Being in Medicine - Jeff Marrs

TUCP Intro/Outro: Thank you for tuning in to the Ultimate Coach podcast, a companion to the transformative book, The Ultimate coach, written by Amy Hardison, and Alan D. Thompson. Each conversation is designed to be a powerful wake up call, reminding us of what's possible for you and your life. So if you're on a journey to expand your state of being, this podcast is for you.

Welcome to another episode of The Ultimate Coach Podcast. I'm Meredith Bell, your host for this episode, and I'm very excited to have as my guest today, Jeff Marrs, Jeff, welcome to our show.

Thanks for having me.

Well, I'm, I want to give just a little bit of background before we jump into our conversation. Jeff spoke this past day at the ultimate experience event in Birmingham on the subject of being in medicine. And he's well qualified to do that, because he's been practicing orthopedic surgery in South Dakota, for 22 years, specializing in hip and knee replacement. I want to give a special shout out to to that events organizer Matt Evans, because Matt is the one who put us together, Jeff, and recommended you as a guest. So I'm really looking forward to our conversation today.

Looking forward to it as well. And again, I agree with you, thanks to Matt Evans, for letting us together.

Was let's start with your whole experience in the world of being because it actually started quite a while back. And well before you met Steve Hardison and got involved in the Bing new movement. So tell us a little bit about that.

Yeah, it's just thank you for asking that. It has been a journey. And I didn't even realize that all roads lead to Steve. I met a friend in business world. Oh, 2007. And around five or so years ago, I don't have the dates exactly right. He had me become interested in a course taught by one of Steve's clients, that's centered around the concept of being as of different terminology, and I went to the course, was resistance at burst. Bob was super patient with me, it really took him about a year to have me see the value of n, went to the course and saw a lot of value in taking a step back from doing into being and started coaching with Bob, one on one coaching, two years of agreements with them. And there was a day back in fall a couple of years ago, I guess, where Bob was helping me work through a particular issue. And he used the term commitment is like a black hole. And I said, Wow, I haven't heard that phraseology before, where do you hear that? And he said, Well, I'm watching the video. Actually, I'm rewatching it. I've seen it before, the term is in the video. So let me just send you the video. So of course, the video was TBO l it NFL. And it took me a couple of watchings to start to see how much gold is in that video. And then of course, it just took me down the rabbit trail of internet searching and getting the book and reading the book in a day. And interestingly, my wife and I had been talking about for a couple of years, there's something happening. There's some draw or some pull to Phoenix or Scottsdale, or Mesa or something because it's like, every day I would erase something. And I'd say to Mariana Look, I don't know what it is. The Southland is just drum ions to that area. So after I watched the video, and after I read the book, I just came out of my office one day and I said, Hey, I know what it is. It's just obvious to me right now. The answer is to go to Mesa and work with Steve. And she was like, Oh, well, let's do that to the human have a hesitation in her voice.

And it's so interesting. I want to circle back to when you said you first started, walk working with Bob and you had resistance. What was that resistance around?

Yeah, that's really a broad question. Thank you for that. I would say it was resistance to change. It was inertia. It was is an affront to my ego, things of that nature?

I'm curious then, what kinds of things did you hear? Or what were some of the key insights you gained, that caused you to make that shift and realize this is so valuable information here, I need to pay attention.

Yeah, actually, in Bob's patient working with me, to help me see that value, he had sent me a Michael Neal book. And I don't remember which one, it was inside out revolutionary perhaps. And in reading that, again, another one of Steve's clients, all roads leads to Steve, in reading and book, I began to understand the concept of, we live in a thought created world. And it shifted in me, the possibility of I'm living in an is world. And we all either see it the same way, or we're incapable of seeing it the same way and whatever, to maybe we actually live in a world of our own thoughts. And that opened up the possibility for me to see, I guess, if, if I'm living in a world of my own thoughts, why wouldn't I choose to create it the way I'd want to create it? And I believe that's kind of what led me into that course.

So let's apply this then to medicine. When you have given thought to your thoughts, and what you can create your your talk in Birmingham was around being in medicine. So what are some of the things you discover that you wanted to how you wanted to be different? Or how you wanted to do things differently?

Well, there's a lot to that. And the talk was a talk with my partner from work, Corey, Corey Anderson. He is a physician assistant, PhD, he and I worked together for many years on the same surgical team. And he's transitioned into leadership roles at a hospital, really brilliant that he and I gave that talk together. And, for me, there was a time I could just tell the story, it may be a bit repetitive for anyone that was at Birmingham.

Most people that are listening to this, we're not so please share it.

All right, I'll retell it then. So there was a day, I'm going to say, again, maybe five or so years ago, I don't have the dates exact. I was in my clinic. And I had a patient coming in for post op follow up after a hip replacement. And he was about 30 days out from surgery. And I happen to be standing in the corner of the hallway, where I could see him walking towards me money because he walked. And I was thinking to myself, Wow, you could do I could even tell it that had surgery, even with my orthopedic guy, his gait pattern looked perfectly normal to me. So we go in an exam room, and I do the stuff, I look at his incision. And that looks great. And his leg lengths are great, and his strength is great. And as X rays look back, they could be on the cover of a technique guide. And I'm, I'm like really jazzed over here. And I'm looking over there and he doesn't look so chaste. And I asked him about it, hey, what's going on? You don't see him all that excited. And he laid out some really brilliant stuff. Lanez, he didn't feel like that he and I had created the kind of relationship they had want to have with somebody who's going to cut his body open. And he had had a couple of things that popped up and didn't feel like they were adequately attended to. So we're in conversation. And I think by the end of our conversation he had he was overall satisfied, in fact, even said, bleeding into it. A Doctor Marisa would have you know, but I'm completely satisfied with my hip replacement. But it was the experience that I felt could have you somewhere. So I was thinking about that. At around that same time, I had seen a TED Talk by a physician, and she had done some research on the placebo effect. The placebo effect is we all know what that means. You take a sugar pill and you get better. We do a sham treatment, a person gets better. Well, they were looking into what factors play a role in a positive, powerful placebo effect. And what they discerned was that if a patient has the experience that they're providing provider is competent, and the provider is compassionate. They're going to have an increased likelihood of a good placebo effect. And I thought well I could apply this to hip replacement, knee replacement. I mean, if you can say make, take, make something out of nothing, maybe you can make something more out of something, right. So around that same time, Cory and I were co creating our hip and knee Center, which is a pretty well defined way of going about doing hip knee replacements that we brought to our whole group about at that time, about 80, surgeons doing hip and knee replacements so that we have some standardization, things like that. And I talked to our nurse navigators, and he talked to Cory and I said, Okay, here's what I propose, is that we show up to the patient looking like we're compassionate, and looking like we're competent, and that's going to have an increased likelihood of them having a good experience. I mean, we'd have a desire to be competent. So why not just have the patient experience that we have a desire to be calm and compassionate. So why not be conscientious about having the patient see that? So it was like we had sunglasses on and one lens was compassion, or one lens was competence. And like, anytime a question would come along. Well, what should we do in this circumstance? The answer would be or the process would be, let's look at it through the lenses of compassion, competence. And I would oftentimes guide us to an answer that seemed like it made sense to us. So even created a formula around this. So actually, I didn't create the formula, I co opted the formula, E equals M C squared, might have heard that one before. Yes. So when they have a nice idea, what that means is experience is equal to our combined our mission, our combined group, commitment, Team commitment to the mission, times compassion, times competence. So we did this for a while now, I was going to give a talk to PA Association, South Dakota pa Association meeting, and I was sitting on the surgeon allows talking to one of my partners who's now retired, he's a hand doctor, he came to Rapid City. This was of the time that everybody did everything. So even though he's a hand doctor, he was doing some joint replacements. So I was telling him the story I just told you. And he said, and I have permission to tell the story from him is that he marzi. Let me tell you about the last knee replacement I ever did. I got this doctor, this was my partner talking about, I got in there. And the patient had rheumatoid arthritis, the bone was really soft, and it kind of crumbled. And I ended up having to a very complex knee replacement, it was basically like a revision knee replacement. And a revision means like, somebody had had an ear replacement, and it comes loose, and we got to put into longer, further deeper, bigger parts, whatever, he ended up using that kind of stuff on her initial knee replacement. And here's him talking now it came out looking good. Unfortunately, she got we got an infection there. And I, I did all the stuff I was supposed to do, I washed it out, washed it out, washed it out, ultimately could not eradicate the infection. And I ended up having to amputate her leg. And so he says after that, do you know what the last thing she said to me in the hospital was? No, what was it? Thank you. And it occurred to me she uses name I just told us this. And she said Thank you, doctor. And it occurred to me like it's a flash of inspiration in that moment. Yes. Do you know why that was because of who you are be. You're being compassionate. You're being competence, new experience, she experienced you that way. So that kind of like shifted or upgraded in my mind, E equals MC squared as a doing to E equals MC squared as a, b. So and Cory and I use that Sherman are bringing being into medicine, talk or methodology. That's what we're talking about being compassion and being competence.

I love that distinction. And I would love for you to talk more about two things. How does that feel, from your perspective when you are being compassion instead of doing compassion? And what's the impact on the patient? Have that in terms of what do they perceive feel experience? So I'd love to have you talk about it from both sides.

Well, can I add a little something into this? Oh, sure. We'll, we'll context. I was with a person who was on my team who was a person to provide an implants, and we were making a shift in the organization to a different company, he was great. I sat down to talk to him and wanted him to hear it directly from me because I wanted to keep him aren t in some other capacity. And he let me know that he wasn't really sure that he wanted that. Because he felt like when he showed up in the operating room, his whole mindset was around not making a mistake. And he used to be a professional athlete. And he said, You know, I show up to the O R, and all I'm thinking about is, don't be missing an item, don't open the wrong item. Don't make a mistake, don't harm the patient will make Dr. Morrison and if I find I'm showing up, like expecting to lose. So when I was a professional athlete, if I showed up to a game, playing not to lose, I would not have been the best player on my team, I would show up to a game playing to win. And I realized over the course of time that he was not just talking about himself, he was talking about me that I have then indoctrinated. I have indoctrinated myself by accepting belief systems that I have been playing, not to lose. So go go in a patient's room, and would lay it we call that lay the crate, like lay out the worst possible scenario. So that patients don't have expectations. So that if something goes wrong, while I told him minimize our liability, or even if we even if we do get a good outcome, it looks like really amazing, because something bad could happen. So when I would go through the process before was a patient, it looked like following a script look like it wasn't, this is me talking about how it occurs. For me, it's myself wouldn't show up like an authentic relating experience, and show up like, okay, these are all the i's, I got a dot, these are all the T's I gotta cross, this is the crepe, I gotta lay, I gotta make sure I lay out every possible complication so that they have a truly informed consent, I got to under deliver a sorry, I got to under promise so that I can over deliver, and a boom, okay, I've got my package complete. It didn't spill like I was sitting down looking the patient in the eye, and really listening to him with heartfelt listening, that are the things that weren't being said to what was really happening behind the scenes that would have a patient show up in my office. Think about having a big surgery. So by actually having an intention around being compassion, it allows me to have experience myself showing up completely different to those conversations. And it upgrades my experience. So it upgrades my experience, where I actually feel like I'm playing to win, not playing not to lose. Like when I understand what's really important, like I'm going to says a patient talk now and go into my granddaughter's wedding in September, and I want to be able to dance the wedding night. Okay, and I can actually feel the emotion in their voice, as you're telling me this. Now, we actually have an aligned mission. But that's the mission, the mission isn't to get you through hip replacement, the get that mission is to get on the dance floor with your granddaughter's wedding.

That's great. So from your perspective, it really feels different. And it you know, what I'm hearing is I was listening to describe how you were in terms of more script like to really coming from the heart and feeling with allowing yourself to feel with that person. The word that keeps coming to my mind is empathy. You're really getting in their shoes and experiencing what they must be thinking, feeling and experiencing. And so what's the impact on their experience of you when they do when you do that with them?

While their experiences their experience? It's my sense that we are forming a deeper connection. It's my sense that they have a higher degree of comfort or confidence going into surgery because it's normal to be. It's normal to be nervous when you're going in for surgery. Right. But if we can create it in such a way that there's certain amount of comfort going into surgery because No, really when you get down to it, what really makes the biggest difference in surgical outcome is not this not the implants, I put, it's not the medicines that we use, it's not my skill set, I mean that this matters, ball matters. But what really matters is, what the patient's got going on in their mind or how they bring themselves to the game. And I tell my patients that tell him that every, every single time I see him in the pre op holding area, look, we're here committed, as a TEAM, to do as necessary to create the best possible outcome with your knee replacement. And I want you to know that I'm good at what I do really good. And I got a great team, and we're all committed. And what you bring to the game matters more than what we bring to the game, what we do matters. But ultimately, what's really going to make the difference is what you bring to the game, what you know, what you do and your commitment, things like that. So I like to get that verbal commitment from the patient, that they see themselves as the most important person on the team or the quarterback of the team or whatever term they'd like to use, and that they're committed to following through.

You know, it sounds like you're indirectly coaching them on Bing. And I, I'd love to know more about how you talk to them, how do you help them see the importance of their role? And how they are being? How their thoughts are going to impact as you say, their outcome? Are there any specific things that you make sure they understand, or I just like to know more about your conversation with them to help them get to that place of taking responsibility for their part in the recovery process?

That's a big question. Well, and

My guess it's somewhat different with each person based on what you sense, their willingness is, because my guess is some of them are like you were years ago where there's this resistance to it, turning it back to you and saying, But Doc, it's your job. To do this. I'm just the patient. Do you have anyone that tends to be resistant to taking that ownership?

Yeah, I think so. I think that's, that's just a natural being a human being right? We have a story in medicine, that the patient's just gonna show up and expect us to do the work and they're gonna get better and not have to contribute. And that's the story. Because nobody, I don't believe anybody. I don't believe anybody actually goes away. I think that's just a story we make up. How I talk to my patients actually is more closely akin to how do I listen to my patients? I have a declaration that I am a fierce, I change I am fierce listening, right, man. So when I when I go on to the patient exam room, I really listen. Like there will be times where for 20 minutes, I don't really say anything other than acknowledge what I've heard. And William Osler said Canadian physician from 100 years ago, as a famous quote, listen to the patient, they they're telling you the diagnosis. And, you know, I've heard this in various forms over the course of my training, that 90% of the diagnosis comes from taking the history, listening to the patient. And it's not just the obvious diagnosis, it's, as we said earlier, as the what's not said, as the between the lines, things of the patients will let you know. So I like to listen to the patient and ask powerful questions and give feedback that I'm hearing them to the point where they really, I get the sense that they're empty, they've said everything they want to say. And it allows me to have access to what I really need to ask the patient have a sense of, do they even really want surgery? I mean, most of my surgeries, what would consider elected. I mean, it's a good idea, you got a worn out knee and you can't go fishing. And we can fix it. But not everybody actually wants the surgery, what level of commitment they have to doing what's necessary to create the best outcome possible. You know, just a lot of stuff, a lot of stuff that I can have access to, from really listening fiercely. So what they have to say, and there's a lot of factors in that like the best the greatest gift we can give another is for them to feel heard. So even having them feel heard develop is developing our relationship, developing the true For us developing the openness developing the comfort around undergoing scary surgery. Now, when I do ask for a commitment, I do sometimes get a look of like, I really don't understand what you're asking me, Dr. Mars, and no, I just got through it. And I will say. So it's a process, I generally tell people, it takes about 100 days to recover furniture placement. It's a process, not an event, the surgery itself is an event, it takes about an hour, the rest of that 100 days is entirely up to you, it will need to manage your discomfort, you'll need to take care of your incision. And you need to make sure you don't fall down you need to do your physical there be just you know, all this stuff. And we can do it looks on paper, like the best knee replacement in the entire world. But we're what's really going to make a difference is how you show up to it. And this falls to me my mind into the camp of working through agreement, where I actually want some sense of a verbal under have an understanding, and a verbal commitment. Yes, I will. I will do those things, and I will do what's necessary. And you know how people are, like Steve Chandler says, Really, they don't they, they like to keep their word. If they say they're gonna do something, there's a much higher likelihood that they're actually going to do it, than if I just tell him what's expected of them and they just sit in the corner and listen to me, if they give me a verbal confirmation that they will do those things. I can pretty much count on doing those things. And then sometimes I get into something really complex, like some patients are really afraid of pain. They've had prior surgery and they've had a lot of trouble managing their pain. We have this Facebook Messenger group that even more than more people that was created by Elizabeth Adams, she has a knock in the UK. It's got a few other people on it can Alton Bach pray for him right now in his family? Largest caveat Annie Elizabeth Warren has been a Bendel given Kevin tipper Marika. On daucus, Elizabeth had sent me a book called pain or sorry, painless, stupid, painless. And it's written by I'm sorry, I've just drawn a blank on the author's name right now. But she's a She's a pain provider, who is trained in three principles, she uses a three principles approach to handling pain. So I read the book was brilliant, in fact, I use personally is the teachings from that book one. In February, in February of this year, when I had my shoulder replaced, co created with my surgeon over the course of about a year, it being the best shoulder replacement in the history of the universe. And literally, I had zero pain, I never took pain men. So I have a half a dozen or so patients who will like we'll take it to a whole different level, we both have an understanding that we would like to fix this, we'd like to create a different future, we can see the default future if we don't fix your knee where you're headed. We want to change the direction of our future by fixing your knee. And it's a process. And there's a risk that you may have discomfort from what you've told me. And I would like you to read this book, and really do your best to incorporate an understanding of principles before we actually do your surgery. We won't be doing your surgery until you have read the book and agreed, agreed to read the book and tell me what you've learned in the book. And I've had a few of those people who have just had like a remarkable experience. After after the surgery of like, well, my last surgery was 10 out of 10 pain and we couldn't even control it. Whereas the surgery is like yeah, it's it's a little bit uncomfortable that it's really not that big a deal. Obviously, I don't think that it's directly reading a book is going to create that for a person, because it's happening inside of them. But it's an opening for them to change the way they see the world.

There's so much of what you have been describing to me, Jeff, for our listeners, most of whom are probably not involved in the world of medicine, and working with patients as you are and yet the key ideas that you're sharing apply to all of us, no matter what our focus in life is this idea of deep listening to people to really help them feel understood. We can do that with everyone. And the trust that gets built because that's one of the things you haven't used that word but that's what to me is happening in the way you are being with your patients. The trust you're developing with them because As if who you're being you're real, you're authentic, they sense that they feel it. And they respond in kind by trusting you. And therefore, when you ask them to read something, those that feel that they've made that connection with you, they want to agree to that, because they sense you have their best interest at heart.

Yeah, I think that's accurate and brilliant. A lot of the stuff is, you know, big, we're always already being right. So what we're talking about here is, is an intention around choosing who or being in it, it lives in every domain of our lives. And it's ultimately transferable to every domain of our life. Interestingly, I actually think the medicine is relevant to everybody. Because at some point in time, we'll all be in medical care and or have a family medical member and medical care, part of a team to this work and to create a great outcome for the medicine, whether it's was our child or parent or sibling. So I think there's a lot of a lot of cross relevance here. One of the other things from a team perspective that we do, is there's a thing called a timeout. This is a World Health Organization, international recommendation, or mandate, or whatever you'd call it, where at the beginning of a surgical procedure, before the surgery even starts, we do a timeout or a surgical pause, which are the terms for it. What that means is everybody starts what they're doing no music on, no talking, nothing in our hands, all fully attentive. And we do the timeout, and we say, Who do we have here with the patient's name will be confirmed that with the wristband, and what are the what are they here for we confirm that with a consent form, we confirm that the site surgical site has been marked with my initials, as an example, what kind of anesthesia the patient has, what allergies and might have just everything necessary for us to all be on the same page. This is good doing right? This is like a checklist. This is like before you take an airplane off yet you go through a checklist. Well in my or we do all that, of course it's unnecessary. But I believe it's an upgrade where it becomes it goes from a doing to a B. So instead of saying, well, we can say all that. But then in addition, instead of saying this is Jones is here for a right knee replacement, what we'll say is we're here as a team, committed to doing what's necessary to create the most incredible experience possible for Mrs. Jones and her right near placement. And in fact, she's planning to go on an Alaska cruise in October. And then sometimes I'll say, Does anybody see it differently? Because if you see it differently, we need to talk about it now. And everybody's always like, yeah, see it? Same way. And then sometimes I'll say, and how are we going to create that, and then the team will, will know by being compassion by being competence. So they, sometimes we get into a situation where we see the final outcome. And stuff gets complicated sometimes, especially like on a revision case, or like the one I told you about my partner with a knee replacement. Sometimes we take detours and backup before we can go forward and it gets super complex. But we see the vision of the outcome, we know we're gonna get there, even when we don't know how we're gonna get there. We know we're gonna get there. So I think that was concepts of the team coming together and agreeing and committing to a common mission. And seeing the future even though we don't know how we're gonna get there is a very transferable concept.

Absolutely. I got chills listening to you share that, because it's so powerful. This idea of timeout, where we all take time before we embark on whatever the action is, to prepare ourselves mentally. And to really think, proactively of who am I going to be in this situation? How will I be not just the checklist? I love that contrast between those very important things, but then framing them in the context of the outcome, the vision you want. And of course, the emphasis on not being concerned about the how tos. Obviously, in surgery, you have to know the how tos but as you say, just like in life, we're going to encounter unexpected twists, turns complications that we didn't necessarily expect or don't want to welcome and yet, how we are being in that moment is going to determine how we respond to them and ultimately the outcomes we get

Brilliant. He said a couple of things that that really resonated with me. And one is, again, it's a two sided, there's two sides to this compassion is only half of it. Competence is the other half. The best way to occur to the patient as being competent is to actually be competent. That's unnecessary. And the other is, yeah, that the taking the time to prepare ourselves may not get this quote, exactly right. But the Abraham Lincoln quote, but something on the order of give me eight hours to chop a tree down, and I'll spend seven hours sharpening the axe lifting.

Yeah, that is powerful. And I think one of the big takeaways for me in our conversation today is the reminder of slowing down. Taking that time to invest in Who am I in thinking about and preparing for Who am I being in this moment, rather than jumping into doing because the doing is so prevalent in our world in our society, and how we get judged by others. And yet, what we do, as you are saying, we are always already being it's, it's what are we doing to be intentional about it?

Right, we focus on that being the doings will just happen.

I would love for you to share in the final few minutes we have together Jeff, I know you've been working with Steve Hardison. Are there certain takeaways? I know there are lots. But are there certain ones that you would like to share with our listeners today that may be useful for them in their own lives?

Yeah, Steve, boy, I think I'm only one guy in his office. So I can only infer from the things that I've heard others say about their personal experiences. But it seems to me that there is no canned approach. Everybody's going to get a different, different. I don't know, experience, I guess. So. Yeah. I don't know that there's a way of going about approaching this where this would make sense for everybody. But I can tell you a few things that have made perfect sense for me, but they might be transferable. That's great. What is we all have we human beings that least as far as I understand it have non powerful thoughts, thoughts or things, thus great being being is everything being creates doing doing creates outcomes, right. So if we go back to our non powerful thoughts, ultimately, they're going to create non powerful outcomes. So we'd want to change those thoughts. We want to get intentional around changing our thoughts. So the term that I use with Steve is surgical thought replacement, like very specific, not powerful thought, replace it with a very specific thought that is powerful. And not just affirmation, like true, like getting deep down in your core, what is actually more true about this new thought, so that it doesn't just like stamp it on top of the old thought it actually replaces the old thought. So I like to think that I'm powerful, not replacement surgeon. And another is along those lines, this has to happen. In order for it to function. This. I mean, this is in flowing in our bloodstream, so it just happens. But it's like an event happens. And like this, like there's an event handler happening inside of this. But when something comes along, there's like an interrupt, and the interrupt will chant will produce an outcome. So things like it's in the gentle art of blessing. Interrupts, I feel like judging someone boom, and said, I'm gonna bless them. And I'm gonna bless them in the context of the way in which I had initially felt like I would judge them. And other and this is the one I'm most excited about. Steve has allowed me to completely change my life. Well, this is a little bit of lead into this one, super, super powerful, powerful for me. I used to see myself as a procrastinator. I would, I would have a phrase in my mind that why I do today what I could put off till tomorrow. completely twisted on the the real meaning behind that that phrase write it everybody know, everybody knew Jeff's a procrastinator, at least my story was I believed everybody needed to Jeff was a procrastinator. You couldn't count on Jeff getting stuff done. And this was a very non powerful thought that I had about myself, the judgment of myself eliciting of myself that did produce a thing that did produce an action that did produce a non powerful outcome. And when I brought this to Steve, we went through the process of out creating that was something that's actually more true. And it was now more true for me is I am The ultimate roll action ater. And the inner up happens that whenever I get the feeling like I'm just going to put that off the moment that happens, there's an interrupt request that says, Get an action around that, it doesn't mean I have to go clean the whole house. But I do something. That is, that isn't a chord that aligns with actually getting that something done. Even though it's just one tiny step was one tiny step in the right direction, every single time I have the desire to procrastinate, instead, I am the ultimate pro action later on, I'd take at least one tiny step towards creating that desired outcome. And I'm telling you, like, I don't procrastinate anymore. It was like he's those will wipe that out of my life. It's amazing for me, just

Absolutely love that. I love everything you shared about your experiences talking about the non powerful thinking, leading to non powerful outcomes. And I love that example you gave of yourself in that transition you made, I bet you every one of our listeners can think of one thing they've said about themselves, you know, Steve Chandler calls it labeling ourselves, I am this I am that and going through that process of digging into it and looking at what is more true for you. And I would encourage each listener to do that. And the idea of not covering it up, but actually replacing it so that you immediately notice when you are labeling or calling yourself anything related to procrastinator and then transforming that into who you are now, and reminding yourself of the real you. That's a beautiful place. Jeff, for us to wrap this up. Thank you for the gift of you and all of what you've shared with me today. And with our audience, I know, there's so many nuggets in here, I would encourage people to go back and listen more than once because we you know, sometimes we listen the first time just to get the information. But the second time, we can go deeper and really absorb how this applies to me. And there's so many things you've shared today that give us that opportunity. So I want to acknowledge you and the wonderful work you're doing with your patients, the way you're being in medicine, so that you're impacting lives, not just on the physical level, but emotionally, mentally, spiritually, the impact you're having on each person who has the opportunity to work with you. So tell us how people can connect with you, Jeff and learn more about what you're doing, and being?

Well, first of all, thank you for this brilliant conversation, I acknowledge you for who you're being and leading these conversations really amazing. If one were to have a desire to find me in the domain of orthopedic practice, go to www dot just Mars je ffmars.com that will lead you to my practice website. within the domain of being most of my activity is on the ultimate coach Facebook group. Easy to find me there. Those would be the two places I would recommend. That's great.

Jeff, thank you again, for being with us and for the wisdom and insights you've shared with us today.

Thank you have a great day.

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