A Podcast with Andrew Skotzko: Beating Trauma, Identity Shifts & Continually Recreating Who You Are

 The anesthesiologist who was influential to me when I was young said, what you have to do is internalize all of the chaos in the room, and then project call. You're listening to a Bio Reset medical podcast with Dr. Cook. If you have questions or wanna talk more about your symptoms and issues, you can always reach us at 6 5 0 8 8 8 7 9 5 0.

The following is a discussion with Andrew Scottsdale from the Aliven Podcast. Matt, welcome to the show. Thanks so much for being here today. How are you? I'm doing wonderful. I'm delighted to be here. Thanks. One of the things that, uh, I thought would be an interesting way to start this off is I, a way I heard you describe a big shift in your life, which is that, you know, as, as a doctor, you spent the first, you know, significant chunk of your career.

You used to knock people out, but now you wake 'em up. Tell me what that means to you. My first half of my career, I, I was an anesthesia. I am an anesthesiologist, and so what I would do is I would basically knock people out a hundred percent by giving them general anesthesia or else I would do nerve blocks and then give them sedation and then guide them through surgeries.

And so we were, that was basically what I did. And then now, uh, I'm using the same techniques that come from the anesthesia world to try to physiologically turn people's brains on and, and, and, uh, reset the body, which is why my company's called Biore Reset. How did that shift happen for you? Like, what was, was there a, a triggering event for you that, like, what caused you to make that shift in your own life?

I had always wanted to do integrative medicine, and yet you go, um, you go to, uh, medical, medical school and it's a gigantic institution. And so then you're, you're, you sort of go onto different services and each service has an identity and kind of a consciousness to it. Okay? And so, um, and, and it's you, when you go onto a service, you'll, you'll show up and so you show up in surgery and so there.

All kind of crazy and super hardworking and wonderful, but, and so then you'll, you relate to them and you're like, oh, I don't think I wanna be like this. Cause it's just, and so then you to family medicine, you relate to them and you go to psychiatry. So you're floating around. And when I got, and I, I was, I had the over my eyes a little bit because I went into anesthesia.

Mm-hmm. And they were by far the coolest people in the hospital. And so just, just for context, like where lo how many locate is this in time? Like is this, when you're in med school, is this after med school? Like where are we? This is when I'm in, in medical school. I'm in med. So this is 1997. 6 97. Okay. So you're in the middle of med med school.

I'm in the middle of med school and it's, it's, um, the anesthesiologists are like lights out, the coolest, nicest people, and they seem totally calm. Okay. And so, and I was thinking, and, and so I'm thinking, hey, uh, these guys are like, by far what seem like super happy, wonderful people. They're my people. And so then I'm gonna evolve into being super calm, like them.

And what I found out is, is that basically it's just a total facade because inside it's like, You're, you're dealing with, uh, uh, this, this anesthesiologist who was influential to me when I was young, uh, named Peter said, what you have to do is, uh, internalize all of the chaos in the room and then project calm.

Okay. So then like, whether, whether it's with the patient or whether it was the surgeon or the nurses, all of that is, and so we're, we sort of orchestrated, um, the environment, it would make everything okay. And so part of that is being a psychiatrist for them a little bit. Part of that is just guiding and being supportive and wise and thoughtful.

And so it's, and so next thing I know I'm doing anesthesia and it's like this is super dangerous. And, and so I was sort of wishing that I had done. I had gone deeper into the integrated medicine. I was like, God, I made a mistake, but I was getting amazing at procedural skills and injection. So I'm, and, but I realized I wanted to really have that deep dive into integrated medicine.

So I started, I started like the month I got out of residency, I started studying. And so I studied acupuncture and I studied Chinese medicine and I studied Ayurveda and I studied yoga and tahi and all of this stuff and ended up getting a doctorate in medical Qigong. And so I thought I was gonna, at some point exit anesthesia and b like kinda a.

Integrative Andrew, we type of character. So wait, really quick, just for anyone who's not familiar with that term, what does integrative medicine mean? Like what is, if I put little air quotes around that, uh, that's a great, that, that's a great question because I think it means very different things to different people, but I think it's, um, incorporating some of the best techniques of western medicine and, and then, and amalgamation of good ideas that come from many of those other places.

I discussed Chinese medicine, Ayurveda, um, there's a lot of wisdom in, in naturopathy, uh, and homeopathy. So there are integrative strategies. Try to put together the best, the best of both of those. Best of east. A lot of, in a lot of ways, what that's saying or what you're doing when you take that approach is you're just being like the ultimate learner and you're just looking at any anywhere, right?

You'll go to anywhere for what will work, what will help patients, and you're willing to sort of figure out how to integrate it all together to make a difference. Yeah. That's really, really good. Yeah. That's great. Yeah, it's so, it's so interesting cuz like, one of the things that surprised me in a really pleasant way as I was getting ready for this conversation, you know, I, I didn't, I didn't realize that you had done so much work in the world of like pro sports, you know, all the work you did with the nationals, for example.

Maybe you can talk about that. But the reason I thought it was especially interesting is that, um, you know, I would not have assumed an anesthesiologist would've spent so much time thinking about movement, for example. And I just thought it was interesting how you've gone far afield and you've like turned, you've left the, the do the, the boundaries of the, of your chosen domain, so to speak, in order to find these things out.

And I'm curious, like, how do you approach that? How do you approach that as a learner, like going outside your discipline to find the answers in spaces where you don't know the, you don't know what's going on. It's a self research, it's a self-funded research project mm-hmm. That has basically been trying to solve my own problems.

Okay, say more about that. So then what happened is I was, um, and so then as, as my early bid kind of 1.0 of kind of, uh, evolving away from anesthesia, cuz I felt immediately like, uh oh, I'm just facilitating surgeries that I kind of don't always believe in. Yeah. And so, so then we were doing yoga and, and tai chi and all of these things and, and once you start to do that, then we started setting kinetic chains and how forest moves through the body.

And, and then once you started to do that, then I started this deep dive into looking at musculoskeletal physiology because we were basically trying to, uh, fix problems. And if you could fix, like I had some back stuff and I had some knee stuff and I had shoulder stuff, neck stuff. Sure. So all those from playing sport, grab bag of pain.

I grabbed bag of pain, and so then I was, and so I, you wouldn't believe how many things. So we went into, um, you know, I, I studied, uh, Indian clubs. We were doing strength training. So we were doing all this stuff and, uh, and it in an effort to kind of improve how force flows through the body. Mm-hmm. Ok. And then once you can have it start to flow more efficiently and functionally through the body, uh, those are the same goals that you would have, whether you're a Tai Chi expert or a pro athlete or a weekend warrior.

We're just trying to get, force an energy to flow efficiently through the body. So then, um, I, I happened to go to a meeting where people were teaching hydro dissection, which is this technique where you put fluid around nerves and do Okay injections, uh, to fix pain. And so, I showed up there and then I called my friend Barb, and I was like, you're not gonna believe it.

I found out what I'm gonna do for the rest of my life. Cause I, and, cause I had been doing ultrasound guided injections all day, every day for like 10 years. Okay. And so then I came, I went to a meeting, I was like, oh, I know more than everybody here about this. Like, this is what we're gonna do and then we're just gonna wrap functional medicine around a, uh, a physiological approach to the body.

So then that's, that's basically what I've done. Is there a difference between functional medicine and integrative medicine? There's just massive overlap. And so functional medicine is a, is a. Term that is used for a thoughtful approach to, um, talking to people, gathering kind of a, a real nice, uh, robust history, and then doing a whole bunch of testing.

So for example, like what we were talking about on the phone, Hmm. Testing your vitamin D level, testing, testing a whole bunch of things, and then putting all of that together and correlating it with the symptoms, and then creating treatment algorithms to support people. And many of those treatment algorithms can be integrative, but then many of those are just straight normal Western medicine approaches.

Yeah. That's so interesting. Yeah. I think the way you explained it to me, or that I've heard you explain it before was it's kinda like being a McKinsey consultant as opposed to like just a specialist, right? You're kind of taking this systems level view and integrating across various subsystems in the body to just solve the problem, uh, you know, as opposed to saying, Nope, I just deal with, you know, knees.

Exactly. Exactly. And that, that is how great organizations are doing things in the world right now. Um, taking a systems approach, uh, that's the, the best when medicine's at its best, it takes, takes a systems approach. The systems type approach to solving problems in any domain, whether that's business or medicine or just life is very appealing, right?

It, it seems sort of intuitively appealing, but a lot of people don't know how to do it. So I'm curious if you could tell, tell me a story or tell me about a time when you coached, let's say you had a doctor who was coming from more, a more traditional approach to medicine, more of a siloed type approach.

How do you co, how have you coached that type of person to learn to see and think sort of systemically the way you're describing? Oh, that's a good one. That's a good one. That's basically, I spent like two hours talking to people yesterday trying to figure out how I could do that better. Part of that is giving people really good protocols because then it, because everybody's sort of, it's interesting, everybody wants a protocol, which is the opposite of systems thinking, right?

Cuz a protocol in this sense is like, just tell me what to do, right? Just tell me what to do. Just tell me what to do so I don't have to think about it so I don't have to think about it. And so then people really want that. Doctors want that, patients want that and just tell me what to do and then I'm gonna do it.

And yet, uh, we're trying to constantly new and, and think broader and, and in bigger terms. And, and so, uh, and then so, and so a lot of the, a lot of what I do is I just basically, I'll do it for people. People will come and I'll, I'll talk them through, we'll, we'll do cases and then we'll go back into another room and talk about it.

And I'll be like, well, what did you think about that? And it's a, and, and medicine and. Medicine is an art. And then when, and if you go back to when I first did this, it's like, it's a very collaborative kind of interesting experience when you're in systems because it'd be like we would sit down in a small group of five or six people and then work our way through this case of this 75 year old lady that comes in with ammonia, let's say.

And that would be different today than if it was back then. And, and so then you're, you're constantly evolving and sort of socializing between everybody who's working on it. And that's, that's interestingly how medicine in the best of times happens because, for example, in like in there's grand rounds or, uh, a tumor board, when there's really complex patients.

And so then a group of people will sit and kind of process that together. And, uh, I think when I'm at my best, I'm talking to a bunch of people with different areas of domain knowledge and then putting that together in, in, in, uh, the most logical way. And, and, and thoughtful, thoughtful way. Yeah. It seems like one of your real strengths, just as I've listened to you on other, other interviews you've done and, and watched some talks you've given, it seems like you have a real strength for, uh, I'll say synthesizing.

So like synthesizing large swaths of disparate material in into like distilling it down into like a cogent coherent hole and putting handles on it so that people can actually get it, grab it and do something with it. Oh, thank you. That's like the only thing that I wanna do in my life, actually. It's like, well, you're doing a good job.

So there you go. So I, you know, I really, it's curious, I wanna go back to a, a point in time. So you described to, uh, just a few minutes ago, you were saying something that, like right after you finished your residency right, and you're, you're kind of getting into the world of anesthesia and you have this like, oh shit moment where you're like, uhoh, I, I'm in the wrong game.

And I'm curious like that, that's such, those moments are so scary, but they're also so transformative and like, those are real watershed moments in our life. And I'm curious if you could just talk to me a little bit about how you navigated that. Right. We were talking right before we hit record about the idea of creating your life and the fact that it's sort of this, oh yeah, this, this active choice.

And I, I'd love to hear about how you approach that because that's, that type of moment happens to everybody and it's scary. Okay. So then I'll actually take you back a little bit before that. Okay. To the time when I was gonna go into medicine. If you look at any kid right now that's a senior in college or they're pre-med, uh, what you want is you wanna make a contribution, contribution to mankind and do something great.

You would, and you'd like to do some research, you wanna have a clinical experience where you take care of patients because taking care of patients is like this, the most gratifying part of it. And so you wanna put, but you wanna, you wanna basically construct all of that together and that is the ultimate dream of being a doctor.

Oh. And you, and then you wanna teach. Mm-hmm. So fundamentally, and so then at, at academic centers, you see these guys that are like these, they teach. Couple days a week, they've got a clinic one or two days a week, and then they're, they're in a lab doing research. And so then these are the great and profound teachers that are impacting mankind.

And it's like the, the ultimate dream of being a physician Uhhuh. So I wanted to do that with my whole Arkansas. And, but then I thought, I said to myself, rather than go down the academic road, I'm gonna do a, the, the clinical private practice where I, and you make more money there. And so that was part of the appeal.

And I said, then what I'll do is I will, I'll have more flexibility to control and navigate what I do, and then I'm gonna figure out how to do research and teach and, and then have the ultimate dream of being a doctor that does everything and then make a meaningful impact. I love it. Then fast forward after a couple years and I'm working in the surgery center and I realized that I'm in a role and I'm trapped in the role and it doesn't seem like there's a way to get out and every year that it, you go, it seems harder and harder to get out, and then you get dependent on a lifestyle and so then I, I felt like six or seven years ago, the probability that I was gonna make it out was like, 10%.

And I, and I was like, and I remember, uh, this friend of mine, uh, whose surgery center I, here's this guy Sharam, who I love, uh, uh, I was working at his surgery center and, and he said, here's the thing, just do this thing that you're gonna do and then keep coming to the, and you can do my cases and do, do half the cases to the surgery center and then get your new business going, and then it'll be great.

And then, uh, once you get that going, I go, Sharam, I go, I'm either gonna die or I'm gonna do this and there's nothing in between. And that was great. He looked at me just like you, and then he goes, okay, okay. There's, there's nothing else to say. And so, and, but I was doing, I was doing the integrative medicine and, and uh, America wasn't really ready for integrative medicine at that time.

What year was this? This is from essentially 1998 until like six years ago. Okay, so it's like 2014 ish. Yeah. And it was like, I was even like, uh, I ran into a bunch of anesthesiologists the other day at dinner that I used, but right before quarantine and they go, cook, you were right. What they were, we made, we mercilessly made fun of youth, uh, for being gluten free, but then it turns out everybody's like gluten.

So, but so then, but, but what happened is, is once I figured it out, that, and, and I had always told myself the story cuz I heard this story about, um, two people. Who were lawyers who wanted to change their career. And I, I, I heard it, I think on Tim Ferriss. And it was interesting cuz I started listening to Tim Ferriss years ago and I was like, and he gave me the hope that I was gonna get, be able to get free.

But the's awesome story. The story was that there was this one lawyer and so she, she opened up a yoga studio and then this other, they both hated their job. And then there's this other lawyer who became this expert in this super narrow thing of import, export legal stuff. So then what happened is he got the things that everybody wants, which is autonomy, money, and respect.

Yep. And then basically she moved into a commoditized market where she wasn't able to get the respect she wanted because she's just like an average yoga teacher. And so the whole thing ends up not paying off. Mm. And so for me, what happened is I started doing all of these nerve treatments and fixing peripheral nerve pain and back pain and stuff like that, that was super derivative of, of what I'd already been doing for 15 years.

But it was just like a, a, a, a modified approach. Mm-hmm. And so then that, that allowed me to sort of like be who I am within my medical practice. And, um, it's like the greatest thing of all time. Like I, and, and even, even now, like I had an, and I, I said I finally have started to make contact with anesthesiologists.

Because they're, I had one fly and, and I trained him for two days this week and they're so easy for me to train cuz they already know like the how to be sterile and how to do, do injections. Yeah. They've already got all this stuff. Like fine. Yeah. So then it's, and I, I. I was awesome because next thing you know, he's following me around and picking stuff up and, and, and doing things.

And I was like, if this is gonna be so easy. And then, and then, and so then what happens is I, I am ecstatic cuz I realized he's gonna be free. Like, I'm literally like going into the Matrix and unplugging him like Neo and then like he's gonna be free and he's gonna go do whatever he is gonna do, you know?

So it's kinda cool. You said something really, really powerful but you said it so casually that I have to go back to it, which is you said something like when you're doing this, you finally, you feel like you're finally getting to, to, you know, be who you are and what's, I'm curious when my experience, there's always like a moment or a kind of moment that is what gives rise to people saying something like that.

And I'm curious when you think about that moment that has you like where you just click in and you go like, yeah. This is, this is me, this is my moment. What's that moment for you? Okay, so the, uh, my friend, uh, Jesse told me this one, and which is interesting is she goes, when, when you start to you, she goes, in life, what you're going to do is you're gonna start to attract patients.

And fundamentally, the patients that you attract all have the same problems that you have, but you've just sort of, you've either fixed your problems or you're very well on your way to fixing them. And so then you have some problem as like 95% fixed. And so then it's like, if you had that problem and it was only 10% fixed, I would be like, oh, I totally got you, because I figured that out.

Mm-hmm. And, and so, um, and so then for me, what happened is all of a sudden, I, I spent from the time that I was 16 until now, trying to fix a bunch of stuff like the back and the knees and the shoulder and all this stuff. And I remember like sitting with a journal and when I was 17 saying, this is gonna be the year you're the legs.

I'm gonna go do squats and I'm gonna be jacked and it's gonna be amazing. And then I hurt, I got hurt. And so then I was like, oh God. And so then, but then what happened is next thing you know, we started fixing all this stuff. And so then now I walk around in clinic and it's like, I see these things that's like, oh, I used to have that.

And so then, and I, it's like, it's like almost ecstatic for me because I realize, oh, I know how to fix that. And so then I just love doing it. And then the, the, maybe the most interesting thing is, is that I think like a huge percentage of anesthesiologists kind of have, are running about like 20% PTSD all the time.

Mm. Just because it's so unbelievably stressful. Because like you meet some 75 year old grandmother and you're doing some surgery for her, and you appropriately managed everything, got everything prepared, but then all of a sudden she starts having arrhythmia, which is like in irregular heartbeat, which those genre of things happen all the time.

But if you meticulously manage it, then you can fix it right away. And so I had thousands and thousands of times where there was a problem and then I fixed it. And if I was so sort of super, super focused and which I spent every second trying to do, then you never have any problem. But you're living with the fear of that problem.

Yeah. You're always waiting for that shoe to drop. Yeah. And so, uh, so and so those moments of terror sort of drive you into being stuck a little bit in, in a fight or flight state. And um, and so then a huge part of my early practice was then just healing all of that stuff. And it turns out everything that we do is like quite helpful for that.

And when I was in medical school, I remember these guys, they were like, Hey, don't go into, like, don't go. It's kinda like walking around the va, they're like, oh, don't go take care of, do anything in ptsd cuz they never get better. Yeah. That was this conversation that was like going on among the doctors.

And so then. If you're having that conversation going on, then when you start to get a little of ptsd d then you're thinking, oh, but I would, I learned in medical school that they never get better, so I'm totally screwed. So that's the existential, um, angst than of an anesthesiologist because you, you're, you're, and, and I ran into an anesthesiology friend of mine and he goes, the problem is, is that you get re-exposed to the same potential trigger every single morning.

Every morning you go back to work and you meet someone, and then you do anesthesia for 'em, and then it's super dangerous, and then yet somehow you magically get through it. But they're, you're, you're afraid because you remember this one time last year or two years ago, or whenever it was, when something almost happened.

And so you're continually, so, uh, so we, we do a lot in the PTSD wellness front, which is the joy of my life because I feel like, uh, that. And musculoskeletal and infectious disease, I think are the three areas that I'm gonna make some a real impact. I think. Sean, I want to actually switch gears here and start to talk about that a little bit because I know you are kind of one of the, one of those guys out on the forefront of this type of work, right.

In terms of treating, you know, what you, the way you described it to me was that your clinic, you basically see 2, 2, 2 kind of categories of, of patients, you know, bucket one is somebody who's very much in the like human performance and optimization camp where you know, it's a total biohacker or maybe a high net worth individual or something like that, where they're really just trying to get everything possible out of what they've got to work with.

But then there's this other camp of like, you know, cases that everybody else thinks are hopeless. Right? Right. And that's really kinda what what you're speaking to and, and you've had really amazing success there, working with a variety of therapies, including ketamine. I was talk to, talk to me a little bit about that, like.

You know, in particular, the thing that I, you had said to me before that I'd love to hear you talk about a little more is you mentioned to me how it's such a, there's almost like this massive societal roi, uh, or a huge yield on, like being able to reset our most vulnerable people. And that's, I think, exactly what you're speaking to right now.

Ketamine is an amazing way to help people, and it's a, it is, you could, you could do something profound to help the most disadvantaged people. Ketamine a as an anesthesia drug that I've been, uh, using as to help, uh, because it's, it's good for pain relief and it's, it's a great, uh, it's a great component of an anesthetic.

So I've been using it for patients, um, for 20 years. But it turns out, uh, it can be very helpful for people with drug resistant depression and ptsd, and it's a mild psychedelic, but then it has this term I've been using, it's, it's called psycholytic. Hmm. And so if there's an emotional trigger and someone's on ketamine, that emotional trigger can go from like a eight or a 10 to a zero.

And because you remember everything that happens in that experience, you're able to sort of process the fact that this thing that I was like, really wired up about all of a sudden turns into total calm. And so then Ima and, and we do it with therapy where we'll be talking to people and they're, they're super frustrated about something.

And then, we'll, and then next thing you know, they're doing ketamine. And so then we say, Hey, What do you think about this? What do you think? How, how would you, and now normally you, you, that person would be, would be like, well that's not true for me. Just like, just you can imagine a million people you've met just like a snap response.

Including, including probably Yeah. Ourselves. Right? For sure. We all got 'em. And yet I, in that state, people go, oh, oh, that's a good idea. And so now, and next thing you know, you're, you're talking. So like, my, my total favorite on this and it's kind of interesting cuz my dad's a psychologist. Okay. And um, and that's partly how I ended up in this whole thing.

Cause I went into that, that does make sense. I went into anesthesia kind of to avoid psychiatry because I was, there was a joke in our family that psychiatry didn't work and, and. I see a lot of, uh, psychologists who come to see me who are in their sixties and seventies, who were somewhat overwhelmed by the, the stress of the experience of their career.

And then what we'll do is, and, and I did this with my, with my dad actually also, which was like the greatest thing of all time Wow. For, for our relationship. And so then what happens is, um, we, we, um, process through stuff and it's like all of a sudden you can talk about a bunch of things that before you didn't think you could talk about.

Hmm. And if you can just, sometimes, if you can just have a therapeutic conversation where you can kind of get that stuff off your chest and then you, you can see that there's a trajectory for getting better. And that, I think is the thing that happens with ketamine. And so then all of a sudden, People were like, I act, I think I'm actually gonna be okay.

So sort of like introduce like a new it actually, like they can see hope where there was none before. Right now, the lack of hope was, was, uh, partly related to the fact that the emotional triggers were so profound that it didn't allow them to see any, anything else. But then as the triggers go away, then you're kind of just like, uh oh.

Oh, that's an interesting idea. So this, this idea of triggers is really fascinating, right? Because they're, it's something we all have, and everyone who has even an ounce of self-awareness has experienced and noticed themselves, like wildly lose their shit over something that was like, you know, they, they've blown something way outta proportion.

We've all done that. Um, but I'm super curious, like, could you, could you sort of in layman's terms, explain a little bit about like what is this link between our neurophysiology and our psychology? Like what is a trigger in our brain and like what is actually happening in the brain when you ha when you work someone through this ketamine treatment that allows what you're describing this reframing to actually occur?

Okay. That's a really, that's a, that's a great question and I hope that I'm gonna do justice to it. Um, We have our consciousness and our framework of how we create our identity and our structure of, of our preferences and, and who we are. Okay? Now then that's intimately mapped into the limbic system. Mm.

And so then the limbic system is emotions. And now, interestingly in the limbic system, I'm, I've had this new way that I've been thinking about this, which is this, that there's emotions that are in rest and relaxed mo emotions, and then there are fight or flight emotions. Okay? So the fight or flight emotions are like fear and anger.

And worry and change. And so then those are good emotions and super useful because if the house was on fire, I might need to use anger to motivate somebody to do something or I might have to. So, so, and we've been running through, through these emotions forever. Okay, now then the rest and relax. Emotions are love, acceptance, gratitude, all the.

All the the touchy-feely good ones that we wanna be running. All the warm fuzzies. The warm fuzzies. Biore Reset Medical is a medical practice specializing in integrative therapies and advanced wellness protocols. At Biore Reset Medical, we treat some of the most challenging to diagnose and difficult to live with ailments that people suffer from today, including Lyme disease, chronic pain, P T D, and mycotoxin illness.

Our team has a wealth of experience in advanced integrative strategies to get you to optimum wellness, many of which can be conducted remotely from the comfort of your own home. Right now, our team's approach is to use the most non-invasive, natural, and integrative way as possible. Find out how we can help you by reaching out to us at 6 5 0 8 8 8 7 9 5 0, or at our website, www.bio.

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Now then the way that our, our brain works is that our prefrontal cortex and all of our senses are mapping into this part of th