Solving For Joy

Speaker 1 (00:00.024)
Joy doesn't always come easily to people. It's a really intentional idea in my life and that I really have to cultivate it.

It's that place where the veil between sorrow and joy disappears. I am flowing with both of these at the same time.

Life at some point will look different. It may not look like what you hoped for and there is grief attached and it most certainly will look very different than what life looked like before whatever struggle you have now, but it will offer itself to you and there will be joy again.

Thanks for tuning in. You are listening to the Solving for Joy podcast, where we're mapping new approaches to life's eternal equation and turning our awareness to solving for maximal joy. I'm your host, Dr. Chrissy Odd, a dual board certified physician, personal professional development coach, and founder of JoyPoint Solutions. May we continue caring for ourselves and others, and may we keep solving for joy. I'll see you on the inside.

Speaker 2 (01:12.232)
Hello everyone and welcome to the raucous hilarity that is today's episode of the solving for joy podcast. I am podcasting from my car today because of interesting situations. and we have already had so many belly laughs. So today I'm super excited to welcome Dr. Red Hoffman to the podcast and also
low key into my heart. So Red started her healing journey as a yoga instructor and then as a naturopath. So Red is a yoga instructor who is a naturopath who also is a medical doctor.

Red is a yoga instructor who is a naturopath who is a medical doctor who is a trauma surgeon. Red is a yoga instructor who's a naturopath who's a medical doctor who's a trauma surgeon who is a palliative care and hospice doctor. Red is a yoga instructor who's a naturopath who's a medical doctor who's a trauma surgeon who's a holistic hospice palliative care doctor TEDx speaker and human who has personally experienced.

very deep losses. And she is here to share her wisdom, heart and perspective with us today. Welcome to my car and to this podcast, Dr. Red Hoffman.

Thank you so much. That was a beautiful introduction and you all should stay tuned because we may end up doing car karaoke on this podcast. I'm not sure yet.

Speaker 2 (02:54.606)
I'm a yes for that. Red is also the host of the Surgical Soul podcast. And as soon as I learned about you, Red, I knew that our listeners needed to hear from you and I needed that I needed to be your friend. So, glad to have

I'm so happy to be here. Thanks. I've been loving listening to your podcast and I love your big smile and I'm glad I got to hear you giggle a lot.

Speaker 2 (03:23.448)
What? I mean, I love when giggling and trauma all together because that's

Giggling and green.

All together. Yep.

I'm going to start by asking you to share with us a little micro joy of recent. What's going on with you in the joy department?

my God, can I just share that I had the greatest weekend. So I got to do the job that I love on Friday night. I was on call and I got to like watch my residents just rocket in the OR. And then I had a lot of downtime. So I got to do some challenging, but I think important work around peer review, which I think is just important. And I feel grateful to do that work because I feel like I get to bring a lot of like love and curiosity and understanding to being.

Speaker 1 (04:14.666)
on the peer review committee. And then I got to sleep post-call, which is always gorgeous. And then my fiance made me a great dinner, which was so lovely. And then on Sunday, yesterday, I specifically told myself that I wasn't gonna do any work work and I was only gonna do my creative work. And so I had a great morning with my fiance who made me breakfast, been feeding me a lot lately. And then I sat outside in the beautiful sunshine

in the, in the shade of a tree that is half fallen down from Hurricane Helene that my landlord still hasn't gotten around to cutting, but it offers beautiful shades. I was like, great, boom for that. And I worked on a book that I'm writing and then I went out to a beautiful dinner with my fiance and went to bed and it was a great weekend. feel like it was such a mix of all these beautiful things that I love. And I was also proud of myself because I struggle with.

having boundaries. had really good boundaries around work a couple of years ago and things have kind of snuck back in and my boundaries have eroded, which makes me cranky. And so I really had promised myself last week that I'm going to work on those and I did. And you know what? The world didn't end because my to-do list is never ending anyway. So what's the difference if I don't get it done? So that's my micro joy.

gosh, what a wonderful micro joy. My brain works in images a lot of the time. And as you were talking about boundaries eroding, I was seeing fences, you know, we talked about mending fences, they're like, people who live rurally and are responsible for many, many fences that go long distances actually know that over time they decay. So I love that you just pointed out how

how normal it can be for our boundaries to erode over time and normalize some mending fences around our boundaries when that becomes evident.

Speaker 1 (06:14.114)
That's a beautiful metaphor. Thank you. You know, I feel like we have times in our life where we feel like, I got it all figured out. Like, okay, I learned that lesson and now I'm good. And then of course things slip back in and again, those fences break down or whatever boundaries erode and then it's okay to be like, this doesn't feel good. What can I do? I'm going to reset again. That's life, right?

Yes. It's like entropy on the metaphysical realm and entropy on the intangible realm. I thought I've had before, but it works. I'm really curious. This is just a nosy question. How do you fit it all in? What is the breakdown of how you work as both a trauma surgeon and a hospice and palliative care surgeon, I mean, physician and do everything?

I work part-time as an acute care surgeon, that mix of trauma, emergency general surgery, and surgical critical care. And I have been working a lot more than part-time recently. By choice, I am creating my dream home and I am financing it with a lot of work and I'm very grateful that I have that opportunity. So that's probably 10 shifts a month.

nights or days. I've learned to be really, especially when I'm on nights, used to all be like, can I sleep? And now I try to be really productive when I'm at work. If it's, if I'm either working or I'm doing all the other work. So that was like a skill that I had to learn over time to learn how to like stay awake all night and really get the work done. And to me, a lot of times, you know, from like one to five in the morning, if it's not busy, that is like some really good uninterrupted deep, I call it deep work time, you know, where you could really dig into a project.

So I think that's one thing. And then in my world of hospice and palliative medicine, most of it is administrative. And so I can do that when I have the time and when the mood strikes or I do a lot of it from home because I also deal with some chronic illnesses. I...

Speaker 1 (08:16.64)
try to really take care of myself. That means like if I don't want to leave the house, I could be just as productive on the phone, sometimes more productive because I didn't waste that energy getting ready. And then I've noticed over time that sometimes the later afternoons are great time for me. So I might do different stuff in the morning, and then I'll be very productive in the afternoon. So I still feel like it is way easier than working full time as a surgeon, even though I wear all these different hats. I think surgeons are, you know, the schedule becomes

It's so untenable.

is the word that comes to mind.

So I feel very grateful for that mix.

have a mix of roles also and they're quite fluid, some of them. And so I also can do many of them from home, which I love. So I think there's a lot of overlap in what I see related to boundaries is that because those roles can be so fluid and flexible that they also can permeate areas where I did not intend them to permeate. I didn't hope that they would permeate. And so it just speaks to like how boundaries can be impacted.

Speaker 2 (09:24.372)
it's a win that it's such flexible work, but then there's also more possibility of job creep.

And I've been learning, it took on a new role in January as a Hospice Medical Director, before that was Associate Hospice Medical Director. And I have been, as I've learned what I need, I've also learned that I need to teach the people who work with me or for me how to best communicate with me. So for me, this is an example. When people just send me these random emails, I'm like,

Is this an FYI? Is this a you need me to do something or you need me to do something now? Like I just get these. I need to be clear because like the inbox keeps filling up. I but I've had to teach people like I'm available, but you need to be clear in what you need from me because I wear a lot of different hats and I need to figure out where it's most important for me to put my energy during this hour of the day. So that's just been like over time and learning how to give that message with love.

to be available, but not to be overly available. All these are things that we don't really learn in medical school and that we may not have a mentor to teach us. I kind of came into this role without a mentor. So it's just kind of learning over time.

There's so much encapsulated in that, especially as a female physician, being over available is a problem. But then as soon as you bounce into pushback, then you get tone checked, right? And it is not mentored often how to be lovingly available, educational, supportive, and interactive responsive all at the same time.

Speaker 2 (11:08.664)
So I am, deeply receiving the medicine of those words right now that we can lovingly teach the people who communicate with us, who rely on us to be available for urgent things to put all caps FYI, if it's just an FYI message for me, it's in haiku. So I get Epic messages on my phone all the time about the kids I care for in long-term care, skilled nursing at night, adore being in contact, but I also am like, if you need me quickly, please call.

And it's like, and we're all learning together, right? I'm learning and then I'm learning how to tell these other people and then they're learning what I need. So it's like, it's just, I have to be kind, not only to other people, but be kind to myself as I'm kind of evolving in some of these roles. I didn't know this three months ago. And so maybe I said, you can call me anytime. And now I'm learning, you know what? I don't want to be called anytime.

That's really

Speaker 2 (12:07.714)
Yeah

I really need some help, Dries. Yeah. That's right. That's right.

truly. And also, you know, we don't know what sensitivities the person we're communicating with is carrying with them, and they don't know what sensitivities we're carrying with us. So it's a whole thing. And what a wonderful tangent. May this be of benefit to people thinking about how they respond to being on call.

laughs

you're delightful and I'm going to go ahead out on a limb and say unique because I think you're probably the only naturopath, trauma surgeon, palliative care doc, possibly in the world. And certainly the only one with your particular personal history. I want to hear just a little bit about how those pieces came together. I'm excited and delighted by this pet.

Speaker 1 (13:00.49)
Yeah. you know, when I was younger, I was not really drawn to science or medicine. I think that came in my young 20s. think, like many women, I took a lot of my feelings, and a lot of them were about my dad's murder, and somaticized them, and ended up with just a lot of symptoms, and that Western medicine didn't really know how to necessarily address. And so that kind of led me down the field of integrative medicine.

eventually decided I wanted to be a naturopathic physician. And I still remember my mom, I still remember exactly where I was sitting. She said, are you sure you don't want to be a real doctor? I was like, no, this is really what I want to do. And it felt right for me at the time. And so I went to naturopathic school in Portland, Oregon, and it was such an amazing like

magical five years of my life. I just was surrounded by so many true healers and people who'd really grown up with a lot of this medicine, who were taught botanical medicine by their parents or their aunts or grandmothers and who had grown up doing yoga and hiking and all these things I had never done. You know, I just grew up in Edison, New Jersey. That just none of that was part of my life. So I was very like enamored by the whole thing. And it changed so much of who I was and how I interacted.

with myself, with other people, with the earth. You know, it was amazing. But during that time, I took time off. My whole story is all about taking time off. I've taken a lot of time off in my life for either illness or for like just to regroup and refine, like refocus, you know? And so I took some time off in naturopathic school and I spent three months in Thailand, southern Thailand, doing a 500 hour yoga teacher training, which is like a whole.

podcast episode in and of itself is ridiculous. But after that, I went to India to study in a truly integrative hospital in Mumbai. And in this hospital, were homeopaths and allopathic doctors who had already been working together for many, many years. And so every morning they'd have this clinics in the morning. And then in the afternoon I got to round in the hospital with the medical doctors.

Speaker 2 (14:50.478)
I'm sure.

Speaker 1 (15:14.166)
And so this was my first time on rounds in a hospital. And then I got to go in the operating room and I still remember my first surgery was a C-section and it was very hot in that OR. And I just remember all this fluid and feeling like I was going to faint, but I was so enamored like with the entire situation. It was just magical. And so I ended up coming back.

to the States and really feeling like, think I want to go be a medical doctor and surgeon. And this was like, I two years left in naturopathic school. And during that time, I was already kind of falling not so much in love with a particular like branch of naturopathic medicine. Like some people really are great at botanical medicine or homeopathy or physical medicine. I was really just very interested in women's health and transgender healthcare.

And I was just feeling more and more like I would probably be more successful working within the allopathic system. And so I finished all my training and I applied to medical school and I always shared and get in the first time, which presented so many lessons about, you know, a little death of the ego and figuring out if this is what I really wanted, which is what it was.

And so I did end up getting in and I got so lucky. I got to go to school at OHSU right up the hill from where I went to naturopathic school. And, you know, my naturopathic background was really honored and celebrated in the environment of OHSU. It's such a special place. There's so much great medicine going on there, but I think that so many of the people who work there, probably because it's like so embedded in Portland,

are just aware that there's so many different ways to approach health and healing. And you see it in the whole campus, you know, the entire cafeteria is organic and like there's a health food store on the first floor of the hospital. I mean, it was just such an experience. And also what was so cool is, you know, there's so much great end of life care in Oregon. It's the birthplace of what was called death with dignity or medical aid in dying. Oregon was the first

Speaker 1 (17:28.608)
state to legalize that. was the birthplace of OHSU, the birthplace of the PULST forum. They had an award-winning palliative care team. So in medical school, I was introduced to palliative care. And it really just set the stage for my, what I ended up doing, which was eventually realizing that not only did I want to do trauma, probably in part because of how my dad died.

But I also really wanted to pursue training in hospice and palliative medicine also because of going through all the grief after my father's murder and everything that happened after.

That's amazing. I'm so glad that you got to stay in Portland for both of those. And our listeners don't know much about your background with your dad, so I'd love to give you some time to give a little context for when and what happened.

Yeah. So my dad, my dad's name was Kobe before Kobe Bryant. And when he was 47 and I was 19, he was on a business trip, working on a gas pipeline between Egypt and Israel. And it was his last night in Cairo, they were going to Israel, flying to Israel the next morning. And he was having dinner at the

hotel restaurant where he was staying. He was with two of his colleagues and at the end of the dinner, they stood up to leave and the man who was sitting behind my father stood up and shot my dad twice and then shot my father's colleague, Bob, who also died and then shot my father's other colleague, Merrill, who lived and who has, you know, I love that Merrill is an old man now.

Speaker 1 (19:08.59)
I that is so cool. So my father died on the scene. I was just recently reconnected with someone from the State Department who was actually working in Egypt that night. So I've gotten to like kind of learn more of the story over the years. so my dad died in the hotel and then, you know, like speak a lot about violent death. the things that come with violent death are often, you know, interactions with

law enforcement and media and in the legal system and all of that kind of played out over the next 10 years, including the fact that my father's murderer escaped from where he was being held four years after he killed my father and he killed 10 more people, him and his brother. And then he went to trial and was sentenced to death and was hung a couple of months after that. And so that was just very traumatizing.

kind of ripped that bandaid off. And then my family went through a very long lawsuit that unfortunately we ended up losing, but that was, you know, very harrowing. I think more for my mom than for me, but it was certainly, I'm actually amazed she ended up going through that for so many years. And then I think for me also September 11th was very challenging because my father was killed by an Islamic fundamentalist.

and the words he was screaming were the same words that were on the radio nonstop after September 11th. And it always just felt like this, I just felt like I was just getting stabbed in my heart every single time I turned on the radio. That was a long time ago. Now I've learned I wouldn't turn on the radio now if that was happening and know how to protect myself. But I don't think I kind of recognized how to protect my peace back then. it was just really, it just felt like this grief that just kept

and

Speaker 1 (21:06.432)
Every time I'd formed the scab, something would like tear it off. that was like 10 years of that, like felt like early grief for me.

I'm so sorry.

thank you. My dad was awesome. He still comes to visit me and he's amazing.

love that. I heard you earlier so wisely just, you know, in passing regard that you somaticized some of your grief reaction, which is a very radically responsible and compassionate way to contextualize how Western medicine disappointed you personally in some of those years. And it's, I think it's a strong touchstone for other people.

Yeah

Speaker 2 (21:52.226)
who have experienced or will have experienced massive disruptions to the world as they know it, which is one way to understand trauma.

Yeah, it's, you know, that idea of somatization is challenging because it's, think, it recognizes the connection between our bodies. I mean, we're all one being, like I'm one being. So of course, what's going on in my mind is going to affect my body. But I think what ends up happening in Western medicine is, you know, it's very easy to say, well, it's all in your head.

Well, it might have, the problem might've started in my head in this grief, but it really did translate into my body and I really didn't feel good. And so while I think recognizing the origins and maybe digging deep in therapy about those origins, that physical being still needs to be tended to, whether it's symptomatic control or a cure or whatever. And, know, when we're sending people away and just saying, everything.

your labs look okay. Well, one, you only get the answers of what you're looking for, right? And two, what I love to say- Yep, exactly. But I love to say to my patients, well, everything I tested for came back quote unquote normal. And I think that I'm really good at ruling out things that are gonna kill you. okay, we can go from, but I acknowledge that you don't feel good. So let's keep talking about it see how we can keep moving forward. And I think that's the language to approach.

a lot of people who are struggling with grief or trauma or whatever.

Speaker 2 (23:25.802)
Absolutely. There's a callback here to a podcast that we recorded last week, where we interviewed Dr. Becca Kennedy, who works with people who have what she calls neuroplastic symptoms or medically unexplained symptoms. And there's just so much room for deeper understanding, compassion, and humility, especially from the POV of the Western medical professional.

Yeah, and it's been fascinating because the last five years of my life after I kind of really moved away from so much of that naturopathic or integrative medicine, I kind of was able to keep that touchstone while I was in medical school in Portland. But as I got into residency and life just got busier and busier, really just moved away from all of that. And what's fascinating is the last five years of my life have just invited me to revisit this because I ended up with long COVID and

with some chronic illnesses that are definitely like real illnesses in Western medicine, but Western medicine still doesn't know really what to do with them or even has a hard time diagnosing them. And so it's been such a, it's been challenging and painful and sad and all the things, but it's also been so cool to like revisit, like to fully integrate that part of my life back into my life has been actually really

and I live in a place in Asheville that it's so much, so many healers here. So there's a lot available to me for which I feel very grateful.

I was curious about that, so I'm glad that you answered it. Do you still feel at home in both, you know, naturopathic and allopathic realms? Because the indoctrination, especially the indoctrination of an acute care surgeon, is quite potent.

Speaker 1 (25:14.508)
Yeah, you know, it's interesting. I think about that concept of home all the time. What does that mean for me? And I don't think that there's like, I'm not surprised that it went from like naturopathic to allopathic. And then it went from surgery to palliative care. It's almost like never feeling quite at home, never wanting to claim one thing and see if I fit, always feeling like kind of like an outsider. But I will say,

really feel like that anymore. feel one in my realm of trauma surgery and acute care surgery, a lot of those problems just require like immediate allopathic intervention. And I feel very, I feel comfortable there. And, and there's no, yeah, it's very clear. would be very different. I think if I spent my life doing more primary care where there's more, maybe more room for that. I don't struggle there.

And then I've also been able to, think the idea of say trauma surgery and end of life care. To me, it's just this that some people need me all the way through. And a lot of people don't need that part of me. And thank God for that because they walk out of the hospital and go on to live great lives.

And then as far as do I feel at home, you know, in the integrative world, I certainly appreciate it. I don't think that's my home per se, because I recognize that I haven't really practiced that. But I think for myself, I keep bringing, I keep bringing more into my life. And I think in some ways, I don't give myself enough credit because I see a lot of medical doctors selling a lot of supplements. And I'm like, wow, I had five years of education on that. And I think after my own stuff of not feeling good enough, I'm like,

But I'm like, I learned all this stuff, God, in like the late 90s, early 2000s. So maybe that's something I should think more about. But I'm so grateful that I know about it. And I feel like when it's appropriate with my patients, you know, especially from my patients who say, come in as emergency general surgery patients, once the dust has settled to talk about, how did we get here? It's always such an interesting question. And then

Speaker 1 (27:27.566)
How do we avoid getting here again? And so when those opportunities arise, I'm so happy to share other things with patients and their families about, you know, things to pursue, questions to ask other doctors, other providers that I know in town that may be able to help in a different way.

I think it just takes a...

village to get well.

I can imagine naturopathic type of aids to wound healing after the work that you do being important as well.

that I think a lot of it, yeah, even stuff that lives more in the medical world. Like I think of pelvic physical therapy for all our trauma patients who've had like pelvic trauma. We never even think about that. And I think, my God, there's so much stuff that lives in our universe. Like good vestibular therapy, that's very much allopathic physical therapy that why aren't we sending more of our trauma?

Speaker 1 (28:26.464)
or like a TBI patients that I mean, there's so much that we don't even use in our own system, much less other systems.

Yeah, I appreciate that. I have one last question for this corner of the conversation, and that is, what do you think it would be useful for MDs to know about NDs and vice versa, since you're one of a rare few who have been trained in both?

Yeah, thank you for asking that. So I'd say to my, I'll start with my naturopathic colleagues. think naturopaths have been around, you know, for many, many, many, many decades. I do think they do themselves a disservice in trying to compare their education to medical doctors. Having done both, I'd say that it's kind of a waste to compare them because I think that they're

they're very different, both what we learn like in the classroom and then also what we like experience because there's just the amount of patient encounters that a medical allopathic medical student will see are so you can't even, know, hundreds, hundreds more, you know, and so you learn so much from every patient. So in some ways I'd say maybe stop.

Stop comparing and just kind of focus on what you do well. Because I'm watching so many of my colleagues 20 years out now just helping so many of their patients and their families using naturopathic medicine or functional medicine. think they, naturopaths have a really beautiful understanding of physiology and how to kind of tinker with that a little bit to really optimize people.

Speaker 1 (30:08.31)
And I think they have a wonderful understanding as we're talking about somaticization and everything of just an intuitive understanding of the connection between mind, body and spirit, which I think we just tend to ignore in the allopathic world for whatever reason. For my medical colleagues, I would say, I don't think the nature paths are coming to take your job. They don't want to be in the hospital. They probably would have, you know, pursued another career. You know, most of them are like small business owners.

I think just a reminder that they have a lot to offer. I think remembering that given the time constraints of the medicine that most of us as allopaths practice, like utilize them. They are small business owners. Most of them aren't taking insurance so that they are allowed to their own schedules. They spend so much time with the patients, time that most of us don't have. So that's like a beautiful resource that they offer our patients and their families.

And for all of those patients who you don't know what to do with, like send them elsewhere rather than saying, okay, you look okay, see you again in six months. What about considering saying, listen, this is what I can do for you. And I would suggest you continue to do these things because those are your suggestions. But if you want some, another layer of support, why don't you go see someone else and get to know.

some of the naturopaths or functional medicine docs in your town and see what they're doing. I think a lot of the stuff is very complimentary to what we offer. And you know what? You don't have to understand everything. And this whole idea of evidence-based medicine, which is obviously really important. There's a lot that I think most of us do in our practice that is kind of got passed down to us from our attendings or from the way we train that is probably not evidence-based, but that seems to work a lot.

I don't think we're all practicing perfect evidence-based medicine. And so, can let that go a little bit. there's, I think also a lot, like, especially when we start looking at, say like Chinese medicine, or looking at something physical like acupuncture, the likelihood of acupuncture harming our patients, yes, you can get a pneumothorax in like the, you know, I think I've heard of one in all, since I've been in this world for 25 years, heard of one person getting a pneumo. You know, I think the likelihood of that.

Speaker 1 (32:26.712)
causing harm is so low and yet the benefits I've had from so many years of acupuncture has been great. So I understand that there's a lot of drug supplement interaction, drug herb interactions, and I can understand shying away from some of that. But then, okay, let's do what about just focusing on the physical aspects, which we know can have mental and emotional and spiritual components to them too. What about just trying that, sending your patients to that?

I appreciate the openness between those two realms that you demonstrate. And I completely resonate with referring when you, when you don't have more to offer and creating relationships and learning collaboratively. I also was just on a phone call with a colleague last night. We were talking about how sometimes evidence-based medicine can be like constricting, restrictive, caging us when we give it that

power, evidence informed. Absolutely. I love a good randomized control trial with statistically significant outcomes and the right confidence interval. I mean, it makes me giddy. That's so wonderful. But also, we don't need it for every single thing. And just because an effect wasn't demonstrated in a given study doesn't mean the study was actually designed perfectly to demonstrate the effect, right? So I was just researching

astragalus for an interview that I was being asked to comment on. And astragalus in traditional Chinese medicine is used synergistically with angelica sinensis. But none of the, you know, hundred and something studies of astragalus' effect on stroke, kidney, heart failure, skin protection, and on and on immune function, none of them actually combined it in a five to one ratio with its synergistic partner that it

lives with in traditional Chinese medicine. So we don't get to conclude lack of effect just because what we did didn't show an effect.

Speaker 1 (34:23.982)
include

Speaker 1 (34:29.622)
Well, it's the same thing I was saying earlier, you know, depends on what tests we run, like what answers we're going to get. Well, it depends on what we study. You know, what we study will kind of dictate what evidence we're going to actually get. And I think that some of these things haven't been studied. Does that mean they don't work? It's hard for me, especially when I think of something like Chinese medicine that's been around for 5,000 years. It's hard for me to accept that something exists for that long.

with, you know, when you think of how many people in the world, we're just one little part of the world over here in the United States. When you think of how many millions and millions and millions of people have been treated successfully with that in countries other than ours, it's hard for me to accept that it doesn't work, you know.

Right. As a medical doctor, I may not be ready to put my credentials behind it affirmatively and say, yes, I believe this absolutely works 100 % of the time in this condition. That's not my, I don't have that power, but I can keep the door open and say, I see that it's non-toxic and generally well tolerated at reasonable doses. And because you have agency, dear patient human, over your body, and because your body is your adventure,

and your experiment and you are responsible for it, I am happy to give you my expert opinion, even a sense of permissiveness. You may add this as an adjunct and also let's make sure that you have it sourced from a reliable brand whose manufacturing processes are trustworthy and have good quality assurance measures and that you continue in partnership and collaboration with a healing practitioner who

Mm.

Speaker 2 (36:11.776)
knows what you're up to with your experiment. I would love for you to tell us, tell our listeners, what is a meaningful goodbye? What does a good death look like from your expert position?

Speaker 1 (36:29.068)
You know, I'll just share honestly, what that brings up for me first is that not everyone has the opportunity for a good death. And I always want to just call that out, you know, not only do I think of my my dad, my boyfriend, but I think of like, so many of my trauma patients, and then all the patients that we don't see who die on scene. So I just like want to call that out. That's like a

a beautiful thing to think about, but it's, you know, just because you're a loved one. So I say how, how someone dies and that does not define how they live, you know, because I think sometimes that haunts haunts the people who are left behind. But if I would get to pick what a good death looks like, first of all, I want to say that, you know, I, I was just giving a lecture tour, our incoming residents right before this and I,

always have been.

Speaker 1 (37:26.156)
was talking about dying at home. And I was saying that like, I think that's obviously some people want that. But I also again, want to shout out, it's not available to everyone. It's a lot of work to die at home for the families. And it's really scary. We're putting like, when I see these home hospice patients, what we're asking for the families is, it's a lot, you know? And so I've kind of

decided over the years that, you know, it doesn't necessarily matter where it is. It's more about like what's happening in whatever room you need to be in. So I love this idea. I think about like, it's just my personal thoughts. I really try to invite like our ancestors into the room. So always ask families who's waiting for these people. And that doesn't work for, that does not work for every belief, but it works for a lot of people in the South.

So I think it works, know? Who's waiting for them on the other side. I love the idea. I always tell families like, look at this, like going out surrounded by love and just being welcomed by love. And they just like think that is so, so cool, you know? I love the idea of I really try to bring, we're talking about joy. Like I really do try to bring joy into the room, especially if, you know, some people are very.

quiet in their lives, but a lot of people have joy. And so I really try to bring that joy in. I really invite families to tell stories, to play music. And I do try to encourage people if they're open to it, to let the family member who's dying, to let them know that they are going to be okay, meaning the people left behind are going to be okay and that they did good work and that it's okay to go. Because I do think a lot of people really need to hear that.

Like, I think we're all just like wanting to know that the people we love are gonna be okay. Especially when you think of older people who've been the matriarch or the patriarch of the family. But also when kids are going and they, I'm sure they worry that their parents are gonna be okay. So just kind of saying those things out loud, I think is really important. So again, like kind of releasing the people, calling in our ancestors to welcome them to the other side. And then.

Speaker 1 (39:41.59)
going out with some joy in the room to me sounds, I love that. are my favorite deaths to attend to.

Thank you for attending them. It reminds me of the term death doula, which whether you identify as a death doula or not, I don't want to assume, but you certainly are midwifing death in many of those ways. anyone who has done that for anyone else before understands, I think, what a profound honor it is to hold loving space.

in those moments.

It is truly just, it's just the coolest experience again and again and again. It's like, it's so funny. When I was a palliative care fellow once during a family meeting, was smiling, big smile. It was like this really difficult meeting and I was just like struck by all the work, the deep work that was going on in the room and the feedback that my attendant gave me after was like, you really.

I'm gonna watch that face, you know? And I was like, well, that's, you know, that's my face. have like a rest. I really do most of the time have a resting smile face. And I think about it because it's like, yeah, yeah, that's exactly it. Not that I can't slip into that sometimes, but really most of the time I'm like, kind of just like awestruck by what's going on around me, either because it's like so profound or so utterly ridiculous that you couldn't make it up, you know?

Speaker 1 (41:19.99)
And I find myself at the bedside like smiling a lot because it's so painful. It's like the worst day of so many of these people's lives. like one, like getting to be there for me is a gift. And then two, really watching some of the families like really lean in is just so God, it's just breathtaking. It's like so, you know, it's beautifully painful. And to get to experience it is it just

I don't know. It sounds so cheesy, but it really is. It is so cool. Like, I can't believe I get invited to share this space again and again. And it's so interesting because, like, I'm sure people who are birthing babies feel the same way. You know, that's just not part of my life, but this is.

Yeah, it's that place where the veil between sorrow and joy disappears. And you're like, I am flowing with both of these at the same time.

Yes, I literally was just telling my resonance. I was saying the veil is thin between here and there, but it's yes, it's also so thin between life and death, happy and sad, between pain and joy. Like, yeah, it's just, wow. It's really where that, you know, how the ocean comes in to the shore and then goes back out and it's all that mixing like that truly is how it is at the end. Yeah.

Speaking of doulas, you mentioned before we started that you have a book doula and that you are soon birthing a book. I would love to hear about the book you're writing.

Speaker 1 (42:59.66)
Well, it's gestating, probably like a month old, but I do hope that it gets birthed in nine months. So I often thought I was going to write a memoir first, but then I recognize that after doing my TEDx talk, which was about surviving violent death, that really, I think this is a book that needs to be birthed into the world. So I'm working on a book and the working title right now is Life After Death, Surviving Violent Loss.

And it's really the book that I wanted slash needed after my father's murder and after that 10 year journey, like during that whole journey, I think I would have picked up this book many times. And it's really meant for all those who have lost someone to a violent death, which is often defined as a death due to homicide, suicide, accident or disaster. And I often add death out of order in there because often that

is such a violent, unexpected loss. And some of the hallmarks of violent death are that folks are not only just dealing with this sudden, tragic, traumatic loss, but they're also forced to suddenly deal with the legal system, law enforcement, usually law enforcement first, then the legal system and the media. And all of those bring their own challenges and complications and

kind of add layers upon layers and oftentimes force the survivor of violent loss to kind of put off their grieving for a while while they're dealing with all this aftermath. And I also think that violent death can be particularly isolating. I mean, my boyfriend died by witness suicide by myself in our backyard. And I am a trauma surgeon and a hospice doctor. And I don't think like I wanted to even say he died by suicide. I mean, my close friends knew for a long time.

this.

Speaker 1 (44:55.85)
And to share the details of that story that were kind of stuck within me until I did some good EMDR, it felt so isolating. It felt like such a horrible, horrifying story to share. And so I think that the level of isolation that people feel when they lose someone to a violent death also needs to be addressed. And so my hope is that the book will do that as well.

And it's really inspired by the seasons because I feel like there are many different seasons to grief. And I feel like those seasons keep repeating themselves. It's not this like step-by-step process that you get get over. It just keeps going and going and revisiting. And we're pushed and pulled by all of this seasonal change and weather and all of that. And we're just kind of along for the ride. So it's really inspired by that idea.

And my last hope for the book is one of the things that I found in my early grief, particularly this last time around, was a real inability to concentrate. And all my desire to read, I've been a reader my whole life. I don't know, my desire, my ability to sit and concentrate was just shot. But what I did find was I read a couple pages. So there were a couple of books that I was able to just pick up, either poetry or books of like...

very short chapters that I was able to like read and then put back down. And so my book is really inspired by like the grieving mind too, like these short chapters that you can pick up anywhere and read one and it doesn't have to be read in order. There's just no formula to follow. It's just like when you need some comfort or when you want to read about a particular topic, whether it's anger or hope or making meaning, you could just pick that up.

and then put it down for a while because that's how our minds work when we're grieving.

Speaker 2 (46:46.112)
It sounds like a true gift. And I love how so many of us are drawn to create the book that we needed in our darkest time. It sounds really, really well considered that you have even considered how the grieving mind is able to metabolize support and information. yeah, you know, I think

There's a comparison here. You become a part of a community when you have a pregnancy loss that was previously virtually invisible. And when you join the community of people who've been affected by a violent death or an out of order death, it's also sometimes an invisible community and very hard to find the others who have walked ahead of you. may this book be a gift to all those who need it.

May this book be born at some point.

I have no doubt that you will make it happen.

Thank you.

Speaker 2 (47:53.122)
Yes. What is one truth that you hope someone listening might walk away with today, whether they are grieving, caregiving, or just trying to stay open to joy in the present moment?

that if you can manage to stay alive, which I recognize is sometimes very challenging, life at some point will look different. It may not look like what you hoped for, and there is grief attached, definitely attached to that. And it most certainly will look very different than what life looked like before whatever struggle you have now, before that struggle started.

but it will offer itself to you and there will be joy again. It may take a really long time to find it and it may be joy that's always tinned with some sorrow or regret. you know, that's like a, that's bittersweet but there's still that sweetness there. So I think like, again, I'd like to say if you don't believe, just believe that I believe. That's all you have to do. Cause I believe that to be true. I know it to be true.

Thank you for offering your belief as an anchor.

Well, a wise woman offered me that belief many, many, many, many moons ago and I remember holding onto it for a long time. So I'd like to pass it on.

Speaker 2 (49:22.52)
beautiful. Thank you for this wonderful conversation, Red. Where can people connect with you and follow your work?

well, thank you so much for asking. You can find me on all social media channels at red MD, MD. So medical doctor, naturopathic doctor, because someone already took red MD. I would like it. And then my website, red Hoffman MD dog.

and hope

I grew up in Houston and we had a trauma doctor who was a media doctor, Dr. Red Duke.

Yes. Can I share my Red Duke story with you, please? goodness. So in my very first day in trauma clinic, as a medical student at OHSU, Don Trunke, you know, a master, amazing trauma surgeon, you know, like really birthed the I think trauma system in Oregon, and a good friend of Red Duke's, he sat down next to me and he's like,

Speaker 2 (50:07.854)
Please.

Speaker 1 (50:30.798)
your name's Red. He's like, do you know who Red Duke is? And I was like, no. And he told me who Red Duke was. And then maybe like, so it was like in 2007 or something, maybe like eight years later or something, seven years later, I'm in residency towards the end of my residency, rotating in Scottsdale, Arizona. And I met this plastic surgeon named Dr. Jim. It turns out Dr. Jim

was very dear friends with Red Duke, like one of his best friends from residency. And this was when Red was really sick and dying. So Jim went down to visit him and he actually FaceTimed me. He's like wanted the two Reds to meet each other. And then he like came back and he shared his eulogy with me. And I remember showing Dr. Jim who was old, he was like in his late seventies. I said, when the day that

Red Duke died, he was trending on Twitter and I showed him. I'm like, look at what's happening here. Like your friend is so loved and remembered. And so I always felt like it was so cool that I got that last minute connection with him. Yeah.

That is amazing.

Yeah, yeah, I love that. awesome.

Speaker 2 (51:45.71)
circle, pro circle moment. It's almost almost like you got a little bit of his legacy handed to you to carry on.

Ha

Speaker 1 (51:55.682)
man, I'll take one tiny little bit of one of those little, or those big cowboy boots he wore. know, I'll take just, yeah.

I'm Dr. Red Duke. That's how we would sign up all the time. Such a character. Oh my goodness. Yes. Well, thank you for being with us. I cannot wait to stay connected. I think that you're amazing. May all of your dreams come true.

Cool.

Speaker 1 (52:20.346)
Chrissy, I just want to shout out to you. I just love the work you're doing. I think we didn't talk that much about joy, but I just want to say, think that, you know, joy doesn't always come easily to people. Like for me, it's like, it's a really intentional idea in my life, and that I really have to cultivate it. And I love that this podcast is trying to cultivate it. And for a long time, I felt like I wish I was a more joyful person. And then I like realized

Sometimes it takes work and that's okay. so having these tools like this podcast, think is like really important. Joy is available to everyone, even in our deepest darkest times, there are just even if you can get a glimpse of it. So I think that the fact that you're doing this is so important. I just love listening to you. And now we have to that do with you. Thank you.

Thank you, preach. love it. Yes, I feel it is a practice. And if you want to have more joy in your life, it's kind of like, I wish I were a person that ate more vegetables. The answer is to eat more vegetables a little at a time.

Awesome.

Speaker 1 (53:25.846)
Right? It's like, it may be hard, but it's not complicated. You know what I mean? It might be really hard to make that change, but it's not complicated.

Amen. Until next time, Dr. Red Hoffman, thank you so much for being here. We'll talk soon.

Thank you.

Red, thank you for the depth, honesty, and courage you brought to this conversation. Your words and your work remind us what it means to show up for life, even when it's hard. If you're a physician coach or thinking about becoming one, I hope you'll join us at the Physician Coaching Summit, November 6th through 8th in Carefree, Arizona. It's one of my favorite times of the year to gather in person with so many of you. You'll find all the details in the show notes.

is something in today's conversation touched you. It would mean so much if you left a written review. I read every single one and they help other people find these conversations when they need them most. Next week, I'll be sharing a conversation with my dear friend and teacher, James Olivia Chu-Helman, about how we navigate conflict in ways that build trust, deepen connection, and honor the relationships that matter most. You won't want to miss it.

Speaker 2 (54:41.11)
A huge thank you to our Solving for Joy team, producer Kelsey Vaughn, Shelby Bracken for our cover photography, and Dennis Kishkoek for our music, and to my wife Su for her love and support. And most of all, thank you for being here and listening. You're the reason we do this. May we keep choosing to be present for each other, and may we find our way back to joy, even in the hardest moments.