FTG 0057 – Osteopathic Medicine and Comprehensive Medical Care and Administrative Careers with Anesthesiologist and Influencer Dr. Elizabeth Zona ’02

Episode 8 November 28, 2023 01:20:50
FTG 0057 – Osteopathic Medicine and Comprehensive Medical Care and Administrative Careers with Anesthesiologist and Influencer Dr. Elizabeth Zona ’02
Following the Gong, a Podcast of the Schreyer Honors College at Penn State
FTG 0057 – Osteopathic Medicine and Comprehensive Medical Care and Administrative Careers with Anesthesiologist and Influencer Dr. Elizabeth Zona ’02

Nov 28 2023 | 01:20:50


Hosted By

Sean Goheen

Show Notes

CW: This episode includes discussions of child abuse, substance abuse including drugs, alcohol, and overdose, and terminal illnesses.


Dr. Elizabeth Zona ’02 Sci (“Dr. Z.”) s a double board-certified physician, specializing in both Anesthesiology and Addiction Medicine. She is a medical director for Anesthesiology at Three Rivers Endoscopy Center and Medical Director for Addiction Medicine Services at Laurel Care Treatment Center. Dr. Z. joined the show to talk about her experiences at Penn State Beaver and in the Eberly College of Science and dancing at THON in Rec Hall. She provides great insight into choosing the right medical school and share her perspectives on osteopathic medicine as a 2006 graduate of the Philadelphia College of Osteopathic Medicine. She also highlights her work in anesthesiology, including how she found that as her specialty, and subsequent work in both addition medicine and as a medical administrator. This episode is great for any Scholar, and especially those interested in medicine or healthcare, those in STEM majors, those interested in one day starting a family, and those who either experience(d) personal struggles, or had friends or family struggle with, drugs and alcohol. Dr. Z’s bio and a complete breakdown of topics discussed are available below.

Guest Bio:

Dr. Elizabeth Zona ’02 Sci is a double board-certified physician, specializing in both Anesthesiology and Addiction Medicine. She is a medical director for Anesthesiology at Three Rivers Endoscopy Center and Medical Director for Addiction Medicine Services at Laurel Care Treatment Center, both in the Coraopolis, PA area. She earned a BS in Pre-Medicine with Honors in Chemistry from Penn State’s Eberly College of Science in 2002. She earned her medical degree from Philadelphia College of Osteopathic Medicine in 2006. After completing an additional 4 years of residency training at UPMC-Mercy she became board certified in Anesthesiology in 2011 and has been a practicing anesthesiologist for over 13 years. In 2016, after losing a friend to opioid overdose, Dr. Zona decided to take on the additional education and training in Addiction Medicine and became board certified in 2019. She has been active with addiction prevention efforts and treatment, while advocating for those in recovery, for over 6 years now. She is happy to speak further about medical school, osteopathy, the fentanyl epidemic, the dangers of counterfeit pills, alcoholism, nicotine dependence and more. Please feel free to connect with her on INSTAGRAM or TikTok, @addictiontokdok.

 Episode Topics:


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Credits & Notes:

This show is hosted, produced, and edited by Sean Goheen '11 Lib (Schreyer), '23g Bus.

The artwork was created by Tom Harrington, the College’s Web Developer. 

The sound effect is “Chinese Gong,” accessed via SoundBible used under Creative Commons License. 

The theme music is “Conquest” by Geovane Bruno, accessed via Pixabay and used under Creative Commons License.

View Full Transcript

Episode Transcript

[00:00:01] Speaker A: Greetings, scholar, and welcome to following the Gong, a podcast at the Schreyer Honors College at Penn State. Following the Gong takes you inside conversations with our Scholar alumni to hear their story so you can gain career and life advice and expand your professional network. You can hear the true breadth of how Scholar alumni have gone on to shape the world old after they rind the Gong and graduate with honors and learn from their experiences so you can use their insights in your own journey. This show is proudly sponsored by the Scholar Alumni Society, a constituent group of the Penn State Alumni Association. I'm your host, Sean Goheen, class of 2011 and college staff member. If this is your first time joining us, welcome. If you're a regular listener, welcome back. You content warning this episode includes discussions of child abuse, substance abuse, including drugs, alcohol and overdose, and terminal illnesses. Dr. Elizabeth Zona, Class of 2002, or. [00:01:07] Speaker B: Dr. Z is a double board certified. [00:01:09] Speaker A: Physician specializing in both anesthesiology and addiction medicine. She is a medical director for anesthesiology at Three Rivers Endoscopy Center and medical director for addiction medicine services at Laurel Care Treatment Center. Dr. Z joined the show to talk about her experiences at Penn State Beaver and in the Eberley College of Science. [00:01:27] Speaker B: And dancing at Thawn and Recall. [00:01:29] Speaker A: She provides great insight into choosing the right medical school for you and shares. [00:01:32] Speaker B: Her perspectives on osteopathic medicine. [00:01:34] Speaker A: As a 2006 graduate of the Philadelphia College of Osteopathic Medicine, she also highlights her work in anesthesiology, including how she found that as her specialty and subsequent work in both addiction medicine and as a medical administrator. [00:01:47] Speaker B: This episode is great for any scholar. [00:01:48] Speaker A: And especially those interested in medicine or healthcare, those in Stem majors, those interested. [00:01:52] Speaker B: In one day starting a family, and. [00:01:54] Speaker A: Those who either experienced or experienced personal struggles or had friends or family struggle. [00:01:59] Speaker B: With drugs and alcohol. [00:02:00] Speaker A: Dr. Z's bio and a complete breakdown. [00:02:02] Speaker B: Of topics to stressed are available in. [00:02:03] Speaker A: The show notes on your podcast app. [00:02:05] Speaker B: With that, let's count backwards from ten. [00:02:07] Speaker A: And get right into our conversation with Dr. Elizabeth Zona. Following the Gong. [00:02:18] Speaker B: Me here today on following the Gong is anesthesiologist and addictionologist dr. Elizabeth Zona. Dr. Z, thank you so much for joining us here on the show. [00:02:28] Speaker C: Oh, thanks for having me. [00:02:29] Speaker B: If you're a regular listener, you know I always like to start with asking how you first came to Penn State. [00:02:35] Speaker C: So for me, that was the only school that existed. Because my sister had gone and graduated from Penn State University in 96 and having been a teenager while she was in college and hearing all the fun stories and getting to visit her at the family weekends and seeing the pride in my parents eyes with her graduation. To me, that was the only school I ever wanted to go to. And actually, the only college I applied to. [00:02:59] Speaker B: Well, that was a bold choice. So I'm glad that you got in and you shared that you started at the Penn State Beaver campus, is that right? [00:03:06] Speaker C: I did, yeah. Unfortunately, my dad was ill with a terminal illness, and so I wanted to stick around, stay close at first, and so I did. I lived with my parents and commuted to Penn State Beaver. It really worked out well for me. [00:03:18] Speaker B: Yeah, I think that's a great choice for students who are in that situation, maybe for economic reasons as well, if they need to keep a job close to know. Living at home can be a great way to help afford education. So great choices there, and obviously you got on the honors track. So tell us about your experience at Beaver and how that set you up to get into the Schreyer Honors College. [00:03:38] Speaker C: Yes, it was interesting. I would say my freshman year at was sort of I felt a little bit like I had taken on more than I was ready for. For a period of time. I got a little nervous, and it wasn't because I wasn't doing well. I was doing well, but I think it was just the adjustment from high school to college and just the rigor of you couldn't declare your major yet as a freshman. But I was in the Science College, taking all of the premed requirements, and it was hard, but I was getting straight A's. I was doing great, but just that sort of, am I crazy to think I could do this? Mentality. And so at some point in my freshman year, I had confided that in my chemistry professor just basically had made some kind of a comment of, like, I don't even know why I think I'm doing this. This is crazy. I'm not maybe enough for this. And he really quickly kind of replied with, whoa, whoa, whoa, don't go there. If you saw you the way I see you, you'd realize you have what it takes. And he very quickly became a trusted mentor of mine, and we ended up doing a research project together. And through that we presented at Main campus, and we won. And I couldn't believe we won first place in the physical sciences division at the undergraduate exhibition. And I was so proud of that. Still am. And so at that event, he had said, you should be in the Honors College. Somebody recently had set the precedent that you could be at a branch and I would be the second. I believe it just happened. I believe somebody was at the Barron campus, and so I applied and got in. So that was how that started. [00:05:16] Speaker B: Awesome. And for any prospective students listening now, you can start at any campus and get into the Honors College. There's only certain ones you can finish at, of course, but you can start at any of our undergraduate campuses. So just want to make sure things have changed over time. So if you're a prospective and listening just for clarity there. So you get up to University Park. How did you adjust coming from Penn State Beaver, which is a smaller campus outside of Pittsburgh, all the way to State College, which obviously it's a massive campus here. What was that adjustment like? How did you get plugged in as a scholar know, figuring out classes and the campus activities and social life here? [00:05:53] Speaker C: So a few things were helpful. Being in the Honors College was helpful because you did have priority selection of when you would select your class schedule. And so I was able to sort of make that kind of work for me. And you also had smaller classes once you got to sort of some of the higher level honors courses. And so I got to know people because even though it is a big school, the Honors College makes it a very approachable number of people that you're dealing with on a regular basis. Also, I joined Alpha Epsilon Delta. I'm not sure if it's still there, but it was the Pre Medical Honor Society, and that was really helpful to me because they would have some sort of philanthropy things. That's who I did, like dance marathon and some other things with. And that was nice just because it broke it down to a smaller group and you could have all the benefits of the coed fraternity life without sort of having to be at that party kind of scene. So I really liked that. That helped to kind of get me in, I'd say. [00:06:51] Speaker B: So what was it like? You mentioned dance marathon. What was it like dancing in Thawn at I'm guessing rec hall based on. [00:06:58] Speaker C: When you yeah, yeah, I think it was yeah, I'm really bad at geography, but up by where the lion is. Yeah, that's where it was. Yeah. So it was huge and overwhelming and completely out of my comfort zone, but one of the most amazing experiences I've ever done in my life. And I remember when they had asked that was through Alpha Epsilon Delta, and I remember they had said, like, if anybody's interested, we're looking for somebody to represent us as a dancer at dance marathon. And I immediately seems to sort of be a theme with me. I immediately thought, that's crazy, I could never do it. And then my second thought is, how do I sign up? So I kind of, again, was like, outside of my comfort zone, but the way I thought it through was, if I'm serious about going to medical school, I'm going to have some really long shifts. If I'm going to be a resident, I'm going to have call. I need to prove to myself that I can push through when I really want to just collapse and quit. And so that was kind of how I saw it. And then once you start getting involved, you see those kids, and any problem that you have is like a big nothing, because you're talking about really little kids with really big diseases. And so once you get involved, it's just amazing and life changing and exhausting and awesome. [00:08:14] Speaker B: That's a great perspective. I've heard a lot of different takes on Thawn on different episodes of this from folks who've been involved as directors or dancers, but I never thought about the practice, essentially for being on a doctor shift. So that's really cool. I have to ask, what are the reactions you get from your fellow medical professionals when you explain that you did that in college, like, by choice, not because you were on shift? [00:08:41] Speaker C: It's interesting. I think we all have our own experiences with shift work and call. There's a reason I don't take overnight call anymore, we'll put it that way. I love sleep. I like to be able to have restorative sleep. I think it's important for emotional and physical health. But yeah, I think there are actually a lot of Penn State alumni who are out there who say, wow, that's impressive that you did that. And they didn't do it for that reason, because it's exhausting. 48 hours is longer than any shift I've done as a doctor. But I will say I had a med school interview a couple of days after, and it was an instant icebreaker because the person interviewing me had also participated in fawn at Penn State, and it was just boom. It was the perfect interview. I was so excited because I was exhausted and I wasn't sure how I would perform on that interview. And when I said, oh, I'm sorry if I seem a little tired, or I had slipped my foot out of my shoe because it was so swollen, and they kind of noticed, and I was like, oh, I'm so sorry, I should have explain. I did this dance marathon like I did Son too, and it was just instant bonding. [00:09:40] Speaker B: That's incredible. So you kind of mentioned in a lot of your answers so far that you were intending to go to med school. So when did you figure out that was the track you wanted to go down, that you wanted to be a physician? [00:09:52] Speaker C: Yeah, so it's interesting. I mentor some premeds now and high schoolers, and I hear they're really working on things very early. To me, I feel like it was a lot more laid back, but I knew what I wanted to do. I just didn't necessarily have it set up ready to go. I wasn't logging hours of any shadowing or anything at the high school or early college time frame. I was the youngest of four, and I remember whenever my one sister was real squeamish and our other sister was kind of accident prone. So you put us all together and the one would be like, oh my God, I'm bleeding. I fall off my bike or something. And the other sister would be like, oh, I can't take it I'm running away, and I was like, running to it. And I'm like, I want to fix that. I want to help. I'd be like, cleaning it and hydrogen peroxide and dressing it. And we kind of joked around. When I was young, I remember one of my aunts, they had said something about like, oh, I'm meant to be like a nurse. We had had a great aunt that was a nurse, and somebody had said, like, well, she could be a nurse, she could be a doctor, she could be anything she wants. And I thought, yeah, like, doctor, that sounds cool. So really young. I remember thinking like, okay, I want to go to med school. I had wanted to be an adolescent psychiatrist, though. That was like, my thing. I used to write about it. As many people will tell you when you start your path, your specialty of vision, your choice often changes over time. But it's funny that I've kind of circled back a little bit because I do talk to adolescents and I do talk about a lot of mental health topics. So I think that was always in there somewhere. [00:11:19] Speaker B: Well on the path there. So getting into med school is its own beast. But before you or I guess concurrently to the med school applications, if you're coming going straight from undergrad to med school, you're Schreyer scholar, you obviously need to do your thesis kind of at the same time as you're doing those interviews and everything. So tell us about your thesis topic and the experience of doing that and how it may have influenced your med school career, your schreyer as a physician. [00:11:49] Speaker C: Absolutely. So I had mentioned Dr. Simpson and how he had sort of more faith in me than I had in myself, and he involved me in a lot of things on campus. But this research project was basically we came up with a new way to quantify antioxidant activity. So antioxidants, we still talk about them now, but it was sort of the big buzzword, if you will, in the late 90s, early two thousand s, to the point where everything was saying, now it's GMO or keto or whatever. That was kind of the big thing where it was like antioxidants, antioxidants. Your orange juice, your everything that you would buy would boast its antioxidants if it had them. But nobody ever really said how to compare those or how to know, do you have 1 something that isn't even bioavailable and I'm going to spend all this money because I think I'm getting antioxidant activity, but I'm really not. And we sort of talked about how it was kind of not really fair to consumers to just say, oh, we have antioxidants, but not to be more specific, like they deserve to know how much and how they work and is it going to help me or is this something that oh, technically it's an antioxidant, but also know harmful to me. So we had looked at they had talked about the French paradox and know, in theory, the people of France had a higher fat diet and yet they had less cardiovascular disease. And there was this question of was it the wine? Was it something in the wine? And so we sort of started air and we looked to see what had been done so far in the field. And there was a I believe his name was Edwin Frankl. It's been a while since I read my own report, but I believe his name was Edwin Frankel. And he had some data out there, but it was all done in human studies. It was in vivo. We would call that. It was expensive. It took a long time. And our thought was, what if we could come up with something that's in vitro so that you would do in a lab, so that anybody could perform this, even freshmen in college or sophomore in college, and that we could do it quicker, cheaper, and yet get comparable results and we could really measure different antioxidants or claimed antioxidants. Number one, do they actually inhibit the formation of oxygen, like free oxygen radicals? And number two, how do we kind of quantify that and compare products? So that was our whole sort of thought and where that started. And because we were looking at the French picture, we decided to start with some compounds that were frequently encountered with different wines. So things like resveratrol was a big one that we were looking at and multiple other compounds. But we got it down to, I think, like six or eight compounds that we compared, just the compounds themselves. So we ordered them from a chemistry catalog and tested them. And once we saw that, yes, they did have antioxidant properties and that you could measure them in the lab with the gas chromatograph before and after the experiment, you could compare them. Then we decided to actually purchase different wines and basically boil them down to a Sludge and then test the Sludge and compare different wines. And our thought was, if we can come up with something that's easy, fun, and quick and not expensive, then you could kind of test all different products and see which ones have these benefits. And so that was what we had presented that year. It would have been my sophomore year. And that was when we had won that award because I think it was such kind of a new idea and really a hot topic. So then that kind of naturally led to me meeting some people in the honors college and being suggested and recommended and going from there. Now, how I use it today, multiple ways. I would say that, for one, I ended up with an honors in chemistry, which I would not have foreseen that because chemistry to me in high school was very hard and it just wasn't fun. When I got to Penn State, Beaver dr. Simpson really made it fun. He made it approachable, he made it understandable, he made it applicable. And he involved me in not just learning it, but teaching it and using it on a day to day basis. And so he remained my honors thesis advisor throughout my years at University Park, actually. And that when I would come home. I'd visit the lab and get some hours in the lab and those sorts of things. But anyway, so chemistry became, then something that no longer intimidated me. And as you'll know, anybody who goes to medical school, you need to have a really good concept of basic chemistry to understand biochemistry and the higher levels of biochemistry. And so that was very important. And the other thing is, I'm still very proactive as far as making sure that people know that what they're getting is what they think they're getting. Right? So I won't digress too much, but to say I do a lot of community awareness events about drug and alcohol prevention and awareness. And one big problem right now is if you get a pill from anywhere other than your doctor or your pharmacy, chances are it's counterfeit, it's fake, it looks like a percocet, but it actually has fentanyl in it and people are dying. And so that's one of those big things that I feel like it's a bigger and more complicated version of that, but I'm still telling people, Buyer beware. Just because somebody says something's, one thing, doesn't mean it is. And you should really educate yourself to make sure that you're being safe. [00:17:03] Speaker B: Wow, it sounds like you just wrote your thesis, like, yesterday. It's so fresh in your mind. That's incredible. [00:17:09] Speaker C: It was a lot of fun. I loved it. I had no idea that I would ever love science that much, to be honest. [00:17:14] Speaker B: Well, you definitely have integrated it into your career, so that's really cool to see. I think there's a big myth. Sometimes students think, oh, I'm never going to use this. I'm not getting a PhD. Why do I need this? But you can use those skills no matter what you're doing. So I think you're great evidence of that. And you talked about med school. So walk us through your process on how did you decide what med schools to apply to, and ultimately, how did you pick the right one for you? And thinking of in a way that students listening, if they're thinking about grad school, med school, law school, what are those factors and how they can pull that into their own decision making, right? [00:17:49] Speaker C: So something important to remember is you have your eye on the prize of becoming a doctor, but who you are and where you come from doesn't change. And sometimes you just want to get out of wherever you are. And I completely understand that. But in my situation, like I mentioned, I had a father who know, in essence, dying slowly at home, and I didn't want to go that far away. So I know a lot of people that have said, oh, I want to go to California, or, I want to go to Florida and sort of this get out of here mentality. For me, it was, I want to be close enough. If there's an emergency at home, I can get in the car and drive home in a reasonable time. But I also want to be far enough away from my hometown friends, and I still have a lot of friends that maybe they didn't go to college or didn't go to graduate school. I didn't want it to be where I felt guilty if I couldn't attend their wedding shower or their happy hour or their weekend event. So I needed that distance to kind of be on my own. The Dixie Chicks had a song at that time, Wide Open Spaces, and it just really resonated with me. Like, I needed to separate myself from the group that I had been with in high school and early college, but I also didn't want to be so far away that I wasn't able to get in the car and come home. And so for me, it was either going to be somewhere in the state of Pennsylvania, which was where I had grown up, by the Pittsburgh airport, or somewhere maybe Ohio or West Virginia, but I wasn't looking any further than that kind of tri state area. So I applied to several schools, but not nearly as many as a lot of people that I know. Keep in mind, too, that applications are expensive and you have to pay for every application, and oftentimes most cases, there's a secondary application. And there were some where I was offered, like, the secondary application, but I literally didn't even have the money to get the secondary application to them. My parents did not have a lot of money, so basically my part time job was like applying to scholarships. You'll see, I had a lot of scholarships because I made it a priority to apply for them. And so those were kind of my deciding factors. And I did. Like, WVU. I did like Ohio State. So there were a couple that I was very interested in. Penn State. Hershey was a very top contender of mine. And I had been what they call a Primary Care Scholar, which means I went through a program my senior year where you spend time with a physician, but you also spend a week on campus at Penn State Hershey, and you learn about sort of what med school's like, and you get to meet the med students and things. And I also really like the idea of Philadelphia being from Pittsburgh. I liked the idea of checking out another city in my home state and getting comfortable there. As I told you, I wanted to get outside of my comfort zone. I wanted to get outside of my comfort zone, but not into some foreign land, if that makes sense. And so when I was offered the spot at PCOM, which is Philadelphia College of Osteopathic Medicine, I had not yet heard back from Penn State, and I was getting antsy. And those were my top two choices, penn State and PCOM. And when I went to the interview for PCOM, carol Fox had interviewed me, and that's what I told you. She had been a Penn Stater and she was like, oh, my gosh, dance marathon. And we just clicked. I loved the visit. I loved the campus. I loved the people that I met. And it just felt like home. And so I guess my big lessons are, know, it's not just the role you want to fill, it's who you are and what works with who you are. Because if you try too hard to be somebody that you're not or go somewhere that you're not, it may never just feel right, but then you also have to experiment a little bit outside of your comfort zone. Know, for me, Philly was a totally different experience. Lived there for a few years, loved it in a lot of ways, but was happy to come back to Pittsburgh. And so that would be my advice, know, think outside of your comfort zone, but also remember who you are. [00:21:34] Speaker B: You mentioned PCOM, right? And it is the Osteopathic Medicine, and you have a do as opposed to an MD. Can you explain the difference for those of us who are not as familiar with the intricacies and the differences and everything that goes along with that? Because you are a full doctor, but I know that much. But I know there's some nuances, so please explain those. [00:21:56] Speaker C: Yeah, no problem. So back in, I think and I have a note here, so I have it right? Because I don't want to do dr. Still anything wrong, but dr. Still. Yes, at still. So he founded Osteopathic Medicine back in 1874. So it's a medical practice that has been around for a very long time. It's nothing new. It doesn't mean that you have somebody that doesn't have experience or doesn't have that background training. He was a military surgeon during the Civil War, and he was actually an MD. And after the death of his first wife and three of his children, back then, he felt that there had to be a better way to practice medicine. And remember that back then they believed in the four humors and they were bloodletting, and medicine was very archaic. Right. So they were very smart and some of the smartest people around, but it was still very experimental and it was very based on, this is the problem that we're going to fix. And so he started the Osteopathic Medical community. Basically, it's the same amount of years of medical school. And nowadays they didn't have formal residency training back then, but nowadays it's the same residency for specialties. Like, I was one of I think two or three dos in my anesthesiology residency class and there were five of us, so you're going to see it in any specialty. But basically his main theories or theoretical sort of ideas were that the body is one unit and that the person is made up of the mind, body and spirit. So it was more of a holistic approach. It wasn't just this is the medical problem and we need to come up with some medical intervention. It was also remembering that the body has an innate ability for self healing and for self regulation and for health maintenance. So first, the first and foremost priority in osteopathic medicine has always been to sort of tap into what the body is currently doing now and try to optimize its ability to heal itself. It's not naturopathic, it's not equivalent to any other specific functional medicine that you hear. It's just basically at our core of our values, that structure and function are reciprocally related and that rational treatment is going to rely on those principles. We're just more inclined to, or at least in our training supposed to be more inclined to focus first on the person and the holistic unit of mind, body and spirit and sort of do some lifestyle integration, maybe some hands on manipulative medicine either in addition to or before reflexively going to medical treatments. And obviously you can't use that everywhere if you have a cancer, it's got to come out kind of thing. That's where the core principles started back in the 18 hundreds. And so we do everything that an allopathic or MD school does in those four years with the addition of an osteopathic manipulative medicine class. So you actually have one extra lab and one extra lecture typically every week. And so it's a little bit some people might be like, well, I don't want one extra class, I already have so many classes. But if you really kind of buy into those principles and you really enjoy that philosophy, it might be for you. I had grown up with a back problem, actually just had two back surgeries this summer. I had an injury when I was like seven years old. So for me, I had been going to a chiropractor my whole life. And the concept of when I went to my interview at PCOM, I mean, I was sold. When I realized that you also do hands on medicine in addition to everything that traditional medicine does, I was sold on it. So I really enjoyed that extra component of the medical background. But keep in mind too, that we take all the same board exams. We have one accrediting body as far as the ACGME. They oversee all residencies, allopathic osteopathic. We take all the same boards. We do have specific boards that we have to take complex so that will have your osteopathic principles in there and all of the allopathic science. And you don't have to take the USMLE's. But most of us do just because we take them at the same time. You're already prepared for the test. I found that USMLE just I didn't have to study for the OMM part of it, but everything else was very much the same. And I took both tests the whole way through step one, step two, step three. And so to me, I wanted to make sure because I didn't know about osteopathic medicine until I was applying for med school, and so I wanted to make sure to myself that I had checked all the boxes and that I wasn't missing anything in my education. And I did. I passed with flying colors all of my medical boards for the allopathic boards the whole way through, first time, no problem. So it's a great medical education. [00:26:35] Speaker B: That's great. And I definitely learned a little bit there. I hope that you listening. If you weren't familiar with the differences, especially if you're on the med school track and trying to decide between these two, that that was helpful. [00:26:45] Speaker C: Yeah, there's nothing I can't do that an MD could do. We have all the same rights and responsibilities. [00:26:50] Speaker B: So let's talk about you mentioned residency, and there's the matching process and starting to figure out which specific track that you want to go into. General medicine, neurosurgery, and in your case, anesthesiology. So walk us through that process. And again, going back to probably I wouldn't be surprised if your answer builds on what you said before about picking med school, but walk us through how you approach that process and how scholars can think about that when they're in this position. [00:27:19] Speaker C: So if you were starting out in med school, your first two years are primarily and this doesn't matter which med school you go to, your first two years are primarily classroom based. So you're mostly in the classroom from early in the morning to late in the evening and sometimes anatomy lab in the evening. You're studying a lot, studying most of the night. Some schools do have, and especially nowadays, some virtual components, but there's a lot of in class learning those first two years. The only summer break that most med students will ever get is the summer in between first year and second year. And a lot of students choose to work that in some way to somehow build their experience. I did not. I took that time, and I was like, I am relaxing. I am enjoying. But then when your third and fourth year come, it's what's considered the clinical years. Right? So med school, that you could call it your Ms, one, Ms. Two, Ms. Three, Ms, four years. So one and two are mostly classroom, and then three and four are mostly what we would call you could call it a clerkship, you could call it an externship. But it's a rotating schedule. So that typically every month. But there may be rotations that last more than a month. Some programs may do like a six week thing depending on which block you're on, but you basically change your clinical environment every month or close to every month. And so you may have a rotation where you're in surgery for a month, and then your next month might be pediatrics. And as you can imagine, over the course of two years, you have 24 months. You have lots of different rotations you could potentially do, but some are core requirements, just like any prerequisites, if you will. So you have to do all the primary care type of rotations. And when you think about it, that's important so that you understand a, you might want to do primary care, but B, if you don't, it's important that you understand primary care. Because if you think of medicine as a wheel, that middle spoke is going to be primary care. That is going to be your internal medicine, your family practice. It's sort of the first point of contact with the system, if you will. In the old days, that was everything. I mean, your primary doctor, your general practitioner was you're delivering your babies and taking out your gallbladder sometimes, especially out in the country, those things are so important to get through and to understand. And you have to do like surgery. Most schools will make you do most of the internal medicine sort of specialties. So that would be your nephrology kidneys, your cardiology, so the heart pulmonary, which would be the lungs. They'll have you do most of those as part of your requirements. So you end up with a few, what we would call electives. And a lot of people may choose to do a pathology month or a dermatology month. Maybe they have a family member that's a radiation oncologist, and they all have always wanted to try that, or medical toxicology, some of those subspecialties, and so they could certainly do that. During this process, what's supposed to happen is something clicks you're somewhere at some point, and you say, this is where I see myself. Like, this is the life that I want or the job that I want. I think it's important to think of multiple things. One, what do you see your day to day looking like? For me, I knew that I at some point wanted to be a mom, and I wanted to balance having a family. So it kind of took out some things. I have a very close friend of mine who's a trauma surgeon, and she has five kids, so I'm not saying anything's impossible, but for me, I wanted that balance of knowing that I could leave work at work, so to speak, and not have what they call that overhead. So it's something to keep in mind. You have to think about the future in the same way that at Penn State, you have to think about studying for MCATs versus going to a fraternity party when you're in med school. You have to think about choosing something that's your future self making that decision, right? What do you want? Not today, but ten years from now kind of thing. So for me, I really, really enjoyed the specialties where it was very intense work while you were there. So you got your fill, you got your dopamine rush, you got your adrenaline. But then once I went home, I could be home. So for me, I loved things like emergency medicine. I didn't know about anesthesia back then, to be honest. I knew that it was a field and that it was important for surgery, but I didn't know much about it. I liked other things. I really liked the idea of forensics and pathology and being there when you're there, but again, leaving and not having to run my own practice and have a beeper all the time, that could interrupt my life at any time. So that was kind of my thought. So I really wanted to do er. And there's a process, as you mentioned, the match, which basically you start thinking about probably start thinking about it very early in your med school journey. But really, third year is when it's kind of like you feel this pressure whether they're putting on you or not. Like, okay, I need to decide next year, just like if you were a senior in high school. And it's like, I need to decide where I'm going to college the year after. So you kind of feel this pressure. And in my Er rotations, I really liked it, and I started to ask myself, what is it that I like? So I liked the hands on, I liked doing procedures. I liked the variety of who walked in the door. It might be a newborn baby with a cough. It might be a 95 year old that broke a hip. I liked that variety. I liked the quickness of it that it wasn't. You start to do rotations and you're like, okay, we're doing rounds today, and we're still waiting on the read of the MRI that was done the other day. To me, I was a little impatient for that, and that's okay. Not everybody is fit for every specialty. It kind of helps you to figure out what your vibe is and what your role will be. And so for me, I wanted fairly instant results. If I didn't like something, I wanted to be able to change it, like, now. And so I was going to do Er. And I had applied for residency through the Eras. So it's basically the electronic residency application system that was in place when I was applying for residency. It was kind of new, right? Because everything was like, new. With the Internet end of 90s, early 2000s, that was kind of a big thing. So it was relatively new, but it had been in place. And so now we're talking about, I'm applying for residency in 2005. So I was all set up for Er. And I spent a couple of months in different trauma centers. I wanted to really immerse myself and see if this is what I liked. So I had gone for, like, level one trauma centers, burn centers, stroke center. I wanted to see it all and decide, was this for me? Well, I had a very interesting case. Unfortunately, it was a bad trauma, and the person ultimately died. But part of what I learned as the medical student was I was just holding. All they had me do was hold the neck because they had to place the breathing tube, and they had to do it quickly. This guy was crashing, like, dying. And so I'm under the bed, and I'm getting bodily fluids on me. I knew I needed a shower after this. He's throwing up, and there's blood, and I'm holding the neck still, and I'm just down there under the bed holding the neck in line, because a neck injury could get worse if they're not holding it perfectly still while they're trying to get this airway. And it was a bad, bad trauma, and they never got the airway. And that plus life threatening injuries. The patient unfortunately died. And having that moment where the efforts were unsuccessful and the mood was so intense and the smells and the sounds and all of it was this big wake up call to me of, like, this is life and death. And something as simple as a procedure of getting something the size of your pinky into somebody's windpipe could have made the difference. I don't know. He could have made it to surgery and still died. I don't know. But it could have made the difference between this person surviving this trauma and not. And it was just this big wake up call about how important airway was. Like ABC boom. And so it just kind of smacked me in the face like, well, this is something that if I'm even thinking about this, this is going to be a scary moment for me if I'm not really good at that. So I said to the Er resident after everybody had sort of debriefed and don't think that they get emotionally immune. I mean, it's hard when you lose a patient's, really hard. And there had been a lot of talk about how things could have been better or how everybody was feeling. And the er. Resident said to me, if you want to learn more about airway, do a month of anesthesia. And I was like anesthesia like, they're in the operating room, like pain medicine and stuff. And they're like, well, that's airway. Like, they're airway all day. And I was like, oh, okay. So I did a month of anesthesia, just thinking I'd learn how to place a breathing tube. Well, when I got to anesthesia rotation, I realized it's so much more than that. It is not only airway, breathing, circulation, but it is really you're that patient's advocate, which is what I'm all about, right? Advocacy and making sure people are protected, and you're that patient's advocate and really guardian for the entirety of their perioperative course. So from the minute that I meet a patient that would come in for a major surgery, I am their advocate. If they say, Look, I'm concerned because I have this sore spot on my arm and I don't want to lay with pressure on this. I'm going to be asleep for a couple of hours or, hey, I have dentures and I don't want my husband my husband's never seen me without that little things that other people are like, really? That becomes part of my job. So my job could be as important as making sure you're breathing and your heart is beating and you're not awake or aware during all this. But it's also the little things, because as I like to remind my patients, if it's important to you, it becomes important to me. It is important to me whether I would have thought that was a priority or not. Your goals are my goals. So when I spent that month in anesthesia, by the end of it, I realized I had the procedures. I was doing nerve blocks, intubations, IVs, access lines, like big IVs in the neck and things. I was also seeing all the variety that I liked. I was seeing little kids, I was seeing older people. I was seeing different major medical problems and different injuries and illnesses that happen to need anesthesia care. And I was also seeing that rapid pace where if your blood pressure is dropping, I can change it like that. And so to me, it was like, okay, I thought Er was it, but there was something better for me. And so that's when I changed everything. And I had already had my application together, so I had to rescind application, and I said to the attendees that I was with that day after the first week, I said, Gosh, I'm thinking I should have done anesthesia. Like, too bad, I already submitted, got everything together for Er. And they're like, It's not too late. You're a third year medical student. You're about to become I think I was maybe just turning a fourth year medical student. It's not too late. You have the rest of your life. Why wouldn't you? What's, a couple of weeks? And I was like, Well, I'd have to have four letters of recommendation by next week. And the one guy who was the chief of their department, it was like during a lunch kind of break, everybody was around. He said he put his hand up. He said, I'd write you a letter of recommendation by next week. Anybody else? And three more hands went up, and we were like, done. And so I changed everything at the last minute. And within a couple of weeks, I rescinded my Er application and submitted all anesthesia applications. So don't think that you have to know in college what type of specialist you want to be or don't think that you even have to be sure. [00:38:06] Speaker B: Your third year of medical school, that is awesome. And I love that you kind of explained the anesthesiology because you obviously have had you've been an anesthesiologist. But something that really jumped out when you shared your CV with me was that you work for multiple people or multiple different healthcare providers simultaneously. And I'm curious, from a time management, work life balance perspective, how do you handle that and is that unique to anesthesiology or is that a lot of different medical practices? [00:38:40] Speaker C: I think there would be a lot of different specialties to which it could apply. For both of my specialties, I am basically an independent contractor. So the way that works is I have my own business and I provide services. Does that make sense? So one thing that you don't learn a lot about in medical school is business. I was very fortunate in that my husband, who also went to Penn State, he studied business logistics, which I think they might call something different now, supply chain management, I think, but it's the same. So he was a business logistics major and he has been, I kind of joke around. He's been my manager since day one, I think. I was actually in college when I bounced a check and he was like, no, if you don't know how to manage your money, let's figure this out right now. And I remember sitting down with him even in college and him being like, this is what retirement is about. This is interest rates, four hundred and one K. All these things that I was so bored with. I'm like, whatever, show me where the patient is, get me to the emergency. You deal with the money. But anyway, so it's more common now, at least in my mind. It seems to be more common now than it used to be. But you have kind of one of two paths when you're a physician is you're either working for one of the big giant medical systems, right, or you're private. And so I'm considered private like a private practice physician, but I have worked in those big systems. My residency was through UPMC and I was employed by Allegheny Health Network for several years and I've gotten to experience both and there's benefits and risks to both, right? So when you have a job with one of those big kind of powerhouse companies, the benefits are amazing, right? They can have really good benefits. You have great health insurance, sort of the predictability, but you're also kind of at their disposal as far as where you go when you go there. And so you just kind of have to think of that. And so when I decided to go basically back to private practice, I decided that I wanted to really manage my own time. I wanted to be able to tell you. I'm available to you three days a week. These are the three days I'm available if you want to use me kind of thing versus having a big system where somebody made my schedule and told me, you have to be here on this day, here on that day, and this is Friday's assignment kind of thing. The other thing that was for me was that I had taken call and done the overnight shifts and sort of the trauma call and all that stuff for several years. And to be honest, you can get a little bit burnout and that's okay. We're humans, right? Sometimes we need to take a break. And so during that time, I had had a little bit of a close call. I had fallen asleep driving after a very long shift. And the reason I was driving was I was trying to get my three year old to fall asleep for a nap because I was nine months pregnant with baby brother, and I was post call, which means I had just come off like a 26, 27 hours shift at a hospital. I hadn't slept, and so I was trying to get my son to sleep. I fell asleep, unfortunately. So it was a wake up call for me and I decided at that point that the overnights just weren't in my it wasn't going to happen anymore for me. So in order to leave that sort of mandated schedule, it became important to me to become my own scheduler, so to speak, and that's where I decided to go private. [00:41:54] Speaker B: All right, Dr. Z, so I introduced you as both an anesthesiologist and an addictionologist at the top, but that hasn't come up so far. The second one. So first of all, what is that, and how did you add that to your portfolio in addition to being an anesthesiologist? [00:42:11] Speaker C: So it's interesting how over time, things can change, right? And I am still an anesthesiologist. I've been practicing anesthesia for over 13 years now as an attending anesthesiologist, but something else sort of creeped into my life, and it was really a passion for understanding the process of addiction. I am the child of an alcoholic, and I didn't realize when I was young that the reason that one of my parents had sort of this compulsive use of alcohol despite it negatively impacting our family and our relationship. I didn't understand that at that point. They weren't purposely making that decision. They were in a disease state and it was hard on our family. It caused a lot of turmoil, and it's hard as a child to have half the time your parent loves you and would do anything for you and they're the best parent in the world, and the other half of the time they hate you and are mean and are fighting and there's so much drama. That was really hard for me. It was one of the things that I was happy to leave home about. I had tried to make that better. It wasn't getting better when I went away. It was like, okay, wide open spaces. I'm going to do my own thing. I think it's also why at some point, I had sort of changed my mind about adolescent psychiatry because I was ready to move on. I didn't want to persevere over all those thoughts and feelings. I wanted to just kind of bury them. And I got so caught up in the whole med school and trauma and anesthesia, and I was like, okay, I'm going to do something 100% different than where I came from. But somehow things can come back and history can repeat itself. And so what ended up happening? A good friend of mine that I had mentioned when I was kind of leaving home, and I said I needed to get away from certain places, and that whole group of friends was partying a lot, and some of them had gone away to school, some have gone to WVU or other schools. And so when everybody would kind of get together, it was a little bit more of a party than I was comfortable with, we'll put it that way. And so I had been and she was we had both been offered a pill at a party once, and I didn't know any better. I didn't know any better back then, but I just happened to get lucky and make the right decision, and I was like, no, I'm not into that. I don't want to do that. It just doesn't seem like a good idea, right? Roll the dice. We'd all had a few beers. I probably could have, on a different day, made a different decision. But thank God I said no. I didn't want the pill. She took the pill. She liked the pill. She loved it. She ended up dropping out of WVU, and she was going for journalism. She was a beautiful girl. She was a bright girl. She was a good friend. She was a generous soul, and just somebody who was the life of the party in all of the purest senses. But she unfortunately became addicted to pain pills that she started by using recreationally. And over the years, she and several other people that I knew and several other people that lots of listeners may know, had developed an addiction. I had gotten so busy with school and moved away that it's almost a shame to say I wasn't paying enough attention to really put it all together. But I knew that when I would come home over the holidays that there had been changes in her and in a lot of my other friends. Whether they were partying too much, they were dropping out of school. You heard somebody was addicted, and then it became you started to hear that people were, like, using heroin and really serious drugs, and you think, like, Gosh, well, that's what they turned out to be. That's really sad, but you don't put it together. I could have been that person. I easily could have been that person if that night I had drank too much to make the right judgment call, or just was feeling wild or rebellious or who knows, any reason, trying to treat self doubts and guilt or whatever from growing up with the drama. I grew up anybody, you don't even need a reason. You could see how it could happen to anybody. It could have been me. And I sat there and I thought to myself, like, wow, this is happening. And how could this happen to somebody who was anything but what my picture in my head of a quote unquote addict was. Well, long story short, she had been in recovery for several years, and I had reached back out to her by Facebook and said, oh, we should get together or something. We'd had a class reunion. She expressed that she wasn't comfortable going, she was ashamed. She had been very popular and sort of the all American girl, if you will. And so she had a lot of shame and guilt. And I thought, well, that's over now. You're better, who cares? I didn't appreciate what she was going through from her perspective. Well, she never made it to our next reunion because she relapsed and she overdosed and she died of a heroin overdose. And we had been friends since we were like 13, and it was like almost like I felt the earth beneath me shake. I mean, not literally, but figuratively. I just thought all of my past, all of everything just came back to me. And I thought, how could this happen? How could that one moment in time have changed her life entirely? And then I started to realize, and at this point, my mom had been in recovery for twelve years, no longer an alcoholic. And I thought, my gosh, addiction is its own beast. And how did I go through all these years of medical training and nobody is really kind of teaching you about what's really going on with addiction? So we took it upon myself to study addiction and to read as much neuroscience and neurobiology as I could about it, really dig into the pharmacology, the physiology of it, and just, I'm like a lifelong learner, so to speak. And at this point I had stepped down from my role at like a trauma center and taking calls. So I had a little more time on my hands and I wanted to kind of read more. And basically, I decided to do some on the job training, if you will, and to work with some recovery centers to learn more and to get to meet some of these people that I had thought for so long. Were making these just bad choices and to really understand that they were suffering from a disease that is a neurological disease that yeah, it might start by some choices. Sometimes it doesn't. Sometimes somebody has a car accident and is prescribed pain pills and becomes dependent, and they happen to have that propensity towards addiction for a variety of reasons, genetic, otherwise. And so I started to really get to know some people that were affected, and just the passion within me just boiled up, and I realized that not only did it make me feel better, because I realized, okay, my parent didn't mean to hurt me or didn't mean to be that way. This was a disease. But also when I would see the looks on people's face when I approached them as the human that they were and not the statistic that they could be, and I didn't dismiss them and think like, oh, you chose this life. Oh, reap what you sow. Oh, sleep in the bed. You know, society has such a stigma, and they're so really mean to these people. And when somebody would say to me, like, gosh, it's so nice that you're actually talking to me like I'm a person, I'm like, well, you are a person. I guess I saw myself in them. I saw my friend Tia was her name. I saw her in them. And I remembered her shame and guilt and how she didn't even want to show up to the reunion because she was so ashamed of what had happened to her. And I thought, I used to go in tanning beds. That was stupid, right? But if I had melanoma, do I deserve care and compassion and treatment or no, because I made a dumb decision and sat in a tanning bed. So I guess it started this whole passion for me. And then through work and through studying, I became a candidate for their board certification process now. And actually, I think in 2025, it should be official that you'll have to basically quit your job and work in addiction for a full year of fellowship training in order to sit for those boards. But because of the seriousness of the crisis level of opioid crisis in our country right now, they did what I think was a great idea, and they gave us a window of, I think it will end up being eight or ten. You have to double check me years of this pathway that I took where you can basically do on the job training and studying, and it took me three years instead of one year, and I did it in addition to my full time job. But over time, I was able to get that second board certification. And I really try to be an advocate for people in recovery, because it could be any of us. It could be any single person. And think about it to the students, when you do make those choices, to maybe blow off a little too much steam with some alcohol, or if you're taking a pill that's not prescribed to you or taking something that is prescribed to you in a way. That's unhealthy. You think about those choices because there are times where somebody could it could deviate your whole course and I could have had all of the things that it took to become what I am today, but if I'd have made that one choice differently, it never would have come to fruition. [00:50:38] Speaker B: Wow, that was really impactful Dr. Z lot to think about there for scholars and even any alumni or prospective students who are listening, I think that's really important message to listen to. And so you've talked a lot about advocacy and obviously in your answer there was certainly that flavor of it or the most recent question I asked. So you have a lot of speaking engagements that you do and you've also built a TikTok following. So can you talk about those opportunities and why you take on that additional work instead of just patient care, but going out and speaking on these topics, whether it's to an audience or to hold your phone up, record a short TikTok clip and reach however many people that way? [00:51:21] Speaker C: So I would say that first I became comfortable talking to kind of strangers about things I had learned and wanting to share that information back in my days as a Schreyer scholar. I mean, when we were presenting our research that opened up opportunities to present to the American Chemical Society, to the Honors College, to the undergraduate exhibition, basically saying, this is what I've learned, and I'm so excited about it that I want to share it with you. And so I got comfortable speaking to people, strangers and things like back then. And then you sort of put a little bit of that on hold while you're in med school and you're just busy. But you do get comfortable kind of talking to brand new patients all the time, right? So you have to go in and talk to somebody that you've never met before. And for people that have social anxiety or things, that could be a really difficult role, and especially as an anesthesiologist, I have to walk up to you. Maybe you're the chillest dude in the world, but you're about that brain surgery, you're not so chill this morning. Like you're feeling vulnerable, you're feeling anxious. And I need to be able to approach you in a way that educates you about what we're doing today and how I'm going to take care of you, but also calms you so that you can actually take down that guard and kind of listen and assimilate that information. So I think over the years I just got comfortable sort of meeting people where they are, which is oftentimes not wanting to hear what I have to say and sort of presenting it in a way that maybe isn't so scary or so boring or whatever it may be in that situation. And then when I was at Allegheny Health Network and I was working there and it was trauma center and everything we had a lot of and actually, even back in residency, we had medical doctors. They have these presentations and weekly meetings, and they might call them an M M conference. You might have heard this on, like, Grey's Anatomy be like, morbidity mortality. So that means, like, sickness and death. So basically, you're like, this is what's going on with these cases. And you kind of look at the different cases or different numbers or trends and say, what could we be doing better? Or what should we learn from this? Maybe you're presenting a bad outcome, and that's not comfortable, right? So sometimes you have to get in front of a room of people and be like, hey, if I would have done this differently, this person would have had a better outcome or not had what, an infection or a complication or something. But that's how medicine, that's how you learn, is sort of sharing information with each other. And so I got more comfortable just getting up in front of maybe the whole medical staff and giving a grand rounds on the approach to the Obstetric trauma patient, for instance. That was something I had trained at a trauma center that also delivered babies. So we would get pregnant women with traumas all the time because we were where they came. And then being at another facility that was delivering babies but had never done trauma before, and they start accepting trauma patients. And I'm looking around, I'm like, you know, over at the other hospital, they do this and this and that and have this protocol. And so I ended up kind of getting involved in some administrative jobs just because I was comfortable speaking out and saying, I'm pretty sure the best way to handle this nine month pregnant person that just had their pelvis crushed is this way. And just from my experience, being comfortable teaching others. And sometimes these were people that were older than me or in a higher up position than me. But if you know that you're saying the right thing, you have that built in confidence of this is how it should be. And I've learned this, and I'd love to share it with you. So I did a lot of speaking at that job. And then after Tia died, I had promised her twin sister that I would make something positive come out of this death. And to be honest, at the time, I was so scared because I had no idea how I was going to fulfill this promise. Her sister was in the ICU, literally dying. And I'm sitting there saying, I'm going to do something with this. We're going to really make something good out of this. And I'm saying to myself, Liz, what are you going to do? Why are you writing promises you can't fulfill? And I thought, well, I just am I'm going to do something with this? I don't know what. So after the dust settled on that and we had sort of come back together, her twin sister and I. And okay, like I said, I still want to do something great, but I want your blessing, I want your permission, I want your vision, because I don't know what this looks like yet, and I want it to be respectful to her and to her surviving family members. And so we decided together that we would approach the high school that we went to and basically talk to the high school students about choices that we make and how we need to realize that there's impacts later on in life. And again, it goes right with the medical thing. Everything is a risk and everything as a benefit. So you have to think about the pros and the cons. And so we kind of started that approach with the kids of, look, everybody's been saying forever, like, just say no to drugs. But we understand you're teenagers, you are at parties, there's things around, there's peer pressure, there's an undeveloped decision making in your brain. And when everybody just teaches you drugs kill people, and yet you see people at the party having a great time and waking up the next day and still going about their life, you seem to think the whole message is a lie. And so then you're less afraid to try something. Maybe we could take a different approach. I like to call it Just Say no, which is know, just say no. Know about drugs, know what they are. If drugs felt horrible, nobody would be doing them, right? I mean, there's a reason why when people come in for anesthesia, like, oh yeah, give me the good juice, and it could be a priest or a nut. I mean, it doesn't have to be somebody who's looking to enjoy it in a bad way, but they do feel good. And so we need to approach that, that, yes, there may be a component as to why people find pleasure in these activities and why people drink or do drugs, but please know the other side of that. Please know that this is how they could hurt your body, or this is how you might decide to do it the first time, but there might be subsequent times that you don't want it anymore, and yet you cannot stop because you're addicted. So that was sort of the approach that we took. And that was before I had actually pursued the formal education in addiction. And then I thought, if I'm gong to be talking about this all the time, I better know what I'm talking about. And that kind of played a role into really studying it. So me then going to the high school as I'm an alumni, I'm a doctor that graduated from here. My friend and I were basically the same kid. We made one choice differently. Look what the impact it had on her life. And she could be here. She missed a lot of really wonderful things in her life, and I don't want that to happen to you guys kind of approach. So I started doing high school talks, mostly at my high school, but also at some other schools that would by invitation. One of the things that would happen is after I'd talk about all this important stuff is I'd get people that would come up to me after and be like, I want to be a doctor when I grow up. Where'd you go to med school? Tell me about that. And so there was this interest more in the career path I took and those sorts of things. So out of that came this mentoring thing, which I had done before. I had had students know or somebody say, oh, so and so she's a doctor. Why don't you go spend a day at work with her? And I had done that before, and I enjoyed it. So when the kids would kind of come up to me, a lot of times it was young know, oh, I really want to do this, so I would be their mentor. Well, one particular girl, her name's Abby, and she's now in her third year of medical school. But when I first started this, she was in high school, and she came up to me and wanted to learn everything. I think the words she used are, I want to be you when I grow up. And I was like, oh. So I took her under my wing, and we're still in great touch. She's a wonderful girl, and we'll be an amazing doctor. But she, over the years, had said to me, she's like, no offense, don't get offended, but your talks are great, but you're in an auditorium, and it's, like, dark, and it's, like, 45 minutes. And it's just you got to understand our bandwidth is like a minute. And I'm like a minute. And she's like, yeah, in today's age, everything is coming at us fast and one after the other, and we don't do well. We don't learn as much. If we're sitting there for, like a half an hour, we're gone. We're probably scrolling through our phones. We've checked out. And I'm like, oh, gosh. And she's like, don't be offended. I'm like, I'm not offended, but, man, here I am all about meeting people where they are, and I'm not. And so I said, well, maybe I'll come up with something else. And she said, you should be on TikTok. And this is like, I don't know, 2019, I guess, 2020. And I was like, no. TikTok to me was for kids, and it was where they came up with bad pranks and trends and ate Tide pods and stuff. I was like, no. And she's like, do me a favor. She said, just download the app. And when you like something, hit, like and when you don't say, no, thanks. And eventually you'll start to see things that apply to you. And she's like, Just check it out. And she's like, there are a lot of doctors on TikTok. And I was like, really? Doctors on TikTok? So anyway, long story short, I started to just peruse through the app, and I was checking it out for a solid year at least, before I decided to post anything. And the first time I posted something, I had no idea what I was doing. I basically made, like, a 15 minutes lecture. It had, like, zero views. It's still sitting there. But then eventually, I started to kind of understand that you really do have to kind of have a short, important message, cut the UMS and the uz, and any second that isn't filled with your voice or something is interesting. So it took off from there. I mean, it's certainly not a huge following. I don't have millions of followers, but it has grown to, I think, a little over 30,000. And that was in probably about a year and a half, maybe, I guess now almost two years. So it's been fun. It's been fun. It's been interesting. And my goal is know, if I can help one person, it's worth it, because I easily could have been that one person. And I probably know I think back to dr. Simpson and how overwhelmed I was at the time my freshman year in college, and how I thought, I can't do this. Who am I to think I can do this? And how I was still sort of in that party scene and when Dr. Simpson kind of took me under his wing and know, if you saw you the way I saw you, you would know that you can do this. And he mentored. You know, I think of myself as somebody that, know, potentially saved by a mentor. So if I can be that person for somebody else, I'm all for it. [01:01:05] Speaker B: Fantastic. So in addition to obviously practicing attending physician and an influencer on TikTok, a lot of your current roles at the top of your CV are listed as medical director for some different healthcare providers in the Pittsburgh area. You talked a little bit know, you leaned on your husband, who's a Penn State alum, but how did you really take on those management and leadership roles? In your last answer, you talked know, stepping up, giving voice to people, but there's a lot of nitty gritty and paperwork and administrative tasks that I'm sure you have. So how did you start learning that and complementing your patient care and the science background that you brought to your initial roles? [01:01:42] Speaker C: That's a great question. I wouldn't have known ten years ago if you'd asked me that I'd end up being a medical director of anything, let alone for two different specialties. But you don't also become a medical director typically right away. That's something that comes with experience and demonstrated responsibility. The role of a medical director is basically for any system, it could be a small office it could be a big hospital system. Mine are both. These are separate practices. So one's an anesthesia practice and one's an addiction medicine practice. But the role of a medical director is basically ensuring quality of care, safety of care. Some of that has to do with efficiency and budget. You don't want to spend all your money on one thing, but you also don't want to cut corners where safety is concerned. You have to spend more. You have to make those decisions. Has to do with regulations. So for instance, when you have your inspection by the various accrediting bodies, they may come in and ask to speak to the medical director about what your policies are. They want to see your policy and procedure manual. I would be the person that's going to sign off on, yes, this is what we allow here and this is what we don't. You really have to be able to have effective communication between different departments. You're part of the staff selection. So if there was somebody who I didn't feel was a good fit for a certain practice, I would be able to say, I don't agree with this selection. I'm not choosing for us to hire them. You could almost think of the medical director as the doctor. That kind of sets the vibe of the practice, right? So if there's a shady place, there's probably a shady medical director. If there's somewhere that's efficient and that's safe and that's good quality care, then you probably have a good, responsible, experienced medical director because you do technically have to have that role filled, even from a legal standpoint, right? So for instance, at the addiction medicine center, everybody who comes in there gets blood work and urine toxicology and a therapy appointment. And technically, there's a doctor order needed to not only get those labs ordered, but also a doctor then has to look at all those labs. So every single client that comes through that place, their orders and blood work and everything is being ordered and overseen by me. And so I oversee their treatment plans with their therapists and those sorts of things. In the operating room. I would be the supervisor of the anesthetic for all the anesthetics, but also I would be the person that sets the regs that would say, like, okay, we're not allowed to do somebody that's on oxygen here because we don't have the capability. If they need to go home on oxygen to send them on that because it's an outpatient center versus a hospital, then you could say, okay, we can do anything. I mean, you're a trauma center. Somebody comes in with a knife in their chest, you can't turn away anything, right? But once you're in that outpatient center where you don't have all of the same capabilities as like a tertiary care center in the city that can handle all your level one trauma, et cetera, there are certain things you can and can't take on. And that's just practicing the standard of care and practicing good medicine. So it takes somebody who understands from the medical background but also who is really willing to, like you said, kind of take that extra bureaucracy on because there is a lot of administrative work that goes with it. And oftentimes it's boring things like schedules or crunching numbers and saying, look, we had this many cases and the national average of this complication is 1%. And we were down at 0.5%. Good job, guys. Or hey, I'm concerned about this trend. What can we do to make it better? Maybe we need to be telling patients to use their inhalers before they come in because it's flu season. Those sorts of things are just kind of big decisions that need to be made at a high level. And I think, again, it just kind of came from those years at that trauma center while we were starting up a trauma program and I had trained at a trauma program. So I guess I felt comfortable saying to people, well, it seemed to me that this worked there and let's all come together and talk about why we're doing this this way. So you kind of end up getting invited onto committees and meetings, which at first feels real great because you're young and you want to be important and then you realize later it's just extra unpaid work. But it was, I think, really impactful not only as they were starting a new program, but for me to learn some of those leadership responsibilities. And so I liked them and so I kept them. If you do something like that and you say, you know what, administration isn't for me, then, hey, you tried it. You go back to just doing your thing and not having to be the boss, so to speak. But I liked it, so here I am. [01:06:07] Speaker B: Awesome. Well, you've taken on quite a bit patient care, speaking, management. What do you do and what do you recommend that scholars do to find some sense of balance or separation from work? Knowing that you do deal with really heavy topics, especially on the addiction side, that they can integrate now as a scholar and for those who are pursuing a medical schreyer, how they can use that later as well. [01:06:33] Speaker C: Well, honestly, this is one of those questions that brings back my kind of osteopathic training. Remember that there's mind, body, spirit tap into what you already have. I think we get so busy in this world and we get so distracted in this world and we forget that we literally have everything we need to succeed within ourselves, right? So, I mean, books are helpful, schools are helpful, obviously, but from a balance standpoint, our body has an innate ability to sort of regulate itself, right? So if we bring in a lot of extra things from outside, like too much alcohol or if we're relying on substances, an actual medical problem and prescription is a different situation altogether. But I'm talking about recreational drug use or those sorts of things. Just keep in mind that that all has to balance out somewhere. So the more clarity you have, the less intoxication you have, the better. And remember that we have a beautiful planet and oftentimes we have a screen in front of our face. Unplug. I have always loved being outside. I've always loved journaling, I love yoga, I love meditation. I don't think I could do any of those roles that I do now, including being a mom, without those resources. So unplug, get outside. If you're having a bad day, walk on a path, enjoy the smell of the fall air. Maybe just get a day to yourself where you take a jog or tap into those. Your body has natural ability to feel joy and to feel adrenaline and all those things that you would be able to augment with drugs or alcohol. But once you augment them with drugs or alcohol, you set the bar higher in your brain and it expects a certain stimulation to feel joy. And that's what people don't understand is that once you set that bar high and say, oh, okay, I need this much of an action potential, so to speak. If you're in physiology, you'd understand I need this much threshold to feel joy. Once that's becoming your normal and your habit, you cannot feel the same joy without that substance. And so I'd encourage you to really think about natural joy and where you get natural joy. Maybe it's writing, maybe it's exercise, maybe it's meditation or spending time with people that you love and just laughing and encourage that. Identify what those areas are that help you to feel natural joy, natural high, if you will. I'm a water sports enthusiast. I love to water ski, I love to wake surf and those sorts of things. For me, that is like a natural high. Whatever it is for you, find it and embrace it and use it because it's a tool in your tool belt that is silly to ignore. And just keep in mind, I'm not saying that everybody it's college. I mean, there's going to be some alcohol consumption, I'm a realist. But just keep in mind what that does for you and what it doesn't do for you. And if you're waking up the next day feeling drained and dehydrated and exhausted and unmotivated, is that in your best interest in the long run? And remind yourself some people can put that down and move on with life and some people can't. And then my last suggestion for that is just to be really careful as far as again, don't take any pill that's not prescribed to you. Last year, Ohio State lost two really bright students. One was gong to be pre med. I understand she was believe and you know, they thought they were taking an Adderall to help them study they thought they were taking an off script prescription pill and it had Fentanyl and it was one of those fake pills I warned people about and three girls overdosed, two of them died. They never got to graduate college or see their dreams. So just keep in mind that our bodies are so valuable and we only get one of them. And experimentation used to be like a journey. Now it can really be a minefield, right? So if you try one thing the wrong place, wrong time, wrong thing, even if it looks like a real prescription pill, it could really be the last mistake you ever get a chance to make. And we all need wide open spaces and lots of places to make our mistakes that we can fail forward, right, and not end our game. So keep that in mind and just rely on what you already have inside to get you through. [01:10:40] Speaker B: Excellent. So we've talked about a lot. I am no expert on any of these topics. So are there any questions that I should have asked or maybe questions that you commonly get from your mentees or from med students that would be worth discussing really quickly that I just didn't think to ask about? [01:10:56] Speaker C: I think one thing I get asked a lot, especially by the young ladies, is about motherhood and medicine. And I will say that it used to be that women were the minority in medical school and medical practice. That paradigm has shifted. My medical school class graduating in 2006 was 52% women actually. And you're seeing a lot more, I think, welcoming of work life balance. So between, I think the COVID pandemic, unfortunately, as it happened, but I think it did help some of that. I think that we've really kind of put another emphasis on mental health but I think it has also just balanced out things to say, look, we're all humans too. So I've started to see just in the 13 years that I've been out of residency training, when you go to a conference now, you'll see maybe there's like a breastfeeding room or you'll see they'll call it a mother's room or they'll have built in childcare track where you can have babysitters while you attend conference. It's much more welcoming to women and mothers now is my understanding, than it used to be in the past. I'm lucky in that that has never been an obstacle to me and probably because of when I entered medicine. But I have heard from some of my senior physicians that have told me that it wasn't always that way for moms, and it was quite different that and I guess we talked earlier about the party scene and thing. And one thing that really I think was a transformation in my journey was my freshman year, I had a really great I thought great time on spring break, and I came back with, like, pneumonia, and I had asthma, and I ended up in the hospital. I looked at myself in the window in the hospital room, and I thought, am I going to be the doctor or am I going to be the patient? Like, which way is this going? And it was right around the time that I had told you some of my friends were making different choices than I was. And it really enforced in me that if I was going to talk the talk, I had to walk the walk. And if I really was going to be somebody to tell people how to be healthy, I needed to be healthy. And so I guess it all comes back to balance and respecting yourself and knowing your worth. And that doesn't just mean, oh, I'm a woman and I want to be treated with equality. It doesn't just mean that. It means know your worth for yourself and don't say, oh, I'm just going to work nonstop so that I can pay off this or that. Know your worth, that you are a human with a lot of wonderful gifts that aren't medicine or aren't academic. So balance that academic side of you with the silly side of you and all those other beautiful sides that we have. [01:13:32] Speaker B: That is really good advice. And as a parent, I appreciate your first comments about motherhood and work life balance and everything. So that's awesome. So you did answer my question. I was going to ask about transformational learning moments. So on the flip side of that, what would you say is your biggest success to date, something you're really proud of and want to brag about? [01:13:50] Speaker C: Let me think. That's a really good one. I've been married for 18 years, which I think a lot of people 18 years is a long time. So I'm very proud of my marriage. I'm very proud of the fact that my husband and I have had we've had stressful times like any couple, but we've always kind of come together and talked about it and communicated. And I think that that's really important. Being a mom is probably my greatest accomplishment just because it was so important to me to really be there and be present for my children and to be that sober, clear, guiding force, so to speak. And so I'm so proud of that. As far as my academic career, I'm still very proud of the Schreyer scholar. I mean, I have my know what they put on your next medallion or medal. I have that here in my office right now. I mean, it sits on a shelf next to a picture of Dr. John Simpson from Penn State. Beaver, don't forget that these are the days, right? I mean, the people that are in college right now, those are some of the best days of your you know, that was definitely one of my greatest accomplishments. But the day I graduated medical school, I remember thinking to myself, anything after this is a bonus, right? Because. I set out that goal for myself. I defeated some odds. I got there, I did it, and everything else is just the cherry on top. [01:15:04] Speaker B: Excellent, excellent. So you've mentioned Dr. Simpson a few times, clearly impactful. Were there any other professors or friends from your days, whether at Penn State, Beaver, at University Park that you wanted to give a shout out? [01:15:18] Speaker C: Know I had a really cool lab partner, Joe Slack, he was really cool. We had a lot of fun in the chemistry lab. He was just a great guy. I had various study partners over the years who I think know, it's nice to be able to find like minded people, you know, when there's a lot of parties going on. It was nice to be able to be like, hey, you want to go to the library Friday night? So that was really cool. Cheryl Ochterberg, I believe was her name, was in charge when it was time for me to be considered for only the second person from a branch campus to apply to the Shire Honors College. And I'd like to thank her for giving the girl from the Beaver campus a chance. Know, I like to think that I accomplished what they wanted me to, being part of the college. And so that name has always stayed a special place in my heart because I didn't know who she was. And people had said, well, you should reach out to her and find out if you're even a candidate for know. I think that there were processes that had to go through to be accepted, but I think the fact that they were even willing to know an off campus kid was really helpful and meant a lot to me. [01:16:15] Speaker B: And Dr. Echelberg was our first Dean of the Honors College. For those of you who are less familiar with our history, I met her. [01:16:23] Speaker C: When we presented when we won that award, and Dr. Simpson had said, I want to make sure you meet Dr. Otterberg. And he introduced me to her and she was just so kind and nice and again to give me a chance when back then it just wasn't a thing for off campus kids to be a part of. It really meant a lot to me that she gave me the chance. [01:16:41] Speaker B: And if you are a student at a campus now, obviously a huge part of you can come in as a second and third year student like both of us did. So regardless of what campus you start at. So just something to keep in mind. Now, Dr. Z, how can students if they want to keep this conversation going, they want to ask far more technical questions about anesthesiology or addiction, medicine and care than I could ever possibly hope to have asked here in our time together. What's the best way to get in touch with you? [01:17:07] Speaker C: So I am pretty active on TikTok. My handle is at Talk Doc. So it's addiction tokdok. And if they comment on anything and just know, hey, I heard your Schreyer Honors podcast, like Instant Follow Back, Instant DM, whatever. I'm on it. I have a special place in my heart for Penn Staters and especially the scholars there. Also, I'm on Instagram, and I can give you my email. I don't know if I'm allowed to do that on this. [01:17:34] Speaker B: We'll make sure that if you want to reach out to Dr. Z via email, just contact us, scholar alumni at psu.edu, and we'll get you connected. Are you on LinkedIn as well, by any chance? [01:17:44] Speaker C: I am on LinkedIn. I'm not very active on there, but I do have an account, and it's under my real name. Yeah. Elizabeth sona. [01:17:50] Speaker B: Perfect. I just want to make sure we cover. I know not everybody uses TikTok or Instagram, so I want to make sure we're covered there. All right, final question for you. Probably the hardest hitting today. If you were a flavor of Berkeley creamery ice cream, dr. Z, which would you be? And most importantly, as a scholar alumna, why would you be that flavor? [01:18:07] Speaker C: Okay, so I am the Crazy Charlie Sundae Swirl, and the reason is because it's vanilla, it's peanut butter, and it's chocolate swirl. So those are all kind of basic things that you kind of expect, right? But it's crazy, and the way it's put together doesn't kind of make sense, and yet together, it all works kind of predictable and yet not. I think I'm kind of that traditional student, but then kind of not. And like I said before, I hear an idea, and I think that's absolutely insane. How do I sign up? Kind of thing. So that's why I think that would be my flavor. But if you want to send me ice cream, I'll take any flavor. I mean, I know the creamer is some good stuff. [01:18:44] Speaker B: There must be something about that flavor in the medical practice, because we had a guest on Back in the spring semester who also serves in a medical administration leadership role, Dr. Gibney. And if you're interested in nephrology particularly, go back and listen to that one as well. Or MCATs did some other perspectives on MD med school. Go back and check that out, but he picked that same flavor, Dr. Z. So there must be something about the medical practice and Crazy Charlie Sunday that is interesting. [01:19:13] Speaker C: Yeah, there's a little bit of what you expect and a little bit of what you don't expect. [01:19:17] Speaker B: I think that nails what a lot of people say about going into medicine. There's a lot of things that, you know, going in, and then there's a lot of things that take you by think that's a good choice. Dr. Elizabeth Zona. Dr. Z. She is an anesthesiologist an addictionologist, a TikTok influencer, and a medical director in the Pittsburgh area and also a mother. So thank you so much for sharing all of your insights. On these different topics with us today. You heard how to get in touch with her on the different platforms. If you want to take the conversation further. Thank you so much for your time and insight today. [01:19:50] Speaker C: My pleasure. Thanks for having me. We are Penn State. [01:19:59] Speaker A: Thank you, scholars, for listening and learning with us today. We hope you will take something with you that will contribute to how you shape the world. This show proudly supports the Schreyer Honors College Emergency Fund benefiting scholars experiencing unexpected financial hardship. You can make a difference at raise. psu.edu forward slash schreyer. Please be sure to hit the relevant subscribe like or Follow button on whichever platform you are engaging with us on today. You can follow the college on Instagram and LinkedIn to stay up to date on news, events and deadlines. If you have questions about the show or a Scholar alum who'd like to join us as a guest here on following the Gone, please connect with me at scholar alumni at psu.edu. Until next time, please stay well. And we are.

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