My text to a friend, in his 30s, whose depression is affecting his marriage, his fathering, and his work…

By the way, all of us have grown up with a certain level of rigidity, of structure, of expectations that have helped us judge ourselves, others, and the world around us.

What I have found is that, often, what we already have in our heads is partly true, but sometimes the exact opposite (as well as  many different variations) can also be true, or can work out well enough, if not better than, what we have believed.

This applies to everything from religion, to politics, to child rearing, to making money, to insights about ourselves and others.

Peace.

Charles Tadros, M.D.

November 26, 2023

Saint Louis, Missouri

My medical profession should stop trying to keep/recreate the past.

Our models of healthcare (“sick care”), and healthcare payments, have been broken from each of their respective inceptions.

Now we know better, but the current systems are just too entrenched in our national gross domestic product (economy)…too lucrative for everyone involved (yes, including most insured patients).

As a system tries to improve / change, all who are involved continue strategizing to discover loopholes, asymmetric advantages, opportunities, and incentives.

https://www.linkedin.com/feed/update/urn:li:activity:7120610853808160770?commentUrn=urn%3Ali%3Acomment%3A%28activity%3A7120610853808160770%2C7122752840334204928%29&dashCommentUrn=urn%3Ali%3Afsd_comment%3A%287122752840334204928%2Curn%3Ali%3Aactivity%3A7120610853808160770%29

https://www.statnews.com/2023/10/23/universal-health-care-amy-finkelstein/

https://www.penguinrandomhouse.com/books/690632/weve-got-you-covered-by-liran-einav-and-amy-finkelstein/

https://source.wustl.edu/2024/03/washus-economic-impact-totals-8-8-billion/

Charles Tadros, M.D.

October 24, 2023

Saint Louis, Missouri

A friend asks, and I respond, about my perception regarding self determination, having agency, in light of this new book by Sapolsky, Ph.D. … “Determined: Life without free will”.

You accept that you have no agency?

Sigh…I have limited agency…I don’t know exactly in what spheres/domains…so I still make plans and goals and make educated/reasonable/calculated efforts… because I never know what will work or what won’t, but I set myself up for success without being too hard on myself if I don’t achieve what I want, when I want it, and with the effort that I thought that I needed.

Determined: https://a.co/d/c9CcJv4

Charles Tadros, M.D.

October 20, 2023

Saint Louis, Missouri

Highly processed foods and fructose intake lead to elevated insulin levels and mitochondrial dysfunction, which, in turn, lead to 80% of chronic illnesses in the US.

When I was in college, healthcare costs were 11-12% of gross domestic product. Currently these costs are 18.3% (2021)… remember that healthcare costs inflate and the gross domestic product also keeps growing, but each does not grow at the same rate.


There is no way that our current medical technology (drugs, CT scans, MRIs, cardiac catheterization, stents, ICUs, specialists, and subspecialists) can lower costs… they are too good at revenue generation!

Newer and more elaborate diagnostic and treatment tools are more and more expensive.


We have to fix our personal and public health (ie nutrition, stress, sleep, exercise, a sense of community/belonging, a sense of purpose) so that we can healthfully avoid entering the medical system until late in our lives.

The medical system is way too expensive, even at the primary care level (let alone at the specialist level, and at the inpatient hospitalization level).

According to the US bureau of Labor Statistics, healthcare and social assistance industry generated 2.83 trillion in revenue in 2022. This makes it the largest industry in the US when measured by revenue.

Primary prevention is the only health-centric, financially sustainable answer. Primary prevention starts in childhood. Secondary prevention (prevention of additional health issues after you have been diagnosed with heart disease, or hypertension, or with diabetes, or with depression, etc) is just as important.

https://youtu.be/0zzRGvwbil8?si=Zud0vqWtIGo1Yhbw

Charles Tadros MD

October 12, 2023

Saint Louis, Missouri

Patient expectations of healthcare providers…

Patients really want perfection. Sometimes this perfection needs to be accomplished with the first interaction.

Nobody, patients or medical practitioners, ever talks about such high expectations.

Charles Tadros, M.D.

September 20, 2023

Saint Louis, Missouri

I have never heard this type of a response, when the question was about the desire to win vs the need to avoid losing. Kobe describes curiosity… curiosity and learning.

https://www.instagram.com/reel/CwVOkctsscM/?igshid=MTc4MmM1YmI2Ng==

Charles Tadros, M.D.

September 10, 2023

Saint Louis, Missouri

What work wants from you and what you want from work are often not even close, and sometimes they’re diametrically opposite.

There should be no secrets, no hidden agendas, no mind reading necessary. Just because you have the skills and the experience, and a workplace has an open position, does not automatically mean that you are a good match.

For the long term, do not contort yourself, your needs, and your goals to allow you to win over a potential employer.

However, for the short-term, typically, you will need to bend more than you wish, in order to lay down the smaller steps needed to achieve your longer-term objectives.

Charles Tadros, M.D.

August 3, 2023

Saint Louis, Missouri

A young friend worried that his bosses and team at work may not be happy with him/his work. My fatherly response:

You can’t read minds. None of us can. Also, you probably haven’t figured out how to read behavioral patterns from the people that work with you.
Ask.
Please understand, any boss who thinks that you’ve already met expectations will just set different or higher standards for you… nobody is going to let you keep making the same money with just coasting after you’ve reached goals.

Remember, sometimes the tasks that you think are important, or the tasks that you take great pride in accomplishing, do not match what your bosses see, agree with, or want.

ASK.

AND, AT THE SAME TIME ASK FOR A FOLLOW-UP MEETING TO REVIEW ACCOMPLISHMENTS AND THE QUALITY OF YOUR WORK.

No one-hour meetings are needed. Just touch base so that they see your work and you know that you are heading in the right direction for what they want from you.

Charles Tadros, M.D.

August 3, 2023

Saint Louis, Missouri

The humane treatment of our sisters and our brothers…

Coming down/off everything from alcohol to some correctly administered and taken prescriptions, to many street drug concoctions is so physically painful, nauseating, anxiety-producing, depression-triggering, trauma recreating, insomnia-producing, loneliness-creating, shame-producing, and crave-triggering that many people may need to be prescribed one or more medications to help alleviate symptoms. These medications may be needed to be taken anywhere from months, to years, to the rest of a patient’s life.

Additionally, almost all sufferers need connection with self, others, purpose, and a higher power/spirituality.

Medications, connections, even emotional, sexual, and physical trauma recovery help sufferers to begin to think and feel in a dramatically healthier way, when off these debilitating substances.

Working on interpersonal skills, life-skills, job skills, financial needs, as well as helping people understand and work with their own perfectionism, shame, embarrassment, anger, frustrations, and anxieties are very often needed.

Just entering people into an evidence-based detox and rehabilitation program is the first of many necessary uphill struggles. These struggles are unavoidable and are part of the healing process.

By the way, there are no textbooks or studies that tell us to give up on people trying to recover…regardless of how long, how many times, or how much effort (their’s and our’s) has been spent in the process.

https://abcnews.go.com/US/community-groups-medical-experts-work-combat-emerging-tranq/story?id=101716074

Charles Tadros, M.D.

July 29, 2023

Saint Louis, Missouri

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