um, I think that's one of the ways that you serve people online, is by trying to get them information, and I, I I think that there's also benefits to like, like, what this is not is an expert podcast, but what it is is like people who have some, like, especially if people are listening who are really like are in med school or earlier in their careers is we're going to review and talk about topics and do our own kind of background research, but also that sometimes it helps to hear about something from non experts because we know what it's like to not know the information and we also are trying to grapple and make sense with it.

Preston: It's a shared curiosity between [01:01:00] both us and the audience. 

Margaret: Yeah. Yeah. 

Preston: And the, the powerful thing is we can have these slow conversations and really dive into topics that form our experiences where on some place like TikTok or 

[music]: Instagram, I 

Preston: can basically create a factoid that I digest into a soundbite and I try to try to shove it down your throat.

And then everybody freaks out because there's not enough nuance involved. And I also freak out because I realized I didn't include enough nuance. And the only place that you can like. So, discuss these things. It's kind of in the form of a podcast. So, I think to take what you described and boil it down, we're really going to look into things like acceptance and commitment therapy and, and we will learn it with you.

And also reflect on how can I put myself in this person's position and think about where they're at. Neurobiologically, so if someone's depressed, they may cognitively be incapable of optimistic thinking and how do I take that into account when I'm being next to them and also how do I [01:02:00] think about their socioeconomic status and where they're coming from and how they even perceive the world.

So these are all really complicated questions and the best way to approach them is just To ask and have those conversations. So we're going to bring on patients that have these experiences, we're going to talk to experts in neuroscience, and we're going to talk to therapists and go through our own research and, and we're inviting you to learn with us.

Margaret: Exactly. And to have kind of grace with us as we are learners along the way, but we promise to try and make it kind of fun and to include details like Sandra Bullock, if you want to sponsor us, you can. This is Sandra Bullock's podcast now. 

Preston: 50 percent of the podcast really wants Sandra Bullock to be 100 percent of the podcast.

Margaret: And I think that's fair. 

Preston: Yeah, no, it's, it's reasonable. I think 

Margaret: that's a, that's my, as a fourth year resident, I'm, that's me teaching you. 

Preston: It's true. I have a lot to learn. Thank you so much for listening. How was the show? We really want to [01:03:00] hear how you think. If you like to come chat with us at The Human Content Podcast Family or on IG and TikTok at humancontentpods.

com. Or you can find us at howtobepatientpod. com. 

Margaret: We have a website, so, 

Preston: yeah. And, and what do you want us to talk about? I know we described a bunch of different things, but if you have a topic that's pressing you or you're interested in, please don't hesitate to go to a website or shoot us an email. And if you wanna find me personally, I'm at it's prerow on YouTube or Prerow on TikTok, you can DM me, mentions about the podcast, and I'll, I'll try to find, find it and look through it.

And then Margaret, you're on bad art every day on 

Margaret: Bad Art, every day on TikTok and nowhere else. Um, and I'm talking about Streganona a lot this month, so that probably won't interest most people here. But if you like Sandra Bullock and 

Preston: Streganona. The 

Margaret: New York Times got interested in it, 

Preston: right? They did.

Which is so fun. Oh, we can get, we can get that, into that more later. So if you want to check in with us on YouTube, we're actually doing video recordings of the episodes and they'll be posted, uh, there every week in line with our episodes. Uh, but anyways, thank you for listening. We're your hosts Preston and Margaret.[01:04:00] 

Our executive producers are me, Preston, and Margaret. 

Margaret: I'm an executive producer? Yeah. I'm sorry. Will 

Preston: Flannery, Kristen Flannery, Aron Korney, Rob Goldman, and Shahnti Brooke. Our editor and engineer is Tracy Barnett, and music is by Omer Ben Zvi. To learn about our program, disclaimer and ethics policy submission, verification in licensing forms and our HIPAA release terms.

Go to website and or reach out to us at how to be patient.com at human content.com with any questions or concerns. How to be patient is a human gun to production. Is your voice supposed to get lower as you go? It's not 

Margaret: medical advice. patient.