Welcome to White Coat, Black Sheep, where science gets curious and dogma gets
uncomfortable. I'm your host, Dr. Steveli.
Today we talk physiology, evidence, and real-world medicine, plus the questions
you're not supposed to ask but probably should.
If you care about health and think there's a better way, welcome to the show.
Hello, Dr. Shan Raja. Thank you so much for joining me today.
Thank you for having me. It's a pleasure to be here.
Man, I'm excited to really get into-- I know we got to chat a little bit briefly
before we-
Uh-huh
... signed on here. So you're a neurologist.
I am.
Practicing in Bakersfield, California.
Currently, yes.
And it sounds like you're from Canada.
I grew up in Canada. I was born in Sri Lanka.
I moved around a lot so-
Wow
... so if you want to listen to all of this.
Yeah.
So I was born in Sri Lanka. There was a civil war at the time, so we left when I
was about four or five. We landed up in Manhattan,
lived there, I want to say, for maybe a year, and then we went to Canada.
Then I grew up in Canada till I was about 21, 22.
Then I went to medical school in the Netherlands, Antilles, on an island-
Ooh
... called Bonaire.
Okay.
And then I did my clinicals in Chicago, Illinois.
Love it.
I did my residency at the University of Iowa.
Okay.
Then I lived in Medford, Oregon, and then Kyle, Texas, and now I'm here.
Wow. I love that journey. And I kind of know the places that you were at.
So, like Mount Sinai for Chicago?
Mm-hmm. Mount Sinai.
Maybe I saw you there and you didn't even know.
Was there a Mount Sinai there? I worked at a hospital called Jackson Park-
Oh
... which is all the way in the south side of town.
I did OB rotation there.
Oh, you did?
Yeah.
Oh, wow. So did you, were you scared when you-
Terrified.
I used to think-
I'm scared everywhere in Chicago, to be honest.
You know, they scare you a lot, but what I found that...
And I lived on the north side of town, so I lived in, what was it called?
Lake Shore. So it was-
Same
... near Wrigleyville.
Yeah.
But I would go to work on the bus sometimes.
Mostly the car, but every now and then, I would take the bus, and I found that
everybody was much more pleasant on that side of town.
They would say, "Hey, how are you?" Whatnot.
Now, would I leave my car open or walk around in the middle of the night?
Probably not, but-
Yeah
... but I enjoyed it. I grew up in Montreal, but we were immigrants of war, so we
grew up in the poorer part of town.
Wow.
There was a lot of Caribbean food and mostly African Americans or Caribbean
Americans, so that part of town felt like home to me.
Wow. That is so-- It's fun to hear, especially-- Okay, so Iowa.
Uh-huh.
Tell me about that one. I roughly know where that was. Is that Hawkeyes?
Iowa is Hawkeyes, yes.
Okay. They're obsessed with it, right?
They are. What is it? They say the population in Iowa is like 15 to 20,000, but
on game day, it goes up to 70,000, which is-
Yeah
... Iowa City, which is-- It's insane there.
Quad Cities?
Quad Cities is near Iowa.
Yeah.
So Iowa City is where the Hawkeyes play.
Okay.
Quad Cities, I want to say we drove there a lot, maybe an hour and a half from
there.
Okay.
Yeah.
Yeah. I actually lived there for a short duration of time.
In Quad Cities?
Yeah.
Which part?
Random. Oh, on the Iowa side, downtown.
Okay.
Is it Bett-
Davenport?
Oh, Davenport.
Yes.
I lived in Davenport. I lived in downtown Davenport.
Davenport, Iowa, yeah.
Yeah. It was like a really cool, like concrete-
Mm-hmm
... I don't know, modern type building.
Did you go to the old soda shop there?
I don't remember that.
It was a while ago.
Yeah, I don't remember going to that.
But Iowa was nice. A farm town.
Yeah.
And there's something to be said about less options.
It's like the Netflix conundrum.
Yeah.
I have spent an hour and a half trying to pick a movie because there's just too
many choices, whereas-
Oh
... it was cable, just the first channel looked so interesting.
Yeah.
And that's kind of like how I think of Iowa City.
There's maybe two or three restaurants.
You don't have to think too hard to go somewhere.
Yeah.
So yeah. It kind of takes away choice, which gives you more freedom almost.
I don't know how Canada is. Definitely Sri Lanka is probably very warm.
Sri Lanka is humid and warm, but I-
Right
... but I love warm.
I do too. So living up in that area, like Chicago or Iowa, I
was out of place.
Oh, it was terrible. I lived in Iowa where the polar vortex happened.
And we had two small dogs, a seven-pound Maltese poodle-
Cute
... and about a four-pound toy poodle.
And the Maltese poodle, we would take him out, and during the polar vortex, he
would sit down and kind of say, "Hey, I'm giving up.
This is the end for me."
That's me. I really like relate to-- I resonate with him.
Like subzeroes, forget it. Why are we alive?
Uh-huh.
How is this like compatible with life?
It was bad.
Yeah.
One of the reasons we left, because I loved Iowa, but I just couldn't.
My genetics likes warm weather.
Me too, me too. Yeah, and I realized, like even just like what I-- You know, you
kind of have like this thing that you imagine people should dress, or like I had
too-- I wore too many colors.
Uh-huh.
Okay, so I'm clearly Florida, California, right?
I w-
So you stood out in Iowa.
So ba- And I was actually told that I was too tan.
Oh, wow.
I just love it. Anyway, so yeah, you kind of find your region, and your region
finds you.
Uh-huh.
Do you-- Oh, go ahead.
I was gonna say, this region found me because my wife is from here, so I have-
Oh
... no say in the matter.
Wow. Is she in medicine?
No, she is at home with my son right now.
Okay.
I'm actually gonna open up my own neurology clinic, and she-
Congratulations
... is gonna be part of that.
That's so cool.
Thank you. I'm excited.
Man. Here in town?
Here in town.
Okay.
Yeah.
What area?
It's gonna be at the Doctor's Park on Ming and Neustie.
Great area.
Yeah.
Yeah.
So, I mean, right, we're just starting out, so we're renting for now.
Love it.
It's gonna be-- The way I describe it is mom and pop neurology clinic.
Yeah.
Because I want it to be personal. There's gonna be-
It needs it
... and I have nothing against NPs or PAs, but the patient is gonna see me every
time they come back.
Yeah.
There's not gonna be four different doctors seeing them.
Yeah.
I wanna build relationships. I wanna have that doctor-patient relationship where I
can remember your son's name or what your daughter's doing or how your dog is.
And I wanna include, actually, functional medicine and-
Yeah
... integrative medicine in there. I wanna have acupuncture, STEMWave.
I love that.
The goal is to eventually maybe even get people to meditate, but that might-
Yeah
... be overly ambitious.
No, I don't think so. No, I think everybody's so over-stimulated.
It is, it is.
Even the iWatch, I can't personally handle it. I feel like my HRV is affected, so.
Mm-hmm. I agree.
I can't-- I, yeah, I don't think that that's wild.
Yeah. I was at my current work in I think February of last year.
I realized I wasn't very happy with what I was doing, that I needed a change.
I got into meditation. I'm Hindu, so I should've been meditating my whole life- ...
but I wasn't. So I got into-
You still have to practice it, right?
Yeah, you have to practice it. Yeah.
Doesn't matter who you are or your background.
Exactly. So I got into meditation.
I actually took a trip to India to one of the oldest living cities in the world
called Kashi or Varanasi.
Okay.
I spent two weeks there meditating, learning meditation.
I came back, incorporate it into my life, and it's kind of changed me as a person,
and I feel like it could change everybody.
Have you heard of the default mode network?
No, but I feel like I need to.
So the default mode network is a brain pathway of ours that basically
is, it goes in a loop when we're not paying attention to anything.
So when you're sitting there daydreaming, it's the pathway that thinks about the
past, the future, who you are, your anxiety, and all of that comes back.
That's the default mode network. And they found that meditation actually can shut
that down. So in Hinduism or yoga, you don't wanna see
things as what can the past be about it, what can the present, you know, future be
about it. You wanna see things as they are.
You don't wanna include all your experiences and put a label on this that may not
be true.
Yeah.
So if you could turn off that default mode network, you can see everything as it
is.
I tried that with every next marriage that I did.
Jokes aside, okay.
Uh-huh.
So that was just two, but who's counting?
But yeah, no, it really is important, right, to have like a fresh start, but then
still somehow learn from your past-
Mm-hmm
... mistakes-
Yes, absolutely
... so you don't create the same-
Yes
... patterns.
Yes. You've learned what you need to learn.
Yeah.
But at the same time, when you sit there daydreaming, I mean, if you go back in
these loops of anxiety, fear, you're never gonna experience anything new.
Yeah.
And those are the things that you kind of need to turn off.
I mean, look at me, for example. I don't know that a year ago I would've had the
courage to open up my own clinic. I still don't know that I know everything about
opening up a clinic. I didn't know that you had to get a DBA.
I learned that-
It's disgusting.
It's called a... What's it called?
Doing business-
Business as. Yeah. And I had to go there about six times to try to get this DBA
license because I sent my wife, and that wasn't enough, then they needed me to sign
something.
I love it.
Then I went there and they're like, "Oh, but your wife started the process, so now
you need to have her come back, or you need to do it a separate way." It was--
Yeah. So, there's so many things that I'm learning, but-
Yeah
... but I'm happy. I'm very happy to where this is headed.
And I get to work with my wife, who, when you have kids and you have a career, it's
like you almost never see each other, so I'm excited about that, too.
I love this.
Yeah.
Okay. So, I'm excited to see in six months, how everything's going.
Me too.
It's hard, right?
It is hard, yeah.
But everything is hard.
Mm-hmm.
If you didn't do this, it would be hard.
Yeah.
If you are doing it, it's like you're just choosing which hard am I going to go
with?
Yeah.
Right or left.
So we have a word for it in Hinduism called svadharma.
It's your true calling. And it doesn't mean just because you like to play the
guitar, that's your true calling.
Mm-hmm.
Not everybody's going to be Led Zeppelin, but your true calling has to get you up
in the morning, motivate you, and it has to change you as a person.
And I found finally-
Mm-hmm
... after meditation, that every time I see a dementia patient, or every time I see
a patient with a disability, it kind of reminds me of my own
dad who has dementia, or a friend of mine that passed away from a disability.
And it's changing me because I'm kind of connecting with them, and I'm vested in
how well they do, and-
Yeah
... that as physicians, we kind of get thrown into this cog wheel of the machine,
and we forget that aspect. And I'm happy that I got that back.
That's awesome. And I think it's really special to hear that you're
not numb to it.
Yes.
You can turn off and be blind to suffering.
Mm-hmm.
And I don't ever want to be there.
No. I can't, and I'll be honest, I can't say that I was always like
this. I think the last year really changed me because in residency,
it's just the way the machine works, right?
They throw you in, you're not sleeping, you're seeing 30 patients a day, and then
there's no way to get through that unless you figure out a way to turn it off.
It's only the people- ... that can somewhat turn it off, make it through.
But then you forget to turn it back on when you have to.
Yeah.
And you kind of rush through life, and then you-
Yeah.
Yeah. So, yeah. So I'm excited. So svadharma, I think I was saying, so it has to
change you. It has to have purpose, make you get up in the morning, and it needs
to bring value as well. It needs to earn a living for you.
Yeah.
You have to have value in the service that you're giving, and that's not taken away
when we talk about life's true purpose.
So yeah, there's these YouTube videos on, there's a
guru called Rohit Arya. I think the videos are from nine years ago, but I'm
surprised that these things are not golden, everybody's not watching them.
Look them up.
The first time I saw his video, I was like, "Who is this pompous man?" Because he
sounded very pompous. But I kind of started listening to him a little bit more, and
I was like, "Wow, this is gold." Everything he says is just matching up with
everything I want to be. And, yeah, he doesn't know who I am, but I'm giving him
credit for changing me.
Like inspiring in some way.
Yeah, yeah.
Yeah. I think you can take a little something from everybody.
Mm-hmm.
Because you're not just randomly mixing with any patient encounter or any
friends or strangers. You're in the right place at the right time at all times.
Yes, exactly. Yes.
Yeah.
Somebody said,
"Do you realize when you are sitting in front of a plate of food, how thankful you
have to be?" Actually, it's another guru, it's Sadhguru. He's pretty famous now.
Rihanna even went there and I think performed for him.
But he said that, "When you're looking at this plate of food, do you realize how
much work that farmer put into it? And then how that got processed
somewhere, and some truck driver drove that, then it went to the market, got
stacked there, and then you cooked it." So imagine everything that had to happen.
Someone had to get a DBA.
Someone had to get a DBA to get this food on your plate.
Yeah.
And that you should be thankful just to be able to eat that.
So yeah, every moment is special.
Yeah. We'll stop complaining. Just say thank you.
Oh my gosh. So, okay, let's talk about dementia.
Okay.
Because you did bring it up, and it is something, I would say as a new grad-
Mm-hmm
... way back 2023, working with elderly patients with dementia,
I thought it was horrific, horrific.
Mm-hmm.
And then I transitioned into this, you kind of watch your own journey.
So then I was like, or is it a gift? Because maybe they want to
forget, or maybe they don't want to be aware of how their body is right now.
Mm-hmm.
And so now that I'm here, I'm just like, I don't think I've made a decision.
I don't want to wish it on myself-
Mm-hmm
... and I don't want to even imagine having it, but in the same time, for
some people, it does almost look like it is a good thing.
I think it depends on the type of life you lived.
Yeah.
One thing-- Okay, I'll say this. Me and my father don't have a good relationship.
He was an alcoholic, which is why he has dementia now.
So that being said, I'll see him now, he's kind of oblivious.
He thinks he's fine. He thinks he's healthier than everybody around him.
But every now and then, I'll kind of see him staring off into space, and I'll
think, is he wondering what he's forgetting?
Yeah.
Yeah.
So that's exactly what I'm talking about, right?
Yeah.
The bad memories.
Yeah.
Or is there any reflection in there?
It's-
I don't know. I think that's a question that science hasn't answered yet.
Yeah.
And then, with all the advances in quantum physics that we're making
with consciousness, and hopefully one day we can answer it.
Yeah, like maybe a body scan.
To tell if he is remembering certain things?
I guess if you could do a functional MRI, you can see what parts of the brain are
lighting up.
That's true.
But even then, is it what specific memory?
I don't think we'll ever know unless they're able to tell us.
The other part of that equation is a lot of the Alzheimer's patients, at least
language is one of the first things to go, so they even have a hard time explaining
it in words.
My family does have Alzheimer's.
Okay.
And I feel like it's more female than male.
Mm-hmm.
And it's scary to me.
Mm-hmm.
I am going to do the DNA testing for myself-
Okay
... just to know.
Mm-hmm.
Because some things you can prevent now, especially, I'm 42, I don't know your age,
but-
Mm-hmm. I'm 42, actually.
Oh.
Turning 43 next month.
Okay. 1983?
Yeah.
Yeah. Awesome. So,
yeah, if there's some action, like maybe it's nutrition or maybe it's something
like an enzyme, what can I do?
Yes. Keeping up with your vitamin D levels, the omega-3s are important.
But maybe I'm biased because I'm an exercise enthusiast, but a lot of the studies
show that physical activity is more important than anything else.
If you can have a good physical activity routine, I think that goes a long way.
That goes for both Alzheimer's and my Parkinson's patients.
In my 14 year-ish career between the university and moving around, all the patients
that do well are the ones-
Mm-hmm
... that have been physically active, and especially Parkinson's patients.
It's night and day. I have some jujitsu guys,
some gym guys, that somehow feel like they're beating the disease because they're
not progressing. That being said, you should get checked also because the new
medicines that are out now, and I'm not supporting big pharma, but the new
medicines that are out now have shown promise in slowing down the progression.
The five-year data looks really good.
That's amazing.
Yeah. And that's what I try to get all my patients on.
I know they categorize as mild cognitive impairment versus moderate dementia versus
severe dementia.
Mm-hmm.
And I don't like to follow test scores.
So if I can talk to a patient-
No
... and they still have activities that they like to do, and they can hold a
conversation-
Mm-hmm
... I'm going to try to get them on the medicine because that's important, to be
able to preserve that brain if they want to preserve the memories like you were
saying before.
Right. If they're good memories.
Yeah.
It's interesting. I have an aunt.
Exercise has helped her.
Mm-hmm.
She was non-verbal. We did a few interesting therapies.
I'll tell you about it later. But, I feel like the exercise probably was-
Mm-hmm
... profound.
Mm-hmm.
But then I also wonder, the environment, how much impact that has.
Because if you're raised in, say, a very comfortable situation that you control
everything, and then now you're older, you can't really speak for yourself.
Mm-hmm.
And I would say a lot of times,
they're with a partner who maybe can take care of themselves-
Mm-hmm
... but not the actual person that has the cognitive-
The dementia, yeah
... dementia. Yeah.
Yeah.
So, yeah, I just wonder the impact of the caregiver, the environment, all of those
things.
It goes both way, because a lot of dementia patients towards when they progress,
they're oblivious. It's the caregiver that takes the brunt end of that.
Yeah.
That being said, letting go of control is hard.
I try my hardest to let my patients drive for as long as possible-
Oh, yeah
... because I think independence is so important.
The moment you take away independence, I feel like they decline fast.
So if I can keep them driving, I usually do, as long as they're safe.
But that's where the frustration comes in.
A lot of dementia patients will get angry, frustrated, and I think that-
Oh, yeah
... like you said, is the loss of independence.
And if you ask me-
Yeah
... what my biggest fear is, it's not death, it's loss of independence.
Having to depend on somebody else to do my activities of daily living, like feeding
myself-
Yes
... or washing myself. I think that's my biggest fear.
You cannot perform your calling.
Yeah.
You cannot create change-
No
... or purpose.
Right.
I don't know what that would look like, but I know that it's super important to me
now.
Mm-hmm.
It brought me to become a doctor.
Mm-hmm.
Because I tried to quit several times, and I'm like, "Forget it.
I don't need to be a doctor."
Mm-hmm.
Because it's miserable.
Mm-hmm.
It's a horrible process. All the exams, all the cost.
I'm the first doctor in my family. It is tremendous to make that leap.
Mm-hmm.
Are you-
See, I am the first doctor in my family.
My father, like I said, we were immigrants of war.
My father was in engineering school before we left Sri Lanka, and my mom was doing
naturopathic medicine. But once we got to Montreal-
Wow
... they had to give that up. They had to work in factories pretty much most of
their lives.
Wow.
My father retired as a pizza delivery man. My mom retired as a factory worker.
So I am the first doctor in the family.
That's huge. No pressure.
Right.
Oh my gosh. Did you have any interesting visa...
Or no, because you were-- Yeah, were there visa issues making that leap from a
country of war into Canada, into the States?
No, we were refugees of war, and at that time they were welcoming us.
Oh, okay.
So Canada was not a problem. And thankfully because of my Canadian citizenship,
getting to the US was not a problem either.
Good. Yeah, there's some crazy situations that I've come to learn just being in
medicine.
Mm-hmm.
And you hear your colleagues and where they're from, and what kind of situations or
paperwork they have to do.
Yeah, it's tough. I see it both ways.
I think when you're young, you say, "Well, everybody should be able to go wherever
they want." And then you grow older, and you have a kid, and you're like, "Wait a
minute. Is that safe?" So you kind of land somewhere in the middle where you say,
"Well, there's two sides to every story."
Yeah, no, definitely. So when it comes to Parkinson's, let's go back to that.
Yeah.
You were mentioning medications.
I see a lot of patients in that facility-
Mm-hmm
... section, like skilled nursing-
Mm-hmm
... assisted living. So there's a lot of rules.
Mm-hmm.
I
see the point of them, right?
Mm-hmm.
So if you are a patient, you have dementia, you don't understand where you are, why
you're there.
Mm-hmm.
Every day is confusing. You don't know if it's day or night.
Mm-hmm.
And there's a lot of anger, agitation.
They have no rules-
Mm-hmm
... I mean, no rights as far as
their schedule, their food, and all this stuff.
So managing the anger and agitation-
Mm-hmm
... right? And the confused person or combative.
Mm-hmm.
There's this many medications that we can-
Yeah
... give them, but they're also falling and getting fractures.
Right. It's bad.
Horrible.
Yeah.
And horrible.
Yeah.
I don't know the answer. I know we're not doing the Thorazine in the neck anymore,
okay? That's TV.
Yeah. And we're not doing lobotomies anymore, thank God.
Keep your brain.
Yeah.
But yeah, I don't know. That is a tough one, but like-
So all the antipsychotics could make the Parkinson's worse, which then makes them
more rigid. Unfortunately, we don't have anything else out there, so at some point
even I have to say, "Okay, well, they might need this." But I try to slow it down
as much as I can. We have some new medications that came out that kind of help with
the dementia agitation without causing the Parkinsonism, a few selected ones, but
then you run into the insurance problem.
"Well, why haven't you tried A, B, C, and D?"
Oh my gosh.
"Well, because A, B, and D causes worsening of the Parkinson's."
Mm-hmm.
"Well, you still need to try it," and then we're at their mercy.
Ugh. What are some symptoms that people would
typically start to see? So if anybody's listening-
Mm-hmm
... what would you kind of pick up on right away?
Parkinson's you mean?
Mm-hmm.
Oh, a good neurologist can walk into the room and diagnose this.
You usually don't even usually need to touch the patient.
But what I look for is decreased blink reflex, so they don't blink as much.
They got this stare going on. And what we call masked faces or decreased facial
expression, so
they kind of look like they're just very serious all the time. They'll look rigid.
There may or may not be a tremor. A tremor I know is very highly associated with
Parkinson's, but that's not always the case.
Mm-hmm.
So I don't always look for a tremor.
It's really the decreased blink reflex, the masked faces that you can tell as soon
as you walk in.
Okay.
Now, there's some what we call non-motor symptoms in Parkinson's that starts-- So
Parkinson's doesn't start when we diagnose you.
The degeneration of that dopaminergic
pathway starts sooner.
Mm-hmm.
So some of the earlier non-motor symptoms are loss of sense of smell,
constipation,
vivid dreams where they punch or kick in their sleep.
Wow.
It's called REM behavior sleep disorder. So those are some of the early symptoms.
The handwriting is getting smaller.
Now, that's a motor symptom, but patients notice that.
They're like, "Oh, I'm writing very small," or-
Hmm
... "The handwriting is getting off." So those are things that I usually ask about
as well, but that's mostly for curiosity, but you can tell as soon as you walk in.
Now we have a scan called a DaT scan that's more readily available.
So-
DaT?
Yeah, DaT. That checks to see if that dopamine is
decreased in the area where we would expect it to be decreased.
I don't think I've heard of that. It's a brain scan?
Mm-hmm. It's kind of like a specialized CT scan.
They give you a tagged dopamine so that it lights up-
Oh
... and then they check to see if it's in that area.
This is a good thing.
Yeah.
Right?
Yeah. It's been around for a while now.
Oh.
It was mostly used for research university purposes.
Mm-hmm.
Now it's readily available for anybody to use.
The idea back then was that a good neurologist doesn't need the scan to diagnose
Parkinson's.
Mm-hmm.
That's part A, so you diagnose this, and then diagnose it.
And the second part of it is you try to give them the medicine, the dopamine.
If they're reactive-
Mm
... to the dopamine, then you've essentially confirmed the diagnosis.
Okay.
So you didn't need the scan, but nowadays it's available, and patients like to
confirm it. Nobody wants to take your word for it.
Yeah.
Which is fine. I wouldn't either, probably.
Yeah. Well, ChatGPT says.
Yeah.
Is this like a-- I guess obviously you do an MRI, all the other regular things
first.
Mm-hmm.
What point would you step into that testing?
That scan? I start with an MRI, just because you want to rule out all the mimics or
strokes or et cetera.
Mm-hmm.
And then once they come back for that return appointment, if the MRI doesn't show
anything, then I would usually order it right away.
Okay. Do you ever do any of those, the testing for Alzheimer's, like
ApoE or any?
Mm-hmm. We do that. I don't do it at the beginning because we have a PET scan now
that confirms the diagnosis.
Oh, great.
Yeah. So I usually do the ApoE testing if we're thinking about the
infusion therapy-
Mm-hmm
... because that'll tell us the risk of bleeding with the infusion therapies,
because those therapies-
Mm-hmm
... come with a risk of bleeding. And those are microbleeds.
Oh.
So you may not feel it, which is why there's some serial MRIs to be done at the
beginning to make sure we're not missing the microbleeds.
But the ApoE testing tells us if you're a high risk or a low risk, so that's
when I do it.
That's fantastic.
Yeah.
When you open your clinic, will you be taking insurance or it's-
Yeah.
Yeah.
Like I said, I'm new to this, so I contracted with a company that will credential
me for about 15 insurances, and then if there's some that come in that I'm like,
"Oh, we can always add some more on." But yeah, I'm wanting to take all the
insurances.
Yeah. I wish that I was better at handling the process of insurance.
I personally, I just, I don't know, I feel like a slight meltdown. I do.
I'm not going to sugarcoat it.
Trying to get things approved, you mean?
Yeah.
Yeah.
When a form comes back to me and I'm like-
Yeah
... "No, no." It's like it's-- I know.
And then they want to do the peer-to-peer.
Ugh.
And then the other person on the end of the line doesn't know anything about
dementia or neurology.
Yeah.
And you're trying to explain it to them, and it's just-
It's like giving a cat a bath. I just reject it.
It's bad. But I think, I wasn't doing it where I'm at now because the policy was we
just don't do peer-to-peer. It takes too long, I think.
I might start doing it at my own practice because I'll probably have a bit more
time to do it. I think it'll just be a case-by-case basis.
Yeah.
Because a lot of the times when I used to work in Iowa or Oregon, if you just
called at them and got angry for a couple of minutes, they would say yes.
That's wonderful.
Yeah.
Just twist their arm a little bit.
A little bit, yeah.
So.
Man, yeah. Insurance is just, it's almost a game.
Mm-hmm.
And I hate to even say it that way, but like-
Yeah
... it's not fair for any of us.
No.
None of us are winning or loving it.
To play devil's advocate, the other side of the coin isn't great either.
I used to think Canada was amazing, but the population there grew, and now my
parents are having a hard time getting to see doctors. The wait time is incredible.
So-
Hmm
... I don't know what the solution is because Canada has socialized healthcare.
Yeah.
And here it's not, and neither of them are good.
There's got to be some middle ground.
But I'm not smart enough to come up with that. That's not my sweater.
It seems like there's space then for both.
Yeah, maybe.
Right? Like it's-- yeah, I don't know. We're not going to solve that today.
No, probably not. I mean, there's people that have been trying for years, and-
Yeah
... yeah.
Yeah, both are definitely complicated.
But, yeah, when it comes to all these specialty tests, I mean, functional medicine,
that's very much within what I do, like genomics.
Mm-hmm.
I think it is the future. It's your body's roadmap.
Mm-hmm.
And some of these tests that I like to, if the patient will allow it-
Mm-hmm
... it really shows you with different level of certainty.
Mm-hmm.
This is a tier one, evidence-based-
Mm-hmm. Yes
... recommendation. It gives you the action items, and if you follow these, here's
the likelihood of it being effective.
Okay.
Or it'll tell you, "This is weak evidence for this," so you could try it-
Okay
... but it may not work. We're not sure.
Do you have a hard time getting that testing approved?
It's-- I don't even try. It's cash-based.
Okay. It's cash-based, got you.
Yeah. On average, it's about $1,700.
Oh, wow. Okay.
So it is expensive.
Mm-hmm.
I went to a conference last December, and there was a skin test out that you can do
a biopsy.
Okay.
And that will tell you a lot of brain-related information.
Okay.
And it was-- I mean, they had a lot of good research studies that they give with
this biopsy kit.
Mm-hmm.
I have never done one before. Is this something that you've ever heard of?
I haven't even heard of it, no. I'd have to look into it.
Yeah.
But no, I have not heard of it. But I mean, there's definitely evidence for
functional medicine in neurology, and so I'm sure that's valid.
Yeah. Do you take melatonin?
I do and I don't. So if I need to sleep at a certain hour because I need to
wake up the next day, I will.
Mm-hmm.
But I find that then the days when I-- like, let's say I take it Monday to Friday-
Mm-hmm
... then I can't sleep on Saturday till 3:00 AM.
Like I guess-
Oh
... my body gets so used to it. So I-
Interesting
... try not to take it. I mean, I'm a workout enthusiast.
Like I do jujitsu, mixed martial arts, go to the gym, so I try to work out as much
as I can so I'm fatigued by the end of the night. Yeah.
And then the meditation has been helping, too, so yeah.
How long do you meditate?
Ooh. So I meditate for about an hour in the morning and probably an hour to an
hour and a half at night.
That's actually really good.
Yeah. It's a lot. It's a lot.
That is a lot. You're very disciplined.
It is, but it's incorporated into religion for me, so it kind of helps in that
sense.
Yeah.
I feel like I'm kind of learning about my religion and meditating at the same time.
But it is intense, but there's some-- like sometimes you just get these experiences
where like at one point when I first started meditating, I would hit these points
where everything would go white, and you'd just feel bliss.
And then I read about it because I'm-
Huh, I need this
... I don't-- I want to connect science with
meditation and not just-
Yeah
... the mystic aspect. And I read about it, and they say that there is a certain
point in meditation where these kind of endorphins do get released, and they're
comparing it to kind of psilocybin a little bit.
Okay.
Yeah. So you can meditate and-
I need more of that.
Yeah.
And get that same feeling.
That is awesome.
Yeah.
So I mean, I know it's a practice, right?
Yeah.
Like your body has to-- you're focusing.
Yeah.
You are calling neurotransmitters to-
Mm-hmm
... a certain site.
Mm-hmm.
And you're activating like different parts of your brain.
Exactly. And you're shutting down different parts of your brain.
I think the shutting down is the part that people don't realize.
Huge.
Yeah.
I'm curious, I don't know if you wear a wearable device. I have this ring.
I want to because I think I-- but the problem is most of my physical activity is
combat sports, and I can't wear a watch.
The ring will probably break, so I've never been able to like accurately calculate
how many calories I'm burning.
Yeah. Well, what about a Whoop? Like the-- it's like a, just a band.
It doesn't have anything-
I haven't heard of it. I'll try it. I'll look it up, yeah.
Yeah. For-- I think my recommendation is mostly the Whoop-
Okay
... moving forward, because with this, like you said, if I'm doing weights or
something-
Yeah
... it's uncomfortable.
It is, yeah.
But, and then if I, there's the iWatch. I feel like that's too soothing.
I have the iWatch, it's just, I can never wear it when I'm doing my jujitsu or
doing my Muay Thai, so it's kind of-- then I stop wearing it, and I'm like, "Well,
it's not really measuring what I want it to measure."
Yeah.
Now it's just me wearing something with EMF on me all day for no reason, you know?
Yeah, seriously. Well, okay, so if you did or when you do wear a
device-
Mm-hmm
... and it's during your meditation, I'm curious what your vital trends would show.
It would be interesting to see. So I've always been the guy, just because of my, I
think, jujitsu, all of that, that goes to the doctor and the blood pressure is
usually like 105 over 65, and my heart rate's somewhere in the 50s to 60.
So it's always kind of low.
Yeah.
So I would, I'd be interested to see that too.
Yeah.
So I'll have to try it.
Do you feel like there's spikes when you initially start the meditation?
Spikes meaning a little burst of anxiety?
Mm-hmm.
Because it's a detox, essentially.
Kind of. So there's two aspects to it.
So if you look at it in the Hinduism aspect, they say when you first start
meditating, you try to-- you start burning off karma faster. So- ...
actually bad stuff starts happening to you.
Okay.
Which-- you were gonna say something?
No.
Okay.
Go on, please.
That's the mysticism aspect of it.
You're burning it off because you want to get rid of it.
Yeah.
You want to get rid of it as fast as you can.
Like bad karma?
Bad karma, exactly.
Okay.
And then there's the experience part of it.
Yes, when I sit down to meditate, all those thoughts kind of like from the day kind
of flood in.
Mm-hmm.
And I think what I've been told to do is kind of step back, just watch the
thoughts, observe them, and like realize they're there, and they'll slowly fade
away. If you try to actively fight them, you will fail.
This is very helpful.
Yeah.
Yeah. I mean, I definitely know I'm not alone, but a lot of people say, "When I lay
down to go to sleep-
Mm-hmm
... my mind just spins."
Oh my Lord. That is the biggest complaint I get from a lot of the-- and it's funny
because it's a lot of the immigrant population, older women That's kind of
the main complaint. "Can I turn my brain off? Can I turn my brain off?
Can I turn my brain off?" And, I give them medications because I'm a doctor, and at
the end of the day, they're there to see you, get medicine.
But I'm always telling them, "Can you just please try to exercise? Try it.
I bet you you'll feel better when you go to bed."
Yeah.
And if I could get them to meditate, hey, we've won the lottery then.
Yeah. Getting, especially my women, to exercise is really hard.
A lot of people say they do walks.
Mm-hmm.
I don't believe any of them. Just so you guys know, I don't think any of you guys
are walking. None of them. So it's like ...
This is what I tell them. "If you're not sweating by the end of it, I'm not going
to consider it as exercise." And then they're usually like, "Oh, okay.
Well then I guess I'm not really exercising."
Do they then tell you, "I just never sweat"? Do you hear that one?
I haven't heard that yet.
I hear that often. And I'm like, "That is weird."
Yeah.
That is very weird. And then I prescribe them to this red light sauna that's 190
degrees.
Uh-huh.
And like you stay in there for 15, 20 minutes.
Do they sweat?
Well, they need to show up first.
So I have an infrared sauna.
I have that.
I actually believe in that. So I have one-
Right
... at my house that I go in, whenever I get the time.
I think it heals me very well, and it warms you up.
There's a huge difference between an external sauna and an infrared sauna, that
warming from the inside.
Yes.
Yeah. It's nice.
Yeah. I actually don't know the science really that is making it so effective-
Mm-hmm
... except that the red light is anti-inflammatory-
Mm-hmm, mm-hmm
... and that sweating is detoxing.
Yeah.
But, I mean, just at a superficial level, my skin, I see a major difference.
Mm-hmm. I feel different the next day, especially guys like Justin, throw me
around, and then I have neck pain, knee pain, whatnot.
So, I go in there, and the next day I feel like I can go back to rolling, go back
to fighting, go back to running around at work. Yeah.
That's amazing.
Yeah. And then we tried the cold plunge. It works, too. Don't get me wrong.
Mm-hmm.
It's just I'm not a fan of cold, so it's like torture to me.
And I'm like, I don't want to stress myself out thinking about this cold plunge.
So I don't do that anymore.
Okay, let's talk about that.
Uh-huh.
So what I know to be true about the cold plunge, there are a lot of
benefits-
Mm-hmm
... with-- And it's really time-dependent, right?
Mm-hmm.
So one to three minutes, up to five minutes-
Mm-hmm
... is theoretically documented as it's very helpful for healing, immune boost,
really giving you energy.
Mm-hmm.
So I guess theoretically, if you had a low morning cortisol-
Mm-hmm
... it would be advised to-
Oh, yeah. Absolutely
... do a cold plunge, right? Like one to five minutes.
Have you heard of heat shock proteins and cold shock proteins?
Yes.
Yeah. So the cold plunge releases cold shock proteins. It'll go out there.
I think of it like, "Pac-Man" style things.
It'll go-
Yeah
... out and eat the bad stuff.
Yeah.
And that's how I explain it to patients.
I love that.
Yeah.
I know. I find myself making like cartoon, like different animated situations.
Yeah.
Sometimes they make sense-
Yeah
... and they hit, and other times they're just blinking at me.
And I'm like-
So here's one that I use often that I find interesting-
Please, yeah
... because it's hard to explain to patients that
this medicine will not change the outcome of the disease. You know?
That's hard to process for them. So I compare my, there's a couple of medicines out
there like memantine or donepezil-
Mm-hmm
... that are memory boosting pills, but they don't really change the outcome of the
disease. They don't slow it down. So I say, "It's like coffee.
Coffee will give you energy, but it's not going to change you or make you a more
energetic person."
That's helpful.
"Once it's out of your system, it's out of your system, and then you go back to who
you are." So, I like that little analogy because it's hard to explain.
I'm going to use that.
Yeah.
Yeah, because I really was not, yeah, I was not explaining that one well.
So if somebody does have a little bit of a tremor, I know thyroid can be
involved.
Mm-hmm.
Do you have any underlying premise or opinion about the thyroid's
role with Parkinson's?
Ooh. I don't know that I've ever read into that. That'd be interesting.
I mean, hypothyroidism or hyperthyroidism can technically have some
similar symptoms. So hyperthyroidism could cause that tremor-
Mm-hmm
... that kind of agitated feeling that the Parkinson's patients get.
I don't know if you've heard this, but a lot of them will describe this like
anxiety, increased anxiety, and internal tremor.
Yeah.
So hyperthyroidism could certainly cause that, and then hypothyroidism can slow you
down and, you know, make you feel fatigued, which is also another complaint of
Parkinson's patients. I'll have to look into that if there's ever been research to
connect the two dots.
If you take that one step further-
Mm-hmm
... I also think of that in the terms of the loop, the HPA, right?
So-
Mm-hmm
... if you're low in one area-
Mm-hmm
... like that's going to kick-
Yes
... another, like the next-
Yeah
... level, right?
Yeah.
To send a signal. So I just, I think there's a lot of connected pieces-
Mm-hmm
...
that whole circuit that we're not really-
Oh, yeah. I mean, we've had research for years.
We still don't know what all the triggers for turning on Parkinson's in a patient
is.
Yeah.
We know it's associated with
pesticides, we know head trauma, but we still don't know every detail of how this
patient goes from here to Parkinson's.
So-
Mm-hmm
... yeah, thyroid might play a part. We still haven't figured it out yet.
Yeah. Or sleep, right? The impact of poor sleep.
Mm-hmm.
How often do you hear, "Oh, I only sleep four hours a night, I feel great"?
I might have to hide my face on that one because I usually do that.
Well, sir, when's your body supposed to heal? How?
I'm with you. I think sleep is important. I just haven't had the time.
So I work, my eight to five-
What? You have a job?
Yeah, eight to five job. Then I want to do my jujitsu.
Yeah.
I want to spend time with my five-year-old. I have two dogs.
I have a blue heeler and like a pit bull mix.
He-
Oh, fun mixture
... so we usually take the-- He's a black cur, I think is the other part of him.
So I have to take them for their walk because they're both under two, they're
puppies and they're restless. So they need their outlet.
And then a little bit of time with the wife, then my meditation, then whatever
tasks. You know, as a doctor, you're not done when you leave.
No.
There's like 50 forms to fill out. "Oh, can you finish this mandatory compliance
training?" You know, there's always something.
Nothing is lost. If it's on my desk, it is lost. Nope, didn't see it.
So yeah, when do I sleep? Yeah, that's the problem.
Man. Gosh. Yeah, I love to do it all. I don't want to miss anything either.
Yeah.
So, and I don't have kids-
Mm-hmm
... yet, so I don't know the answer.
Well, the perfect life, I think, is balance between all of that, and that's what
I'm hoping having my own practice will do.
Sharing time with my wife, finding balance for all of it-
Yeah
... where we can not just kind of close our eyes and coast through life, but
live it.
Yeah.
We've been in California for two years.
You know, we've not been to LA to actually like look at LA.
We've only been to the airport to pick up family members.
I don't really know what there is to look at.
I mean-
Yeah, I guess not.
I don't know. I went to Santa Monica.
Mm-hmm.
I mean, I used to really enjoy going there, right? Like it's kind of picturesque.
Yeah.
You've got the Ferris wheel.
Uh-huh.
You have the pier, but then there's this guy who's on a megaphone-
Okay
... yelling out his message. And I mean, it was the entire weekend.
There was not-- You would think that he would be arrested. He was not.
It was like, it was horrible. So I'm like, "Well, that was a waste."
So you heard him the whole time you were there.
The whole time.
Yeah. And then my perfect getaway isn't really the city.
I was using that as an example. Like if I could take my blue heeler and go for like
a nice hike, I think that would be much better.
Okay. That's pleasant, yeah.
Yeah. We went to General Sherman, Big Sherman.
Oh, yeah. Yeah, the tree.
But the, like you have to park somewhere, then take a bus.
We had our blue heeler, we had my five-year-old who was not five yet.
It was hot, and we were like, "No, forget this." We went past Big Sherman.
We saw another big tree, and we're like, "This is Big Sherman for us today."
I wasn't going to wait in that one-hour line to take a-- It was ridiculous.
No, that's horrible.
That is not relaxing. That's not what you go to the forest for.
What about the redwoods? Did you make it to that?
So we used to go to the redwoods a lot when we lived in Oregon.
Okay.
And I do miss it. I'm a big "Star Wars" fan.
My poodle's name, he passed away now, was Anakin, so- Yeah.
When we went to the redwoods and it reminded us of the movie, it was great.
I love it. I feel like Carmel is pretty beautiful.
Carmel is nice. Expensive, but nice.
Yeah, just don't look at the numbers.
Yeah.
Money's not real.
Yeah. But that white sandy beach, you don't get that anywhere else on the coast.
Yeah.
So Carmel is nice just for that. It was really windy when we went there, but it
was-- Let me think. My favorite place along the coast would probably still be
Oregon, because I think the Oregon coast is quieter and-
I can bet it
... not as jam-packed.
Mm-hmm.
We went to a little town, I want to say called Wheeler, Oregon, if I remember this
correctly.
Sounds adorable.
There's only one restaurant in that town.
It was right on the coast, and the best fish tacos I've ever had in my life.
Ooh.
Me and my wife talk about that all the time.
That's awesome.
It's a storybook town, too, so there's some cliffs that go up, and we always say,
"Maybe we'll retire there and write books while we watch the rain on the ocean."
I love that. Okay, that's romantic.
Yeah.
Super cute. They probably have Airbnbs that you could rent.
Mm-hmm. I bet you. Yeah.
Okay, so that's living.
That's living.
I think that's beautiful.
Yes.
That's really just taking it in, enjoying the beauty of life, and we're not
trained to do that.
No, we don't have the time.
Yeah.
The Western life is different. I think we say we have all the
luxuries, but we don't have the time to enjoy the luxuries.
Yeah.
I have this beautiful backyard. I think the people that owned it before us were a
retired judge.
Mm-hmm.
We have a rose fountain. We have a natural pond. We have a koi pond.
I don't know how much time I spend in it. I'm too busy working.
I'll get to go out around when the sun goes down.
By then, mosquitoes are killing me, and I'm like-
Yeah
... "Let me go back inside."
You're like, "Well, that was not lovely."
Yeah.
Man, yeah. Definitely after going through residency and everything leading up to
that, you're just juggling, right?
Mm-hmm.
It's constant.
It is. It's like no time to put your head down.
Yeah. So learning how to just be still-
Mm-hmm
... to manage all of this energy-
Mm-hmm
... it's hard.
It is really hard.
I'm trying to do that now. I don't sit still.
Mm-hmm.
I'm very fidgety. That's my baseline. I've always done that.
So have you done any meditation on your own?
No, I need to.
Okay. I feel like this is something that I'm passionate about that I could
hopefully in the future impart on you.
Please. No, for my health and my longevity-
Mm-hmm
... I must learn this.
Mm-hmm. I got my wife, who was an anxious person, onto
Kriya Yoga, which is breathing techniques, and she's really liking it and she's
enjoying it. So yeah, it's definitely, I think it works.
I need to look that one up and I'm going to-- Yeah, I need to make changes.
Yeah. I want to see more of the world.
And when we were growing up, that's the dream, right? I want to travel.
I know.
And I've gone to one foreign country other than the US or India, which to us
is like home, is I went to Portugal with one of my best friends.
Oh, that's gorgeous.
It was a great time, but other than that, I haven't seen anything else.
I realized my travel, I guess you have to have a reason-
Mm-hmm
... because I don't know. I don't know why I have to have a reason.
Mm-hmm.
I don't just do vacations. I do trips where I learn.
Ah.
It's a conference.
Okay.
So I find, Rand, if you're doing a conference and it's way over there in a
different country, I'm more likely to make it to that than the Marriott down the
street.
I
guess I could see how that's nice because you're multitasking, but then you're not
really turning off, are you?
Never.
Yeah.
I'm not turning off.
So that's why I liked India. Even the phone barely worked there. I was turned off.
I need to be-- Yeah.
I didn't even know the language. So India has like, I don't even know, I'm probably
making this up, but 300 languages or something like that, right?
Yeah.
And I didn't speak the dialect there. It was just somehow I got by.
I didn't even use my phone. It was a lot of hand signaling, and I just felt-
Oh my gosh
... finally I felt free.
That's something.
Yeah.
I feel like when I'm holding my phone, it fuels almost like an energy like this
through-
Mm-hmm
... like a loop.
Yeah.
Is that crazy?
No, I don't like to have my phone on when I'm at home.
And as a physician, it's hard. We're on call.
Yeah.
So when I'm on call week, it's practically glued to me.
Yeah.
But I try to throw it when I get home and not try to deal with it.
Yeah.
But it's also, every few seconds you're like, "Okay, let me go answer that email.
This is the time to do it."
Yeah, there's one more thing.
Yeah, exactly.
But you will never finish your list.
No.
Ever.
So I always tell my wife, I was like, "I just want to be caught up one day so I
could relax."
Never.
And she's like, "That's never going to happen."
Impossible.
"You're going to have to learn to relax while there's stuff to do."
Right? It just tastes bad.
Yeah.
It sounds bad. But she's right.
Yeah, she's absolutely right.
Wholeheartedly.
She's always right. I've fought her for God knows how long.
We've known each other for 20 years, and she always ends up being right.
You're a smart man already.
Yeah.
At 42 years old. Some guys, it takes them their whole life.
Oh, yeah. No, these last few years, I think when Yoda was born, my son,
it kind of just brought us together in that we had one goal and it's to survive
this. We didn't have any help. We didn't have my parents there.
We didn't have her parents.
Sounds like growing our own kids.
Kids are like that, aren't they?
Oh my God. Okay, I don't have kids yet. I will never pull the trigger.
Just proceed. Okay, go ahead.
Yeah, so we didn't have her parents. We didn't have my parents.
I was working, and she was going to school at the time doing her master's, and we
just somehow had to survive this period.
Yeah.
And that, I think, brought us closer and just kind of an understanding of each
other.
That's badass.
Yeah.
It's like this isn't about love or feelings right now.
No.
We have to live through this.
Yes, exactly right.
Oof. Man.
And my son is, I don't know. I've been around kids.
Me and my younger brother are 14 years apart, so I've been around kids-
Mm-hmm
... and I've kind of helped raise my brother.
But my son is probably the most stubborn kid I've ever seen.
If you tell him, "The sky is blue," he'll fight you until you say the sky is red,
and he'll want-- It's unbelievable.
It depends on the time of the day.
Yeah.
Maybe he is right if it is at sundown.
Yeah. We named him Yoda, which in Sanskrit, which is our version of Latin,
basically the oldest Indian language-
Yeah
... it means warrior. And my mother-in-law always jokes that, "Well, you named him
warrior. What did you expect? Maybe you should've named him Don or something."
Something more soft.
Yeah, exactly. Names have power, absolutely.
Oh my gosh. So what is your full name?
My name is Sulakshan, my first name.
Okay.
My last name is Mahendrarajah. So Sulakshan, Su in Sanskrit I think means more, and
Lakshan means radiant. So my first name means more radiant.
And Mahendrarajah is Maha means great.
Indra is the name of the king of the gods, and Rajah means king.
So I guess my last name means great king of gods or something like that.
You cannot be a loser. You had to--
Good thing that you're not, right?
Yeah.
Man, what a great name.
I try.
Yeah.
Yeah.
At what point did you start going with Shaun?
You're like, "These people can't."
So as soon as we moved to Montreal, my first teacher
there said, "Oh, well, we're not going to pronounce this.
We're going to call you Sulak." So the first part of my first name, Sulak.
Oh, man. How old were you?
So for-
Four?
... grade one, grade two.
Yeah.
Yeah. So I was Sulak for a while. A lot of my Montreal friends know me as Sulak.
Then I went into retail. I had a lot of jobs.
Immigrants-
Mm-hmm
... not a lot of money, so I've worked every job you could think of.
So I went into selling clothes, and I wanted to relate because I was working on
commission, and I wanted to relate to the customers, and my name wasn't going to do
it. That's when I went with Shaun. Then I went to residency, and everybody always
thought Shaun was easier, so.
You had to clean it up.
Yeah.
Oh my gosh.
Shaun has a good meaning in our language, too.
I think it means shine or something like that, or sun or something, so.
So you're still radiant.
Yeah, still radiant.
Yeah. That's cool. Yeah, mine means brave.
Oh, I like that.
Yeah. Valerie Valor
Oh, yeah.
Yeah.
Yeah. So that's Latin. Is it the under the final background of that?
I wish I knew-
Okay
... as much as you about my name. So my middle name is Felice-
Okay
... which is from Malta.
Okay.
It's a common last name there.
Okay.
It's my grandma's middle name.
Yeah.
I mean, that's her last name. It's my middle name.
And then Savelli-
Okay
... is my last name.
Malta is beautiful.
It is.
And no extradition. I know this because of a USA show called "White Collar" I used
to watch.
Oh. Good to know. Yeah, they have some interesting Bitcoin
laws there now.
Okay.
It really, really upgraded their harbors.
Oh, nice.
I went there throughout different points in my life.
Uh-huh.
And I still have a lot of my family that's there.
Oh.
Yeah, so I went there this past August.
Mm-hmm.
And I just was shocked with the harbors-
How it changed. Uh-huh
... from rowboats to mega yachts, like packed.
That's me when I went to, so Colombo is Sri Lanka's main city, and I went there,
and we actually had a skyline, and I was like, "Whoa, when did this happen?"
Isn't it crazy?
Right? Yeah. It's crazy.
Man, do you still have family there?
Yeah. My father's side had... So there were seven kids on his side.
So he lives in Montreal, but a lot of the uncles, aunts, cousins, they're still all
in Sri Lanka. I mean, they had to live through the war, so I always feel a little
bit guilty when I go back because I escaped-
Do you really?
... the war, and they didn't. They had to live in concentration camps, and I'm
like,
I don't have an excuse for-
Wow. That is,
yeah.
Yeah.
That is a good one.
Yeah.
I can't even imagine. I mean, I don't think I have any
family that... No, I take that back. So Malta did have the Great Siege.
Mm. Okay.
So that did drive a lot of my family out of there.
Okay. Got you.
So my grandfather, he came over on a boat.
Okay.
But I don't think at that time they were escaping war.
Okay.
They never spoke about it if they did, but he snuck in.
He was illegal here for 20 years.
Oh, yeah. When I first came to the US from Canada, it was illegally, I think, but
luckily when we went to Canada, we got our citizenships.
But yeah, I
mean, my father looked like, I think, one of the main
persons in the rebel side. So before he left, he left before us.
So my father left, and we didn't have contact with him for about four years.
Him and my mom weren't getting along at the time.
So me and my mom actually grew up in a orphanage temple type place.
Mm-hmm.
So I grew up in a temple, which is where my faith got stronger, I assume.
But anyway, so before he left, he got caught and tortured, and the story that
he tells us is that he was tied upside down.
Oh, my goodness.
And they put gasoline on those burlap bags.
Mm-hmm.
And then they put a rat in the bag, and they tie it to your head.
And the rat goes crazy from the gasoline smell, and it starts trying to gnaw at
you.
Oh, my goodness.
It's crazy stuff.
It just makes you, I feel gratitude.
Yeah.
I just feel gratitude that I do not-
Didn't have to
... have to experience that.
Same. Yeah, absolutely.
Gosh. The things people live through.
Yeah.
It makes me feel weak.
Yeah. It's crazy. I mean,
nowhere near what my father lived through, but just crossing the ocean, getting
there, living through, like in Montreal, where we lived, I've had a few friends
pass away from gang violence. So I've seen some stuff, too, and I'm just always
like, I can't believe I got away and I'm here, sitting here.
Just my story of war-torn Sri Lanka to hear sometimes surprises me when I think
about it.
Oh, my gosh. No, you feel guilt, which is-
You do, yeah
... yeah, it's interesting.
Survivor's guilt. Yeah.
Yeah. That's a real thing.
Yeah.
Or the fact that your ability to earn income is-
Mm-hmm
... now dramatically different.
Yes, absolutely.
Yeah. Generational wealth is something of interest to me.
Mm-hmm.
Just breaking through. I feel like the middle class is, it sounds so, I don't know,
like why should I complain, right?
Mm-hmm.
But I feel like no matter where you drop in at life, you're there-
Mm-hmm
... and it's your duty to do the very best, break through whatever barriers
are given to you-
Yeah, absolutely
... because you can and should.
Yeah.
Right? Fulfill your purpose.
You don't want to be complacent.
Yeah.
No.
So-
I believed in that, too. Right?
Yeah.
I want to make a, for me, there's purpose.
I want my son to say, "Okay, well, I have that savings."
Yeah.
"Now what do I want to do? What is my purpose in life?" Not, "Okay, well, this is
what's going to make me money."
Yes. To take from-
Exactly.
Yeah.
I hope whatever he does makes him money, but I want him to find his true calling
and not have to do 15 odd jobs, waiter, working at the bus stop, and-
Yeah
... selling clothes as Sean to try to get through with.
But that was your journey.
Yeah, that was my journey.
Yeah.
And it made me who I am.
Totally, and you wouldn't be who you are-
Yeah
... without it.
No, absolutely not. So I wouldn't even be a doctor if it wasn't for my first job.
So my first job was in a factory called Pantorama, and the job I got
was pushing a cart, and then they'd sew clothes.
So you would take the clothes, there would be a sticker on it, and you put it in
the box of the store it goes to, and then you would lift boxes, too.
So you worked 40 hours a week, and the pay at the time, per hour, was
$5.90.
Oh, that's beautiful.
And you got a half an hour lunch. That was my first job at 16.
I think my parents planned this because as soon as I was done that summer, I told
myself, "There is no way this is what I'm going to do for the rest of my life."
Like, I have to figure it out.
Yeah. No, I mean-
Okay
... I think those are the moments-
Mm-hmm
... that you really develop that thought.
Yeah. Absolutely.
And that mission to change it.
Yeah.
Yeah. I worked at Applebee's. I was a hostess.
Uh-huh.
And then
I worked at a place that sold chicken wings.
Okay.
So I was a server.
I've done telemed, or not telemed. What is it?
Like the call center.
Mm-hmm.
Yeah.
Oh, telemarketing. I did that, too.
Telemarketing.
I thought my soul lost some credibility after I worked there.
It's so bad.
It was bad. It's so bad because you're-
It's so bad
... selling stuff. I think we were selling those rolls that go in the receipt
machine.
Yeah.
And I think you could get that for free from the bank.
So I still remember it, the pitch or whatever they say is-
Yeah
... "Hey, we noticed that it's time for you to renew your sale, and we're running
a special." And it wasn't really a special.
It was no special.
I'm probably living some of that karma now.
Let it go in the next section.
Right.
Yeah. I think mine was a nonprofit.
So saving, I don't know. It was something related to kids.
Okay.
So I mean, yeah.
You do what you got to do, right?
Yeah.
I was 16.
I only lasted at that job for two weeks.
Yeah.
I felt so guilty that I wasn't selling, and at some point, I started pretending to
have a Texan accent just to get through the day.
Oh, let's hear it.
I'd be like, "Howdy, today is the day that we have a special going on.
What do you think about it?" It was a long time ago.
It was probably better back then, but-
It's pretty good
... but I would just try to make the day go by, and then they caught onto it
because they would listen to your, some of your calls, and they called me in.
They're like, "Yeah, this isn't going to work out."
This isn't going to do that.
I was like, "I know. We were about to switch ways.
Don't worry about it."
Oh, my gosh. I did radiology, so I was a tech first for about-
Uh-huh
... 10 years.
Oh, okay.
Yeah, MRI, CT, and I thought I wanted to be a radiologist.
Okay.
But then I was like, "No, I have too much personality to be in a small room."
Yeah, you would be in a dark room all day. No, that wouldn't work.
Because same with me, talking about the accent made me remember something.
Did you know, and I know this for a fact, that somebody that works for Dutch Bros
told me they have to initiate conversation with you.
Have you ever driven through Dutch Bros?
Yes, I have.
You know what I'm talking about? I'm not going to name him.
I don't want him to get caught for corporate espionage, but-
You remember this person's name.
Yeah. Well, yeah. I do jujitsu with him. So yeah.
So he works at one of the Dutch Bros, and he says they have to do it.
So whenever I go through, I try to have fun with it. I'll come up with stories.
They're like, "What are you up to today?" "I'm going to drive through because I've
just given up on living in Bakersfield. I got my dog here.
We're about to just drive, and the first place I want to stop, I'm going to stop."
Sometimes it's, "Hey, I just got my bounty hunter license today.
I'm going to get my first job." And it's always fun.
It gives them something fun to think about, but if my wife is ever there, she'll
call me out, too. "He's lying. Don't listen to him." I'm like, "You just ruined his
day. He was telling a good story."
Yeah. And it's like, I wonder what his face actually looked like.
Yeah, exactly.
Because he's really like, "Is this for real?"
Exactly.
Surprise.
Yeah, you broke script.
Now you're going to want to try it.
Yeah, for sure. Although, I have to say, I'm not my best self going through, say,
Starbucks.
Uh-huh.
Yeah. No, they try to do the conversation thing, and I want to just hit the roll
the window button.
That used to be me, but now I try to make-
Well, not profits
... and there are days when I just don't feel like speaking, but-
Yeah
... my wife is always like, "You know, I'm so pleasant to everybody.
Nobody wants to have a conversation with me.
You're over there in your hoodie, and everybody wants to tell you their life
story." I'm like, "I don't know. I don't know what to tell you."
Right. That is so cute. That is just real life.
Yeah. That's real life. I think I was like, "I think they know that I don't really
want to hear it, and you're too eager for it." I was like, "Just tone it down."
They could feel like the-
Yeah
... what is it? It's pick me vibes, right?
Exactly.
Yeah. I think the last person at Starbucks was like, "So what's your favorite
movie?" And I was like, "We don't
need to. I'm good."
Oh, man. It's funny. But no, I try my best to connect with people now.
I'm a little bit different with...
I think Yoda, my son, really kind of made me change a lot, so-
That's good
... no, I have fun with it.
Okay, but that it's also you're going to live longer like that.
Mm-hmm. Yeah.
Right? We know that to be true.
Fun fact.
Yes.
I think they did a survey, and don't ask me for where I got this from, but I read
somewhere that they did a survey about what constitutes happiness.
So they surveyed people that were happy, and they found the common factor was not
money, was not living in the forest. It was a sense of community.
Huh.
Sense of community is what makes you happy.
So you have to have a cult.
Something like that, yeah.
I'm kidding. I'm joking.
Probably why they're always smiling in a cult.
They keep showing up. You're like, "This is great."
Yeah.
You should-- No, I actually, I think that is-
Sense of community.
Huh. Okay. Yeah. That makes sense.
Sure.
But yeah. Is it the connecting part?
I think it's just connecting with people, being, I think,
selfless, right? If you have a sense of community, you're doing something for
somebody without expecting anything in return sometimes.
And all religions teach us that that's really the ultimate, right?
Yeah.
That makes you happy, sometimes to just be able to help without any expectation.
Okay. So on that, okay, I was raised with that.
Mm-hmm.
And I didn't realize that it is a religious-based-
Mm-hmm
... concept. It confuses people to be selfless.
Mm.
They're like, "What do you want?" I'm like, "Nothing."
Right.
So it's almost fishy.
Yeah.
Right? But it is genuine.
In this day and age, it is fishy.
Yeah.
Yeah.
And I'm like, "Why are you confused?"
I know I'm selfless, but if you try to be selfless to me, I might not trust you.
That's just the world we live in, right?
It takes me a while to say that, yeah.
Yeah. So, it's not common, but it is a spiritual base.
It is, yeah. I think to help, yeah.
Well, it looks like we're getting the wrap up-
Oh, okay
... signal. But yeah. I definitely enjoyed having you on.
Yeah. It was fun being here.
Yeah. I'm excited for your practice.
Thank you.
I love what you're doing. And functional medicine, if you ever need that element-
Mm-hmm
... in your practice, and you want to collaborate, I would be honored to do that.
Oh, yeah, definitely. And then we'll talk more about meditation.
Yes. Absolutely. Thank you so much.
Well, thank you so much for having me. It was very fun.
Thank you guys for joining.
Thank you guys.
