Financial Minimalism, Music, and Medicine with Dr. Steven Bradley

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Steven Bradley (00:52.939)
Jimmy, thank you so much for the invitation. So happy to be here, I listened to quite a few episodes, so happy to be here.

Jimmy Turner, MD (00:59.052)
Yeah, super excited to have you and you know, I did a lot of research on you before bringing you on. listen to the Black Daughter’s podcast. I found your Instagram page. We’re going to talk about that in a minute. I really love your work and so excited to have you on. Stephen, tell us a little bit about your background. I’d love to know a little bit more about, you know, growing up, where you came from and how you got to where you are today.

Steven Bradley (01:03.169)
He he.

Steven Bradley (01:19.979)
Yeah, it’s been a difficult question to answer now. I just relocated to Florida about a year ago. So I grew up in Navy brat up and down the East coast of the United States. Ultimately, my dad retired in Jacksonville, Florida. So I was there for the last like portions of high school. And then I did a master’s program in Tampa, went to med school in DC at Howard University, went back to Chicago for residency training, four years of anesthesia there at University of Chicago. And then I,

went into the Navy, so I practiced in Virginia for four years, doing anesthesia there, went back to Chicago for a one -year CRIT care fellowship, and then moved to Tampa a year ago. So people were like, are you from Florida? I’m like, yes, but no. So it’s a pretty complicated question, huh?

Jimmy Turner, MD (02:06.082)
Yeah, no, it’s kind of come full circle for you though with the Florida roots and then coming back.

Steven Bradley (02:11.217)
It really has, we were talking about USF, because I was at USF for a master’s program, know, the master’s programs that everybody does to try to increase their chance of getting into medical school and being able to, you know, not being accepted to that medical school in particular, but coming back and being able to work with students from there, residents from there, has definitely come full circle.

Jimmy Turner, MD (02:33.644)
Yeah, so we were sharing before the show and I’m like just, you know, public transparency, number one. So I applied to South Florida, didn’t get into USF and ended up getting into Wake Forest. I went to a really small school in South Carolina, I guess they’d never heard of. And so that wasn’t super helpful for me, but I’m from like an hour North of there. And also share some commonality with you. So my dad was in the Navy, although he got medically discharged before I was born, but

We ended up moving around quite a bit up the eastern seaboard too. So what was the furthest north you got?

Steven Bradley (03:04.525)
For a little bit of time in Rhode Island, my dad was in training up there.

Jimmy Turner, MD (03:08.716)
Yeah, that’s pretty far. was only up to New Jersey, so not quite the extensive travel list that you have there. So, you talked me through the transition from Navy to Fellowship because there are some people listening to military and in my mind, I didn’t do military, so I’m thinking, why not just go straight into practice? So, what led you to the extra year of Fellowship and why’d you do that?

Steven Bradley (03:30.229)
Yeah, so when I was figuring out in medical school, what do I want to do for a specialty? I ended up falling in love with the ICU and My goal going to anesthesia was always to become a critical care doctor I went to University Chicago because they have a phenomenal ICU program. I Accepted this military scholarship kind of in the middle of residency my brothers in the Navy my dad’s retired just kind of a family legacy there and

Because of that, I had the service obligation, so I had to call the Navy, and I’m like, complete civilian. I had locks at the time. I Googled people from the Navy, found somebody, I’m like, okay, this guy sounds like he knows what he’s talking about, and I emailed him, and it’s like, hey, I’m supposed to report in 2018. What’s the chances I’d like to do an ICU fellowship first? And the first email he sent back was, use your proper rank.

when you’re addressing senior officers or something that had an effect. was like, okay. What is my rank? And ultimately his email was, was still very curt response. The Navy doesn’t have a need for critical care positions. Okay. So I finished residency in 2018, reported for active duty as a generalist. And of course we all know a year or two later came a rip roaring pandemic where the two or three…

Jimmy Turner, MD (04:29.102)
Ha

Steven Bradley (04:52.927)
ICU docs at my large military hospital weren’t enough. So it was kind of, it’s like, you know, not that, you know, was like, hey, you know, you guys were very short -sighted and not allowing me to do the fellowship. I say that also because there’s a huge demand on Reddit. People are always asking about military medicine and it’s always hard to really discuss the pros and the cons. There’s a lot of cons or a lot of things that will complicate your path should you choose to go that direction. I’ve got several.

episodes kind of describe my experience. I try to be very positive and sometimes like it can delve into a little kind of negative side. It’s being real. But that is one of the things that it can delay you doing what specialty or subspecialty you actually want to do. So I had four years in the Navy to really think about do I really want to be an ICU doc? Do I really want to go back to training? Ultimately the answer was yes. Going back to

the institution I trained at, I really hedged my bets, so I knew a lot of the attendings and the faculty there. So it was a fantastic year, great training, kind of like a victory lap, if you will, to finally bring everything to an end.

Jimmy Turner, MD (06:04.684)
Yeah. So, so you took the journey through the Navy. Did I felt like you were going to say this and then you didn’t. So did you get thrust into like an ICU position when they didn’t have enough doctors during the pandemic?

Steven Bradley (06:13.231)
They tried. They tried. The State Department for Optics was going to send the hospital ship up to New York. They sent one to New York. They sent one to San Diego in California. And it’s the military and the government. We’re going to go in and save people. They made all these claims the ship has a thousand bed capacity. really has like

200 bed capacity because half of those are bunk beds you like how bunk beds in a hospital don’t work that well And I just remember it was like social distancing and the military they literally said you cannot Go out anywhere at your command the command said you can only go buy groceries and go home It was like if you got caught in town or like doing stuff there could have been repercussions but in the middle of this they throw all of the physicians and APPs from this hospital onto the ship

So we show up, I’m supposed to deploy to New York. There’s three or four neurosurgeons. There’s the one cardiac surgeon from our hospital. There’s like nine anesthesiologists. There’s seven or eight CRNAs. That’s just from the anesthesia side. And I remember being in the casualty receiving area of the ship, it’s just a large open area. And we were all standing in formation. There’s like 300 people in this room the size of a basketball court.

Jimmy Turner, MD (07:34.68)
Wow.

Steven Bradley (07:35.303)
And you know, social distancing, social distancing, social, it’s like, are we doing here? And the long story short, their request was made by a senior officer. like, Lieutenant Commander Bradley, I heard you’re interested in ICU. We want you to be the medical director for the MICU. And I’m like, yeah, I’m not really trained for that. Remember when I wanted to do the ICU training? And long story short, that didn’t end well. I ended up not.

or being, that’s the right way to put it. Let’s just say I didn’t go on that deployment. Then I almost went to Iraq about two months later. It’s a long story. I talked about that in the podcast episode too. But yeah, they definitely tried to get that ICU training, which, you know, as an anesthesiologist, we do a lot of ICU, but being a medical director for a medical ICU was a bit outside my skill zone at the time.

Jimmy Turner, MD (08:30.168)
Yeah, no, I can appreciate that being an anesthesiologist. I don’t think that I’d want to be a medical director and I see without that training. But so take me back. You, I know this from learning about you, but you love music. Okay. So take me back before medical training and tell me about your passion for music and tell me and the listeners, you know, what that transition was into medicine and why you decided to go that route.

Steven Bradley (08:34.475)
Hehehe

Steven Bradley (08:54.349)
Yeah, so my parents, they had very humble beginnings growing up in Florida, both of them. Parents were sharecroppers or had kind of government housing. And long story short, my dad went to the Navy and they always wanted us to have the kids. I have a brother and five sisters. They wanted us to have opportunities that they didn’t have growing up. One of those was music lessons. So I was forced to take piano lessons, you know, starting from probably I was like nine or 10 years old and

over time I started to really enjoy the music lessons so much so that I studied music for a year in college. I was a music major starting out. My reason for pursuing that career in medicine, I had a buddy in college, were both freshmen, they say in college, know, everybody, whatever percentage, change their majors. I’m like, that’s not gonna be me. I’m not gonna change my major. That’s lame, that’s wack. So we were both music majors and I remember Ben.

changes major to pre -med right at the end of freshman year. And I was like, Ben, why would you do that? know, music was great. Like if I practiced hard, I’d get a B or a B plus. If I didn’t practice, I’d get like a B or a B plus, maybe a B minus. So I was just kind of coasting, enjoying college. And when Ben changes major, said, Ben, why would you do that? Pre -meds are really hard. And that struck me that I said that. I’m like, why am I in college to…

do easy stuff, why not apply myself? That conversation happened, I went back to Jacksonville, I worked construction over the summer to help pay for school, I was at University of Florida’s teaching hospital in Jacksonville, so Cheyenne’s running electrical conduit in the sub -basement. So the sub -basement, you go down to the basement of a hospital, there’s transformers and a concrete floor, you pull up a grate in the floor, there’s dirty water down there, so I put on a pair of like,

you know, Woodlands camo waiters and go down in this muddy water and run electrical conduit. And working at the hospital was my first exposure to people in medicine. I’d see folks drive in and fancy cars. And I was coming in at five in the morning to start the day. So I was actually coming in before a lot of these physicians were. And being exposed to that, we went around and indoors and actually hung some lights and I saw a physician’s office and the degrees on the wall and the

Steven Bradley (11:20.161)
guy was working with doing construction, was like, you if I did it all over again, I’d be a doctor. I’m like, Yeah, that sounds better than this. And from there, it was a big leap of faith. Could I actually handle the coursework? I looked at nursing. I ultimately settled on a pre -physical therapy degree, because I do believe in having a Plan B. And if physical therapy, that’s great. I would still have the prereqs to apply to medical school.

And so that’s what I changed my major to and just leaped in with both feet. And it was cramming that pre -med coursework, or the prerequisites anyways, into the last three years of college. I then started working at Walgreens. So I think I was working about 35, 36 hours a week during my junior and senior year. There’s a lot of just going to class, going straight to work, closing the store down at 10, coming back to the dorms.

studying for three or four hours, then repeating it the next day and the next day. And at the end of that, my grades were okay. I squeaked out a 3 .51 GPA and had the prerequisites, had the grades to actually apply to medical school. So it was just a leap of faith that I really enjoyed. The journey was stressful, but each, you know, looking back, I could look at the previous semester, like, okay, you got through that.

let’s try this next one. So it was very much a journey that again was stressful, but I did enjoy and lean into.

Jimmy Turner, MD (12:54.05)
Yeah. So, so I remember hearing you say that in my mind, the concept is like altruism versus money. And, and, and, and I want to hear your take on this because I personally find this really refreshing, but a lot of people are told like, you can’t go into medicine unless it’s, you know, a passion, like you really want to serve people, that sort of thing. And you’ve been really open and transparent that that’s not the reason you went into medicine. So can you share that with us?

Steven Bradley (13:03.192)
Yeah, yeah, yeah

Steven Bradley (13:20.087)
Yeah, yeah, there’s a quote that’s like a career in medicine’s only for someone that cannot imagine themselves doing anything else. I’m like, that is such pompous, self -infatuated crap, in my opinion, respectfully. When I was looking at changing my major, going into medicine, my biggest goal was to be able to provide for a family one day.

There was a path of music and being a music teacher or struggling musician worse. And how do I raise a family on that versus being a physician? I said, Hey, if I could make $200 ,000 a year, I can support my family. And it sounds like a really fun, challenging, rewarding career. Those are the two reasons that I really was considering going into the field. So, and I say it because it wasn’t to be rich. And I think that’s where a lot of people, you know, confuse this, you know, if the goal is to be rich, you may never reach that goal.

but I had very attainable goals when I approached this. And from the cerebral perspective, I just enjoyed the challenge of the coursework and seeing if I could do this, if I could get to this next step, if I could get into medical school, if I could match into anesthesiology. And I think for me that’s helped because when people, in my opinion, when you do a lot of stuff out of altruism,

Well, that wears out. We know burnout is real in medicine. And if you’re just doing this to help people or because it’s the only thing you can imagine yourself doing, well, when the going gets tough, like, and you’re burnt out and you’re out of altruism or you have a patient that you don’t identify with that’s racist or a homophobe or, you know, has injured people, that altruism, at least for me, wouldn’t allow me to provide the same level of care.

So I practice, consider my practice to be out of professionalism. As a banker, know, bankers may or may not be altruistic, but you expect them to be professional. That’s little money meets medicine tie in there. But as a physician, my goal is to be professional. So I talk to every patient the same way, clearly explain risk benefits, alternatives of procedures. I do my best every day when I’m in the hospital. I stay…

Steven Bradley (15:44.393)
abreast on research. I read, I publish, I do all these things out of a sense of professionalism because to me that that’s what kind of carries throughout from day to day.

Jimmy Turner, MD (15:54.924)
Yeah. So I love that thought process for multiple reasons. One of them is just completely, it just validates me personally. I practice anesthesia, but then I also have this business and this podcast and really trying to increase financial literacy among physicians. And you could imagine that some people looking at that and saying, Hey, you just want to talk about and teach about money all the time. Are you even a real doctor? And in fact, I’ve had blog posts that got syndicated on different things, KevinMD and

Steven Bradley (16:02.517)
you

Jimmy Turner, MD (16:22.466)
different, different sites. And I’ve had people say that, like, I, know, I wouldn’t want you to be my doctor because you clear it like this, this isn’t your passion. And, and I have a similar thought process to you where it’s like, no, I love medicine. I love practicing medicine. I enjoy procedures. love taking care of people. I’m really, really good at it, but it really does kind of come out of professionalism. And, and the, the analogy that, that I kind of felt when you were describing that is marriage, right? Like you can think about love as a feeling that’s going to go away.

Steven Bradley (16:28.366)
man.

Jimmy Turner, MD (16:51.18)
Like if you’ve been married, like I’m sorry, and maybe I’m just being a little too raw and honest here, but like love is a choice, right? And when you choose, it’s actually a deeper form of love that isn’t, you romantic and you’re not gonna see it the same way as movies. But when you pursue that, actually think that’s actually more profound in a marriage. And so for you, like that concept of professionalism isn’t like below.

Steven Bradley (16:51.36)
Yeah.

Steven Bradley (17:00.802)
Yeah.

Jimmy Turner, MD (17:14.114)
Passion, I think it’s actually a higher calling where you’re gonna, you’re saying exactly that. You’re gonna be professional no matter the setting, no matter the patient, whether you agree with them or not. I think that’s a refreshing take.

Steven Bradley (17:24.481)
Yeah, and I do want to say, you know, do whatever floats your boat as you’re listening. If you are driven by passion. I look, I got a lot of people that are extremely passionate about what they do about it. They’re sending me David Goggins videos and all those like inspirational clips from social media. And that’s what drives them. And I love that for them. I love that for you. If that’s you, it’s a little different for me.

Jimmy Turner, MD (17:50.124)
No, that’s why I love it. I think it’s a different take and it’s refreshing. You know, there is that push that you just have to be passionate in medicine. And I find that really pretty cool. all right, so we talked about, I thought about, you and I, we’re both fans of alliteration. We talked about this before the show. And as I was thinking about the title for the show, I don’t know if I’m going to go with this in the end, but it was like, you know, mindfulness, minimalism, and music, because those are three topics. And you know, money meets medicine. I’m a big fan of not only alliteration, but apparently, M’s.

Steven Bradley (18:13.791)
yeah.

Jimmy Turner, MD (18:18.604)
with alliteration. So yeah, so we’ve talked about music and you mentioned you want to talk about minimalism on the show, which I thought was a really cool topic. So when you think about minimalism, what exactly does that mean to you?

Steven Bradley (18:19.735)
I liked it.

Steven Bradley (18:31.713)
Yeah, I think along with this journey of professionalism and medicine at some point as a kid, you know, I wanted a Dodge Viper and I wanted the original Hummer, like the H1. There wasn’t an H1 because it was just the Hummer back in the day. And I loved cars and I was watching sports. I was doing all the other stuff. And in residency, I stumbled upon first a documentary, Minimalism. Let’s see, a documentary about the important things. It was on Netflix.

Jimmy Turner, MD (18:40.696)
My man.

Steven Bradley (19:02.049)
and I watched it and these guys had such a different take on life. They like went full tilt in the minimalism, like had like two pairs of pants. And one of the things that stuck out was they had a picture of a house and some study of how often people are in different rooms of their house. And they kind of tracked it over a period of a month or six months. And there’s like so many rooms in these houses that people just don’t go into. And it’s like, well, why do you have all this space? Why are you paying for all of it? So that really got me thinking about

You know, what are the important things in life to me? What are the things that I’m trying to impress my colleagues and people around me? I realized that documentary kind of challenges you to find the one, two or three things that are important to you. Now I, you know, I have more than two pairs of pants. If you work in banking or in a real estate or in medicine, like you probably can’t get away with a pair of pants and a shirt, but there’s aspects.

and concepts in the documentary that I have been able to integrate into my life. One of which is I’m not a big sports person at all. And a lot of it was like playing into the McKeesmo and like as a dude, you’re supposed to be into sports. And I just gave up sports. A lot of it had to do with Colin Kaepernick. And I thought we like, we’re boycotting the NFL. And I was like, yeah, all right, well I’ll boycott. And then like everybody else went back to the NFL and I was like, you know, I’m good without it. So I don’t watch any sports.

Cars. I used to think, you know, I wanted that Viper, I that sports car so bad, and I ended up with a 2011 Volvo XC90. It’s a total soccer parent car. This is so comfortable, it’s paid off. This is the best thing ever. I’m not worried about people denting it or scratching it, and I realized for me, cars aren’t as much of a passion as I thought. It came back to music.

I love music. During my career progression, there’s times I could play more music and play less music. Now I have the finances, which we’re kind of warming into, talking about finances. I can buy a lot of the musical instruments that I want. And then art is the other thing. So people, my friends, they laugh, and my wife especially, they’re like, how are you a I have, I think, 20 musical instruments and about a 40 piece art collection.

Steven Bradley (21:27.341)
But those are the only two things that I really, really do. The art collection, speaking of finances, a lot of that stuff can evolve around your community. There’s usually artists, communes, and galleries that support local artists. So most of the art I’ve purchased has cost less than a hundred bucks. I have a couple of nicer pieces, a couple of commission pieces, and the most I spent is 4 ,000 for like a huge commission piece from a local artist that I know.

and it’s phenomenal so I get to help their career and invest in them. But my art collection is also limited by the wall space that I have in my house. So I’m like, okay, I don’t have any more room for art than I’m not buying any new art. And for me, speaking of that disciplined pursuit of less and what brings you happiness, when I walk around and I can see a piece of art that like there’s a Biggie Smalls kind of portrait on my wall here.

the guy that was doing all my framing in Chicago, he made that piece. So I look at that and I see him. Or the Hebrew Brantley statues, I met Hebrew Brantley when I was doing residency in Chicago. So being able to walk around the house and see art that I purchased with my wife on our honeymoon, all those little memories throughout the day, or those little hits of dopamine, and again, very reasonably priced. I don’t think I’ll ever jump into that big price tag art world.

I don’t collect as a term of investment, but it’s just one of the hobbies and probably like my second hobby to music. When it comes to music, yeah, I have like 20 instruments, only two or three like high ticket items. It’s a financial show. like the most expensive, I have a very nice keyboard. You’ll see it like on it’s professional keyboards, like three or $4 ,000 for a Nord keyboard.

What limits my music collection though is I only have so much time to play these instruments. So, unless I’ve practiced a certain amount of time, then I don’t allow myself to buy another instrument. Most of the instruments I have are really cheap in the $200 $300 range. And some are more toy instruments that I will pick up from Amazon. I have a weird stylophone thing, a stylophone that David Bowie plays in the song.

Steven Bradley (23:54.893)
and my melodica was like 20 bucks. It’s a bunch of random instruments, but I love it because it’s a reasonably priced thing, at least, you know, it’s not a car collection, right? But it’s reasonably priced. And then when I have time, I can spend so much of the free time doing what I love and actually playing each of these instruments that I own. So that’s the the the music piece. no, the minimalism, the minimalism piece. Yes, I do have two.

fairly substantial collections, but I do invest a time. And because I don’t watch sports and I’m not out washing my car or taking care of a lawn or gardening, then I have the time to share between mostly just music and then spending time with my wife.

Jimmy Turner, MD (24:41.494)
Yeah, I think that’s really cool that you’ve kind of carved that out. And I actually remember talking to an attending of mine when I was in training and he said he didn’t watch sports. And so at the time, I was just completely engrossed. And I’m a sports guy, so I still love sports. But engrossed in fantasy football and watching every game I possibly could and all this stuff. then my business…

started requiring more and more my time. And back then was full time, I was practicing medicine 50 something hours a week, maybe 60 hours a week, and I had 20 hours on the blog at the time. And so the way that I got all the time to work on those passions of mine on the side was to basically give up sports. And so I think that that’s actually really true. And people were pretty surprised by that when you actually make people catalog their time. Like, most common complaint I see from my coaching clients are like, I don’t have time. I’m like, OK.

Steven Bradley (25:21.702)
man.

Steven Bradley (25:29.623)
Yeah.

Jimmy Turner, MD (25:33.92)
So do you watch TV? And they’re like, well, yeah, I watch probably an hour on Netflix every night. I’m like, OK. Do you get on social media? And they’re like, yeah, yeah, I do. I’m like, how much time do you think you spend on social media? like, I mean, yeah, it’s probably an hour, something a day, just like doom scrolling on whatever their social media platform of choice is. And so you do get a lot of time back when you get pretty specific about your hobbies. And so it sounds like you’re a minimalist with two exceptions being music and art.

Steven Bradley (25:50.509)
Yeah, yeah, yeah.

Steven Bradley (26:03.394)
Yeah.

Jimmy Turner, MD (26:03.482)
and digging into your Instagram page, which by the way is, is awesome. I actually really, I I really enjoy your Instagram page. What’s your, is it at Steven Bradley MD, I think. Okay. All right. So, so on there, I’m not a big musical guy. Like I love, I love music. I’m just not like if I sing people’s ears bleed. So I try not to, I try not to do that, but my daughter loves music. She plays the flute, she plays the drums and it’s, know, big, big passion of hers. And so,

Steven Bradley (26:07.629)
You

Steven Bradley (26:11.915)
Yeah, yeah, yeah, that’s it.

Steven Bradley (26:21.634)
You

Jimmy Turner, MD (26:30.166)
I loved it, but you had an instrument on there I’ve never seen before. It’s like, it’s like a sound, like what is it called? Use it for like your mindfulness Monday things. The hand pan. Yeah. So I look, I looked that up and those things aren’t cheap either.

Steven Bradley (26:38.455)
Which the handpan with the big, yeah.

Steven Bradley (26:45.131)
Yeah, that was one of the pricier pieces in the collection. It’s a… Well, they’re… I don’t know whether indigenous too, but there’s a lot of people over in Europe that make these handpans. It looks like a flying saucer kind of thing. It just has a real peaceful sound to it. I came across, think, I can’t really call the artist’s name, but there’s a guy on Instagram that just plays it. It’s the most beautiful music.

Jimmy Turner, MD (26:49.304)
What is that? Where does it come from?

Jimmy Turner, MD (27:00.184)
Yeah, does.

Steven Bradley (27:13.867)
At the beginning of the year, kind of started this mindfulness journey, if you will. And because I’ve played music for long time, I’ve recorded music, I was making a lot of lo -fi stuff. And then I said, well, maybe what if I just started making music that leads to relaxation? I’m working in anesthesia, know, pre -op anxiety is huge. Anxiety in general in our world and community is huge and people are stressed. like, what if

I just tried to channel some energy into making music that would combat that. And I found the handpan, it looks like a huge flying saucer, just looks like so much fun. It’s a percussion instrument, has a real peaceful tone. And so I looked around and I ordered one online. Ironically, I ran into a Nepalese store in St. Pete, this guy from Nepal, and he was sourcing handpans straight from the motherland. I was like, okay, well.

Let me send this back to the big box retailer and buy local. So I’ve had a really fun time since January recording. I’ll do a lot of kind of drone background that kind of puts you in not a trance, but in a spot that you can reflect and be mindful. And for me, it’s twofold. One, it makes me every Monday between Sunday and Monday, I have to go stop and record a piece, upload it to my digital audio workstation.

mix in a couple other elements, master it, finalize the project, and then send it off, you know, put it over back over the video and then post it to social media. So it’s really forcing me to improve my skill set with music production. I’m also getting to learn the instrument and then hopefully some people are finding a little bit of a break as you’re doom scrolling, like you mentioned. Then maybe you pause for 60 or 90 seconds and you can just hear something a little more.

peaceful and tranquil and you can kind of check out and be a little more mindful.

Jimmy Turner, MD (29:15.672)
Yeah, I mean, that’s exactly how I felt when I was listening to it. It was pretty, it’s pretty cool. Yeah. So in the introduction, speaking of being mindful, you have a background studying ethics, which, so my, my original business is called the physician philosopher. It’s because I was philosophy major. And so I’m like, I’m seeing that I’m like, man, this, guy did like two years of ethics studying. Like I, so I’ve got to hear a little bit about that. And how does that like impact your, your clinical practice?

Steven Bradley (29:18.764)
Nice.

Steven Bradley (29:31.681)
Yeah, yeah, yeah.

Steven Bradley (29:42.603)
Yeah. So the ethics training was concurrent with, my last year of residency and my year of fellowship at the university of Chicago. It has a McLean center for clinical medical ethics, Dr. Mark Seigler. He kind of coined the phrase clinical medical ethics and the program is a year long. I was, I got interested, you know, in part due to my interest in critical care and you see some patients in the ICU. I think we had one patient that ended up on a total artificial heart and was in the ICU for like six months and

really complex case management and discussions. And I said, you I wanna lean into this. It’s so easy to kind of shy away from family discussions or defer to somebody else. I wanna like get really good at this because you know, you’re not memorizing a table or a chart or doing calculations. This is just pure, like as a philosopher, this is pure interpersonal skills and respect for other people and knowing their cultures and all this stuff. I…

had a decision point, I try to be a chief resident or do I do this fellowship? I talked to some mentors and was like, hey, let’s go for it. Let’s do this ethics fellowship. So the first month was spent in didactics. I was able to take a research block from residency and we had lectures from philosophers, from psychologists, from parishioners, from clinicians, from bioethicists, from patients. And after that month of didactics,

we would rotate and cover the ethics consultation service. And every Wednesday we would have case conference and we sit for two hours and review cases. And there would probably be like 30 people in the room from different specialties, from PEDs to surgery to internal medicine. There was nurses, there were physical therapists, there was chaplains. So an extremely multidisciplinary group. And over the year, as we got to know each other,

We built these relationships where we could have really difficult conversations, people’s different views on maternal healthcare or religious preferences. And we got to a point where we could just have these discussions and we had so many complicated situations and we were able to navigate through together. So I spent a year doing that during my time in the Navy. was able to work on the ethics board there at my hospital. I spent a month in Quintana Bo Bay.

Steven Bradley (32:10.401)
gave a lecture on medical ethics at the hospital there and it’s highlighted on my CV. And then during my CrickCare fellowship, I was able to participate in the fellowship for an additional year.

Jimmy Turner, MD (32:13.538)
That’s cool.

Jimmy Turner, MD (32:22.69)
Yeah. So, so I find that really fascinating because I don’t know, maybe it’s cause I was lost major, but, and not to get too philosophical, but I’ve always found it really interesting. The difference in ethics between Europe and the States, particularly as it relates to this might be, this might make sense being on this podcast, but finances and, the reason why is because it comes across to me that in Europe, it’s very utilitarian. So it’s what, what is best for everybody.

Steven Bradley (32:37.783)
Yeah.

Steven Bradley (32:49.43)
Mm

Jimmy Turner, MD (32:51.896)
and let’s make decisions based on what is best for the group. Whereas in America, it seems like we will spend every possible dollar that we can to prolong someone’s life a single day. And the impact of like almost that different view of ethics impacts healthcare finances, it impacts individual decisions because it feels very different than ethics from Europe. Am I way off base there?

Steven Bradley (33:15.135)
It’s, it’s, it’s, God, it is, it’s incredible. And the sad thing is, like, I don’t, I think it’s just inherent to our culture, this Western culture, that we will never be, you know, highly unlikely we’ll be there. My wife and I just got back from Copenhagen. We have a, expecting our first child. We had our baby moon there because we heard number one, Denmark is one of the happiest countries in the world. They always rank like between one and three or whatever scales or ranking systems they use to rate this.

And we go there and like you described it, the culture was just so different. In Copenhagen, they’ll like leave babies outside the grocery store at a bassinet while they shop. And they just want the kid to get fresh air and then they’ll come back and take their kid and go to work or go home. It was such a different culture. What we noticed was we went to a park on a Wednesday at nine o ‘clock and there was a group of eight or nine adults developmentally.

disabled adults in wheelchairs or walkers or you know, whatever the case. It’s like eight or nine of them and they had one or two caretakers with them and they just took them to a park in the middle of the day. And it’s their social services are so good. They pay a lot of taxes, but as a community, as a country, they’re happy because their people are being taken care of and it’s just a very different experience. I did a week or I did two weeks rather.

in London with the NHS as I was finishing up fellowship. And one of things that struck me is in the ICU, they would discharge patients and on rounds they would say, are they a candidate for readmission? Are they a candidate for renal replacement therapy? And it’s like, man, like that concept is, is we have a limited resource. Is this going to ultimately benefit them and be okay for the greater good? And again, it’s just a perspective.

Jimmy Turner, MD (35:12.974)
Yeah. And I, I don’t know, for whatever reason, I found that really interesting. I think I would love to have sat in that room of 30 people and seen different perspectives that that must’ve been incredible. And, you know, it’s really thoughtful. Is there a particular case that sticks out in your mind in terms of like one of those case case studies that you had to discuss with the 30 people in the room that was particularly challenging or interesting.

Steven Bradley (35:20.29)
Yeah.

Steven Bradley (35:34.997)
Yeah, some of the, kind of a combination because they got so crazy. They were super specific, but a lot of times like, perjurients. So pregnant patients that had some kind of catastrophic incident, but maybe because we were in Illinois, so maybe they would come across from Indiana. So then you’d have issues that were intersectional who’s a medical decision maker because

They’ve been together for 20 years. It’s a common law marriage, the common law. The common laws are different in Indiana, but we’re in Illinois now. termination of pregnancy or the law is different in Indiana where they came from or Illinois. those legal issues and obviously we’re in Illinois, so we had to treat them at treat patients as such. But with those complex patients, think the craziest consult I had in the room was.

endocrinology, critical care of medicine, OB anesthesia, neonatologist, neurology, OB anesthesia, think I said it already, OBGYN, there’s like eight or nine different specialists and having to navigate a family meeting where there’s two or three…

different groups of family members and then there’s the family and then the people that are married in or common law and having to navigate a family meeting that that’s complex was, mean, I don’t want say a work of art, but it takes a lot of dedication being able to observe how that was done has greatly influenced my practice.

Jimmy Turner, MD (37:24.814)
Yeah, I think OB anesthesia is probably the closest I’ve gotten to major ethical stuff. And what’s always blown my mind in those conversations is like the ethical ramifications of the decisions that are being made are so complex that you could probably have meetings, multiple meetings about doing the right thing. And yet these decisions have to be made in a very short period of time. Often the mom comes in and there’s something going on and we need to make a decision right now for the safety of the mother or the child.

or both and and we have to explain the complexities of ethics and medicine to a patient that probably knows nothing about either and somehow try to do the right thing i mean that’s just it seems impossible

Steven Bradley (38:04.417)
It’s tough. The biggest thing is trying to, if I can just, sometimes I’ll say straight up like, would you mind trusting me to get you through this? If there’s, we’re truly that short on time and just having that patient put trust in you, just soliciting it and asking for it. And then paternalism, knowing that, you know, we came through these careers to help people back to that altruism or professionalism piece. And we also have to sleep at night.

and be rest assured that we did the right thing for us. between those two concepts, like that’s how I recommend navigating those decisions. Do what you think is right. Think about if what I did right now was published in the front page of tomorrow’s paper, what would people think about that? Those are some kind of quick and dirty ways if you’re just on the fly and you gotta go now.

Jimmy Turner, MD (39:00.942)
Yeah, yeah, that’s good advice. Well, Stephen, we’ve talked about music, we’ve talked about mindfulness, we’ve talked about, you know, minimalism and ethics. So, so many things to cover and I know that you’re a multi -talented human being that has lots of different interests and has a wonderful take on so many things. So, if people wanna learn more about you or hear more from you, where should they find you?

Steven Bradley (39:08.727)
Thank

Steven Bradley (39:22.017)
Yeah. my Instagram is at Steven Bradley MD. And initially I started out to be a medical influencer and make some spare change. And I was in the Navy and realized I didn’t really like posting that much about medicine and it shifted into music. So if you like music, there’s some music there. think the same six people, you know, one of which is my wife, like the little music posts I do. but every Monday is mindfulness Monday. I also host the black doctors podcast and the newest venture is.

ambient .rx, it’s a YouTube channel where I am publishing a lot of the music, the mindfulness and the sound baths and meditation music there and trying to build a resource that if you want to unplug or do some meditation or yoga, you can pull up that YouTube channel and hopefully eventually a Spotify playlist and you can kind of keep track of that. Maybe drop an album by the end of the year, hopefully.

Jimmy Turner, MD (40:19.832)
That’d be pretty awesome. Well, Stephen, thanks so much for coming on Money Meets Medicine.

Steven Bradley (40:24.523)
Jimmy, thanks for having me.