speaker-0: Monday comes early. This chapter closes. A new door opens. This is the second shift.

speaker-1: When you've defined yourself in a very important role, a very important job for a long time, and you suddenly walk away from that, ⁓ I can't define my retirement by my golf game. ⁓ Doesn't mean I don't try to play golf, but I needed to find a way to still think that I was relevant.

speaker-2: This episode includes a discussion about suicide prevention and substance use disorder, including the loss of a family member to overdose. If you or someone you know is struggling with either of these issues, resources are available. For the National Suicide and Crisis Hotline, just dial or text 988 to connect with trained crisis counselors 24-7. You can call the Substance Abuse and Mental Health Services Administration National Helpline at 1-800-662- where you can get information about local treatment options, support groups, and community resources. Steve Anderson spent 35 years in emergency medicine. He chaired everything, won every award, and then his daughter died of an overdose. Today, he runs the Naloxone Project. This conversation got personal fast, and I think you'll hear why we wanted him as our first real guest. Yeah, what stuck with me is his framework for priorities in the span of that career of his experience. Family first, what makes you whole second, job third. We'll come back to that at the end because I think that's the thing most second-shifters get back Hey everybody. My name is Brian Jepson. Welcome to the Second Shift podcast. I am your host and now very recently retired officially, emergency medicine physician and a financial planner. My cohost, Aaron Milich. Aaron. Glad to be here. I am a ⁓ almost retired military pilot, turned financial advisor. So ⁓ we are here to explore life after the identity shaping career. Awesome. Well, I'm excited to ⁓ have us joined by ⁓ our very first guest ever actually on the podcast. And he has a very extensive bio of lots of awards and honors. And I'm sure this probably is the top of his list being the first guest on our podcast, Dr. Steven Anderson. Welcome, Steve.

speaker-1: It's brilliant to be here.

speaker-2: So I'm going to go through ⁓ your bio here a little bit and hit some of the highlights. If we went actually through it all, that would take up the entire session. I'm just going to hit some of the highlights and things that kind of set you apart a little bit. First of all, 35 years practicing emergency medicine. That in and of itself is an accomplishment, if you ask me. But you retired several years ago. Most of your career or all of your career looks like was in Seattle, in Washington. Auburn Medical Center, is that right? And then you were the chair of everything, the trauma, stroke, education, emergency medicine, chief of staff, pretty much every leadership position at the hospital. It sounds like you covered that and have done an extensive amount of work with ASEP, which for those who don't know, that's the American College of Emergency Physicians.

speaker-1: Correct.

speaker-2: which I'm a member of as well. That's how I got to know Stephen is that he's the chair again of the ASAP Exploring Retirement Section, which is perfect for this podcast. But besides that, ⁓ let me look at some of other things. So ⁓ you've been, you received an award for innovation in suicide prevention from the American Foundation for Suicide Prevention and ASAP, which I think is very interesting. I would like to learn more about that. ⁓ spokesman of the year, chairman of the board, chairman of the emergency medicine foundation, which is something also that we'd like to get into at some point. And I mentioned the exploring retirement section, the Naloxone project, and also have received the John A. Ruppke, forgive me if I said that incorrectly, but John A. Ruppke Legacy Award for lifetime contributions to ASAP. So we have a celebrity. here and we appreciate you joining us. Thank you, Steve.

speaker-1: thrilled. ⁓ It's kind of always amazing to listen to my bio be read because 99 % of the time it was attendance. ⁓ I just just learned that show up because if you don't show up, they don't know how you thinking and you don't have an opportunity to actually say what you think would be the right pathway to take. And if you turn out that you get to chair them, then you get to help direct all those things that we talked about.

speaker-2: Yeah, that's even better. All right, Aaron, jump in. What do you want to know? Well, immediately. And you I'm coming from the point of a knuckle dragging military pilot. So context is important. You guys are physicians. I'm the dumbest one in the room. It's a it's just my life as I accept it. So you started in emergency medicine 35 years ago. And the question that I like to ask physicians who have practiced for for decades is What did you think your career would look like? And then how did reality diverge from that?

speaker-1: Okay, well my pathway started different than most people. I actually started training as a general surgeon thinking that I would do trauma surgery, but took a year out ⁓ and this is a bad pun to get the helicopter program off the ground at University of Michigan and ⁓ kind of fell in love with emergency medicine at that point in time. So when I finished my surgery training, ⁓ I never practiced as a surgeon. I had a friend that grabbed me and said, hey, I know you were the acting chief resident of the emergency department at Michigan for a year. Why don't you practice emergency medicine in Seattle? And it turned out that that's where a lot of my friends were, was in emergency medicine. So I found myself at a suburban, a small suburban hospital. Now it's a large regional referral center. But when I joined, it was a small group that was a democratic group. and they took me in and helped to train me even further in emergency medicine. And every time I turned around, I would say, I looked at what were the things that bothered me the most at work or the thing that I thought was killing the most people in my community. And every time I found one of those, got involved with that particular area, I was blessed to be the physician of the year for the American Heart Association. ⁓ because cardiac disease, what was killing most people in the United States. And I helped to ⁓ institute ⁓ CPR training. I founded at one point the largest training center in America for that. ⁓ Worked to get ⁓ defibrillators in all the schools, ⁓ worked to get CPR training back into schools and a lot of those sort of things. And then it turned out that stroke wasn't being addressed. And then it turned out that having trained as a trauma surgeon and being in emergency medicine, my hospital needed a trauma program and jumped into that. So I jokingly said, a lot of the times it was looking and seeing where the need was and attendance, just showing up and saying, I think this would work. I don't think this would work. And getting other passionate people to follow me along those lines.

speaker-2: I'm interested, you know, as an ER doctor myself, and a lot of us out there see all those things, you know, on the shift. see all those things. Heart disease, drug abuse, suicide. What drove you to become a community advocate for that, as opposed to just, like most of us, just treating and doing the best we can for them when they get there? Sounds like you went out and tried to change the system.

speaker-1: Yeah, little speech is that emergency medicine is filled with fabulous people who show up every day at their shifts and try to make ⁓ the world better for one person in front of them on the gurney. ⁓ The people that rise above that are the ones that realize that health care really is beyond the gurney. It's your entire department. If you're really conscientious, you realize it's not just your department, it's your hospital. ⁓ then the people that we acknowledge with bigger awards are those that realize that their community means their mayor, their EMS system, their neighborhoods, their state, ⁓ maybe the entire country. ⁓ so, ⁓ once you become an emergency medicine physician, your value is always appreciated literally any place you show up. You have an expertise having gotten to this stage that almost any organization likes to have. ⁓ They like to have you on the sidelines if you're a soccer coach, as a DR doctor. They like to have you explaining plantar fasciitis to them. If you're in a marathon running group, ⁓ you're literally always appreciated. But I just kept finding that there were needs that nobody was taking ownership for. ⁓ in my particular community and my community just got bigger and bigger and bigger. And ⁓ at one point in time, find, actually I got educated by a much younger colleague that if I really wanted to change things, then I needed to get involved with advocacy. ⁓ And that's a whole nother thing to go down the road on, ⁓ going to my state Capitol, going to Washington DC and all those sort of things. But I keep coming back to the fact of where I noticed that there was a need that I didn't think anybody was taking ownership on, it was sort of like, okay, I'll go over there and see if I can make some sort of a difference.

speaker-2: So Brian took my question. So I'm going to pile on ⁓ since he unapologetically stole my, where I was going with it, but it was a perfect segue. So what you've, you have survived a tremendous amount of time in a profession that has a, a very large burnout rate. What's interesting to me is that ⁓ it sounds like what kept you going or these things that kind of pulled you into to action. ⁓ were large ⁓ kind of ⁓ systemic issues that you were addressing that required an incredible amount of effort to overcome the inertia of the system, which would also lead to burnout. So now you're kind of juggling, you know, have, you're practicing burnout in the department and you're practicing burnout because you're going to the state Capitol and you're seeing how politics is really done. How did you keep going for three decades balancing burnout?

speaker-1: You know, it's funny because emergency medicine is still a relatively young ⁓ specialty. I mean, it's just a little over 50 years old and I'm blessed to have known some of the people that founded the specialty. I talked to the early career physicians section earlier today and I told them that early on, a lot of what we fought with were our colleagues for recognition as emergency medicine truly being a specialty that deserved its place at the table, eventually at the head of the table. ⁓ And nowadays the burnout's a little bit different. The burnout is because of factors that people don't feel like they have the ability to jump in and change. ⁓ B, whether that's corporate medicine, whether that's other issues that they don't feel like they have control of. And my answer to them was kind of the answer to this question was, if you don't show up, ⁓ then nobody knows that A, it's a problem that you see. ⁓ And then I also told people that if you show up to any meeting to complain, you better come in with at least some suggestion of how to change that. And that philosophy worked pretty well for me. And when I did get burnout, and let me tell you, there are lots of times in my career that I felt like I wasn't going anywhere, and it was unbelievably frustrating. And... Clearly what kept me going were those people that were around me who still had the passion to try and see something change, who would continue to, ⁓ you know, I say that the fire burns brighter the more sticks you throw onto it. ⁓ The more people I had around me telling me you're doing the right thing, don't let it get you down. And they weren't always things, like I said, in the gurney. at the gurney, at the bedside. Sometimes they were hospital-wide, sometimes they were community-wide, and sometimes they were outside of medicine completely. But if I thought that my being there would bring, you know, passion to my own soul, then it kept me going. I'm gonna jump towards the end of this right now and say, nowadays, now that I am retired, If somebody comes to me and says, will you do X? ⁓ There's like four answers. The first answer is it brings me joy, it brings me passion, it brings me happiness. Yes, I'll do that. ⁓ The second answer is nobody else can do it or nobody else can do it in less than years and maybe I can do it in two weeks if I applied myself. And then I'll say yes. The third thing is somebody will come to me and say, would you and if I can mentor somebody else to be successful in that area, That's always my first choice now. ⁓ Let somebody else put it on their CV and advance their career ⁓ and I'm there to help. And if it's no, no, no, then the final answer is usually no. ⁓ Successful people say yes a lot, really successful people say no more often. So nowadays it's sort of picking my battles where I really think I can make a difference and it brings me passion. But I can honestly say that it was the passion away from the shift work that kept me from burning.

speaker-2: think that's an important point. mean, and I think that that's where a lot of people, whether it's in medicine or outside of medicine, if you don't have optionality ⁓ and variety, that it becomes very easy for things to just become boring and mundane. And then it's easy to focus on the negative stuff that's there that we don't like. ⁓ I think that, you know, what's interesting, I know that you retired a few years ago from clinical medicine, but certainly not retired from volunteer work. So you're not actually retired yet. You're just not working for money. Right. Is that one way to think about it?

speaker-1: exactly right. My wife would say, my wife would say, wait a minute, I thought you retired. That's a classic line around my house. That and don't you have someplace else you should be. But the time commitment now I'm as busy as I ever was. It's just the big differences. I'm not making any money anymore. I'm on fixed income now. But I'm doing all these things that really do bring me and I'm blessed.

speaker-2: So how does that feel? How does it feel different now that you're choosing everything that you're doing and because there's no money involved in it, you definitely have to prioritize things. How does it feel as a, because I know you do a lot with volunteer and volunteer work with ASEP and without, just wanted to kind of understand the psychology.

speaker-1: This goes way, it goes way back in my career and it answers Aaron's question from before. What really kept me from burning out, what really brought me passion was seeing that I could make a difference by being involved. And frequently it was with organizations that didn't have the resources to have me as a paid CEO or anything else like that. Physician of the Year for the American Heart Association was only reimbursed in the fact that I could get. I could get paid to teach classes, but I was never paid to design the classes and figure out how to get them to the places where they really made a difference, like with the Medic One group in Seattle ⁓ and things like that. So ⁓ there was an awful lot of, and writing a program to help with suicide prevention. ⁓ Again, there was no money in that, but ⁓ my gosh. Every single day I ever came to work, there were people in ⁓ the back area that was the safe area with psychiatric disease that had no place else to turn but our department and our gurneys. And it became pretty obvious to me that there were some simple things that we could do. ⁓ We created something called the Ready Program. Real emergency aid depends on you, which was how to handle the first few minutes of potentially suicidal or volatile situation and what to expect if you called 911. it's just that I saw so much of it that it just took a couple of other passionate people to help me write the script and do something that was then on the web way back in the era that that was something new. And so it's seeing the need, seeing the Seeing the frustration from your colleagues, your community, and just seeing the tragedy on your own gurneys motivated me to want to do other things. And I tell you what, in the long run, when I die, A, I'm never going to say, boy, I wish I'd spent more time at work. And I'm never going to say, I wish I made more money. ⁓ I'm going to say, wow, I can't wait to see all those other people ⁓ in the afterlife that helped me do all these things that I am proud of having done.

speaker-2: Well, not to mention all the people that you impacted by those decisions. think that's a fantastic question or sort of lead into a question is I'm sure that there are ⁓ innumerable physicians who see problems and they're like, gosh, I wish I could jump in and fix something. So how were you able to do it? What's the difference between you and the next physician who's like, I know this is a problem. I think I have a fix. Can't put it together.

speaker-1: Okay, so you hit one of the points is if you're going to get frustrated, try to think through what you'd like to see it do the right way. ⁓ Or if you see flawed policy, and I've done that, you know, this is just wrong, somebody's got to step up and do it. Come up with an alternative. ⁓ I always told everybody that if you're going to come up with an alternative, make sure there's a economic argument for that. ⁓ Because nobody's going to go along with anything that hasn't figured out the money, the money trail. ⁓ But then I'll say it again, is that ⁓ if you reach the stage in whatever career you do, that you can see the problems, then you've probably earned the right to show up and say, I've looked at this, I've thought about it, ⁓ and I think this is a logical alternative or a different direction to go. Or this is the key, this is the thing we need in our epic computer program that would make a difference or something like that. ⁓ You've earned the right to be there, but if you don't bother to show up, nobody's gonna pay attention to you as much. ⁓ You can send an email, you can send a text, but showing up in person with your passion ⁓ is, to me, is the key. ⁓ And then everybody, I give people permission to talk. ⁓ You've earned your right to be there, but I also qualify by, before you talk, listen. I can't tell you how many times I've changed my opinion by and then just either shut up or realized what I was going to be there for, one going to make a difference. listening is key there too. But I just keep saying there are avenues, there are committees, there are sections, there are task forces. There's any number of ways to get involved. And if you don't see it happen, form your own task force, form your own exploring retirement section. in the American College of Emergency Physicians. So you've got a way to stay relevant.

speaker-2: So Steve, give us a little bit of a background on the Naloxone project. How did that start? ⁓ What do you do within that?

speaker-1: Okay, we're gonna go back a ways and we're gonna get a little emotional here. ⁓ I helped create a program years ago, it one of the things that helped me rise in the viewpoint of ⁓ ASEP, ⁓ of program to alert ⁓ every physician in America who was logging on to a computer program that a patient was a recurring patient. ⁓ You can use derogatory terms like frequent flyers, but what it really meant was we weren't solving their issue and they had nowhere else to turn but to come back through the revolving door to the emergency department. We had a program called the Emergency Department Information Exchange and I helped figure out how to take that from the three hospitals that initially exchanged information to all 50 states. ⁓ had Eddie as an option ⁓ to alert people, to people that had ⁓ mental health problems, substance use disorder. Those were the sort of things that ⁓ I started with. I also was the first physician at the American College for Emergency Scientific Assembly, our annual meeting to lecture on the opiate epidemic and how early on, we were the vectors or we were part of the problem. We were writing prescriptions for opiates because we didn't realize there were alternatives or other ways to go and that we were part of the problem. And so I got involved there. ⁓ Subsequently, I kept getting brought back into other ⁓ spheres of how can we help this group that ⁓ with substance use disorder that really didn't at that time have much of other places to turn to except the emergency department. Now we're gonna get personal. ⁓ Along that journey, ⁓ very beautiful young woman, ⁓ Casey Anderson, who was my daughter, who was a successful ⁓ stylist in Seattle, met the wrong person at the wrong time who said, hey, you're kind of an adrenaline junkie like your dad, ⁓ you should try this. And my... ⁓ daughter said that the first time that she tried an opiate, she said, I knew instantly that it was going to be a problem for addiction for the rest of my life. She was successfully in rehabilitation, but the problem with substance use disorder, it's punctuated by episodes of relapse. The problem was when she relapsed one day, it was even in a sober living house. It was with fentanyl. She had been sober for a while and it was a lethal dose and there wasn't naloxone there. So there's a hole in my heart that'll never be filled, but I have lots of people rushing in with love and opportunities to try and fill that hole. ⁓ A dear friend of mine named Don Stater came to me and he said, I know your story. I know where you're coming from. I have a vision that every hospital in America will hand a dose of naloxone to anybody that could be at risk. ⁓ and I want to call this the Naloxone Project, would you be interested in being involved with it? And I said, ⁓ Don, know, absolutely no question. He hit all the buttons. A, ⁓ it was the passion. B, there were things I knew I could do that nobody else could do. And I saw an opportunity to help mentor people to change the entire trajectory. ⁓ And then he didn't even wait another 30 seconds before he said, would you chair the board? ⁓ And so, yeah, so we founded the Naloxone Project. will ⁓ not to dwell on it too long, we have kind of three divisions now that keep me very relevant and very involved. One is to try and see that all hospitals hand Naloxone directly, not prescriptions, they never get filled, but hand Naloxone directly to at-risk individuals, that obstetric departments hand it ⁓ directly to pregnant women. who are at risk because it's the number one cause of death in pregnant women. And now our third objective is to try and get it taught in the health classes of every school in America how to recognize overdose and administer naloxone and to see to it that naloxone is in every school in America. I was instrumental in putting AEDs in the schools for the rare heart attacks. We have fire extinguishers, we have tourniquets, which hopefully never get used. but people die every week in the bathrooms of high schools in America from overdose. So we want to put the naloxone into all the schools. So I've been super active in all of this and it has brought me great joy ⁓ for the first time in over, in my entire practice career, almost 35 years. Last year we lowered the overdose death rate in America for the first time. And it wasn't by a little bit, it was like by 24%. People would say there are ⁓ a couple of reasons for that, because it's a multifactorial process to decrease substance use disorder and overdose deaths. But everybody agrees, naloxone in the community ⁓ is one of those things. So there, thank you for giving me a couple minutes to pontificate on it. But I want you to realize it's a way I stayed, in my opinion, very relevant at all levels, at state levels, because you have to change state policy 51 different ways. It's different to address a problem in Alabama than it is to address a problem in Massachusetts or California, plus involved federally. ⁓ And that can be true with multiple, multiple, multiple things if you get involved with advocacy, ⁓ which ⁓ again, brings me around passionate people. ⁓ Some people get very disappointed by our federal government, but I've met some amazing people there. who are there because they want to try to make a difference.

speaker-2: I mean, I think there's lots of important things in your story. ⁓ And one, think, is that you're right. know, of all the things that we try to do to save lives or to increase safety, Naloxone in the community is probably the one that's going to make the biggest impact because of the scope of the problem. So that's number one. Number two is how you turned personal tragedy into advocacy. you know, it takes, it takes that. And it doesn't always take that, but when that happens, it becomes a personal passion project, which brings a lot of meaning. And you have a different voice than others because it's touch I mean, I feel that myself

speaker-1: clearly several paths you can take. Yeah, when something that tragic and personal hits you, there are certainly several pathways you can take. ⁓ The pathway that helped me tremendously from the dark place that I went to. mean, imagine being one of the... ⁓ resources for the entire country on substance use disorder and opiate use disorder to the father of ⁓ a ⁓ fentanyl overdose. ⁓ What brought me out of that was the idea that I know there was another Casey around the corner and I could do something to hopefully save that life because everybody deserves a second chance or third chance. ⁓ And we have the ability to do that. ⁓ And I would just say that ⁓ back when I was working with the American Heart Association, it's because my mom died of a heart attack and it got me really involved. And I just look and saw the tears of those that were left behind and the open spaces that I thought maybe we could do something different. And it resurrected my life at that point in time and has kept me very proud of where I am right now. The Exploring Retirement section in ASAP has a, you've heard this several times, Ryan, has a statement of ⁓ remain relevant. That's our creed, if you would. And finding a way to remain relevant is really important. When you've defined, know, Aaron, as you said, when you've defined yourself in a very important role, a very important job for a long time, and you suddenly walk away from that. ⁓ I can't define my retirement by my golf game. ⁓ Doesn't mean I don't try to play golf, but ⁓ I needed to find a way to still think that I was relevant. And ⁓ again, so this has helped to do that along with the Exploring Retirement section in ASAP and a couple of other projects that I try to stay involved with.

speaker-2: So help me connect the dots between the projects, your passions that have a deeply personal connection ⁓ throughout your career and retirement, physician retirement specifically. How did you get into that? What brought you there? ⁓ And yeah, just tease that out for me.

speaker-1: Yeah, let me answer the question. How'd you decide to Yeah, so again, I'll quote, every great start deserves an exit strategy. At a young age, I arbitrarily picked a number. I said that when I was 65, I didn't wanna be ⁓ doing nights and weekends and holidays, ⁓ 12 hour shifts. I just thought to myself,

speaker-2: Probably a good start.

speaker-1: Maybe you're not gonna be ⁓ as sharp as you were and ability to multitask and all of that. ⁓ And the other thing I said is I didn't wanna be the guy that every time I sat down for my shift, my partner turned to me and said, so when are you gonna retire? know, when they've asked you that for about the fifth or sixth time, it means you've probably missed the window that you should have. I wanted to walk away from emergency medicine, if you would, at the top of my game on my terms. at a time that I sat. So I was approaching 65. And as I approached 65, I was blessed because at a younger age, somebody did take me aside and said, financially, you should be planning 30 years from now. ⁓ And one of the key things that I tell everybody is you don't want to have to keep working because you have to keep working. you would like to be at a time in life where financially you can walk away at the time that you want to. I know people that can't buy what's called their tail for medical insurance, so they have to keep working and things like that. So I was blessed in the fact that I had reached a stage where I could walk away comfortably. I mean, I'm not wealthy, but I'm certainly comfortable. and have the ability to do all the things that I really want to do. And there's travel in there and there's time with family and all that sort of stuff and bad golf. But as I started to approach 65, I started to think, so what are you going to do? There should be a glide path. ⁓ And so the Exploring Retirement section in ASEP talks about how to create that glide path within your practice and your group. Can you get out of nights? Can you get out of weekends or should you cover weekends because ⁓ you can do that and get the senior discount during the week? ⁓ How do you build the glide path at work to know that you can walk away, you're not leaving your group strapped with an empty slot that they can't fill. So creating ⁓ the longevity in your group. ⁓ we could plan for me leaving, but also that I was then at a preparation. But when that started, I looked around at ASAP, which was a really important part of my life actually, having been the chair of the board. And I realized there were all these other colleagues of mine that were same age and had all very similar issues. They didn't know how to define what they were gonna do once they walked away from the gurney. And they were looking for relevance. And they, a lot of them have all the same questions about how do I design retirement to make sure that I'm healthy, that my spouse can be taken care of or my significant other, that ⁓ I lived where I wanted to live, ⁓ I financially was stable, I could do those things that I wanted to travel and do. And that's born out the exploring, what started as what was called a member interest group, which was supposed to be a circle of, a small circle of people that wanted to talk about the same topic a lot. But it just turned out that ⁓ within a couple of months, there were hundreds of people joining this member interest group. So it became an entire section in the college, which is another level. And because we all wanted to network together and learn from each other and share that camaraderie too. So that worked out well in ASAP as well.

speaker-2: Yeah, I think it's such a great, great group. You know, I don't know if other specialties have something similar. It's part of their colleges. I'm not sure of it. But when I found that it was there, I wanted to join it because I like learning from others who've been through the same thing or who going through the same thing. We all kind of approach it a little bit differently, but I think there's a lot of connectedness. and you know, same emotions, similar psychology, similar challenges ⁓ with different nuances in our stories. so I think it's in which really is why we decided to do this podcast too, because I think it's it's a part of careers that aren't talked about very much, ⁓ you know, at least not overtly.

speaker-1: Yeah, mean, early on, a lot of people will tell you put away as much as you can, know, be the ant, not the grasshopper. ⁓ But you obviously, the two of you realize that to the extent of being financial planners and recognize it. And that's the first thing I tell any young colleague is that we send individuals to doctors for medical advice because they're the ones trained to do this. We need to send our younger colleagues to financial planners because It's one thing to play in the stock market. It's another thing really to plan for 30 years from now to comfortably be able to walk away to the existence that ⁓ I won't say that money isn't an issue, but that it doesn't drive your everyday decisions. I think it was a guy named Johnny Carson who said having money, it doesn't bring happiness. All it does is bring the, it removes the concern of not having money. ⁓ And I think that that's an important thing, that it's not something I have to worry about day in and day out. And so kudos to you for recognizing that and bringing that to the Exploring Retirement section, along with podcasts like this where people can learn how to ⁓ remain relevant and stay happy and still make a difference.

speaker-2: So what's the difference between a physician who retires well and one who struggles from what you've seen? And privately, what are those physicians asking you about?

speaker-1: Yeah, two things. Number one, there's the group that that struggles to retire because they don't think they have the money to do it. And I would tell you that that's a smaller group maybe than you realize. The problem is convincing them that they really can live off the money they have, that maybe you can't be buying a new car every other year, and maybe you can't be traveling to Europe four times a year, or maybe you can. But bottom line is, is setting up, you know, for years as a physician, All you had to do was do another shift, pull another shift, and then I can afford that extra expense I wasn't seeing. So having a budget and trying to figure out how that adapts itself in retirement is something you really need to do in a financial planner will help that. So there's the group that struggles with retirement because they don't understand a budget and the fact that I'm now on fixed income and pulling another shift isn't an option. The other group that is a much bigger group is just exactly what I've been speaking to. The group that totally defined themselves as a physician at the gurney, saving lives, making a difference when they went to work every single day, and now doesn't see how their existence impacts ⁓ the rest of humanity in a way that it used to. And they struggle with their relevance. that's where you just have to convince them that they have expertise. Like I said, that's welcome anywhere. My homeowners association, for gosh sakes, likes to have me show up at meetings because I can give them suggestions on how to be sure that our community is healthier and safer. So I mean, the list goes on and on of how to be ⁓ impact the people around you still. And you know, I still haven't... I still haven't gotten to my closing statement, which at some point in time I need to bring in. And so I'll do it right now because the most important thing I want anybody to understand at any point in their lives, in their careers, is that you've got to prioritize things in life. And at my group in my hospital for 35 years, I recruited what I thought was the best group to be in, in the entire state of Washington, if not the country. with a simple statement that this group prioritizes in the following order, family first, whatever makes you whole, second, job third. ⁓ And what makes you whole could be marathon running or your church or being a coach for your kids' soccer team or being in the American Heart Association or the American College of Emergency Physicians. There needs to be something that makes you whole ⁓ and fills your soul. I try not to let that prioritize over family because ultimately no one ever said, I wish I'd spent more time at work and less time with my family when they die. And family is something that you can always have around you, even at whatever ages, be it at two years old or be it at 92 years old. So family first, whatever makes you whole, second and job third. We wanted people to be in... engaged with our group. wanted people to have the job as a priority where we knew they'd always show up. They'd always be good doctors. They'd be committed to making our group all it could be. But if it leapt above what made them whole or leapt above their family, we would tell them it's time for you to go home and reprioritize your life. ⁓ Either this isn't the group or ⁓ there's another direction for you or... or ask us how we can help you make sure that those priorities don't disappear. So there, I have friends who said on my tombstone, it's gonna say, family first, what made me a whole second job third. It's sort of a mantra that I really try to instill in everybody.

speaker-2: Yeah, that's really good advice. know, mean, the Harvard happiness longitudinal study shows that most the thing that makes most people happy and healthy and have longevity is quality of relationships. It's not about money, status, job, anything else. It's how good and how deep and meaningful are your relationships. And if you're if you're prioritizing everything else over relationships, you're missing the point. So. Thank you for bringing that. We're gonna start wrapping it up. This has been a great conversation. One other thing that I loved about what you said about staying relevant and realizing that as a physician, as an emergency medicine physician, everybody still wants to hear from you. I would say even outside of your clinical experience. As a physician, when you retire, you don't give up your wisdom, your empathy, your... quality of communication, all that stuff that being a physician and other high impact professionals taught you over the years, that can be applied in whatever you decide to do. so, great conversation. Steve, thank you for joining us. It's been enlightening. I appreciate all that you've done and continue to do for ASAP and for the community at large. ⁓ I do want to, we're going to end with what we call the reckoning. and, and this is, this is basically the hot seat slash punch in the face questions is how we like to refer to them. Short answers, no hedging, three short answers, short question. Aaron, it's up to you. Go for it. Okay. Let's go. It's the reckoning. You are still, ⁓ working, ⁓ but not. for monetary value, okay? So you've been clearly passionate, you're engaged, you are making a difference. You've already mentioned the of the reunion in the afterlife of people that influenced you, that you've influenced, that have helped along the way. But from now until someone speaks to you at your funeral, what do you want people to say about you at your funeral that they wouldn't say right now today?

speaker-1: that I never stopped trying to change the world for a better place, and that my actions ⁓ went beyond just my words.

speaker-2: Unfortunately, have to make you stop doing everything you All you can do from this point forward is play golf. That's it. What part of your old identity will always be the hardest to let go of?

speaker-1: I'd say I want to be a healer. That's why I became a doctor. having, I would love to say that people continue to bring me their problems and that that makes me feel good. It doesn't, you know, they just load on my shoulders sometimes, but I want to still, I don't want to have to give up being able to help people with my experience and my knowledge that's come about. I really don't ever want to give that up.

speaker-0: It does.

speaker-1: even if it's trying to show them how not to swing the golf club.

speaker-2: Fair enough. Good. Good. Okay. Last one. What's one thing you believed at say around year five of your career that you now know is without question completely wrong?

speaker-1: This is an inside joke besides Bertilium. ⁓ Sorry. ⁓ I would say that more money and more status is the goal. was very, you know, if you go way back as captain of my high school swim team, I was competitive. And then I got into medicine and I wanted to be chair and I wanted to do this and I'd wanted to do that. That's not... what it's all about. Doing those things may help you achieve ⁓ what you think has impacted humanity, but it's the impact on humanity. It's not the CV. It's not the, and all of that.

speaker-2: Great answer, great answer. That's fantastic. So Steve, you've set the bar high for all of our further guests, future guests. So we appreciate you, your willingness and your candor and ⁓ just for joining us today. So thanks again for joining. ⁓ Any final words before we close it?

speaker-1: I'll say until we do this again, until we play again. Hope to get invited back and good luck with this. ⁓ I know you're gonna bring in lots of fascinating people.

speaker-2: Yeah, absolutely. We'd love to have you back on soon. Aaron, anything else from your end? No, I appreciate it, Steve.

speaker-1: Thank you.

speaker-2: Brian, I don't have to tell you that that was a phenomenal conversation. It hit hard. And I think that there's some ⁓ values and nuggets in what Steve talked about. And so let's just spend some time unpacking it and teasing out some threads that both we found relevant that landed with us and maybe a common thread across all Second Shifters experience. Yeah, for sure. I think Steve was a great guest. I mean, he Mm. Had a lot of words of wisdom. I think the most impactful, ⁓ excuse me. I think the most impactful portion of that was obviously his personal story that he told us about his daughter and how ⁓ difficult that must have been. ⁓ particularly given his situation is as, ⁓ someone in his position on a national level who's working for individuals who have substance abuse disorder and then to have his own daughter ironically die of a fentanyl overdose. ⁓ Difficult I'm sure but very ⁓ Generous of him to share that with us. You know, I think that a lot of people have Those situations that come up in life, right? mean life is difficult for everybody and everybody has challenges that they have to face and you know, we've had our own and I know you guys have had your own and I think that there's ⁓ Different ways that you can go when you face that right so In my mind, there's three different pathways that you can choose. And I think we all probably choose elements of each pathway at given points during that progression. It doesn't happen all at once. But one pathway is kind of the quiet acceptance, where you just understand that this is one of life's challenges. You just deal with it. You accept it and you move on. ⁓ the other pathway is, ⁓ grief and grief that can become destructive. And I think he mentioned that, ⁓ where, you know, he was in a, towards a dark place, ⁓ when things, changed and he, he made some decisions that took him out of that, took him off of that path. ⁓ cause I think that that can happen in that. That's a pathway that even though we're, all probably go on at some point, if we stay on it, ⁓ it's, it's destructive. Third pathway is to fight and, and, or advocate. And, ⁓ that's what I admire about Stephen is that, ⁓ you know, he took this to the next level. And, ⁓ one thing that he said is the thing that kept him going and, and took him off of that path is realizing that, there's another. person like his daughter that he just around the corner that, you know, his advocacy could save. ⁓ And so I thought that was super impactful and something that we all need to take to heart and figure out what the best pathway is for us. But hopefully it's not the destructive grief pathway, at least not for very long. So thank you for sharing. Yeah. Yeah. And I think what's What stuck out to me in the kind of you take that and get to like the meta level of that experience for Steve. You he said that he wanted to pursue or be remembered or continue to be. He's always kind of seen himself as a healer. ⁓ And yet, you know, you don't have 100 % efficacy or outcomes as that. And it didn't dissuade him. He found purpose ⁓ in tragedy. ⁓ Like you said, there's another Casey around the corner that, that, ⁓ you know, his, his, ⁓ efforts are, trying to help. ⁓ so I think that, that, that was absolutely, that was a, a, an incredibly personal, ⁓ relevant story. think it's a lot of, ⁓ people, ⁓ who may not be ready or comfortable or even, you know, certainly not at the point to talk about, ⁓ that sort of experience, ⁓ out loud. So huge, token of gratitude for, for Steve, ⁓ talking about that. ⁓ It moved into, for me, the point that resonated when you tie it all together, or obviously the perspective that you get. Everything goes in priority. Sometimes we get that wrong. Work is not... I'm going to maybe mash his words in a way that impacted me, but... Work is to be put into the perspective of ⁓ family and those things that make us whole. And I think that that's a challenge for guys like us is that work, we look at work as like, well, that's the key component of wholeness for us. We derive an element of identity. ⁓ There is a virtue in work, ⁓ but sometimes we take that to the extreme and we try to extract ⁓ more than what's intended ⁓ from that. kind of the virtuous endeavor of honest, good work, especially at a high achieving identity defining career. And so think that really resonated because here's a guy that's, I mean, led the charge across his field, helped tons of patients and providers and his takeaways, that didn't make him whole, right? But the work itself in and of itself didn't make him whole. It had to be put in its place alongside the true things for the families, family and those components of life that do make us whole in our line to our values. Yeah, mean, I definitely I think that life has its seasons, right? You know, where where sometimes work certainly takes up the bulk of our time, if not our energy, but. when we let that spill over and over prioritize it, I think it can become a habit. ⁓ you know, especially those of us who are kind of moving into their second shift, ⁓ you have to. constantly reprioritize to be sure that that habit of work and creating your your identity, your work identity doesn't ⁓ take away from what's actually meaningful and what actually brings you makes you whole. so yeah, and that's a challenge. It absolutely is, especially for those in high impact careers that took a lot of effort to not only get there, but to stay there. It's hard not to just kind of keep that pattern going. It's a cautionary tale. I think that, I mean, one of the things that, know, Steve's not here to kind of defend himself, but I think it got me thinking, right? Like ⁓ he said he was busy as ever in retirement. And so my question is, especially as a second shifter, especially as an advisor, you know, kind of helping transition people into retirement, ⁓ is that healthy? Is he actually retired? Did he just trade one treadmill for another? Yeah. Yeah. It's, it's a tough balance. I feel it myself. You know, I feel it myself where, ⁓ you know, and for me it's, I am recognizing that it needs to be forefront of my consciousness. Cause if, cause if it's not, if it's not a purposeful choice, I default back to patterns of just working all the time. Right. And so, so I think it's a, I think it's a choice that we don't have to wait till our second shifters to make. I mean, I think it's important that that's prioritized from the beginning. ⁓ even though it may not feel like you're truly in work life balance. I think the, the prioritization of that is a conscious decision. And if we don't make that decision, we default to our worst, patterns, think. Yeah. No, and I think that, I mean, the balance is key. I think we've all seen or heard of friends and colleagues who have gone, you know, there are two ditches on that road, right? There's the, I'm going to continue to work as hard, if not more, because I'm retired and maybe I don't have kind of the structure that I need that my previous career gave me, or I'm in a new career and it's not well-defined. And so I'm just going to grind as hard as I can. That's one ditch. The other ditch is like, hey man, I've made it. And so now it's just nothing but life in the hammock outside. And so I think that, you know, Steve's kind of, kind of fadeaway jumper of, of staying relevant, is, is important, but I think that you hit, there's important caveat to that. Right. And I think you just said it was, was there, has to be, ⁓ there has to be deliberate effort put forth in the second shift in retirement. ⁓ because it's great. Hey, you can stay relevant. can learn lifetime learning. It's great. ⁓ but. You know, again, it, it, becomes this sort of a treadmill that you're just running to for the sake of, of running. And so it does take a kind of a momentary pause and sort of self-reflection to say, this is not, you know, I'm grinding for the sake of the grind. It's not making me whole it's distracting. And I'm kind of falling back into old habits that maybe I had in my previous career. Yeah, for sure. ⁓ it's a good conversation. He was full of pearls and it was awesome to just hear from him and extract some of those things. And we could spend a whole other hour talking about the things that he taught us. Well, why don't you close us out? And before that, however, if you had five more minutes with Steve, what would you have What didn't we cover that you thought we should get to this? You know, I think that there's a lot there. ⁓ know, we talked a lot about the Naloxone project. I would like to hear more about the suicide prevention stuff that he did. ⁓ Also like to explore more about his experience with the Explore in Retirement ⁓ group with ASEP. And I think we'll be able to ⁓ have that five minutes again. You know, he offered to come back on, is awesome. And I think we should take him up on that. He has a lot of experience as chairman of that ⁓ department, helping other people understand what retirement is like. So I think we can tap a lot more into that wisdom. How about you? Gosh, mean, it's sort of a ⁓ kind of a treasure chest of experience that I think is kind of a through line among the second shifters, right? Like on the surface, I really, the question of swapping treadmills, you know, that was my, that's what I wanted to kind of pin them down on is, you know. ⁓ Does he feel that way? You know, are there moments that he's like, you know what, ⁓ I can see that this is a hustle for the sake of the hustle or ⁓ is that not, you he sort of, I mean, he's cracked the code. Like this is a healthy second shift, healthy retirement. I want to get him back on and talk about that. Yeah. Awesome. All right. Well, let's go ahead and close it out. ⁓ Thank you for listening to the Second Shift podcast. where we talk about how we turn an impactful first career into something equally meaningful in your next phase of life. If this conversation meant something to you, please share it with someone else that may also need to hear it, which will allow us to reach more people. And until next time, in the words of today's guest, Dr. Steven Anderson, stay relevant.

speaker-1: you ⁓

speaker-0: The work you did mattered. And you're not done. Welcome to what's next.

speaker-2: 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 SecondShiftPodcast.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.