- You're now three years out of residency. You've worked urgent cares,
primary care offices, semi-hospitalist positions, was the juice worth the squeeze? (sighs loudly) Hey guys. Welcome to another episode
of the Wednesday check up. As promised, I have my special
guest here, Dr. Luis Espina. - Hello. - Dr. Luis Espina's quite
the special character. We did residency together. Even though we're a few years apart. Do you want to say how many years apart or we're not gonna do that here? - I'm almost old enough to be your dad. Yeah, so we're kind of a few years apart. - A few years apart. I'm putting it nicely. I'm trying to be as kind as possible. - You are kind. - Because ageism is a thing. - Ageism is a thing. I joke about my age. It doesn't really bother me. - In my last responding to
comments video, someone asked, should they pursue medicine as a second career in their mid-life? And I thought to myself, who
do I know in their mid-life, - Hopefully. - That went into medicine? And my mind went to no other person than this lovely doctor by my side who actually was my senior resident. - [Luis] I was. - He was a second year when
I came in as a first year and he was my, quote on quote,
buddy, when I was an intern. And the buddies are second years that help out the first years. And then when I was a second
year and he was a third year and we both happened to be on
call, we would hang out a lot. - Yeah. - Talk about life. - Yeah, we were roommates for a while. It was like going away to summer
camp, it was a lot of fun. - Well, you would have to
be hanging out in the room to be roommates, we were
running around the hospital. Especially you. - Yeah, we didn't do much
hanging around, truth be told. We ran around the hospital. - What was your career prior to medicine? - So that's a... So I was an engineer I guess I still am an engineer. I don't have to give that one back. I was a mechanical engineer first. Did that for a number of years. And then ended up doing... I have a master in biomedical engineering and I worked for a medical device company. - Just casually a biomedical
engineering degree - And then here I am. - Now wait, to me, you told
me you used to work on planes. - So that was before I
was ever an engineer. I went to... - This guy had 48 jobs
prior to becoming a doctor. - I did, I did. - I want to figure out how
you go from working on planes to getting biomedical engineering degree, to then waking up, working in a prestigious
company and saying, "I want to go back and be
a scrub in medical school." How old were you by the way? - When I started medical
school, I was 37 years old. A friend of the family's
was over to visit. And my mother was behind me,
the lady was down the stairs at the front steps of my house and I was walking down the stairs to help her with something to the car. And she kind of offhandedly
asked, "Luisito," you know... My dad's Luis and I'm Luisito. - I call him Papasito. - He calls me Papasito. So the friend of the family
turns around and she says, "You know, Luisito, what do you think you're
gonna do for a living? What do you think you're gonna do?" And I said, well you know, I've been thinking about
biomedical engineering and I can still hear my
mothers voice over my shoulder. She says, "Metika, the day he realizes he has a doctor in his
heart, he'll be happy. He'll be free." The process started. Dr. Amartrano, who was my
Anatomy and Physiology professor made me fall in love with the
anatomy and the physiology, and the chemistry classes,
and the organic classes, and biology. And I just kept falling
deeper and deeper in love. And then I financially,
it was just me and my mom. You know, I was like, "you know what, maybe I need to get to
work and stop with this nonsense of four more years of school." So I was like, "we'll do the
engineering and we'll get out." And as time went on, I
finished engineering, I didn't go to school for a year or two. And then I went to grad
school while I was working and got my masters in medical. And then at that point
it just bit me, you know. I just really wanted to be a doctor. I ended up doing grad classes at UMDnJ. - What was the day that you say, "I'm
applying to med school"? - Do you remember the day? - Yeah, I remember applying. And I remember that-- - Did you tell your
wife before you applied? - Yeah. Well, we weren't even married yet. We weren't even married yet. - Well, I'm gonna call her your wife. - Gosh, yes, we've been married forever. But we were dating still at the time. And she knew what I was doing. - Did she say you were crazy? - No. Jennifer's always been for some bizarre reason, the
woman's always believed in me. And she just, in her mind, she knew it might be messy,
but it would get done. We were talking about getting married. Buying a house and everything else. - But instead, you're like, "I wanna do the $275,000 in debt and eight more years of education." - Yeah. - Because you really wanted
to meet me in the future. - I did. I did.
- Was that it? Man, you were the cherry on top. - I hate making this channel about me, but I feel like that what it was. Just be honest.
- It really was. - It was all about him. I knew that he was coming out
of his diapers at this time. But, yes.
(Dr. Mike chuckles) For me, among the things that I love about being a physician, when I'm at work, I never have to justify to myself, what it is that I do. I'm a very simple guy. I'm not a complex person. I need to just be able to
very quickly tell myself, "okay, you're doing this for this reason." So, when I walk in to the
room and I close the door. And it's me and the patient that's why I'm doing it. - What's the biggest surprise starting third or four year of clerkships, when you're actually at the
hospital that shocked you? - A lot of things shock you. Fatigue shocks you. Exhaustion shocks you. - To me it was paperwork. - Well, that didn't shock me as much because I...
- You have more experience. pay more attention to it. The other thing that I will tell you, that I still, to this day, I've come to terms with it, but it is something that
I deal on a daily basis, which is I wrap my arms
around my own ignorance. - Okay. - The greatest thing
that I learn in medicine is how much you don't know. And how much you have to
constantly read and study and read and study. There is no "oh I
graduated and it's over." It's everyday of your life. Just now we were talking about something. It drives me so crazy that I
have to look it up right away. And read about it. And what is it. And refresh your memory. And I say that's part of the charm. - You're always learning. - If you love to learn and
you're like a nerd like me. - Like us, can you throw me in? - You are, you are, man.
Like us. - You speak nerd fluently.
Okay, good. - And that's a good thing. The drive basically comes from that. It's that combination of the most beautiful
things you can imagine. Science with all its beauty. Technology nowadays is incredible
the things that we can do. And then you add a human element. And that is honestly, one of
the most beautiful parts of it. If not, the most beautiful part. When you close the door in that exam room. And it's you and the patient, it's a dance. A lot of times the patient comes in and the chief complaint written down by the MA is sore throat. And you walk in the door and before this visit is out, this patient is crying their eyes out telling you their deepest fears and things they've experienced and pains that they're having. Things that they were terrified of. They told the nurse that
they had a sore throat. But you have that moment and
you make that connection. And to have the privilege of walking that mile with that patient is something kind of
heady and kind of big. I, you know, I would
complain about being tired, I would complain about
the paperwork endlessly, my son will just look at me
when I work on something, and he goes, "ugh, notes." - Electronic health record. - It's agony
EMR. - Prior authorizations, all
these things, they're crazy. And it's the price you pay for
the privilege of the dance. - He's so much more poetic than I. I make my video about med school. And I keep it super practical. This guy comes in and makes an analogy
of medicine as a dance. - Don't let him kid you. - (chuckles) This guy. - One of the things about this experience as I said is the people. So when I first find out
who my buddy's gonna be. (Dr. Mike laughing) I see this guy's picture and I'm like, "oh, who's this young, pretty boy, I am not gonna deal with this kid." So one night, I was sitting in my cubicle, he was sitting at his cubicle. And it's really the first time
we've ever exchanged words. 'Cause he was on other rotations. In the first few hours
that I knew this young man, I knew that I'd met another brother in this walk through life. And I realized the depth
and breadth of life that one can experience
in such a short time. And it was another reminder of don't ever judge the book by the cover. Get to know the story. Find out what's going on. Because you have an opportunity
to meet amazing people. And do beautiful things. And learn and experience. And that's something I've gotten from him. - What is the biggest challenge that you had as a almost 40-year-old in comparison to your
20-year-old colleagues? - Fear. - What fear is that?
Fear. - What were you afraid of? - Fear. I was afraid of everything. I was afraid of making the wrong decision. I was afraid of not knowing enough. I was afraid of... When you're 20, you look at the patient as them and you are us. And this is game. And it's A, A, up stick,
up stick, right trigger. - He knows what that is. I'm impressed already. Can you do it a little bit more realistic? - Right, so you know, A, A, up stick, up stick, right trigger. - There's no A on the
Play Station controller. That's Xbox. - I'm not saying that they don't care. I'm not saying they're not empathetic. I've met young, young people, that care. It's just, there is a separation. I was that young once. And you look at a 40,
50-year-old, and you go, "God, never." I look at you guys and I'm
like, this was last week. What the hell happened to me? Where's my hair? What's with the gray? When I would see a patient, it wasn't "holy cow, you have
this disease," it was like, "my god, man, we have this disease! "what are we gonna do?" You know, it was that fear. It was the fear of
making the wrong decision about residency. It was the fear of
studying for the test wrong and studying frequently
wrong for the test. - Is that because the
family is on your par? - Yeah, 'cause the stakes were so high it was any mistake that I made, I felt like I was failing my wife, my son. - So how did you deal with that pressure? - Badly. I internalized a lot of it. I used to smoke like a bloody chimney. - As a doctor. - I remember the first time
that I saw in anatomy lab that I saw lungs from a
smoker it made me so nervous, I went outside and had a cigarette. - Don't do that. - It wasn't until the
end of medical school that I actually stopped. And it was, you know,
stressed, and bad sleep and I wish that I could say
that my age and maturity contributed to smooth sailing
and everything is beautiful, the truth is, it was not that. It was a road of many falls. And picking yourself
again and facing it again. And again. And feeling like you
don't deserve to be here. And getting up and facing it again. And that constant feeling of fear and self-anger and loathing
for your inadequacies. And even with the patients,
when you don't know the answers, when the attending ask you any question, you feel less than. And I've seen that a
lot in older students. There's that commonality that
there's that pressure of like "my god, my husband's gonna kill me, "my wife's gonna kill me,
my partner's gonna kill me. "I gotta do this." And you know, it adds another element. - Positive. What advantages did you have
being nearly 40 in med school with colleagues, like myself, in 20's. - That you would have to
kill me to make me quit. You would have to kill me to make me quit. They were gonna take out a graduate or they were gonna take a
cadaver out of that school. (Dr. Mike laughs) They was no other way it was gonna go. - Now, what about life experiences? Didn't that help? - I've always been a guy who could talk to anyone. And it's useful. Because those experiences are valuable. When somebody's in pain,
and they're showing up, and they're in pain and they're terrified, you need to be able to
connect to that person schnap. - Quickly. - And if your perspective is very limited, you've only had certain
experiences in life, these are your circle of friends, these are the only people you know, you haven't failed in life, you haven't had a bad day, you haven't, you know, had these things. It's harder to connect. It's harder. I've seen people do it. It's harder. - Well that's why diversity
in medicine is important. And not just sex, religion, race, but also of ideas, all
of this needs to be. - Absolutely. - I was 24 when I started residency. Everyone would look at me and be like, "are you...what are you? "You can't be my doctor." So there was some preconceived
notion to being young. Did it help being an older
presence in the room? A more mature presence, sorry. (Dr. Luis stutters) (chuckles) Don't hit me. It does. It helped. It's certainly an advantage. The negative is the fear. The positive is you bring to
the table all these things. - Yeah. - And the other thing
that I also saw a lot with the older students was
you'd have to kill them. They would not quit. - On the day of your residency graduation, which I was fortunate enough to attend, here's some cute pictures of it. Me and little Loui. - [Dr. Luis] That's my boy. - [Dr. Mike] What did your wife tell you? - My wife and I don't really
have to talk too much anymore. She can just look at
me and tell me a story. Sometimes just the way
she'll touch my hand, I know what she's thinking. And it was just a long,
long, long, long hard road. And it's not over. What I always feel from her, and I'm eternally grateful
for it, is her support. And I feel her love, I feel all of that, but my wife and I, we've
been together a long time. And we've done a lot of things together, we scuba dive together, we've gone mountain climbing together, camping, kayaking, she's my partner-in-crime, she's my best friends, we do everything together. So there's a lot of communication that goes between us without words. - Okay. - 'Cause she's been my partner
throughout all of this. She doesn't have to say too much. She just kinda have to look
at me and tell me you know, she's proud. - What did her look like? - She was proud. She was proud and that every
once in a while, she's like, "the old man can still keep going. "so you know, he's doing all right." - You're now three years out of residency. You've worked urgent cares,
primary care offices, semi-hospitalist positions was the juice worth the squeeze? (Dr. Luis sighs) - Yes. Yes. Now, I reserve the right to complain. (Dr. Mike chuckles) I love being a physician. If you ask the engineer,
"did this make sense?" The answer, logically, would be no. The opportunity cost to
get into medical school, and to be in medical school is so high. The debt is daunting. And you have a family, and
you know, it's daunting. It really is daunting. That being said, you know sometimes I joke and I call medicine my mistress. You know, she takes my money, she keeps me away from my family, (Dr. Mike chuckles) she runs me ragged and treats me bad. (chuckles) But I love her
and I keep coming back. I don't know how else to say it. It's a beautiful experience
to care for your patients. It's so beautiful. But you are putting your family
through a lot of sacrifices. You are putting yourself
through a lot of sacrifices. So my advice to anybody
who's gonna do this, if you are doing this because
you wanna drive a Maserati, and you wanna have nice
clothes, you wanna live, you might achieve that. If that's your reason, I think you would be better
served doing something else. You have to love the science. You have to love the learning. You have to want the ball. Again, old movie, winners want the ball. You gotta be that person. You want the ball. You always want to be the one. And if that's you, come on down. I think there's no better way to end that. - Yeah. - We have to hug it out. - Alright. - Guys, thank you so much for watching. If you wanna see this gentleman again. Come back on Sunday. We're gonna do a Grey's Anatomy review. If you wanna see more reviews,
medical drama reviews, Adam ruins everything reviews, click here down below. And as always, stay happy and - And healthy. - You know it. (bopping music)
I loved this video, it's one of the most powerful videos on Dr Mike's channel, honestly these two are so powerful together omg