speaker-0: Monday comes early. This chapter closes. A new door opens. This is the second shift. So my point is as people, ⁓ your audience moves into the second shift, I mean we know what it's like to be a physician, an emergency physician in the midst of of crisis trauma, you know, hands in people's chest and all that kind of stuff. But all of a sudden you're in this next career and the roadmap's not so clear. And maybe it's not clear at all, particularly for those of us who are so heavily protocol driven, A, B, C, D, E through Double Z. ⁓ And then all of a sudden here we are in a new territory with new decisions and no ⁓ obvious clear path. But I think you have to trust yourself that you're in the right place.

speaker-1: What if burnout isn't the real problem? What if the real problem is that somewhere along the way we lose sight of what brings us deep joy? Today's guest is Dr. Tom Mayer, an emergency medicine physician, a crisis leader, the medical director for the NFL Players Association, author, and someone who has spent decades helping both physicians and elite athletes perform at their highest level. In this conversation, we talk about why leadership is something you do, not a title you earn. Why relationships matter more than resumes, how failure can become fuel for growth, and why every high performer needs to recover as intentionally as they work. But more than anything, this is a conversation about building a career and ultimately a life that continues to bring purpose and joy even as it evolves. I think you're really going to enjoy this one. This episode of The Second Shift is brought to you by Targeted Wealth Solutions. Making a major career change or facing retirement can feel like leaving a familiar identity behind. At Targeted Wealth Solutions, we specialize in helping physicians navigate these exact transitions. As a fee-only independent fiduciary, our job is to take that financial complexity and turn it into clarity, giving you the freedom and permission to explore your next move. If you're ready to design your exit strategy with someone who speaks your language, let's talk. Can learn more at TargetedWelt Solutions.com. Now, on to today's conversation. Hello again, welcome back to the Second Shift Podcast. I'm your host, Brian Jepson, a recently retired emergency medicine physician and now a CFP financial advisor working with targeted wealth solutions. If you're new as a listener, this podcast focuses on how to successfully navigate through important transitions in your career and your life, especially some of those areas that aren't talked about as much, like the behavioral or the psychological or identity identity impacts that might come with it. I'm excited to introduce our guest today, someone who has evolved through multiple career transitions and leadership opportunities, Dr. Tom Mayer. Welcome, Tom.

speaker-0: Brian, it's a delight to be on with you. I've been looking forward to this very much.

speaker-1: Appreciate it. So a little bit more from his bio, and then we'll have Tom take us deeper into his story. So Tom Mayer is a prominent figure in the fields of emergency medicine and sports medicine. He's built a distinguished career focused on athlete health, safety, and emergency response, making significant contributions to both clinical practice and medical medical education. So a few highlights. He served as ⁓ medical director for various professional sports teams and events, ⁓ which includes the NFL Players Association, where you're currently the medical director of that, I believe. Is that right? Yeah. ⁓ so played a crucial role in developing and implementing protocols for player safety and injury management, founder of Best Practices Inc., which is a physician staffing and management services company for emergency departments across the country. ⁓ was a leader in ⁓

speaker-0: That's correct.

speaker-1: Crisis response, including 9-11, Hurricane Katrina, and COVID-19. He's an author and a speaker, extensive publications, written multiple books, contributed to more than 100 publications, textbooks and emergency medicine, leadership in patient safety, and an educator. So holds academic appointments, lectures at various institutions, has earned numerous awards for his service and contributions to healthcare. So man, where do we where do we begin? So Tom, I'm gonna let you tell us where. So you've done some incredible things in the field of emergency medicine and ⁓ and elsewhere. So why don't you take us through some of those transitions and decisions that led you to such a fulfilling and varied career? And maybe I can start with this. Was there a moment early in your career when you realized that your path wasn't gonna look like the traditional emergency medicine career?

speaker-0: Yeah, well first of all, Brian, thanks for having me on. I appreciate it a great deal. I think what you're doing is extraordinarily important ⁓ as we transition across the arc of of what I call our deep joy in life and and ⁓ s sort of sing with all our voices instead of just one. ⁓ I'm not sure if I'm on my second shift, my ⁓ Yeah, probably twelve or something like that. So yeah, I I mean I went to ⁓ most people

speaker-1: I think you're more than two.

speaker-0: go to college ⁓ you know, and ⁓ have a clear sense, you know, for me, they they played football, which I did. I played ⁓ in ⁓ high school with three sport athlete, ⁓ it ⁓ in order to go to college. I did quite the opposite. I'm I w went to college to continue playing football because they weren't gonna let me play high school anymore and I didn't want to go straight to to semi pro. ⁓ but I went to to my goal was to play in the NFL. And ⁓ eventually had a a shot at that and I'll tell you how that worked out if we have time. But you know, shortly after I started my ⁓ football career, started as a freshman, which was very unusual in those days 'cause I was a middle linebacker, ⁓ coach said called me in and I thought, you know, a trainer comes in and says you've got to go see coach. That's not usually a good thing, particularly the head coach. ⁓ But you know, I had ⁓ I was twelve and three, meaning twelve tackles, three assists, two interceptions that game before. So I thought I don't know why he could be calling me in. Yeah, not from that. ⁓ maybe something else. And he said, you know, you have to choose a major. And I said, A major what? You never say anything about a major, you know, when you recruited me. No, no, you have to have a major field of study. So I chose theology and you know

speaker-1: Could be benching year from that, right?

speaker-0: Why? It's I was always interested in how things work, why people do what they do, interaction with the ethos, the cosmos, and everything involved in in between. Plus, to be honest, Brian, you didn't have to take tests. You just wrote papers and sat under trees and and had discussions. And yeah, so I started out as a theology major. It wasn't until my ⁓ junior year that two professors took me aside and said, Has it ever occurred to you you might have more impact?

speaker-1: Yeah.

speaker-0: as a physician than as a theology professor. You know, I I didn't think about much of anything. You know, that was what I did in theology. I didn't want to do anything beyond that. But I trusted these guys. And so when I was a junior, I started taking pre med courses with all the freshmen. ⁓ so ⁓ y you know, I've always looked a little older than I than I am, including now. so that that was pretty pretty disconcerting to them having this old man only two years older than them but look much older in their classes. So ⁓ that's ⁓ I would never have become a and and I can tell you a quick story. The ⁓ chemistry one ⁓ one taught by Dr. Keith White, chairman of the department, all the at the school I went to undergrad, ⁓ all the level one courses had to be taught by the chairman of the department, not by TA, not by somebody else. And so I get in chemistry one ⁓ one. I'm cooking along, doing okay. The first ⁓ exam comes up and, you know, it's a hundred pages. It's one of those mimeographed ⁓ things. You remember that. Some of your folks will not, you know, kind of a odd smell and a purple look to the print. And ⁓ Dr. White's sitting up front and he says, begin. And so I flip the page and the first question is, and this is verbatim.

speaker-1: Yeah.

speaker-0: A mole is Avogadro's number of particles or and then there's five choices, A through E. W who's Avogadro? I don't remember any Avogadro. He's got a number? What do you know? A mole, I mean that's a critter, isn't And that's something it's out on your lawn. So I had no idea. So I thought about it for maybe three seconds and I realized, well, this has been fun, you know.

speaker-1: Well what's a number? All creature that's

speaker-0: We're still in drop ad. I can drop this course. I can go back to theology. I'm all good. But I was out of respect for Dr. White, I'm gonna finish the exam. So I just started doing A, B, C, D, E, E, D, C, B, A, all the way through 100. So I got twenty ⁓ that now in football, when you run a slant and go route, that's called a sluggo. And that's what my answer sheet looked like, a sluggo route, just because it you know zigzagged back and forth. But I finished the ⁓ the one hundred and flip the page and there's an envelope in the back typed on there says bonus question. If you get this question right, you get an A in this course, no matter what you did on the first one hundred questions. And I thought, can't be any worse than Avogadro. Let's give this a shot. So I open it up and it says Tell me the name of the man who cleans this room every night so you can have a great place in which to learn. So I walked up to Dr. White and I said, Dr. White, this bonus question. He smiled and I said, Do you want his first name or his last name? And he looked at me and said, Tom, if you can give me his first name and his last name, I'll not only give you an A in this test, I'll give you an A in this course. As long as you show up, as long as you do your work. So I pushed it and said, ⁓ what if I can give you the names and ages of his six kids and his wife? And he stood up, you know, how People sometimes take their glasses off and point. And he pointed at me and said, Tom, if you can do that, I'll not only give you an A on this test, I'll give you an A in this course and an A on every single course you take in chemistry that I teach. So I was as good as my word, he was as good as his. ⁓ and that's how I became a chemistry theology b biology major. My point is that I didn't become a doctor because of my inherent intelligence or ar articulate nature.

speaker-1: That's fantastic.

speaker-0: Yeah. It was because of a janitor that was nice to me.

speaker-1: Well, what a gr what a great lesson though. I mean, I'm just ⁓ I I can't think of a better way to d to describe the importance of relationships, right? And and and being aware of your team members, especi especially those who aren't forefront and most people ignore. So

speaker-0: We do training camp visits. A couple years ago at training camps we were we were at the Broncos and walking around, you know, I'm seeing the players because I'm their medical director, but I'm also talking to the medical staff and the trainer. And I I look and as I turned around, every door that walked out of the the ⁓ the locker room had a sign on it with a Broncos logo that says, You can always judge the character of a man by how he treats those who can do nothing for him. Yeah. That as you recognize is Goethe, you know, Wolfgang Goertha. And I so I turned to the trainer and I said, Greek, what's up what's up with this? And he said, ⁓ Coob's dad, ⁓ Coach Kubiak, his son is now an NFL coach, head coach, ⁓ Coach Coob's dad always told him that, and he wants the players to remember that. And I took a picture of it, and and if you look, you can see that right at the bottom next to the Broncos logo, the the paint is worn away because everybody

speaker-1: I just laughed in it.

speaker-0: before they walk out of the door. So, you know, it's i as you say, it's it's relationships that matter.

speaker-1: So let me ask you this, is that something that came naturally to you or is that something that you developed ⁓ you know, purposely over your, you know, early in your life like that? ⁓ I think

speaker-0: Y you know, like most successful people I chose my parents extremely well. ⁓ my mom and dad taught me that, my dad in particular. ⁓ Pop was a tanker in World War Two, auto mechanic ran his own shops w when when I was growing up, and I just saw the way he treated other people. And it wasn't like he was outgoing, gregarious, ⁓ all that kind of stuff. ⁓ but he was just always nice to folks and it didn't matter who the folks were.

speaker-1: Yeah. That's great. So w wonderful life lesson there. Thank you for sharing that. So so take us take us to your next step. Take us to the I'm now an ER doctor and and then I became a NFL

speaker-0: I always I liked I am old enough. I gave I gave a a speech about ⁓ a month ago. ⁓ a thousand CEOs and and they could each bring one person from their organization ⁓ that they thought was an up and coming person that somehow need to hear me talk about leading in times of crisis. The QA session, I love all that stuff. ⁓ young lady, you know, steps up to the microphone and said, Doctor Mayor, how old are you? And I said, Well, young lady, there's a lot of people that would say that's ⁓ a somewhat indiscreet question, but I'll answer it. ⁓ when you get to my place in life, it we don't call it age, we call it carbon dating. ⁓ so I'm old enough that there weren't emergency medicine. Yeah, exactly. ⁓ there weren't emergency medicine residencies when I went through ⁓ medical school and residency. I trained in surgery and pediatric surgery, very drawn to acute care.

speaker-1: Green.

speaker-0: And ⁓ and I realized that the acute care that I really ⁓ loved more than anything else was the emergency department. And so w in ⁓ that way, ⁓ chair ⁓ August first, two thousand one, Corey Stringer, a tackle for the Vikings, died of heat stroke, inconceivably on an NFL field for the Vikings. And ⁓ I got this phone call. I was chairman of the department of ⁓ emergency medicine at ANOVA Fairfax. Level one trauma center, six helicopters, you know, academic program. And ⁓ when Corey died, I got this call from Gene Upshaw. Gene was the executive director of the NFL Players Association, best left guard in the history of the game in the Hall of Fame. And ⁓ but my best friend and said, Doc, you gotta step up to the plate. And and Gene didn't ask these things, he told these things. So you know, I August first, two thousand one, I become the medical director.

speaker-1: Yeah.

speaker-0: of the NFL Players Association. So the interesting thing is that, you know, I get this question all the time, how do I build my resume to get a gut job like yours as the medical director of the NFL PA? Yeah. And my answer is Gene didn't didn't do a job search. He didn't call a firm. He didn't ⁓ flip through a whole bunch of resumes. He certainly didn't consult Chat GPT because it didn't exist at that time. He called me because he trusted me and he trusted me because we were best friends.

speaker-1: Right.

speaker-0: And we were best friends because our family our kids went to school together, were themselves best friends. And so ⁓ to me the the punchline is don't build resumes, build relationships. And twenty five years later I'm doing the same thing.

speaker-1: Yeah. Yeah, that's ⁓ su such an important thing, you know. And I I I think especially i if I'm thinking about our audience who who may be people who are, you know, wondering about what's next for them. ⁓ I I think

speaker-0: I'm a big fan of Brene Brown's and and ⁓ you know the whole idea of imposter syndrome, vulnerability, all the pieces that go with that, which is ⁓ obviously certainly not a ⁓ an exclusively female thing, it's a human thing. And and so you know, I'm I become the medical director. I certainly knew sports, ⁓ sports medicine, both from the emergency medicine perspective, but having been an athlete who had a brief ⁓ tryout with the with the Bears and the Vikings, but y you know, my we faced an issue shortly after I started and I made the unusual ⁓ step of going making an appointment with Gene. We lived about two miles apart. ⁓ his office was in downtown DC. So I drove from Virginia down to DC and sat down and talked to him and said, Gene, here's the issue. I framed it. We could do three things, it seems to me. Here's one, two, three. Here's the strengths and weaknesses of each. And I didn't say what should I do? I just looked at Gene and he said, just go be Tom Mayer. That's why you are Tom Mayer. That's why I hired Tom Mayer. And I walked out of there, and my wife, Maureen, said, What did Gene say? And I said, I don't have a clue. I don't have any idea. But I do know what he was saying. He was saying, I hired you because I trusted you. And I trust you to make the right decision. Appreciate you letting me know. So my point is as

speaker-1: Yeah.

speaker-0: people, ⁓ your audience moves into the second shift. I mean, we know what it's like to be a a physician, an emergency physician in the midst of of crisis trauma, you know, hands in people's chests and all that kind of stuff, or going to the to the ⁓ bereavement room and talking to people. But all of a sudden you're in this next career and the roadmap's not so clear. And maybe it's not clear at all, particularly for those of us who are so heavily evidence either evidence based or evidence influenced, protocol driven, A, B, C, D, E through double Z. ⁓ and then all of a sudden here we are in a new territory with new decisions and no ⁓ obvious clear path. And I think you have to trust yourself that that you you're in the right place.

speaker-1: Absolutely. You know, I I think a lot of a lot of people, especially as physicians or other high impact careers, you know, I mean we have s we have s I don't know if you want to call them soft skills, but we have skills that we've developed over the years that are have nothing to do with clinical practice, right? I mean we've we've developed them through our practice, but you know, we we bring value to almost any table as long as you as long as you can ⁓ Realize what you're good at and ⁓ you know, that's all you have to focus on. I I I love what you said. Just be just be yourself, you know, br bring bring to the table what you already know that you're good at. And if if you don't know that you're good at, then do some self self ⁓ some in introspection or talk to some people around you that know you well and and help kind of piece that out. But but yeah, it's it's

speaker-0: You know, one of the things that we bring n naturally, perhaps preter naturally as emergency physicians, is calm in the midst of crisis, calm in the midst of what everyone else looks at and thinks, ⁓ my gosh, ⁓ my gosh, ⁓ my gosh, what do we do? What do we do? And that's, you know, the patient, the patient's family, the you know, nurses, docs, and everybody else. ⁓ I don't know about you, but I didn't learn that in a didactic session. I learned that by watching attendings and colleagues That I admired for what they did. And ⁓ I I remember there was a pediatric cardiothoracic surgeon ⁓ I trained at the University of Utah, ⁓ Mansel Pierce was his name, superb clinician. But I remember that that the nurses used to say that you can't do anything that will ruffle Dr. Pierce. You know, it it doesn't matter what happens. And I thought, you know, I want to be like that. And I had already been paying a lot of attention to him, but a little bit more on the surgical skill side and and you know, where do you place the suture, how tight do you tie the knot, all that stuff. But you begin to see, ⁓ I there's a lot of skills here that I'm learning if I pay attention and if I say to myself, Okay, my heart rate's up, but now's the time for it to come down. 'Cause I can't help people if I'm running around with a ⁓ heart rate of one sixty and and flustered.

speaker-1: Yeah, I I like I like that you noticed and paid attention to not just technical expertise of, you know, so I guess the question is how do we choose our mentors, right? ⁓ do we look at them because they're technically great at something? I think that's one way, but I I think probably the most influential people, at least it as I look at my life, the most influential people were not about technical expertise or anything like that. It was it was about How they cared for others, how they viewed me, how they interacted with me. Those are the people that I wanted to be like.

speaker-0: Yeah, and you know how appropriate that that Homer's ⁓ got a current interpretation. the the Nolan ⁓ film, which is ⁓ I I think I think the world of Chris Nolan and and his work, you know, that said he misses a lot. For example, Mentor, as you know, was chosen by Odysseus to he knew he didn't know he'd be gone twenty years, but he knew he was going to be gone for a while. So he cho chose mentor to be able to look after his son Telemachus. And and certainly he does. But what people forget is that regardless ⁓ the Fitzgerald translation, the Fagel's translation, Emily Wilson's translation, ⁓ it's not actually mentor the man that is counseling Telemachus, it's the goddess Pallas Athena, who takes the form and the visage and the voice of mentor at all the appropriate times, including the you know, death and the a Great Hall, the chapter that describes ⁓ what happens to the suitors. And and so my point is, you know, if you're gonna choose ⁓ if you're gonna choose a mentor, do what I did, choose a goddess. And my goddess's name is Maureen, my beautiful and brilliant wife. ⁓ but it's it wasn't a man who was the first mentor, it was it was a goddess.

speaker-1: Yeah. No, that's great. It's a great story. I didn't know that actually. I need to I need to spend more time with Homer. ⁓ so tell me about ⁓ you know, let I I I want to transition what this conversation because I I think it transitions ⁓ very seamlessly right now. You just you just writ wrote a book recently. It's called Leadership Is Worthless but leading is priceless. So what do you mean by that? Well

speaker-0: Yeah. I was asked by ⁓ my ⁓ publisher, my editor, you know, hey doc, can you r summarize this arc of your career across leading in times of crisis between the Pentagon and relational anthrax? I wrote the original concussion guidelines in the NFL and COVID. I led a ⁓ mobile emergency team to Ukraine after the war broke out. And and they wanted me I had been giving talks about this, but they said, you know, you really ought to distill this into a book. So I did. But my point was You know, there's over sixty thousand books on Amazon alone with leadership in the title. If you ask any AI, you know, d tell me about leadership, it kind of fries its ⁓ electronic brain because it spits back that, you know, there there's over a million articles written on leadership. And yet if I ask my audiences, as I often do, have any of you read these books or these articles, they raise their hand and I say, What did it say? vacuous looks and not because they're not smart people. And and so my point is leadership is worthless. It's just what you say. And and you can say anything you want. Try saying and not doing as an emergency physician. How far that that's not going to get you very far. And nurses will eat you alive. And they're very good at that. They're highly s ⁓ trill ⁓ drilled and trained in that. But but leading is priceless because it's what we do all day, every day.

speaker-1: And they're good at that.

speaker-0: Not just emergency physicians, but every person. You know, I said to that audience of CEOs and their acolytes, every single mother is every bit as much a leader as you are. The sooner you understand that, the better off you're gonna be. Because it's action. Our actions defined our leading. People talk about culture all the time. ⁓ culture, we have got a great culture. Well, why are half your people burned out? Culture can't be that good. And my point is the culture is not the words on the walls, it's the happenings on the halls. It's not the words, it's the actions of the people who do it. So the culture is defined by what you do all day, every day. So leading equals action equals culture. The culture is created every day. You and I had the great joy of doing that for decades as emergency physicians. Why? Because at the end of the shift, night shift, day shift, afternoon shift, you get in your car. You put the key in the ignition and you say, What did I leave in there? What was my legacy that I left behind? Now we get to measure our legacy one blank, one patient at a time. So each time we discharge a patient, each time we admit a patient, we have created a legacy. And collectively, that pulls things together to say, Yeah, I led today. So my point is.

speaker-1: Yeah.

speaker-0: we need to get away from this wistful, worthless word someday. Someday I'll be a leader. Come on. You know, the word we want is today. Today I am a leader. That's not a question. The question is how will I lead today? Or tonight, you know, w however it is that we're working. And and if you do that and you say I'm a leader, I make a difference in people's lives. And I'm proud to make that difference in people's lives, big or small. I'm not talking about saving lives. It's a lot often it's you know, ⁓ first child with a fever in the middle of the night that isn't really a fever, yeah. ⁓ but and calming them down. So th those ⁓ individual stories of patients ⁓ collectively each shift help us say, ⁓ okay, that's what I did. Now I think that when you go second shift, it gets a little it's it it's either harder, stranger. more complicated because it's not as discrete. Meaning, you know, what what did I do? I'll give you an example and I think you'll enjoy it. I was asked to speak to Alliance Bernstein, one of the ⁓ most elite wealth management companies in the world. And I'm talking to their ⁓ to their folks and ⁓ you know, really, really bright people as you are in terms of your financial management. Well my boys were younger, we had three boys now young men.

speaker-1: Yeah.

speaker-0: ⁓ and I w happen to be in town because I had to travel a lot in my various jobs. when I drop them off at school, I'd say the same thing every day. One more step in the journey of discovering where your deep joy intersects the world's deep needs. I swear I said this to them. They prefer to take the bus, as you might guess. They don't want to hear that stuff. And and your your listeners don't either. But my point is every time I talk to people, I say to them, what's your deep joy? And so I'm talking to Alliance Bernstein, ⁓ Adam Sansevera managing partner was kind enough to ask me to chat with these folks. And as you might guess, they started with, you know, maximizing ⁓ r returns, returns on investment, you know, maximizing ⁓ shareholder value, you know, creating wealth. I mean, hence the name wealth management, huh? And I said, And what else? And I just kept saying, and what else? And What else? And all of a sudden a young lady with tears in her eyes said, My deep joy is unleashing dreams that people could never have even thought of if they hadn't had the wealth to be able to do it. Yeah. And and they they got it because it it ri that's not just returns. That's what are those returns create, meaning their own deep joy of the clients that they work with, the partners that they work with. So that makes sense to you, I'm sure.

speaker-1: Absolutely. You know, I I it it makes sense to me both as a financial advisor and as a physician. Because to me, you know, ⁓ to kind of tie in those two stories that you just told us, I mean, I think at the bedside, when or like after we leave the shift or whatever and we're looking back and reflecting what kind of impact we made that day, those patients don't ten years from now may not remember anything we said. Right. They're not gonna remember any of the technicalities or how well we stitched their their laceration or whatever else we did for them. But if they remember anything, it's gonna be how we treated them. Right. And

speaker-0: You know, my Maya Angela who said this, ⁓ obviously not an emergency physician, but a very, very wise lady. Yeah. ⁓ said people won't remember what you said to them. They won't remember what you did to ⁓ But they'll always remember how you made them feel. That's us.

speaker-1: Yeah, absolutely. And and we have that opportunity as physicians every time we walk into a room. But also I I would say that then extends to your team members. I mean, you know, the emergency department is a is a team environment. And ⁓ you know, and and some teams function better than others, and and a lot of that I think comes down to who's leading it and ⁓ you know, on that particular day. And so As physicians, I think that's also important to remember is again same same idea. It's not necessarily how good of a doctor you are. ⁓ technically, it's about how you're treating your team members. And and and if you treat them with respect, they'll respond to you. So if I take that now into finance, ⁓ working with clients or teaching, you know, financial advisors or or or whatever thing that you're doing there, again, it's the same idea. It's not about it's much less about. returns or no net worth or, you know, all the other stuff as as it is about how how can you help that person find their joy in life and and you know, and wealth is money is only a tool to to do that. And so rather than focusing on the tool, focus on the goal and be sure that you have the goal right. Cause I I think a lot of people a lot of people get the goal wrong.

speaker-0: Couldn't agree more. I last week I gave a speech to ⁓ I'm part of a National Academy of Medicine ⁓ task force on situational awareness and how do we put that to work in in crises ⁓ of the situations that we see. It's a very elite panel, and I was kinda I was happy to to be have been asked. Well, the guy who asked me, Dr. Dan Hanfling, was I hired him right out of residency and ⁓ he became and is widely renowned as one of the world's experts in disaster medicine. You know, I ⁓ first of all, ⁓ ASAP gave me the Mills Award a few years ago. You know, it was a very short year for r nominees, I guess. I don't know how I got that one. But they asked me, what's your secret? And I said, well the only secret I've got is I hired people who were not only better than me, they were much better than me. And they made me better and they made the whole group better. So Dan is introducing me and it's interesting because ⁓ he could have said ⁓ some of the things that you said, you know, Pentagon, inhalational anthrax, COVID, all that stuff. But the way he started was said, you know, ⁓ the the only thing I'm gonna tell you about Dr. Mayers, when he hired me, I sat in his office as the chairman and I said to him, It would be an honor to work for you. And he put his hand up and said, Dan, if you think you're gonna work for me, don't come here. People don't work for me. People work with me. If you're willing to do that, then I'm willing to have you join this group. Wouldn't you know, I hadn't bought thought about that in thirty years. But it's funny what ⁓ as you say, people notice those things, not so much, wow, I got double digit returns and all that kind of stuff.

speaker-1: Yeah. So let me ask you a little bit more about what you you you ta talk to us a lot about deep joy. So how would you say that deep joy is different for you than happiness? Or is there a difference?

speaker-0: Well, there is a difference, I believe, and we put a lot of time into this. ⁓ we're in the process of writing both an article and likely a book. ⁓ when I talk to my players, I talk about the difference between life span, how long you live, day of birth, day of death. You and I had the great joy of extending the day of death. And on you know, not every day, but sometimes and and we but we did. That happened. Health span is how healthy you stay over the arc. of your lifespan relatively healthy, some of which we can control, some of which we can't. You know, I've got p ⁓ patients, former players with Parkinson, you know, I can help them, I can get them to the right people, but we don't have a cure yet. Hopefully yet, key. Yeah. But the the third piece is joy span, the joy you feel over the course of the time that you have. So I I to me I make a distinction between happiness, which is Somewhat fleeting, evanescent, ⁓ in the moment. It's not exclusively hedonistic in any particular way, but has more of a material feel, as opposed to the joy someone feels. For example, when I say f discovering where your deep joy intersects the world's deep needs, you gotta start with your deep joy, not the world's deep needs. The world's deep needs are unfathomable, there's no bottom to that well, and they're often unanswerable. But if you're doing what you believe is your calling, and you know, you can call it North Star, one true way, there's a whole lot of ways. But to me, it comes down to the Aristotelian idea of joy, including both eudaimonic joy, the joy that you see when you see a little kid. You know, I can walk into a room at three o'clock in the morning going, I can't believe it, I gotta go see this kid who isn't really sick. Or I can look at the little kid and go, Wow, that's a beautiful baby. You know, and you know, if I voice that to the parents, he he's really active, you know. It's this is good news. I mean, I know your concern, but his activity, he you know, ⁓ you you see what I'm saying. So you know, it could be a sunset, it could be a sunrise. Homer called it dawns rosy fingertips, which I happen to love. But there's also ⁓ generative joy, the the joy of creating joy in others, unleashing joy. unleashing ⁓ hope, which I think is a key role of all of us as leaders, whether in financial issues or physicians or anything else. And so you put those two together and it I think it's ⁓ it's an emotion above happiness to me.

speaker-1: Yeah, no, I I agree. If as I thought about my own question, I I think the difference between joy and happiness is that you can be joy in sorrow. And and I I think that a lot of joy for me is how well are is your life aligned with your purpose or you know, with with what your intention, what what you what you think is important.

speaker-0: Sure. Yeah, I'll give you an example, Brian. I I took care of a ⁓ and you've been there. middle of the the night, fourteen year old I shouldn't say middle of the night, it you it's ten o'clock at night. Yeah, ⁓ fourteen year old kid's out playing basketball and drops. You know, full cardiac arrest comes in and the short and long of this I mean, this is a beautiful looking kid and a beautiful family, and we could not get anything going. Yeah. And I kept going back to the to the family room and letting them know what was happening. We let actually let ⁓ come into the ⁓ resuscitation room and and all of that. And the bottom line is you know, we couldn't get anything, you know. And I actually asked the parents in the room, you know, is there anything else you want me to try? I always ask that of the nurses, residents, and fellows, just d so, you know, w there's none of that left unsaid. Yeah. So I go back and I sit down with the parents and this is gonna be hard. ⁓ The mother grabs my hands and says, He was a good boy. You would have liked him. And ⁓ sorry. Well, that was unprofessional. ⁓ no, no, it's great. So ⁓ to illustrate the point you just made, that didn't create happiness in me. I mean, it was quite the opposite, but it created joy. That that that's the way the parents would feel in the midst of the worst day of their life.

speaker-1: Yeah. far. And for them for them to be able to voice that in that moment. You know, I I think maybe we c many of us can r reflect backwards on that, but in that moment, man.

speaker-0: Yeah, it's ⁓ and it turns out he had an almost left coronary artery. ⁓ because I'm sure you're wondering, you're probably as many physicians in your audience that have it, that's what happened. But you know, it's ⁓ it it it's looking at the arc of a career and and moment by moment. And as you say, lots of times I've had happiness. ⁓ and and but those distilled come to a different place. ⁓ so that you know, some of the deepest joy I've taken has been in times of sorrow. knowing that I'm ⁓ you know, I r I hate the fact that it happened, but I love the fact I was the one there.

speaker-1: Yeah. Well, and I think it's important, especially in the context of second shifts, is as we try and kind of find that joy, I guess, in our life or in our in our career. ⁓ how do we go through the the changes that need to happen or create the options that need to happen to continue to align that? Because you know, I I think our maybe our purpose can change over the years, right, or over the decades.

speaker-0: Yeah.

speaker-1: And and if we can't modify our our environment to match that, I I think we feel that disconnect. And maybe that's part of what burnout is, is we're we're just no longer feeling the same joy that we used to out of yeah.

speaker-0: actually wrote a book a book, won the Hamilton Award from Marin College of Healthcare Executives for the best leadership book of the year. ⁓ I told them I'd prefer to have the best leading book of the year, but they didn't they didn't get the joke. Yeah, and the reason I wrote the book is it battling healthcare burnout is because the definitions of burnout to me were too abstract. You know, we're ER docs

speaker-1: ⁓ battle book yet.

speaker-0: definitions drive solutions. You know, defining the problem should tell you how to fix the problem. Yeah. And so to me, burnout is just the inability to feel your deep joy. Yeah. And so how do we reconnect to that? You know? And part of it is reconnecting to it, but the other is realizing, you know, ⁓ my deep joy has changed somewhat. Yeah. You know, but you come right out of residency. You know, I I don't want to work on fast track. I don't want to work over there in that soft side. I want to work in the in the core, see in the resuscitations and floating lines and resuscitation pates and putting tubes down. And then over time it becomes, you know, I actually been there, done that, got the t shirt, happy I know how to do it. Happy that when they can't get the tube, they call me. Yeah. But I really prefer sitting down and chatting with people and getting to know, doing what that janitor did to me, which is treating me like a prince. And Brian, I was no prince, trust me. So being able to just treat people right in the the time I mean I I had a chairman of the board work a shift with me in the emergency department and I insisted it be a a a Saturday night shift, ⁓ not overnight shift, but Saturday evening shift. Told him he's gotta put scrubs on and come with me wherever I go except to the bathroom. And ⁓ you know, after a while he said, Doctor, I why wouldn't anyone want to come here? You know, 150,000 visit emergency department borders all over the place. And and I said, Sir, people don't wake up in the morning and say, you know, it's a hell of a nice day. I think I'll go to the emergency department. Yeah, it it disrupts their d something happened or something persisted long enough that they finally come in to see us and saying, you know, I I I'm the guy. We're the guys, we're the girls, we're the people that, you know, when you're having the worst day of your life.

speaker-1: Which one should I choose?

speaker-0: Come see us. This will help you.

speaker-1: So let me ask you about this. You you'd mentioned ⁓ I think in previous conversations that we've had ⁓ just talking about about failure and how failure can be a fuel. You know, it sh you shouldn't look at it as you shouldn't look at ⁓ mistakes as failure, but more as opportunities. Can you talk a little bit more about that?

speaker-0: Two good examples I think from from the athletic ⁓ thing. So to me, there's a whole chapter in the book, making failure your fuel. We have to do that. And and we do that in healthcare all the time when we say, Okay, let's have a we call it after action report, case review, trauma review, cardiac arrest review. We should probably do more of you know cons consulting parents who have a child with a fever that isn't really a fever review. Yeah. But we it and and my guys in the NFL do it all the time. You hear it ⁓ from all the time. We broke down film. You break down film, you know, y you might think they're in there hooping and hollering, look at that, you know, I can't believe it what a great play. What aren't I a wonderful person? And that happens. But the real purpose of breaking down film is making failure your fuel, saying what went wrong. You know, not did it go wrong, but it might have gone wrong. You know, I did get this guy down, but just by his ⁓ shoelaces. So When you begin to look at that, I I learned it from ⁓ really two people, Abby Wombach, unbelievable speaker, unbelievable personality. ⁓ and if you've never heard her ⁓ Barnard College commencement address, it's twenty two minutes and forty-seven seconds of pure joy. But one of the main things she focuses on is making failure your fuel. Power failure ⁓ is power, is fuel. Use fuel to power up and become better at what you do. The the other is the in the 2000 NFL draft, a player, a quarterback was taken ⁓ the one hundred and ninety-ninth player. Six quarterbacks were taken ahead of him. Six quarterbacks taken ahead of him. How does that make you feel? You know, for a lot of people it'd be, well, you know, I really thought I'd go higher, I thought I'd go better, all that kind of stuff. He didn't do that. You know, he he remembered every coach, every team, and every player that was taken ahead of him. And he he used failure as his fuel. And he did pretty well. He won seven Super Bowls, five ⁓ Super Bowl MVPs, five NFL ⁓ MVPs, and his name of course is Tom Brady. But if you ask Tom, as I have, he's gonna tell you I didn't set out to be the GOAT. I didn't set out to be the best quarterback of all time. I didn't even set out to be the best quarterback in the National Football League that year. I set out to be the best Tom Brady I could be. And he can tell you every coach, every team, and each of those six quarterbacks, not just who they are, but the first time, pardon my language, that he kicked their ass. So that's making failure your fuel.

speaker-1: Yeah. one other concept I want to talk about a little bit before we end is the and I again I think we had talked or we had you had talked to me about this prior, but it's you know how physicians ⁓ like so in in the NFL, for example, you know, ⁓ or with professional athletes, recovery time is as important in your success as playing time, right? ⁓ I don't know that we translate that very well into medicine and especially emergency medicine. So tell us a little bit more about what you think there and what what doctors need to do to emphasize that recovery time so that they can continue doing what they have to do on an elite level.

speaker-0: Yeah, so there's you know, three fundamental insights to the burnout book. One, I gave you the definitions, the inability to feel your deep joy, and of course the question is how do I get back to my deep joy? ⁓ but number one, every team member, not every physician, every team member is a leader. Lead yourself, lead your team. Every charge nurse is every bit as much a leader. Every tech, every environmental services people, give them my history with janitors and EVS. We don't even call them janitors anymore. appropriately. ⁓ so every team member's a leader. Number two, every team member is a performance athlete, no different than my twenty two hundred athletes in the National Football League, involved in a cycle of performance, rest, and recovery. Performance, rest, and recovery. We've neglected rest and recovery, particularly in healthcare, but in life in general, which gives us burnout, or in the extreme end, Wendy Dean's great concept of moral injury. We're transgressing moral injury commitments, particularly to the the good of the patient because of the systems replaced it. And then the third is the the work begins within. The work begins within. We can't wait for someone else to fix the system, to lower our job stressors, to help us increase our adaptive capacity. ⁓ And you get it completely to today I am a leader. When you say that, something goes out the window The window closes, it can never come back, which is what? Victim mentality. Everything's happening to me. You know, you cannot feel that way if you're the leader. You'll have failure, but failure is your fuel. And to the extent that you can be grateful for it so that you're able to take that and make yourself and your team and your world, y you know, both in the sm ⁓ small W and large W better, one patient at a time. But By putting those things in action.

speaker-1: Yeah, great. You know, that's just awesome advice. If I I'm just thinking of those people, you know, I mean, a lot of people are coming out of residency burned out, feeling burned out, out of residency even, or even out of medical school. And and so, you know, i I mean it's it's I guess a little bit ⁓ easier to understand how, you know, if you go through twenty, thirty years of of career and you're starting to

speaker-0: First yeah.

speaker-1: look for something different. That's kind of more my story, but but how do we teach new, you know, 30 year olds, doctors to create a career, to create a a pathway that keeps them engaged, happy, joyful, finding their joy aligned. ⁓ you've done a lot of different things in medicine. ⁓ How did you how did you figure that out?

speaker-0: Well, I think it's ⁓ it goes back to that that your deep joy changes over the arc of your career. Yeah. ⁓ that concept of singing with all your voices, you know, I encourage I speak to medical students and residents all the time. ⁓ I'll I'll admit you probably don't have this problem, but but my wife says that there ⁓ should have been a filter. installed between my brain and my mouth. So I don't say and ⁓ i if it if ⁓ maybe it needs change it's probably just leaking badly so I don't say what I think which is you know when a medical student or group of medical students residents say I'm burned out I don't say use God here use outta here but because everyone they are where they are. That's like telling a person don't be depressed. You know? That's not going to help them in any way. So

speaker-1: Yeah. How can it be burned out?

speaker-0: the help side. I think the faster as people, emergency physicians, financial planners, you know, sports medicine, we move from the problem side to the solution side, the better we're going to be able to help people and the better we're going to feel. So I I encourage them to say, well, you know, what was your deep joy that took you into medicine? Have a good conversation about that. ⁓ but I also say, and what else? And what else? Okay, and ⁓ you know, I spoke to residents at a at a ⁓ like you in a in a western environment. Well you know, why did you rank this program? It's a great program and all that and what else? Like to mountain bike, like to hike, like to be outside. Okay, do it, you know. But use that time. Yeah, use that time not to think ⁓ in a victim mentality, everything's happening to me, but you know, what is it that you took joy from and

speaker-1: Yeah.

speaker-0: what's the ⁓ you know, bathe in that ⁓ joy of the great outdoors. You know, other people train in New York City. They want what happens in New York City and all that goes with that, the theater, the the hustle, the bustle and all that. but helping people understand it it's not the problem with burnout is to admit burnout is to admit failure. And and that we've got to get past that. We've got to get past that.

speaker-1: Yeah.

speaker-0: Because you know, first of all it means decrease the job stressors, because burnout's just a ratio of job stressors and adaptive capacity. You know, I might increase my adaptive capacity by mountain biking, by road biking, by taking a hike, by you know, when I get up in the morning and see dawn's rosy fimber tips, don't look through the window, get outside, feel the air and all that goes with it. ⁓ but helping people understand that burnout's not failure. And even to the extent that is, it's failures your fuel. How do I use that to move past that to another place to be able to enjoy it? But look, you know, I I personally totally get moving from emergency medicine to financial ⁓ management, wealth management. But others would look at you and go, I'm sure you've heard people go, What? What I don't get it. I don't get it. Well, it's not your deep joy. It's my deep joy.

speaker-1: Yeah. ⁓ I I think that's awesome. And and a lot of the things that I've that I try and talk about, you know, within my financial practice is is what what true wealth is and and you know how how money is a is a tool. ⁓ it can provide optionality for you. ⁓ it can take some of the stress off of making some of those changes and helping you, you know, find your alignment. I mean, I think that there is a lot of of that burden that we feel especially as young physicians, you know, where we're loaded with debt and and you know, this is the this is the path, I've got to stay on this. I've got to, you know, the sunk cost fallacy of I I put all this time into here, I just gotta stick with it. but that as you progress throughout your career and your life, ⁓ I think wealth, what wealth means to you changes, ⁓ and or should change. Sure. And and so, you know, I I like to ⁓ And my sessions, I'm starting kind of a new thing, but I'd like to ask the same question to guests and the final question for you, maybe it's not the final one, but a question for you is how would you define a wealthy life and how has that definition changed for you over over the course of your career?

speaker-0: Well, I think what you end up doing, ⁓ in in your case and frankly in all of our cases, is wealth instead of being a balance sheet, is a combination of of wisdom because you're spending as much time teaching your clients, these are the markets, you know, this is your risk tolerance ratio. If losing money is going to be a problem, then high risk investments are not for you. You know, if you're willing to take high single and very low d ⁓ double digit returns, then these are the these are the products, these are the ⁓ classifications that you can get involved with. You know, I I may not like, for example, ⁓ investing in something and then ha having mezzanine financing come in over the top because they're gonna be f you know, last in, first out. But boy, I love making that investment where I'm the mezzanine. And I don't mean me, but the people I work with have a mezzanine product that are going in and saying, you know, these are gonna be profitable business. We're gonna get paid. But we're gonna get paid first, not because we're last in. all those things come into ⁓ to ⁓ to me it's wealth equals wisdom plus hope. Hope not not just in the markets, but hope in terms of of life, of of the interpersonal interactions that we have, that we are indeed creating something. you know, am I what am I creating for my kids, for my grandkids? You know, and part of that's a balance sheet. I got I'm good, got that. Understand it. They don't care about that. It you they don't want that. They my my grandkids call me Doc O. You know, I want to be called granddoc. They decided it was gonna be DocO, you know. I want Docco to play with them. They want their ⁓ our our oldest ⁓ son's ⁓ wife and kids are coming out this afternoon. We're gonna spend a week in the wilds of Wyoming just having fun. They don't care about the money. They didn't make anything what ⁓ whatsoever. No, it's good you know, when it comes time to go to college and that's all paid for. Yeah, sure, I got it. But that's not what they're gonna remember.

speaker-1: No. I mean I I think that those are those are the rich part of our lives that has nothing to do with money. Money could never purchase those, right? I mean that that requires us to be there and to be purposeful about our intention, purposeful about our legacy, and just like you say, how how you treat people. And I think that's that's actually what leads to joy.

speaker-0: Yeah, I agree. Couldn't agree more.

speaker-1: Awesome. Tom, ⁓ it's been a pleasure talking to you. I mean, just full of words of wisdom. I could keep talking forever. I'd I'd l love to hear all your stories.

speaker-0: Yeah, I'll come back. We'll come back. I don't know if you've ever had ⁓ repeat guests, but ⁓ count me in if you want to. I've enjoyed it.

speaker-1: Absolutely. I'd I'd love to have you back again. Is it any anything else you want to say before we close it out?

speaker-0: No, just ⁓ you know, it's funny. I I'm often asked, you know, hey doc, you talked about all this deep joy stuff. What's your deep joy? My deep joy is helping other people find and fully express their deep joy. And so if that does some inkling of that for your listeners, then happy to ⁓ have been a part of it. My my email is just t-h o m-a y e-r-m d at gmail dot com. My cell phone is seven ⁓ three. four ⁓ three four one four seven. If whenever this thing, my weapon of mass distraction, ⁓ rings and I don't know who it is, I always answer the same way, this is Dr. Mayer, the answer's yes. Now let's figure out what the question is. So if I can help any of your listeners in any way reach out, I'll be they don't have to go through you. They can just reach out to me directly.

speaker-1: Fantastic. I mean that's that's an an amazing offer. I I hope some of them take you up on it and and thank you for sharing your joy with us. I think that that came through very, very nicely and you know, it's just again been been a pleasure and I appreciate you taking the time. Okay, take care. All right.

speaker-0: It's my honor. Thank you, brother.

speaker-1: All right, let's do our recap of some of the things that we learned from Tom. I thought it was a great conversation. He he did a wonderful job. He's full of wisdom, ⁓ full of stories, ⁓ which I enjoyed, and I'm sure that you did as well. But let me pick out a few things that I think are are particularly relevant and important for us to remember. Number one, relationships are the most important. So one of my favorite stories that Tom shared was how he got an A in his college chemistry class. It wasn't Because he knew all the material. In fact, he knew very it sounds like he knew very little of it and and and just tried to fill out the the answer sheets in a pattern. But he got an A because ⁓ of the bonus question. The bonus question was, ⁓ tell me the name of the janitor who cleans this classroom. And Tom not only knew his first name, he knew his last name, he knew ⁓ his kids and he knew a lot about him. And that tells us something about Tom, but ⁓ also Tells us something about how we should all be intentional about forging those relationships and what matter what should really matter the most to us. ⁓ the second part of that is how he became the medical director of the NFL Players Association. And again, it wasn't because he sent somebody a resume. It's because he had developed a real relationship with somebody who knew him and trusted him, who picked up the phone and asked him ⁓ and offered him the job. So I think. Important to remember opportunities often come through those relationships long before they come through our credentials. So for anyone thinking about a second career, ⁓ networking isn't just about collecting business cards. It's really about investing in people and investing those relationships. All right, second point, leadership isn't a title, it's what you do today. So Tom's distinction between leadership and leading really resonated with me. Leadership is what we talk about, leading is something we practice. And whether you're a physician, a parent, a financial advisor, a volunteer, you're leading somebody every day through your actions. And as he said, culture isn't created by the words on the wall, it's created by the actions in the hallway. I love that. All right, ⁓ number three, happiness comes and goes, but deep joy has staying power. I love what he said about joy and how he distinguishes that from happiness. So happiness is often tied to the circumstances. Deep joy comes from aligning yourself with with your purpose. And even on some of the hardest days and the hardest moments, whether personally or in the lives of the patients or or other people that we deal with, you can still find deep joy because you were exactly where you needed to be at that moment. Okay, fourth point elite performers recover on purpose. I think this may be the most practical lesson for d from today's conversation. Professional athletes don't just train, they recover. Yet in medicine and as physicians, we're often taught that working harder is the answer. And Tom challenged that, and I think it I think it was important. If we're gonna sustain a long career, we have to give ourselves permission to rest and recover just as intentionally as we perform. That's not a weakness. It's part of being excellent. Okay, finally, true wealth is bigger than money. So I couldn't leave without asking Tom how he defines a wealthy life. And I love where he landed. Says wealth isn't just a balance sheet. It's wisdom. It's hope. It's relationships. It's having the freedom to spend a week with your grandchildren, knowing they'll remember your presence more than your portfolio. As a financial planner, I try and help people with fine build financial capital and to ⁓ create a ⁓ money plan. But more importantly and ultimately, I try to help them build lives they don't need to retire from. That's what true wealth is really about. In closing, Tom reminded us that our careers will evolve, our roles will change, even our definition definition of success and purpose may shift over time. But if we continue to pursue our deep joy and continue to find that alignment and continue to use it to serve other people, we'll never really stop growing. I hope today's conversation encourages you can encourage you to think not just about what you're building, but who you are becoming. Thanks for listening, and I'll see you next time on the Second Shift Podcast.

speaker-0: The work you did mattered. And you're not done. Welcome to What's Next. Thank you for listening to the Second Shift. If this conversation landed with you, please download our free guide called the Second Shift Blueprint. Five questions you and your partner should discuss before any major transition. Get it at secondshiftpodcast.com. That's number two ndshiftpodcast.com. And if you're approaching a transition and want to talk through the financial strategy, we offer a complimentary 30-minute second shift audit. Details are at secondshippodcast.com/slash audit. Join us next week for another great episode. And remember, your life and identity doesn't end with retirement. It's just entering its second shift. The content shared in this podcast is intended for educational and entertainment purposes only and should not be considered personal financial advice. You should always consult with a financial professional to determine what is appropriate for your individual circumstances.