Matt Sherrer (Host 1): Welcome to season three of the Fresh Flow Podcast. Mitch, can you believe it ,man? We are like official now a third season. Did you ever think it was going to happen?

Mitch Tsai (Host 2): I did not. Three-peat, Yukon, Lakers, Bulls. Here we go.

Host 1: That's right, man. So, how did you spend your off season? You know, just had our time off in between season two and season one, are you more of a Tom Brady on the yacht partying in Ibiza with Jay-Z and Beyonce, or are you more of an Aaron Rodgers darkness retreat, go into a cave, do some ayahuasca? Where do you fall in that spectrum of off season?

Host 2: Well, winter season here in Vermont for the non-skiers, if you're an academic physician, is known as academic season. So, hunker down a little bit, do a little bit of work, and try to get ahead for the spring and summer when I can hit the golf links.

Host 1: Speaking of academia, how about you go ahead and introduce our guest today. This one is going to be a riot. I can already tell.

Host 2: So, I get the pleasure of introducing Dr. Chris Gallagher. He trained at Emory. And then, he worked in Sweden, Duke, San Diego, Tampa, Miami, Stony Brook. So, most of those are sunny, warm places. But apparently, he just keeps getting run out of town. We're going to figure out why. He's always demonstrated and interest in resident education and training the future of our specialty. And I hope we all get to learn something from him today.

Host 1: Chris, welcome man.

Chris Gallagher, MD: Thank you. Set your expectations low, and let's do a caveat podcast right from the start. I retired eight years ago. So, anyone listening to this may indeed say, "Wait, he retired eight years ago. Nothing he has to say has anything to do with anything. I'm going to watch cute cat videos." And boom, you guys are off.

Host 1: I think that's why people tune into this podcast is so they can not listen to us from the beginning. So, you're amongst friends, so you're in the right place.

 Chris, tell us, first of all, you're known for the Board Stiff Books. Tell us just about the process. How did you get involved in that? How did that idea come about? And then, what was it like to write the books?

Chris Gallagher, MD: Okay. So, Dave Lubarsky and I were at Duke, and we just started writing notes. And it was such an ancient computer. I think it was like coal-operated or something. And as we were writing the notes at one point, we said, "Well, let's print it out and then we'll staple it and give it to the residents." So, we printed it out and we were sitting there talking and we looked, and then we saw there were 90 pages. I was just like, I kid thee not, we looked at each other and we said, "This could be a book." And then, there was a pause. And then, we looked at each other and we said, "This could be a book!"

So then, Lubarsky, who I hasten to add, has gone into great things. He's a chairman of the Westchester and he was Sacramento and he was CEO of the Galaxy and won the Nobel Prize and everything. So, good for him. He is doing wonderful things. Good for you, Dave. He's also still working, unlike me, the lazy slob that I am.

But anyways, blah, blah, blah, blah, we pitched it. And eventually, Houghton Mifflin, or somebody rather, took it and they were very leery of it. Because they said, you know, "This thing's a little goofy." And I said, "Look, that's our audience." I mean, these are anesthesia people. I mean, there's laughing gas leaking from the machine all the time. So, this thing will really work. But then, the best part is the title. And the title came from my wife. So, I was at home and I said, "Hey, you know, we're writing this book and it's a review book about anesthesia boards, but I just don't want to say review. I want it to be something snappy." And then she said-- and this is an exact quote-- "How about the way I am at your doctor parties?" Bored stiff? And it was like, "Oh, my God." It was, you know, like when the sun shines through the clouds of Vermont and Alabama. And you look up and you say, "Oh my." And I said, that's it, Board Stiff. Then, when we went to the publisher people and said, "I want to call it Board Stiff." They looked at me like I had an extra head coming out of my dorsal flipper. And they were like, "Oh man, no way. No, we're not going to do that and all that." But I said, "Okay, then don't publish it. See ya!" And they were like, "All right, we'll do it." So, that's how Board Stiff came around and then proving that nothing exceeds like success. We did a Board Stiff 2, and then I did a Board Stiff 3. People eventually asked me, "Are you going to do a Board Stiff 4?" And I'm like, "Look, I ain't like Hollywood. You know, I'm not going to milk this thing." So, that's the Board Stiff story.

Host 1: You can sell it to Disney, like the Star Wars franchise and they'll send you a check.

Chris Gallagher, MD: You know, it's going to be better than most of the stuff that's coming up. But I don't think I'm going to beat Wicked For Good. That did pretty well this weekend.

Host 1: It did pretty well. Yeah.

Chris Gallagher, MD: It did pretty well.

Host 2: I heard the reviews weren't so good for Wicked 2.

Chris Gallagher, MD: Reviews weren't good, but like 150 million in a weekend. I mean, that's the kind of stuff they're paying academic anesthesiologists.

Host 1: Right, right, right.

Chris Gallagher, MD: For you listeners, you can't see this Because this is just an audio thing, but Mitch and Matt both have-- remember those big ropes of gold that Mr. T had around him, and they have bling on their fingers and they both have grills. They both have big gold grills with like champagne glasses on their teeth.

Host 1: I am the Flava Flav of podcasting.

Chris Gallagher, MD: You should really do this a visual. This should be a visual, vlog thing

Host 2: Vlog. So, Chris, you mentioned your wife, and you come from a family of medicine, medical people, healthcare providers. Your grandfather was a frontline medical officer in World War I. Your dad was a surgeon. Your mom was a nurse. How did this upbringing sort of inform you and your life, and how you decided where you wanted to go and what you wanted to do?

Chris Gallagher, MD: Nobody likes a lecture, but everyone likes a story. So, let's tack stories to everybody. So first, my grandfather. He's in World War I. He is in a frontline dugout, taking care of people. He can see that the Germans are about to surround them. The Germans are firing flares to indicate where they are. So, he writes in his journal: "Flares went up to the west, indicating we were being surrounded. Could I get away in the gathering dark and escape and leave the men who were crying to me for help? It said that once to every man and nation comes the moment to decide, and this surely was my moment. I could no more leave those men than I could cut off my own hand. I went into the cellar and lit a candle for light." So, that's how it all started. I mean, like, that's my grandpa. Like, wow, wow, wow, wow.

Host 1: Yeah.

Chris Gallagher, MD: So, that's my grandpa. So, my dad was a surgeon and he had a unique gift in that he was a linguist. So, I would tag along as a little kid in the hospital. Every person he'd bump into if they spoke a foreign language-- and you guys know how hospitals are, hospitals are all Towers of Babel. There's a nurse from Mexico, there's a specialist from Italy, there's a tech from Rome, you know. So, I would go around and he'd be doing all his doctor stuff. He'd be like speaking all these languages to everyone he ran into, he could speak something. I'm like, "Oh, my God." I said to him, "Dad, how do you do that?" And it was funny because he picked up a little statue of a cat and he said, "Well, in Spanish, this is el gato. And you just go from there." He totally doesn't remember that story, but I do. And I'm like, "Oh, that is such a cool thing to do." So, that was my dad.

And then, my mom was a nurse, and I'll tell you the best story about her. In the course of her nursing training, one time had to do like public health thing. So, she had to go visit what was then quaintly called an unwed mother-- boy, does that date me? And it was freezing cold. This was Wisconsin. It was freezing cold. She was so cold. It's cold. She gets in the house, she's so happy to be warm and she has to talk to the woman to say, "Well, how did this come about?" And she goes, "Oh, I took a bath after my brother did. That must be how I got pregnant." But my mom's like-- she was so happy to be in a warm house. She's like, "Fine. Made pregnant by bathwater." That's in some official record somewhere or another. Anyway, so that's the parents.

Then, my sibs are all really cool. They're all in medicine. They're all funny as hell. I mean, when we get together, like security comes to our room and says, "You guys are laughing too loud. There's complaints from all around you." So, they're all a ton of fun. They're all medical and stuff. And we swap stories. And then, my wife has a PhD in public health. So, I took care of people one at a time. She takes care of people like 30,000 at a time.

Anyway, what did all this do for me? I don't know. I guess I wasn't smart enough to be an engineer. I went to college with engineer guys and they were so good at calculus. I never got a single maximum problem, right? Okay. Not a single-- okay. You know, what's the maximum right circular cone you can fit into a right circular cylinder? The answer is 4/27​πr2h. But don't ask me how I got it. I could memorize it, but I couldn't figure that stuff out.

So anyway, everyone was medical, so I thought, "Oh, what the heck?" And I'm not smart enough to do anything else, and I'm no good with my hands, so I can't fix anything. My toolbox at home only has one thing in it, a pen to sign the check to pay the guy who fixed the thing.

Host 1: The guy. That's right,

Chris Gallagher, MD: So, that's how I ended up here.

Host 1: Well, so you wound up in healthcare, you wound up in academia, heavily involved in resident education. Could you please, Chris, just list your detailed plan for the six ACGME core competencies and how you delivered upon those in your time as a program director, please, sir?

Chris Gallagher, MD: So when the six core clinical competencies came out, I, like everyone on the planet, laughed their ass off, and I'm saying to myself, "Um, okay, let me get Occam's razor here and see if I can differentiate between interpersonal and communication skills and professionalism." And you know what? Even with one of those flat back razors, I couldn't cut it. Of course, what did I do? I wrote a book about it. I wrote Six Core Clinical Competencies in Anesthesia. It has to be the worst book ever written in history. I mean, I think it sold two copies. One was to my mom and I think the second one was to my mom too. But I said, "Well, hell, if they're telling us, we have to teach this material. Then, I'll write a book about it." And I wrote a book about it. But it like so many other things, I don't need to tell you or the other people listening that it's like, "Oh my God, really?"

Host 2: I remember the one and only lecture I ever heard from Dr. Gallagher, and it was at an SEA conference and you were on a pro con panel about competency-based graduations. And if you would, could you just share with the audience, you were on the con side...

Chris Gallagher, MD: Yeah. So, here's the Reader's Digest version of things. Okay, let's find a place exactly halfway between Vermont and Alabama, between you two guys. That would be what? Wilson, Pennsylvania. You're in Pennsylvania, okay? You have 10 residents. You have 10 residents, they come in. Five of them are fantastic. It's unbelievable. These people, their hands are spun gold. They learn and they know everything, okay? They're so good, after one year, you graduate them all competency-based, yippy dee doo da. So now, it's now your second-year residents. And who is in that class? Five morons. Morons. These people could not pour piss out of a boot with the instruction, nip them on the heel. So now, you have five people who are dumber than rocks. And it's like, "Well, you know what? Competency-based medicine, we have to keep them until they're competent." Well, guess what? you have to keep these people in there for 10 years. So gradually, all your best people are gone, and you're left with dumb people. And pretty soon, your residency is full of such morons that they will be stacking bodies outside your surgery center like cordwood when these people are trying to give one of Versed for a cataract. And so, in that sense, I found the competency-based argument to be somewhat lacking.

Host 2: So, what should we do? I mean, everything that's happened, the six core competencies, competency-based, what would Dr. Gallagher do?

Chris Gallagher, MD: Okay. If I were the king of the universe-- spoiler, I'm not-- the thing I would do is get rid of all the extra stuff that we make the residents do. So like, one of the things I did at one of the SEAs when an ACGME guy was there-- I hope you guys can keep up with all these letters-- is I said, " You know, every time ACGE gives us one more thing to do, and it's like filo pastry and ACGME says, "Well, you have to teach them the ethics of research." And it's like, "Give us a break. We know about the ethics of research--" You know, you have to get consent and you got it and you can't, you know-- but, "Oh, we have to teach the residents that." Okay. So, in Vermont and in Alabama, you have to fit in a filo pastry. And how do they usually do that? They usually do it with an online course.

Now, given my recent spate of medical problems, I may be meeting the creator sooner rather than later. But one thing for damn sure, if they send me to the place I deserve, the person who's going to be there right next to me is whoever invented online courses. You know this stuff, this junk that we send to the resident, "You must score 80% and you've got to do this, and you got to do that." And then, all the residents are smart. They game it. They don't look at the module, they go to the test, they take the test, they get them wrong, they see what the right answers are. And then, the second time they get 80% right and they're done. So again, if I were king of the forest, all we would do with the residents is do cases with them, teach them good stuff, but don't have them do any of the extra junk that just burns up time.

Host 1: Yeah. So, you alluded to it also when you mentioned your recent spate of health issues. Are you in sinus rhythm at the moment or are you irregularly irregular?

Chris Gallagher, MD: Yeah. No, I went into AFib and I don't know why. And I go into the doc to get my well baby visit. And she goes, "Hey, you haven't any palpitations?" I'm like, "Should I?" And she goes, "Yeah, you're in AFib." And I'm like, "Ugh." So anyway, I'm probably going to get ablated soon or repossessed or something. Yeah, you know, the old crate gets things wrong with it, so...

Host 1: So, I got to know, did you choose academia for your healthcare or did you choose the private practice setting? Where does Chris Gallagher go?

Chris Gallagher, MD: Well, the thing is there's only a private practice around here. There's no med schooly thing, so we'll see. The main kicker with all this stuff is nobody seems to be in a big hurry to do stuff. So, I'm going to see my ablation guy January 5th, but I'm going to drive to his office right when we're done, and walk in and the lady behind the desk will say, "Are you checking in?" I'll say, "I'm a little early. And I'm not supposed to be here untill January 5th, but I'll give you all my information and I'm going to give you my card, and I'm going to tell you, the second somebody cancels or, God forbid, goes the other way, give me a call and I'll zoom right in and you can ablate me and get me going just like that.

Host 1: You're not kidding, are you? You're going this afternoon, aren't you?

Chris Gallagher, MD: Well, that's what I did with the first cardiologist. They said, "Well, they'll call you within two weeks. " I say, "Look, by then, there's going to be a clot the size of Connecticut in my left atrium. And the next time you guys try to interview me, it's going to be like, 'Today's interview with an aphasic guy. It didn't go too well,'" you know? So, I just found that to cut through the paperwork and the computer stuff, to actually go there. And then, I always say like, "Hey, can I talk to the doctor for two minutes?" And then, like the first one, I said, "Hi, I did cardiac anesthesia for 20 years. I know what all this stuff is. I know what the score is. Just get me in there and get going. What do you say?" And they're usually like, "Okay." And then, that night I'm like, "Yeah, can you come in three weeks earlier?" So, if I were in Vermont or I were in Alabama, I'd go right up there and run up to you guys and say, "Save me, save me."

Host 1: Well, come on. Are you chewing aspirin like Skittles right now?

Chris Gallagher, MD: No, they put me on Eliquis. You know, am I going to bleed into my head, you know, it's the blood too thin? Is the blood too thick? Is it bleh?

Host 2: I think the interesting thing here is, you know, if we were talking about finance or trading stocks, this would be considered inside trading. As a physician, you know how to navigate the system, right? And I think that the point that sticks out to me the most is that, you know, you ask for two minutes with your doctor.

Chris Gallagher, MD: Yeah. And the lady kind of goes like this, "I don't know." Then, I see the guy come out of the thing, and I know the guy has an Arabic name. So, I turn to him and I go, "As-salamu alaykum.", I shake his hand, "Atakallamu al-qalīla mina al-‘Arabiyya" I speak a little Arabic. all of a sudden he wants to talk to me. So, this goes way back to dad, always able to talk to everybody everywhere. And this helps too.

Host 2: So, you know, you were the longtime program director at Stony Brook. Alan Alda opened up a center for communicating science there. I don't know if he had an opportunity to sort of interact or--

Chris Gallagher, MD: I don't think Alan Alda ever heard of me or wanted to talk to me, or he never had anything to do with me. I mean, he's a big kahuna. He's a big star. I'm like a little baby fish.

Host 2: But, you know, it's how do we get back to the humanities as an anesthesiologist./ Your mom's adventures, and where she wrote, you know, of bathtub water, you can't do that in the EHR today, because I'm sure there's no box for it. But how do we as a profession sort of move back to the roots where you grew up in?

Chris Gallagher, MD: Well, I wish I had the magic answer. I mean, I can sit here and do all the usual stuff. And it's like we're spending too much time on the screens. Here we are on the screen. We're using smartphones. Nobody's reading books anymore. Back in the good old days, oh, you know, I read War in Peace. Everyone should read War-- and, you know, the short answer is I don't have an answer. Again, if I were the king of the universe and everything were at my beck and call, people would read more books. They would spend less time on their phones. Like, I'll give you an example. Just like a standard thing I say when I talk to someone is I'll say, "What are you reading lately?" And almost invariably, the people will look at me and say, "Well, I just read the internet."

Host 1: By the way, nobody wraps a book. The way Mitchell Tsai wraps a book. When you get a book from him, if he mails it to you, it's like getting into Fort Knox. It's perfect. Perfect cuts, perfect seams, perfect tape job. It's unbelievable.

Host 2: And more importantly, it's not Scotch tape, it's mailing tape extra strength.

Chris Gallagher, MD: Mailing tape. That's tough stuff.

Host 1: So, Chris, we've kind of talked about private practice medicine, academic medicine. You've been retired for a few years now, but you were probably seeing this towards the end, the blurring of the lines between academia and the private world. Is academic medicine still a thing, or is it dead?

Chris Gallagher, MD: That's the $64,000 question. And I'll go back to my earlier caveat. I've been retired for eight years, so everything I say may be discounted. From what I saw towards the end and talking with people since I've left, it seems like academe is sort of dying. Let me give you just one like concrete example that you can hang your hat on.

So, I work like a dog, dog, dog to get Stony Brook into the simulation network, the thing that's used for the maintenance of certification in anesthesia. Very controversial topic. You can say it's a good idea, you can say it's a bad idea. But it was something in academe and we were there. We were one of the first centers. We were actually the first center to actually do a MOCA, I mean, actually do it and certify some people. And at a simulator meeting after that, the people from Harvard came up to me and they were pissed. I mean, they looked at me and they came up and they said, "We were really expecting harvard to do the first one." And I looked at them and I said, "Look, man, sorry that the State University of New York at Stony Brook beat you to it, Harvard." I don't even think they talked to me after that. But anyway, okay. So, we did that and I did a whole bunch of stuff and a whole bunch of people helped me. A lot of people helped me get the MOCA thing there. As soon as I left and retired, it died. Look at the Simulation Education Network. It's not at Stony Brook anymore. And is anyone to blame? No one's to blame. What happened is it's like, "Okay, that takes time and manpower, and it doesn't do cases and bring us in money. And it gives us a little academic-- what, panache? A little academic--

Host 1: Swagger.

Chris Gallagher, MD: Swagger, whatever. And it's like, "No, let it die." Those people that were doing that stuff, have them do cases. So, my understanding-- and you guys know better than I do-- my understanding now is in "academe", basically everyone's doing, just doing tons and tons and tons of cases. And consequently, they're making tons and tons of money. So as an economic sidelight, I got out of academics just in time to not make any money.

Host 1: Congrats.

Chris Gallagher, MD: I mean, there's got to be a genius to that. And from what I hear from other people at other places, nobody's getting academic days. People are just banging out cases by the bazillions, and they're making ton of money. So, let me go on and say, is that a bad thing? Well, to all the guys making ton of money, I don't hear any complaints. I mean, I looked up some of my old residents, the houses they're buying, oh my God. I mean, I'm here in my retirement double-wide mobile home with full pine logs with a refrigerator out front. And residents, people that I taught are in Zanadu. They're in these like multimillion dollar-- they have hot and cold running servants. I mean, it's unbelievable. And I'm thinking to myself, "Oh my God. that's good. The student exceeded the teacher." You know, they're making a ton of money. Good for them.

Now, the big question, is this hurting residents? That they're basically just doing cases and everyone's not getting academic days and stuff. I don't think it's hurting residents at all. Residents are doing tons of cases, and that's how you learn. You learn by doing tons of cases. I mean, me sitting there on my nonclinical day and coming up with some brilliant lecture that I'm going to give to them on the academic afternoon, you know, when they're all just sitting there looking at their phones anyways and texting each other and sexting each other, you know? I'm like, I don't think all my academic schlock really did that much good--

Host 1: To compete with sexting, right?

Chris Gallagher, MD: Yeah. Yeah. And I would like to think that all the stuff I taught in the sim center was, "Oh, this is so brilliant and this is so fantastic. And, oh, my residents are going to be so much better doctors because of their time in the sim center." Were they better for the time in the sim center, or maybe they'd have been better off just doing cases the whole time? So, I suffer no delusions about things being less academic, but it's still okay for the residents.

Host 2: You've talked about the residents, you've talked about the department, sort of the academic anesthesiologist. But what do you think about the specialty, right? And this is where you look at every program because of the 1990s and now with the Great Resignation, we're missing a cohort of anesthesiologists that can mentor the future generation. There's that discussion. How do you mentor the next generation coming into academia? But there's really no pooling of resources. Like you said, Harvard and Stony Brook, right? But it's not like New England got together and said, "Hey, Dartmouth, you're going to do sims. Maine Med, you're going to do research. And then Vermont, I don't know what we're going to do, but we're all going to do different things and we're going to rotate our people based upon what they want to do and where they want to go. You don't see that as a collective.

Chris Gallagher, MD: No, that's all news to me. I'll give you an example when that MOCA thing started, the SIM network thing. I went to different places to see how they did it, and other people came to Stony Brook to see how I did it. So, we had someone come from Northwestern and we had someone come from Texas and they saw how we did things. And then, I went to a couple different places and saw-- and I went to Pennsylvania and stuff and saw how they did things and that I thought was a great sort of cross- fertilization, you know? I actually got to see them in action. They got to see me in action. And it was the only time that I really saw cross fertilization. So, the stuff you're talking about, Mitch, you know, different groups, I think would be a great thing. But I don't know how that would happen.

Host 1: So, Chris, tell us about retirement, man. You kind of joked in some of the earlier emails that your goal today is that that this year doesn't end up on your headstone.

Chris Gallagher, MD: Right, right. Yeah. goal is to stave the guy who wanted to chisel 2025 in my headstone. And then, when January 1st comes, it's to try to keep 2026 off.

Host 1: So as a guy who worked really, really, really, really hard back in the day, what are you doing these days? What occupies your time?

Chris Gallagher, MD: Well, I mean, I like to write and, you know, I wrote the anesthesia books and stuff. And then, when I retired, I kept writing. And the first thing I wrote-- again, it's too bad this isn't visual. So, the first thing I wrote was This is Retire Wrong. And it's an adult coloring book on like everything you shouldn't do in retirement. So, like, here's one. "Tony doesn't believe all that hooey about taking care of the heart." So then, there's a picture of him, you know, doing that stuff. And then, you know, when you rent a car, did you ever get in a car and wonder who else drove it? So, I wrote a book called Florida Plates" Who Rented This Car Before Me?" And what I did was, I just-- the vehicle, ha-ha-- of the book is I just keep putting people into the car. I would just think of the craziest thing and throw them in a car and then just see what happened. And then, the last thing I wrote-- this is remember in like junior high and stuff and you'd have someone come on career day, and they would like talk about their careers. So, I thought, "Well, that would be kind of funny to like look at the career day, tales from the career day. And it's just like all these different-- and of course, everyone's weird, no one's normal. Everyone's weird, weird, weird. Like my favorite guy who comes in and talks to the kids is a guy who works at a sewage treatment plant. And he says, "Kids, when you get a job, say to yourself, if I went on strike, how long before they would pay me?" And he goes, "I make sure the sewage gets taken care of. Guess how long I'd stay on strike before they gave me a raise?" And the kids are sitting there and he goes like, "What would happen if every single philosophy professor went on strike? But you're a garbage man and go on strike? Damnit. Oh, they're going to give you a raise.

So anyway, you asked me about retirement. I like to write, I like to cook. Now, I'm having to cook low carb, which is tough. Ugh. I like cookies and stuff, but I'm trying to do that so I can stay alive at least through '26. And then, I mean, the main thing about retirement is just that the time is my own. So, I can do what I want. It's funny when I talked to you guys before the times of yore, you guys are always like, "Yeah, I'm a little busy charge. Where's the paddles? Yeah, first, just a second. Here. But the compression should be faster. Oh my God. Get the hundred units of blood." And I'm like, "Is this a bad time? Is this a bad time?" And then, I'm like, you know, I want to take a nap, I can take a nap. I give retirement my highest recommendation.

The main thing, why did I retire at 59? We're all medical. Everyone listening to this is medical. None of us know how many years we have left. I do know this though, the beginning years are more likely to be healthy than the ending years. So, we all know that person who's 86 years old and they're still at the hospital, they're still working. Good for them. Some people like to do that. I hasten that there's a million ways to retire. My way isn't the right way for you, but there's other things I'd rather do. There are other things I'd rather do. So when I was getting ready to leave Stony Brook, I just went up in front of the residence, and I knew who was going to follow me and she's way better than I am. So, I said, "I have good news for you and good news for you. The good news is I'm leaving and the good news is you're getting an upgrade."

Host 2: That's a wonderful statement in itself, right? Having the opportunity to leave a department knowing that it's going to go even farther than where you took it.

Chris Gallagher, MD: Oh yeah, it's way better than when I ran it.

Host 1: No. Mitchell said that to me many, many, many times though, right? What's the goal of a mentor, is to take you to the end of my capabilities and throw you as far down the road as I possibly can. See Mitchell? I do listen. I do listen when you talk.

Host 2: And then, just in case our listeners do read, your Career Day Tales, it's based off of Chaucer's Canterbury Tales. And then, Matt, we should probably list all of Chris's books and their Amazon ranking on the podcast posting.

Chris Gallagher, MD: The funny thing is Amazon rankings are like Danielle Steele will be like number eight and Stephen King will be number three. And then, you see one of mine and it's number like 12,000,690. You know, I'm right after the Keokuk 1971 phone book. So, trust me, my best royalty check ever, I think I got one for $2.36 But most of the time, all they do is they send a thing that said, "Uh, there really wasn't enough to warrant cutting you a check, so..."

Host 1: We don't make pennies anymore, right?

Chris Gallagher, MD: Yeah. Since I don't make pennies anymore, I ain't getting any more royalties.

Host 1: Chris, we asked this of all of our guests, and it's kind of become one of our signature questions. What does Chris Gallagher coming out of medical school, coming out of residency on fire for medicine? Looking back on that, what does Chris Gallagher now tell Chris Gallagher back then?

Chris Gallagher, MD: Nothing. And why is that? Never give advice, because smart people don't need it and fools won't take it.

Host 1: Chris, brother, this has been fun, man. This has been a blast. We will stay in touch. And it's been really, really fun having you on, man. Thank you so much for doing this.

Chris Gallagher, MD: It's been fun. I'll let you know if I get into sinus rhythm or if I bleed in my head or, you know, if they need someone to unplug the ventilator, I know a couple guys. They'd be happy to. I know a lot of people that'd be happy to do it. Oh, yeah.

Host 1: It's going to be a fun season, Mitch. We got to make sure we have this much fun every episode. It's going to be tough to replicate. Thanks everybody. This has been fun. We'll see you next time.