BONUS! Code Orange: We Got Dr. Orange on the Pod

Dr. Orange: [00:00:00] If Nina has done my loan tape during this, I will reveal my identity to you. 

Margaret: On our podcast. They'll be like, "Who do you 

[music]: have?" On your podcast. 

Dr. Orange: Well, I'm honestly, like, I was half-joking, but I'm kind of not really 

Margaret: joking.

We bring you this special emergency episode between seasons of How to Be Patient and me off my break that I was supposed to take because we have a very special guest today. 

Preston: We said, um, code orange, code orange. Margaret, you need to come to the pod immediately. 

Margaret: So I don't need a break for this when we have breaking news.

We have Dr. Orange on our podcast today. And if you guys aren't on TikTok, you may not be aware of the fruit basket of burnt out healthcare workers that has emerged. Um, and Dr. Orange, I think, was the first of the bunch. So Dr. Orange, we are so excited to have you on today. 

Dr. Orange: Thank you so much for having me. I can't even believe that it turned into something that...

'Cause we're, [00:01:00] uh, someone's inviting me on a podcast. 

Margaret: I was, like, in your comments, like, "Come on our podcast." And I was like, "We're real, I promise." 

Preston: This might be, like, the fastest I've gone from, like, seeing someone's content to thinking they need to be a guest. I, I'm pretty sure I fo- saw your first or second post and I was like, "Insta follow," and also, how, how can we learn more about you?

Dr. Orange: Oh, I appreciate that so much. It means a lot. 

Margaret: So Dr. Orange, I don't know if you would like to tell us anonymously, which you will stay during this episode, um, a little bit about your account. I don't, I don't... How many weeks has it been? Like, four or five weeks when you made your first video? 

Dr. Orange: Yeah. It hasn't even been a month yet.

Margaret: It hasn't... It's felt like it's been a lifetime together talking about healthcare. 

Dr. Orange: I know, right? I know. I think it'll be a month, like, tomorrow or the next day or something, so who knows. But it does feel cra- I was not expecting anything, honestly, when I first started, let alone, like, I think today I'm almost at, like, 20,000 followers, which is mind-blowing to me.

Preston: [00:02:00] Mm-hmm. Y- you were anticipating being an angry orange yelling into the void, and the void said, "Wait, do you have any more where that came from?" 

Dr. Orange: Yeah. The void was like, "Wait, us too." 

Margaret: So we always start with our guests, whether they are fruit or people, we always start with an icebreaker, and usually related to what we're gonna be talking about during the episode.

So we're gonna be talking about your, uh... You probably aren't yet, are not yet at the point with social media where you would call this your work. Um, but your work, still, regardless, because I think you really touched on a nerve in a way that has unleashed a force on healthcare TikTok, I, I think in a good way.

But for that icebreaker question, my question for you and for Preston and for myself is: When you first got into medical school, what did you think practicing medicine was going to be like? 

Dr. Orange: Honestly, I mean, I don't know if I ever thought about it, which it gives, like, part of the problem. But, like, going through this journey, like, you think you wanna be a doctor.

'Cause when I was a kid, I pictured, [00:03:00] like, my pediatrician and that, I think that's what I thought being a doctor was like. But from the patient's perspective. Like, well, he seems happy. He's always helping me. Um, and I think I just thought that's, like, what it was. I mean, definitely not as much of, like, the admin things of the side.

It's like you just go to work, you see patients You go home. 

Preston: And then you s- then you sign a clipboard every now and then. 

Dr. Orange: Yeah. Yeah, exactly. Um, yeah, probably. I really definitely, like, didn't give it a lot of thought of, like, what I thought the day-to-day would be. I just was so focused, like, "Okay, get into medical school," and then during medical school, you're like, "Okay, match into residency."

And 

Margaret: then everyone's like, "Residency's horrible, so you shouldn't be happy anyway." And then you're like- 

Dr. Orange: Oh, that's exactly what it is, and then, like, I became a resident and they're going like, "Wait." "But it was the fun part." 

Preston: So wait, Margaret, before I answer, what... At, at what stage are you asking? Like, when we were a kid, we thought we were medicine, when we were in med school?

Like- 

Margaret: Uh, you were like rosy-cheeked, and you were on your first day of [00:04:00] med school, and you were like, "Here we go. My journey has finally begun. I've gotten through the MCAT, and I'm here-" Yeah ... I'm making it in this big 

Preston: world." Okay. So I'd, I'd done some shadowing at that point, but I still... I pictured myself, I think, in an inpatient setting, and every patient is undifferentiated, and they're a mystery, and I'm like...

Everyone's like, "Darn it," you know? "What's connecting all these dots together?" And then I would think really hard about what was going on, and I would go spend an hour with the patient just talking with them, you know, getting to know their story, and then, "Oh my God, wait. They, they went spelunking last weekend.

Actually, nobody caught that." You know? And it, and it's all because they showed me their phone, and it had an Instagram photo of them cave diving, and then we get the histo tests and blah, blah, blah, you know. "Oh, thank you, Doctor," like, "You, you solved the case," and wow, I, I combined medicine and science and humanity, and I feel fulfilled every day.

That, that's, like, what I was picturing [00:05:00] it was gonna be like. "

Margaret: Thank 

Preston: you for saving my life." Yeah, exactly. And then I say, "It's my job." And then I, and then I go save the next patient's life- I just like helping people ... and then go to the cafeteria. Yeah. No need for thanks, citizen. It's what we do. It's 

Margaret: the satisfaction of a job well done, honestly.

I had the opposite experience. And I think our longtime listeners know this. Preston and I have talked about, like, our own medical families. I have two siblings who are doctors who are four and eight years older than me. But more importantly, my dad was a primary care doctor. And he was a great doctor. I'm from a college-sized town, like- 

Preston: Normal, Illinois, shout out

Margaret: Normal, uh, shout out Normal, Illinois. Um, his patients would come up to him, and I feel like he really, like, enjoyed the people part and the thinking part. But especially over the last 10 years that he practiced before he retired, it was like the emergence of the corporatization that we're now fully in of medicine and primary care and the like, how do we make this system work?

How do we be e- somewhat ethical about this? And like, how do you make this [00:06:00] so that this is sustainable? And my mom and my dad-- my dad was like, "Why are any of you guys going into medicine?" He's like, "Listen, I like my patients, but, like, this is not the game that you think that it is." And so I was like, "I'm not gonna, I'm not gonna," and then, like, worked in ministry and worked in some other things when I was like, "Oh, I like psychiatry and eating disorders," so I guess I am.

Um, but I have a distinct memory coming into med school of my mom being like, "Maggie, you gotta protect yourself, and you can't let medicine eat you 'cause it will take everything that you have." I was like, "Okay, dark. Love you, Mom." She was right. 

Dr. Orange: Oh, yeah, I was gonna say it's nice that you had people kind of, like, warning you.

'Cause, like, I don't have any medical anything in my family, not even a nurse, you know? 

Preston: Um- Mm-hmm. 

Dr. Orange: Not, 

Preston: not even, like, a medical banana or 

Dr. Orange: watermelon? Yeah, no medical bananas, no papayas. No, yeah, no medical care carrots to guide me. 

Margaret: Yeah. 

Preston: So for me, medicine was an angel. For Margaret, medicine was a monster that she had to [00:07:00] protect herself from.

And for Dr. Orange You really think about it 

Dr. Orange: It was a mystery 

Preston: It's a, what was it gonna be? Yeah, who knows? 

Dr. Orange: Hopefully you get it. 

Margaret: Hopefully I'm like this, even 10 years, I'll check back in to my internal state. Yeah. Yeah. 

Dr. Orange: Yeah, I definitely could tell you when I started med school, I did not anticipate, um, venting on the internet as an orange about my job.

Margaret: So beyond our icebreaker, I have my first question for you, Dr. Orange, again about your work, which I'm gonna call it your work because I think that it is important enough at this point that it should be called that. What made you post your first video? 

Dr. Orange: Honestly, that's a good question. I think I have just been...

You know, I think it was like a week of difficult days, 'cause like there are good days, you know? But I think I just had that week, like a week where day after day it was just exhausting. Like, it was just like so many tough days and I was like, "This can't be it." Yeah. "This can't be what I signed up for for the rest of my life," you know?

And then to cope with that, I would [00:08:00] just doom scroll at night. Like if I, if I'm just scrolling on TikTok, my brain ends up thinking about work, you know what I mean? But then I was scrolling on TikTok and I'm like, people are really just posting anything. Like you, you could post anything you want on there.

You know? And then I was like, well, my life, like a day in my life is not interesting 'cause I, I wake up, I go to work, I eat whatever I work on, I go to sleep, you know what I mean? Like it's not as that interesting. And then I was just thinking like me and my f- my medical friends talk about how difficult and like sometimes awful this is and it's like widespread.

It's known widespread in the medical community, but people that are not in medicine like do not have any idea about it. I was like, you know what? I just wanna get this off my chest and I post on TikTok because why not? And I just want to stay anonymous obviously, um, so I can't just post on the internet complaining about my stuff.

Preston: It was such a breath of fresh air because, uh, like You used a filter to say the most like [00:09:00] unfiltered thoughts you had about your work. And influencers, like they dress it up, right? Like the day in the life kind of thing. I think everyone makes fun of them for like glorifying it. But even when they do the burnt out post or there's like, "There's a dark side to medicine post," it's usually some contrived BS about how they're like, "Sometimes I get tired and I don't feel like going into work."

And that's like the extent of like, "Oh, wow, they're human too. They get tired sometimes." And it's, it's just so much more than that, and that's what you tapped into. 

Dr. Orange: Yeah, I definitely didn't-- I re- I mostly just did it to, um, get it off my chest, um, 'cause I thought it was like kind of funny. And I figured that like some people would relate to it.

Preston: It, it is funny. It's not just kind of funny. 

Dr. Orange: But I definitely, I mean, I still can't believe like how-- And it's like 20,000 followers. It, it's like just so much more than I ever thought it would be. I don't know. 

Margaret: Preston and I have talked about this kind of like [00:10:00] on air, off air of like having a platform and kind of the f- the feeling of it even while you're going through your day in healthcare, and not in like an ego way, but just in a like, I have this part of me.

And I think I hear a lot from people about like they feel like they gave away a lot of parts of themselves or had to truncate them or they didn't have time because they chose medicine. How has it felt for you to like have this like kind of fun secret that's not just venting, but it's kind of like making other people be inspired to also be honest, like to carry that into your workdays, like even if it's just you knowing that?

Dr. Orange: Well, I don't know if it, it has to just be something that I'm picking up on more, but I feel like I'm so much more aware of people complaining about medicine and, like, the day-to-day in medicine. I'm sure they were complaining before, but I feel like I make so much more of a note of it. But then also, sometimes I, like, go into work when I'm having, like, a really tough day in my head.

I'm like, "Well, I'm just, like, gathering data for my next post." You know? And [00:11:00] so I don't know if that's what made me more conscious of it, but it makes me like, "Okay, well, this isn't directed at me, but I'm gonna use this to my advantage to post about something that I'm sure a million other people are also going through that are in similar situations," you know?

Yeah. But then also sometimes, like, I'll go to, like, show a picture on my phone or something to one of my coworkers who I, like, didn't delete a work video and they'll go, "Shit." 

Margaret: Like, other people are like, "Oh, no, they can't see this, like, scandalous picture." It's like y- they cannot see me talking as an orange right now.

Dr. Orange: Oh, yeah. Yeah. 

Preston: It's, it's like being Spider-Man. Yeah. Like, you can't reveal your identity. 

Dr. Orange: Yeah. No, I'm not gonna give in secret. 

Preston: True. True. Well, you gotta keep this one going. Y- you had one post that I really liked where it was... I don't even think it was about medicine necessarily. You were talking about decision fatigue.

You were like, "I make so many decisions all day, every day, and then I come home and one person asks, 'What do you want for dinner?'" And you were like, "I don't 

Dr. Orange: give a fuck" "... about 

Preston: what I put in my body." 

Dr. Orange: [00:12:00] It is, it's so true.

Margaret: I feel like the, um, one of the parts I think that you've, like, unlocked online is, like, the non, like, s- not, it's not like... It's very honest. It's more blunt than anyone can be, like, forward-facing in their career in medicine online. But it's not like you're still not punching down. And Preston, you talk about this more than I do- Mm-hmm

and more succinctly. But it, it's not like you're like- Your videos don't feel like someone making fun of patients or, like, losing the respect for patients that you have as a doctor, even when patients are involved in, like, the complaints or the stories. But I think it, it, it feels like that moment when you're all in, like, the workroom and someone makes a joke that's just, like, a little dark, but it's just honest and you all, like, crack up and you have, like, trauma bonded from working too many hours together.

Like- Yeah ... that is the tenor that I feel like you strike with your content and, like, why I think it's, like, more than venting. It's like, I don't know, I think [00:13:00] you're bringing people some joy just because they see your honesty and your humor in it, and it lets them kind of catharse through it and also still laugh without, I don't know, losing the part that's like, "Yeah, and I still care about my patients."

Dr. Orange: Yeah. Uh, yeah. Well, I definitely, like, when I am posting something, I mean, I, it's not like I think before I start recording myself. I kind of just, like, press record and, like, whatever comes out, comes out. Or I'll think, like, "Oh, I'm gonna make something about, like, portal messages today," you know? But, um, but I, like, really feel for my patients, so I definitely don't want to make fun of them and I try and, like, make that-- or I try and get that to, like, come across.

'Cause, like, it's not... And I've said this in one of, like, one of the videos. Like, it's not patients' faults that the system is the way it is. It's the system's fault that we have to, like, go about it this way. Um, but yeah. So I, it's, I try and make it, you know, not making fun of people. 

Preston: And I think patients recognize that.

Like, I've seen in your comments people who are like, "I'm a patient, and I think this humanizes doctors," and [00:14:00] like, "I appreciate this perspective." So like, it's, it comes across, I think, the way you intend it. 

Dr. Orange: Well, that's, that's, that's nice for sure. 

Margaret: So we are going to take a quick break, and we will be right back with some more questions for the illustrious Doctor Orange.

Dr. Orange, we have more questions for you. Preston, I recognize that I am the one that outlined this episode, but also if you have specific questions, I do want, I do encourage you to lean in- Oh, I- ... so I don't dominate Dr. Orange's 

Preston: time ... I do, I do have, I do have one question, and you may already have this on the list.

How did you pick an orange? I- in a world of infinite filters, near infinite filters, what, what brought you to an orange? 

Dr. Orange: I remember looking through, like, a bunch of different ones. Like, I remember opening, I think it was like a chicken nugget, and I was like, "I don't know. Something about this. I don't like the wrinkly..."

Like, I don't know. Um, and I just a lot of these fruit filters have, like, things in the [00:15:00] background. I, I really don't actually have, like, a legitimate answer for you. I just remember when I landed on the orange, I was like, "Oh, this is the one." Like, I like the way that it makes my mouth kind of big and, like, my eyes a bit wide which I'm doing now.

'Cause, like, I'm a, I'm a very, like, um, expressive person, so I felt like I could still get my, like, expressions across. Um, and I didn't want a filter that the fruit just stays still. Like, I wanted to be able to, like, move my head around and it move with me because I, like, like I said, I'm, like, very expressive.

And I think that's why it's like part of the reason that people like these video posts is because like it's not like I'm just a, like a voice or a recording. Like, you can, like, I feel like I'm, like, a person under there, you know? 

Preston: Yeah, so, so pragmatically, your affectations could come across much easier, and there wasn't BS in the background.

That's- There's 

Margaret: psychiatry. 

Preston: Yeah. 

Dr. Orange: That I feel like I don't think I probably thought about it that thoroughly, but for me- Your mental 

Margaret: status while you were filming these 

Dr. Orange: videos. I'm gonna be completely honest, the first video I ever filled, uh, [00:16:00] this, ever filmed, I'm sorry, was in my car in, um, a parking lot of a grocery store.

You're 

Margaret: just like, "I'm either crying or I'm gonna make this video." 

Preston: What an origin story. 

Margaret: Did you- Yeah. Okay, here's my question for you, and I, I don't know if this was conscious at all or if this was like, this was internet, like, 12 years ago. There used to be this, a YouTube account that was called The Angry Orange 

Preston: The Annoying Orange?

Margaret: The Annoying Orange, that's what it was. Okay. I 

Preston: watched him, yeah. I was gonna ask about that, too. 

Margaret: Are you familiar at all? Is that your son? 

Dr. Orange: No, I, you know, it's so funny. I saw, people have commented that, and I'm like, "Oh, well they don't like me." 

Margaret: No, it was, like, very, it was like, like, a... I'm trying to think of, like, a kin- Like 

Preston: a Charlie the Unicorn equivalent humor of like, uh, you know, "Hey, hey, hey, hey."

"What?" 

Dr. Orange: Oh. "

Preston: Orange you glad I didn't say why?" Like, those types of jokes. 

Margaret: Shortly 

Preston: after Justin Bieber's advent- 

Margaret: On repeat, yeah ... on YouTube. Like, it was that era of YouTube. 

Dr. Orange: Yeah. I can picture, like, exactly what you're talking about, but I definitely don't know. 

Margaret: I [00:17:00] felt it, like, added to the aura. Well, it's, it's like the same 

Preston: exact face filter.

Yeah. 

Margaret: Yeah. 

Dr. Orange: Oh, really? 

Margaret: Yeah. Mm-hmm. Yeah. 

Dr. Orange: Oh, that's so funny. 

Margaret: My, one of my next questions for you is, like, what it's been like as well for you to see all of the other fruits pop up. 

Dr. Orange: Oh my God, that is, like, what the... 'Cause in the beginning I saw, like, a lemon, and then, like, a grape or something, and I was like, "Oh, that's funny."

And then I felt like I, like, went to sleep, and the next day I, like, re- like, opened TikTok, and I had, like, all these mentions. And I was like, "Oh my God." But it also kind of, like, re- like, confirmed everything that I'm saying. Like, we're all, like, so just beat down. I think that's what it's about. Like, they feel it as passionately as I do.

We're, you know, like, "Yeah, I'm beat down saying my piece." 

Margaret: Yeah. I mean, I know Preston, you contributed. 

Preston: I was an early tag, yeah. I remember saying the, the coterie of, like, burnt out fruits or crispy fruits is expanding. Oh, yeah. And I was like, "If there's a therapist, can y'all be a mango? I think that would fit."

[00:18:00] And then, like, the next thing I know, there were, like, three or four, like, therapy mangoes in the comments that were saying, "I have arrived." And then I was like, "Oh no, what have we done?" Dude, there's, 

Dr. Orange: and there's still, like, new ones that are being created. Like, a couple of new ones today that I have seen, but I honestly, I mean, I, like, can barely keep up.

But it's, it's- 

Margaret: There's so many. 

Dr. Orange: Yeah. 

Margaret: Yeah. 

Preston: Well, you're their leader in a way, you know? Agent, the original, like, uh, y- Patient X or Agent Orange, whatever you wanna call it. 

Dr. Orange: Oh, so funny thing, I want to, like, follow all of them, but I'm sticking to the bare bone Tropicana. 

Preston: Yeah, I saw that and I appreciate it 

Dr. Orange: So I'm gonna think of it.

I don't know for how long yet. It can't be forever. 

Margaret: I love it. Do it. Do it. 

Dr. Orange: Maybe until they, um, acknowledge my existence. 

Preston: No, I think, I think it, it should be forever because then it, your only, uh, friend would be Tropicana when they follow you back. 

Dr. Orange: That's true, actually. 

Margaret: So you are primary care, is that correct?

Dr. Orange: Yes. 

Margaret: Are you adults or kids? [00:19:00] 

Dr. Orange: Adults. 

Margaret: What do you think, if there was one change that you think is, like, feasible, like, if there was just someone at the top of your, like, your organization, organizations in general, what, like, boundary or support staff or, or, like, limit on the number of patients you saw per day, like, what, what do you think would be the number one thing that you wish you could just snap your fingers and it would, like, this would make the workday a little bit more bearable?

Dr. Orange: There's, like, two that are tied, but if I had to choose one, definitely the, uh, like, time insurance. Like, and there's, so, like, where I work right now, there's, uh, it's 20 minutes per appointment, depending on the type. Sometimes 40 if it's, like, a preventative visit. Um, but they're already, like, there's talks of them cutting us down even more, which is, like, I can't even think about it because, like, we're already, like, drowning.

Uh, if the time insurance, like, didn't exist or if they just weren't so, like- Sure. I mean, 'cause that [00:20:00] is like, that's my hour-to-hour stress. You know what I mean? Like, the sheer athletic deal every 20 minute, like, am I going over? Is somebody waiting? Um, so that, that's one. And then the second would just be the in-basket.

We just need to get rid of it. We need to get sent results and that's all. If you wanna talk to your doctor, make an appointment. 

Margaret: No, I recently-- So I was in adult residency and now I'm in child fellowship, and one of the things I- we've talked about on the show with, like, burnout is that the, not to the level that primary care pediatrics is, but, like, the inbox and number of collaterals and working with schools and therapists and teachers and ABAs and DCF and la, la, la, la, la, la.

The inbox is like, could just eat you. Like, and so it's, like, gotten to the point where I never felt this way in adult residency for psychiatry that I'm like, "I need to have a different boundary with this." Like, I don't, I can't just, like, respond to all of these like I used to easily be able to do. And I know in primary care it's that times, like, a million.

And [00:21:00] I feel like after seeing some of your videos, I started getting videos on my For You page that were, like, different people in primary care talking about their boundaries with, like, how or what they respond to- Yeah ... uh, in the in-basket. And- 

Dr. Orange: I-- So what I have done that it, like, kind of helps. I mean, it depends.

Results I usually stay on top of, but, like, portal messages where it could be, I could see, like, back and forth happening, I wait until four o'clock to answer. And then I'm gonna get somebody on that day and I'll wait until four o'clock to answer. Like, we're not doing this back and forth throughout the day.

You know how some things, like, pile up. Um, but it's tough because, like, if I work in an office with, um, a bunch of other doctors, maybe like five or six, and when one of us is out, like, we're covering. So like, I sometimes I have to cover my basket and someone else's, and that is completely, like, unsustainable.

Like it's, it's-- Those days are awful with the in-basket. 

Margaret: Yeah. I mean, to your, I guess, to your point, like At, especially some of the things you get in the in-basket that it's like, it's not just like a med [00:22:00] refill or like I need to reschedule my appointment. That it's like, "Hey, I'm having this complex side effect.

Can I change this medicine or can you order all these tests?" Or like, "I saw this," whatever. Even if it's like, again, understandable and well-meaning by patients, like at that point, if I can't answer the question in two sentences, I feel like I'm getting into the area that it's like, are we gonna actually...

Am I gonna be able to even talk about this with you on messages? Like- Yeah. 

Dr. Orange: Yeah Yeah ... '

Margaret: cause there'll be, I don't know, there'll be requests that are like, "Can we just change this medicine like this?" And I'm like, "No, we need... What do you mean the like..." For mine it's like, "What do you mean that like the teenager is like seeming suicidal now?"

Like- Yeah ... no, you need to see me. 

Dr. Orange: And like I'm still like a new doctor, so it's not like my slots are filled every day. Or like, or if they're filled for that day, like I'm gonna have openings in the next few days. You know what I mean? So, 'cause other doctors I get, like if they've been there for a while and, you know, it's hard to get with them, like that's tough to manage or to work around.

But like for me, like just need some videos, that's it. And we can have an actual conversation [00:23:00] and, you know? 

Margaret: Yeah. I mean, I think it's interesting to like think about. We talk about this in psych a lot because of telehealth, that like sometimes I'll have people who, I'm sure you experience this too, but I'll have people who like log on and they're like driving while we're supposed to be having a visit.

And I'm like, "So I can't... I don't wanna see you die." Like what- Yeah. 

Dr. Orange: Yeah, I had a patient that was like nail prepping once, and I was like, "Can you pay attention to me?" 

Margaret: It's like, "You didn't say any of those things." It's like, "I did. You just were cutting the cucumber." 

Preston: They, they just have a blender and every time you try to talk- 

Dr. Orange: Yeah

she's like, "What are we doing?" I'm like, "I said for real prepping. You're doing something very mirror hard, boy. She says like, "Give me 10 minutes." 

Margaret: Like, we only have 15. Like it's- 

Dr. Orange: She did that right. 

Preston: You can run the blender for five of them, please. Yeah. I'll be typing. Don't 

Dr. Orange: worry. Yeah. 

Margaret: Have you ever thought about...

I mean, I know you're saying you're kind of like a newer attending, um, so it's like early, but what do you think of like direct pay or like concierge medicine, whatever you wanna [00:24:00] call it? Like given the level of Burnout, I feel like that is what a lot of people are talking about, like both in clinical and healthcare settings and then also online 

Dr. Orange: Um, I mean, that's definitely like the most, um, popular thing that people are commenting.

But I honestly like don't know too much about it. I don't know like how you get into it. I get like... It's, it's essentially like starting your own practice, um, and like how to with insurance. So I understand the basics, but I really don't... I mean, it sounds ideal and I'm sure it has its own battles. Um, but I don't know much about it because I have only ever worked within hospital systems and no one there has been like, "You should probably..."

Margaret: No, they don't want you to know those things. 

Dr. Orange: Yeah, exactly. No, honestly. "

Margaret: Oh, wouldn't it be awesome if you just stay in our academic center and we'll support you and we'll pay you $12 and it'll be great." No. 

Preston: Focus on the pizza party. Don't worry about that stuff 

Margaret: outside. Focus on the pizza party. 

Dr. Orange: You hear like, remember where a family- 

Margaret: Don't you care about the patients?

And you're like- Yeah, yeah ... "Sure. Girl." Um, [00:25:00] yeah, yeah. So is this something that you've kept entirely to yourself or is it something you've like told a couple of your close friends or is it like this is your true secret? 

Dr. Orange: I've told my fiance and that I think is the extent of who knows. 

Margaret: I would feel so fun and like be like, "None of these people know that I am a voice-" 

Dr. Orange: I think at some point I'm gonna tell like one of my best friends.

I do- don't know when yet. 

Margaret: It'll be... Are they also in healthcare? 

Dr. Orange: Yes. 

Margaret: Okay. So then it'll be awesome. So maybe they'll see it. You, you need to get to the point where they like send you one of the videos and then you take the wig off and you're like, "No one can tell anyone else that I'm Hannah Mont-" 

Dr. Orange: You know, honestly, it would, uh, if that ever happens, I think that's what I'm gonna do.

Like I'd say if they ever send me one of my videos, that's gonna be, I'm gonna face time them and share my screen. 

Margaret: Has, like, I mean, I know it's only been a month, but like has there been any part of you that is like I don't know. I guess, like, [00:26:00] w- do you think about, like, this social media presence as, like, a real thing?

Like, do you think about making your videos longer than a minute so you can p- I don't know if you have med school loans, so you can pay off med school loans if you get monetized? 

Dr. Orange: Like, oh, I have med school loans. But, like, I mean, I, I don't think I could ever do it full time. I mean, maybe if, if ... Honestly, the ideal scenario would be somehow figure out how to, like, make money off of it and cut down to, like, three days a week, 'cause I think that is manageable.

Like, like if I'm using PTO or something and there's a week where I'm only there for two days, like, that, I'm not completely dead. And also, it's also the fact that, like, I'm still at, like, a big hospital system, so I- and I'm tied there because of PSLF with, like, getting my loans forgiven. Um, so I would definitely wait until my loans are paid off before I make- Unless 

Margaret: you get a huge Tropicana sponsorship.

Dr. Orange: Yeah, yeah. Yeah. Exactly. 

Preston: The new face of Tropicana, [00:27:00] like, just in a grocery store- A million- ... it just says Dr. Orange, 

Dr. Orange: you 

Preston: know? That would 

Dr. Orange: be absolutely amazing. Yeah. They have millions of dollars. 

Preston: One out of one Dr. Oranges recommend this orange juice. 

Margaret: Cup of orange juice a day keeps you away from your burnt out primary care doctor.

Preston: Yeah, very true. So okay, f- follow-up. Do you like orange juice or do you just follow Tropicana for the bit? 

Dr. Orange: I tr- Trop50 on the bit, but I do like orange juice, as long as there's, like, not a lot of pulp 

Preston: That's, that was my fault. Pulp or no pulp. Okay, so not too much texture 

Dr. Orange: If there, a little pulp is okay, but- 

Preston: Yeah, so n- little bit of po- uh, pulp.

Do you like mimosas? 

Dr. Orange: I do like mimosas, 

Preston: yeah. Okay. So, so there, there's a lot of potential here for collaboration. If Tropicana doesn't work out, you know, Champagne can, can enter the scene. 

Dr. Orange: But you know, there's so much I'd say 

Margaret: Mm-hmm. 

Dr. Orange: If you guys get my [00:28:00] loans paid through this, I will reveal my identity to you.

Margaret: Wow. On our podcast. We'll be like, "On your podcast." 

Dr. Orange: I'm honestly, like, I was half-joking, but I'm kind of not really joking. If 

Margaret: we can get you there, we will get you there. Like, we're... That's our dream. That's my dream for myself, but, you know- Yes ... we are working at it. 

Dr. Orange: Oh, uh, on b- if I'm coming up, you're coming up with me, she- 

Margaret: We're, we're all going up.

Well, I mean, like- ... I don't... One of the things, like, I feel like Preston, your skits, like, the first couple years you were posting, and, like, how this podcast exists is because of, like, Glaucomflecken reaching out to you. And, like, certainly who has been more of, like, an example of how, like, humor and anger at how the system is, like, of then going into advocacy than D- than Will or than Dr.

Glaucomflecken. Mm-hmm. And so I feel like Dr. Orange, you're along that same line that Preston and Will Flanary or Dr. Glaucomflecken are. That is this, like, com- it's, like, reality. It's not just... Not that it's bad, but [00:29:00] it's not like you're like, "Here are five fun facts about primary care." Like, you're bringing- Right

the reality of why healthcare is l- burning people out. I'm sorry. I like 

Preston: the fun facts about primary care too. No, I was gonna, no, I was gonna say, "

Dr. Orange: Here 

Preston: are five fun facts about primary care. Fact number one, I hate my job." Yeah. Fact 

Dr. Orange: number two, 

Preston: the inbox can die. Fact number three, give 

Dr. Orange: us more than 15 minutes- 

Margaret: Another fact?

So what's next? What's next for Dr. Orange? Uh, well, 

Dr. Orange: I get married. With Cheese. Oh. That's exciting. Congrats. Thank you. I get married next year. Um, but honestly, I mean, I, my 10-year plan is I am probably gonna stay where I'm at until my loans are forgiven. 

Margaret: I'm gonna sigh. 

Dr. Orange: Yeah, I'm gonna suffer for five more years.

Uh, but honestly, I'm figuring out how to, like, adapt to this new, like, attending life than what I thought it was gonna be. Um, I can definitely see myself changing directions within medicine. Not completely. I don't wanna specialize in anything. Um, [00:30:00] but I don't know, maybe like the direct, you know, patient care, um, or just something, like, a little bit less clinical.

But I, I don't really know 100%. 

Margaret: You're early in this process of, like, social media and stuff like that, but- I don't know. I think it's easy to be like, "Oh, this is just like a random funny thing I'm doing." But a lot of people try to make videos and like try to strike a chord and make this part of their career.

And like you're already at 20,000 followers and are doing this in like a way that's really natural. So I, I do feel like there's something about your presence online that like I think you will, but, like, I hope you take seriously because I don't, I don't think it's just, like, a random thing. Like, I think there's-- Even though you're behind an orange, like, face-

I think that there's something you're doing that people in healthcare, like, need, and that's part of why we wanted to have you come on the podcast because, uh, your voice is very unique right now. 

Dr. Orange: Oh, that's very nice. That's very sweet to [00:31:00] hear. Um, and I'm definitely gonna keep doing it. And I think, like, ideally, it does become something, but it's not like I ever planned to do this.

So if it doesn't become something, I don't wanna be disappointed by it, you know? Um, but I'm glad that I'm bringing so many people joy, and it's also very therapeutic for me. Like, I sit in my car and I record these videos and I, like, just talk into my phone. 

Margaret: Someone walks by and is like, "What are you-- What is wrong?"

Dr. Orange: But it, but it's definitely also helped me, like, realize, like, how many other people feel the same way. Um, which makes me feel a little less crazy. Like, I-- In the beginning, I was like, "Maybe everyone else kind of knew h- how they felt about this and, like, were okay with things going into it." Um, but I think a lot of people didn't, and that's what I'm learning.

Margaret: Yeah. I mean, even as someone that knew, I still am like, "What the hell?" 

Dr. Orange: Yeah. 

Margaret: I don't know if you've seen that meme, and Jason, I'm gonna make you put it on the screen or whatever. Maybe we can't. We'll put it in the [00:32:00] comments on Spotify, which is where we are always in the comments. The Piss Me Off Factory.

It's like, "Man, I hope I don't get pissed off at work today." And then it's, like, a picture of a cat going into a building that's just, like, an old factory titled The Piss Me Off Factory. And the number of times I've sent that into my, like, co-fellow group chat. 

Dr. Orange: Oh my God, yeah. I think I said in one of my videos too, like, the doctors I used to shadow and stuff before med school, they all said they wouldn't do it again if they had to.

And at the time-- And at the time, I was like, "Well, they're cynical. They don't, they don't mean that." 

Margaret: You know, I really wanna help people. 

Preston: Yeah. They're not, they're not truly moral like me. 

Dr. Orange: Yeah, no. Yeah. And now I'm there and I'm like, "Get me out." 

Margaret: They're not a genius at clinical medicine like me. Yeah. 

Dr. Orange: It's like that, 

Margaret: like, is it Billy Madison where he's like, "Stay here.

Never leave." 

Dr. Orange: Yeah. They got me, they got me, you know? 

Margaret: I feel like part of this is, like, you hear, like, attending life's gonna be the time you finally start enjoying it and everything's gonna be great, and then it's like, what the hell? [00:33:00] Actually, it is not maybe quite as great as it was made out to be. 

Dr. Orange: Yeah. I mean, residency is just a whole different beast.

I don't, I don't know. And honestly, as, um, psych people, you guys won't like this answer, but, like, I used to-- Like, if I had, like, a traumatic day in residency, I would be like, actively in my brain, like, "Oh, let's tuck that down there," like, and, and forget about it. And, like, but, like, be very conscious of it and, and be like, "Oh, that one, like, I need to forget that one."

Margaret: Okay. Okay. Suppression. We love, we love to see that as one of the, one of the coping tools. I always tell my patients and my friends in medicine who aren't in psych that it's like, that is a coping skill in the same way that if you have a house and it's like sometimes I don't wanna get rid of stuff or declutter so I put a bunch of stuff in a box and I put it in the attic.

Dr. Orange: Yeah. 

Margaret: But at some point- Yeah ... if it's like the boxes are coming down the stairs and the attic is sinking into the rest of the house, perhaps we need another skill. 

Preston: Perhaps it's time to move. 

Dr. Orange: [00:34:00] Sounds a great way of putting it. I was gonna- 

Margaret: Yeah. That's why I make the small bucks. That's what they, they put us in here for.

I mean, I always tell med stud- I told med students, like, if you feel like as you're leaving the door, and if this is, like, a once in a while thing for you, that you're like, "I'm going to break down crying in the bathroom today, and I know that for sure," consider, especially at the med student level, where you're, like, important to the team but not, like, dependent on you- 

Dr. Orange: Mm-hmm

Margaret: consider taking a sick day. Like, you don't have 

Dr. Orange: to- Oh, yeah ... 

Margaret: be mentally sick. Like- 

Dr. Orange: Oh, yeah. No, totally. And I'm a definitely big proponent of that too, and definitely also did that in residency. As long as it didn't put work on, like, other people, as long as I'm, like, on elective where it didn't, you know, if I called out it wouldn't matter.

Margaret: That is crucial. Preston, do you have any burnout, burnout tips that you've come up with since our original burnout episode? Mm. 

Preston: Which 

Margaret: I think was also full of a lot of dark jokes of us just being like, "Yeah, I don't know. The pizza's not working. You guys." 

Preston: I'm pretty sure I mentioned this in a video I made about Dr.

Orange, and [00:35:00] we may have talked about this before, but that the, the-- when you try to st- like, look at the people that have studied burnout, the conclusions they've come to as far as the things that really move the needle are time off- In getting paid more and and venting with your colleagues. Those, those are like the big three.

Or they didn't call it venting with your colleagues. I think they called it, like, I don't know, r- like decompression sessions or something, debriefs I think is, is how they put it. 

Dr. Orange: Now, you know, I've said, like, if my salary was double what it is, I don't know if I'd be 

Margaret: You didn't have loans also, like, tying you down.

Preston: Yeah, it just, it just, you gotta relieve pressure somewhere. You know, if you have pressure coming from the top, which is your job, but then, like, from the sides and, like, from the bottom, everywhere else, like, you, you have no release. If you're being paid a lot more, you can hire a house cleaner. You know, you're not stressed about, like, groceries in the same way.

You can, you can buy those fun things that, like, make you feel good. But you're- 

Dr. Orange: Yeah ... 

Preston: when you're on a budget, depriving yourselves of any worldly pleasures while [00:36:00] also getting worn down by the system, you know, like, the only thing that'd make it worse is if you're, like, in a calorie deficit or something.

Like, let's, let's just make this- Just 

Margaret: as a random example- 

Preston: Make this as hard as possible ... Preston's never 

Margaret: experienced. 

Preston: Yeah. Yeah, yeah. This has nothing to do with my PGY2 year, okay, guys? Let's chill. 

Dr. Orange: No, totally, though. It's, it's so true, though. But that's why even just making these videos has definitely...

Like, I, I feel like I walk into work with a little bit less tension in my shoulders. 

Margaret: Yeah. I mean, that's like, I don't know, Preston and I have talked about this. Like, I started making my little, like, TikTok writing things that are, like, not about healthcare, um, my, like, intern year in February in Boston when I was on the medicine half of the year and was just, like, not seeing the sun.

And I was like, "This, some part of me that is not in the hospital has to exist." And it was, like, writing about, like, a Taylor Swift album at first. Yeah. But it was just, like, even going in and being like, "I have 1,000 followers for my little, like, you know, Taylor Swift [00:37:00] journal prompts or something" was It, it, again, it was like there's this part of me that is not being, to, you know, quote my mom's warning, uh-

be eaten by medicine. And I feel like that's one of the things, and I think one of the things Preston and I get asked about sometimes in different ways is, like, how do I keep this part? How have you had time to do X, Y, or Z? And some of that is just the point in training and that we're in psychiatry training, which is a little bit different than if we were neurosurgeons in terms of timing.

But- 

Dr. Orange: Yeah ... 

Margaret: I feel like a lot of people end up asking, like, how do you carve out this time that is not for anyone else, for you, but you, and not about medicine directly at least. 

Dr. Orange: I mean, it's for... It's really tough. Like, I have to make, like, a very conscious decision to do it. Like, if, if that means waking up an hour earlier to, like, work out in the morning and just, like, be by myself.

Or even not work out, just wake up and, like, go sit on the couch like Zoom with that only on or, like, a little bit before work. But I feel like, uh, I mean, in medicine you have to, like, be very conscious about it or else you are [00:38:00] not gonna have any time to yourself. 

Preston: And even, like, the more organic content creators in medicine, if you, like, look at their talking head videos, I feel like 80% of them are walking from their car to the hospital.

[music]: Yeah. 

Preston: Or sitting in their car after their shift. That's, that's like the telltale sign of a true medical content creator is when they're in a parking garage in their car, like, "Let me tell you about what's wrong." Like just got done crying 

Margaret: in their car. 

Preston: Yeah. Right. And, and, and the thing is that what we didn't know until now is that Dr.

Orange, you too are in a car, except it's a grocery store parking lot. 

Dr. Orange: Well, that was just from the first video. But for a lot of videos, most of the videos since then, it's usually either before or afterward. 

Margaret: Now you're in the stu. 

Dr. Orange: Well, I'm still, like, embarrassed to, like, record a video in front of my fiance.

You know? So if I do, when I, like, in my car and, like, secluded by myself. 

Margaret: You're like, "No one can know." 

Dr. Orange: Yeah. 

Margaret: I think those are all of my questions for tonight, uh, for you, Dr. Orange. Preston, do you have any other questions for- 

Preston: No, I, [00:39:00] I think that's it too ... Leah before we- I, I think we, we just wanna see more of you.

And we are so glad that you came out and shared your story with us. 

Dr. Orange: Yeah, I appreciate it so much. I definitely plan on continuing to make videos, but, uh, I had fun talking to you guys. 

Margaret: We're glad. We're glad. We ho- Yeah. Our hope is always whenever we have someone on who's actively in medicine, is that we're not just, like, adding another- thing onto their plate without, like, promoting them or just, like, that it's at least a little fun.

So we're glad that y- this was not burnout inducing for the 

Dr. Orange: No. Yeah. It probably was more cathartic than anything. Do you 

Margaret: know what I 

[music]: mean? 

Preston: Well, so, so your, your tag is @dr.orange on TikTok. Are you anywhere else yet? 

Dr. Orange: No, just Bluesounds. No. Yeah. It's 

Margaret: an exclusive deal with 

Preston: TikTok. 

Dr. Orange: Okay. Just- Yeah. I think it's do- dr.dotorange is my actual thing, but I think dr.orange you can 

Preston: probably- Okay.

Too, too many other Dr. Oranges. So @dr.dotorange you can, um, find our esteemed [00:40:00] guest. If you wanna see- To be back 

Margaret: on when you- 

Preston: Yeah ... 

Dr. Orange: once a month instead of therapies. 

Margaret: Yeah, we have two psychiatrists, like, we'll be like, "Dr Orange, how are we locking in?" Yeah. "What is going on? What's our mental status?" 

Dr. Orange: Yeah. 

Preston: Um, thanks again for being on here.

Um, for the audience, if you guys want us to interview more fruits, we can, uh, screen the pile. I don't- 

Margaret: Edible Arrangements, if you're listening. I don't... 

Preston: Yeah, I don't know. I'm gonna Fruit of the Loom, Tropicana. Our inbox is always open. You know where to find us. It's @humancontentpods on Instagram and TikTok.

I'm on TikTok at, @presro and Instagram @itsPresro, where you can also find our podcast videos. Margaret's @badar everyday on Instagram, TikTok, and Substack. Shout out to everyone who's been supporting us recently. Um, I had my first New York Times debut, so some of y'all were actually commenting on the New York Times, like, style post.

The Lexapro and Prozac T-shirts we got, [00:41:00] got the attention of, like, some of the, um, journalists out there. So th- it's, it's our big break, y'all. And, and 

Margaret: if you- You did say that in season three. Yeah. You're going for style. 

Preston: I have a ton of these extra shirts too, so we'll do, um, a special on the Patreon. So if you guys want some, I'm gonna make a post coming up in a week.

And then, uh, if we have a, a couple winners of these, um, different drawings, we'll, we'll send some shirts your way. Uh, just let me know. I think I got some Risperdal, some Propranolol. I think there's a few other Fluoxetine, so just let us know. 

Margaret: Shout out to Doc Sine. 

Preston: Dr. Sine. He called me the other day during work and he was like, "Oh, never mind.

I was just gonna be venting about stuff." So thanks, Dr. Sine. 

Margaret: Let me connect you to Dr Orange. 

Preston: Yeah. Thanks again for listening. We're your hosts, Preston Roche and Margaret Duncan. Our guest today was Dr Orange. Our executive producers are Preston Roche, Margaret Duncan, Will Flanary, Kristin Flanary, Aron Korney, Rob Goldman, Shahnti Brooke.

Our editor and engineer is Jason Portizo. Our music is by Omer Ben-Zvi. [00:42:00] To learn more about our program disclaimer and ethics policies, submission verification, licensing terms, and our HIPAA release terms, go to howtobepatientpod.com or reach out to us at human-content.com, um, howtobepatient@human-content.com, that's our email tag, with any questions or concerns.

How to Be Patient is a Human Content Production.

Thank you for watching. If you wanna see more of us or if you wanna see... This is Lilac. She's my cat. She's gonna be waving her hand at one of the floating boxes, which will lead to more episodes. Lilac, point to the other episodes. Lilac doesn't know what the internet is, but I swear they're there. They pr- they probably exist for real.

But in the meantime, I'm just gonna pet Lilac, and then I'm [00:43:00] gonna go dance in the background