247: Attention, Memory, and Anxiety with Howard Buddin

This week’s guest is Howard Buddin, a neuropsychologist and four-time guest on Systematic. He joins Brett to talk offer his perspectives on psychological health in and out of quarantine.

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[00:00:00] Brett: [00:00:00] This week’s guest is Howard Buddin, a neuropsychologist, and four time guests on systematic. It’s great to have you back, Howard.

[00:00:07] Howard: [00:00:07] Great to be back. Thanks.

[00:00:09] Brett: [00:00:09] It’s been, yeah, it’s been about five years since we last talked. So I I’m going to assume a lot has happened. When we last talked, you had finished your postdoc, you had opened up, S C neuro it, I know that’s the web address.

[00:00:22] Is there a longer name for that? No, it’s called SC neuro.

[00:00:26] Howard: [00:00:26] just the neuro I mean, the it’s a short version sort of, of South Carolina. Neuro-psychology

[00:00:33] Brett: [00:00:33] Yeah. I, I did put that together, so

[00:00:36] Howard: [00:00:36] when I, yeah, when I was coming up with it, I want it, you know, uh, my, my wife, uh, a lot of what she does involves marketing, um, branding, advertising, et cetera, for small businesses. And so, you know, sort of by association, I I’ve adopted and learned a lot from her.

[00:00:53] And one of the things is like, eh, make it easy. Right? Uh, you have, yeah. You have people who have these. [00:01:00] Horrible, uh, business names and emails, right. That just take you an hour to type out. And I didn’t want that. So yeah, I seen neuro

[00:01:07] Brett: [00:01:07] anything with the word neuro-psychology and it would be unmarketable it’s just too hard to say.

[00:01:14] Howard: [00:01:14] Yep.

[00:01:15] Brett: [00:01:15] Yeah. So how’s the clinic going?

[00:01:17]Howard: [00:01:17] Um, it is going, uh, it is going really well by most measures. Um, Of course with the pandemic this past year has made things interesting in a lot of respects. Um, we’ve had to adjust a lot for changing, um, like how we deliver services, right. Um, how we see patients, uh, in addition to keeping up with the.

[00:01:42]Governmental and health insurance, billing Like it’s, it’s, it’s been a lot, but, um, we we’ve kept things running and kept everybody, uh, fortunately employed and, uh, had been able to keep, keep seeing patients. But, uh, yeah, we’ve [00:02:00] grown, grown quite a lot in the last five years. I went from a. Just one man operation more or less two, um, hiring on, uh, several employees, including, uh, opening a second clinic, uh, hiring a doc doctor, run that one and, uh, you know, fantastic support staff, office manager, et cetera.

[00:02:23] So, yeah.

[00:02:25] Brett: [00:02:25] that’s awesome. You guys doing a lot of, uh, tele health now?

[00:02:29]Howard: [00:02:29] Yeah. Yeah. Um, in the, uh, early, early days of the pandemic, um, we, we almost Mo we, we more or less kind of shut down if you will, uh, for a couple of weeks and just did kind of limited tele-health as we were kind of getting that stuff set up. Um, and now that we’re sort of in the swing of things, um, we probably do.

[00:02:53]Uh, I, I want to say like 70% of appointments are telehealth. Um, sort of [00:03:00] the unofficial rule is like, we want all patients to do tele-health and less when you’re calling to schedule the appointment, you know, if they say something like what’s a computer, uh, you know, then we’ll, we’ll, we’ll work it for an inpatient visit, but otherwise, um, you know, we try to minimize exposure like that.

[00:03:17] And for in-office visits, they’re set up so that. We’re only, we only ever have one patient in the clinic at a time. Um, and they’re spaced far apart to give us time between patients to walk through the office and do, you know, grab the sanitation wipes and wipe everything down and, um, get prepped up for the next person.

[00:03:37] So we’re, we’re doing our best, you know, to minimize the risk of transmission. Um, you know, of course being. Directly involved in healthcare delivery, like, and a lot of our patients being that in that older sort of more vulnerable group of

[00:03:51] Brett: [00:03:51] sure. Yeah.

[00:03:52] Howard: [00:03:52] um, you know, the, the risk is higher still. So we want to protect ourselves, right.

[00:03:58] Uh, myself, my employees, as well [00:04:00] as, um, make sure that we’re not, you know, a spreader kind of node or vector. So

[00:04:07] Brett: [00:04:07] So how have the types of problems you’ve seen, um, have they changed with the, the pandemic? Are you seeing more certain types of stress or, I mean, there are obvious answers to that, but.

[00:04:21]Howard: [00:04:21] Yeah. The, the biggest one, um, as far as like, right. So, so people generally are going to be more stressed out because. Almost almost all at once. Um, all of the normal Moore’s of our daily activities and so forth, right. The anchors of stability that we really fail to appreciate, and day-to-day life were just sort of ripped out of the ground.

[00:04:45] Right. Um, so when, when, when that stuff happens, right, people are going to get upset and stressed, but, um, we’re seeing in, and you’ve seen in the last couple of months, probably a lot more articles have been popping up online about the mental [00:05:00] health side of things, um, as a result of the pandemic. Um, yeah, that’s been going on here and I’ve.

[00:05:07] Talk to other doctors or you know, of different, um, specialties around, uh, around and about. And we’re all seeing kind of the same thing, which is, yeah. People are coming in with really people. Who’ve never had problems before on the behavioral or cognitive side are showing up with problems. Um, primarily related to like attention and concentration and memory, um, and, uh, heightened anxiety and symptoms of depression.

[00:05:35] Um, those are the big ones. Um, and without getting too, too long into it, you know, you know, there’s a, always a relationship between your mental health and your physical and cognitive abilities and health. Right. Like, it’s easy to think of, right? If you get the flu, you’re not going to be able to do the things as well as you usually do them.

[00:05:55] And if at all, it’s the same thing. If you’re stressed out anxious, depressed, right. You’re not going [00:06:00] to be sleeping. You know, a lot of people have like severely disrupted sleep, um, that has an impact on cognition. Um, and so yeah, people just show up that are completely out of sorts or, you know, if they’ve been well-managed, you know, like with depressive or anxious, Um, conditions for years, it’s all of a sudden these symptoms have just blown up out of control

[00:06:19] Brett: [00:06:19] Sure.

[00:06:20] Howard: [00:06:20] it, it it’s, it’s the wild West.

[00:06:22] It’s like hard to manage on our end. We’re kind of like, Ooh,

[00:06:25]Brett: [00:06:25] Yeah. Um, the anxiety doesn’t surprise me at all, but the, uh, attention and memory is that, uh, correlated with anxiety or is that something specific to kind of pandemic life?

[00:06:38] Howard: [00:06:38] Yeah, so good. Good. That’s a great, great question. At the best way to think of it is, um, Like like this. Okay. So we’ve got to pay attention to, um, things without him within, in other words, uh, if you’re driving down the road, there’s a lot to pay attention to, right? All the cars around you. And if you go to shift lanes, you’ve got to look over [00:07:00] and make sure there’s no cars next to you, et cetera.

[00:07:01] Um, so you’re paying attention to what’s going on out in the wide world. Um, but you’ve also got to pay attention to the things that are in your head, right? Like you’re. On your way to the grocery store, let’s say you’re driving. Right. And you think like, Oh yeah, I need to also pick up some eggs. Right? So you’re focused on the stuff that’s going on in your head and, and the outside world.

[00:07:25] Now, your brain is built to rapidly shift. Back and forth, uh, rapidly shift attention, back and forth, um, between, you know, whatever it is you need to focus on. Um, but what happens when your, um, anxiety kicks up, stress kicks up really high as he is. You’re more likely to spend more and more time worrying.

[00:07:50] Right. Thinking, um, about what’s going on right now, or what’s coming down the pike in the future. And so you have this buildup [00:08:00] of thoughts that you’ve got to focus your attention on and therefore your brain you’ve got less cognitive wattage to direct, to focusing on what’s going on in the outside world.

[00:08:11] Okay. Now the final piece to this is that. Um, if you’re not focused on something, um, then it’s unlikely, uh, are the chances that it makes it whatever it is going on. The chances that makes it into memory are significantly reduced. Right. Um, you know, it’s like if I, if I asked my kids, even, I’ll say like, remember to put your plates away.

[00:08:35] Uh, after you eat and if they’re watching TV then, or they go, Oh, okay. Okay. Right. And I’ll say, what did I just say? And they’ll even characterize it as a memory thing. Oh, I don’t remember. Right. But really they just weren’t paying attention. Right. So it looks like walks, like sounds like a memory problem.

[00:08:52] Um, But in fact, in so many cases, um, it’s a focus thing and the focus problem [00:09:00] comes from being just overwrought, overcome overwhelmed, um, with, with worry and concern for all these things we’re trying to manage as adults, uh, that normally come to us, if not automatically than easily enough. Um, But, but like I said, you know, all those normal sort of, um, rituals and things we do would do and, and rely on, um, w we can’t do those things as well.

[00:09:23] If at all right now,

[00:09:25] Brett: [00:09:25] so I’m not asking you to, to give any medical advice, but what kinds of things would you say in general, the population who by and large are suffering from heightened anxiety? What kind of stuff is good? What kind of mindful stuff. Can you do to kind of deal with life right now?

[00:09:47]Howard: [00:09:47] Oh man. Yeah, that’s the wild West part I was talking about earlier. Um, you know, because it does vary so much from person to person, but Jen generally, um, I would [00:10:00] say, you know, number one, just kind of like being, um, w two use use the exact unit term mindfulness, right? Um, Mo most adults are, uh, pretty, not great at being mindful.

[00:10:14] Um, which is to say turning, you know, the turning the focus inward and saying like, well, how am I doing in this situation? Right. You know, we tend to be thinking about like, what do I need to do here, here, here. Um, but paying attention to yourself and noticing like, Hey, you know, I’m. Boy, you know, I sure am like more irritable, right?

[00:10:35] I’m like snapping at people and that’s just not me. Right. Um, it is kind of a good step one. Um, you know, recognizing when you’re under stress, uh, and acknowledging that, right. Um, paying attention to that, um, because the, a that’s going to impact everything around you, right. It’s gonna affect, you know, family members, coworkers, et cetera.

[00:10:56] Um, so be being aware of that and not, [00:11:00] um, Being, uh, uh, not, not being hesitant or afraid to, to reach out and seek some additional help, whether it’s from your primary care doctor or, um, a therapist or counselor or something like that. Cause I’ll, I’ll tell you if there’s one, as far as healthcare delivery goes, if there’s one good thing, that’s come out of this pandemic.

[00:11:22] Um, it is that the, with, with telehealth being fairly ubiquitous now, um, The, for people to be able to access, you know, kind of like individual counseling services or something like that is a lot easier than it used to be. Right. Cause you don’t have to like carve out time to drive out, to go see a counselor or a therapist they’re all online now.

[00:11:44] They all have it all, but you know, if they want to stay in business, um, they’ve got tele-health services set up. So I would say something like that would be a, you know, a good first start. Um, it, you know, if, if it’s something that’s manageable for you.

[00:11:58] Brett: [00:11:58] Yeah. I just went to my, [00:12:00] anyone who listened to last week’s episode will know that, um, Better help started sponsoring my podcasts and they do online psychiatry and I’m not being paid this week to talk about it. But I did go to my first therapy session, like in my life through them. And yeah, it was really like, I don’t know if I would have gone, like I’m not motivated to go out and set up an appointment, sit in a waiting room, go to someone’s office.

[00:12:30] But if I can do it from my home, Yeah, that is great for me.

[00:12:35] Howard: [00:12:35] Yeah. Yeah. And honestly, like I, especially for young adults who maybe have like kids and a job and all this right. A lot going on, they’re already, they’re already time limited. Um, I was, uh, you know, I, I’ve always been really hesitant to, um, Refer them out for therapy or to recommend therapy because it’s like, look, you’re, you’re already busy.

[00:12:58] Like, what am I going to do? Like [00:13:00] tell you that the fix is a stack, something else on top. Like, even if I think it might be beneficial, um, that, that in itself can still, you know, be, be a lot to ask somebody to take on. But exactly, like you said, like now you don’t have to do all that stuff. Right. Um, and even, you know, there’s, I think, I think everybody could probably benefit at some point.

[00:13:21] From like a single therapy session, even. Right. And just to like walk in or, or, or, or set up an appointment just to say, Hey, uh, I just need to, um, open this pressure release valve for, you know, 45 minutes and, uh, you know, to somebody who’s a, an unbiased uninvested third-party right. Like there’s some cathartic value in that.

[00:13:41] There’s some therapeutic value in that.

[00:13:42] Brett: [00:13:42] Yeah, that’s, that’s exactly what I found turns out. It’s a good thing.

[00:13:48] Howard: [00:13:48] Yeah.

[00:13:49] Brett: [00:13:49] so as a result of anxiety and depression, and the sudden shift to work from home, uh, productivity has become, [00:14:00] um, Uh, heightened and in my opinion, not necessarily healthy focus for a lot of people that are struggling to find their footing in a changing landscape of work right now.

[00:14:14] Um, have, so one of the topics that, uh, that comes up and that I know you have some feelings on is the idea of multitasking. And, uh, in general, what is your, your, can we multitask?

[00:14:31]Howard: [00:14:31] right. So the short answer to that question is no. Um, but I’ll give you a little more that this goes directly back. So, so first of all, let me, let me add to that and just say like, yeah, as far as like what I’m seeing clinically, um, to go back to that question, the, um, Boy. I, I would say the majority of people I’m seeing at least of people that are gainfully employed, right.

[00:14:59] That aren’t retired or [00:15:00] whatever. Um, that productivity piece, I mean, I am seeing it in droves these days is probably the, I dunno, majority of things I see. Yeah. Um, who are having problems with. Work productivity, uh, staying on top at home, et cetera. So back to multitasking, at least the way that people normally think of it, right, is doing two or more things at once.

[00:15:29] Right. Um, and like, like I was mentioning earlier, you know, your brain is wired to switch attention back and forth rapidly really, really quickly and efficiently. Right. Or efficiency being the right speed plus accuracy equals efficiency. Right. Um, so your brain is built to do that really efficiently. Um, but what your brain can’t.

[00:15:50] Slash won’t do is dedicate a hundred percent of focus to two things simultaneously. It can’t be done. Right.

[00:15:59] Brett: [00:15:59] yeah, [00:16:00] that makes mathematical sense. Sure.

[00:16:02] Howard: [00:16:02] yeah, it would be akin to too, like I know analogies are often drawn between the brain and computers and they’re usually like much more flawed, I think, than what people realize. But if we can make that analogy for just a second, it, it would be, um, Uh, similar to, um, you know, simultaneous processing and, uh, a single core kind of processor, right?

[00:16:24] Like it’s not actually happening. It’s, it’s doing the same thing. It’s swapping really, really quickly. Um, so your brain can’t do that. So we want to, you know, as I tell patients, right, like when you leave the office today, you’re going to be disabused of this notion of multitasking. Um, cause it doesn’t work and you’re just going to end up, um, You know, splitting your attention too much, trying to do too many things.

[00:16:49] Uh, and instead of trying to get lots and lots and lots of stuff done, right, it’s a skill. Uh, you want to try to be able to zero in on one thing and do it to the best of your ability to see that through to completion [00:17:00] before you begin something else. Um, but, but

[00:17:04] Brett: [00:17:04] what do you say to people who are suddenly facing with working in an environment where they have kids around? They have, uh, they have zoom calls going on while they’re trying to do work. Uh, whatever additional, like for me, office work was more distracting than anything that happened at home. But I don’t have kids and I’ve always had a quiet office and it’s always been a safe space for me.

[00:17:28] And I know that a lot of people working from home are faced with almost a need to multitask. Now

[00:17:35]Howard: [00:17:35] Yep. Um, boy. Yeah. The worst thing I could do is like pitch some sort of vibe, our, you know, disconnected solution and say like, well, you know, what you need to do is make sure you’re not interrupted, ended up. Right. It’s like you say, people are forced right. Effectively to, um, adopt, uh, or rather alter. How they do things because they’ve got kids at [00:18:00] home or, or, um, you know, they they’re forced to change their work because they can’t go into the office and the, you know, the normal support staff or, or mechanisms are gone.

[00:18:10] Right. And, um, they they’ve got. All this stuff going on. And th the man that, that the simplest answer is, is that, you know, sometimes I’m just sitting there, like, how am I supposed to solve this problem? You know, it’s a boots on the ground thing. Um, in other words, like it can be so different from one person to the next that there’s not a good universal solution for it.

[00:18:33] Um, there, um, what I tend to. You know, on the clinical side, what I tend to look for, um, uh, is, is more of these, um, symptomatic or clinical kind of changes, like a big one, probably the most common one is, um, People’s sleep has just thrown completely off balance. Um, either cause they’re trying to stay up [00:19:00] later to get more done or they can’t fall asleep because that anxiety piece we talked about earlier, right?

[00:19:05] Like anxiety is a super common disruptor of sleep. Right. Cause you lay down, you lay down in bed and um, All the things you kind of had competing with your attention all day long are gone those outside environmental things, right. You’re just sort of left there with the internal things to attend to. In other words, your thoughts, right.

[00:19:24] And so there’s kind of spiral spin up. It’s like the hamster wheel. Um, and it keeps people from being able to fall asleep and, or, um, has the, you know, waking up they’re up and down during the night, uh, you know, just waking up like a shot. With worry about what they need to do tomorrow that didn’t get done today.

[00:19:42] Um, so kind of zeroing on things that I can address like that, right? Like maybe we need to recommend, um, some kind of a medication intervention to help with sleep. Um, Yeah, maybe it’s something as simple as saying like, all right, you know, you carve out some [00:20:00] time, half an hour to go on, do some exercise or a walk, right.

[00:20:04] Um, to help out with that and to help with stress relief. Um, but yeah, I tend to focus more on those clinical pieces that the symptoms of, um, cognitive or behavioral change. As opposed to being able to, I mean, I would be overwhelmed. I mean, there’s no way, you know, we can solve those pragmatic problems. Um, but yeah, can offer some more practical solutions in addition to the clinical stuff, like, okay.

[00:20:33] You know, to the best of your ability, try not to have, you know, a Skype call going on one end and, you know, TPS reports on the other, uh, uh, and, um, But, but yeah, at the end of the day, it’s man, that’s it that’s been one of the hardest pieces to, to address over the past several months is trying to offer some kind of, um, case-by-case help.

[00:20:58] But,

[00:20:59] Brett: [00:20:59] Yeah, [00:21:00] so basically single task, as much as you’re able to, but. I mean, you gotta do what you gotta do.

[00:21:06] Howard: [00:21:06] Yeah. Yeah. Right. And then kind of like, you know, I, I, I’ve heard David Sparks use the, uh, expression. Right. You know, sometimes you’ve, you’ve got 15 gallons of water in a 10 gallon bucket. Right. Like what are you going to do? Um, in, in, in some of these cases, really like one of the, like people really so often whether they come into the doctor or talking to a friend, um, what they’re really looking for is validation.

[00:21:33] Right. Like they, they want somebody to say, like, that sucks. I’m really sorry to hear that. Right. Like that’s. That’s powerful medicine. Right? Um, like we, sometimes we don’t want people to offer solutions. Right. We like to offer a solution to a problem they’ve never had, you know, we just need somebody to say like, man, I, I feel for you.

[00:21:56] Right. That, that sounds like that’s really hard. Um, [00:22:00] so, you know, in addition to everything else, I mean, you know, offering that validation, right. And it’s not forced. I mean, I’m not like phoning it in. It’s like, I really feel bad for him because, Hey, I’m facing a lot of these challenges on my end. Right. Um, I mean, I’m working, I go home, uh, in the evenings and, um, have some dinner and help put the kids to bed and everything.

[00:22:22] And then usually I’m, I’m back in the office, uh, at nine o’clock or so, and for another couple of hours where the work

[00:22:30] Brett: [00:22:30] yeah.

[00:22:31] Howard: [00:22:31] and it’s how I manage it.

[00:22:32] Brett: [00:22:32] Yeah, we, uh, overtired listeners will know this already, but, uh, we had a kitten that we had for about nine months that we had to, uh, get FIP and we had to put it to sleep. And that was. Like one of the hardest euthanasia’s I’ve ever been through. And honestly, out of the outpouring of support, you know, where I, where I mentioned it on social media, uh, the things that mattered the [00:23:00] most to me, the things that, that felt the best were people that just said, Oh, wow.

[00:23:05] That’s, that’s horrible. That sucks.

[00:23:08] Howard: [00:23:08] Yeah, yeah, yeah. You don’t, you really don’t want to hear the, um, everything happens for a reason

[00:23:16] Brett: [00:23:16] Oh, yeah. Rainbow bridge stuff. No,

[00:23:19] Howard: [00:23:19] Right, right. And there’s actually even been some research around that. Um, I think it was, uh, uh, the researchers followed a group of, um, people going through cancer treatment. And, um, and they were looking at, you know, what kind of things were helpful when talking to providers or family members or whatever, and yeah.

[00:23:38] Even if at first it’s something that you think you want, it’s like, after a while, you know, the research shows us in this study, it was like, it wears on people quickly. Right? Like, I don’t want to hear that things happen for a reason. Right. I’m sick. Uh, um, yeah. You want that validation?

[00:23:54]Brett: [00:23:54] So let’s switch gears and, and talk about, uh, lightsabers.

[00:24:00] [00:24:00] Howard: [00:24:00] Okay.

[00:24:01] Brett: [00:24:01] Tell me, tell me a story about lightsabers.

[00:24:03]Howard: [00:24:03] Um, so I am a, card-carrying died in the wool, you know, long standing. Star Wars nerd. Right? I have, in fact, in my, I have a couple of star Wars art things here in my, my clinic office. And, uh, even a trashcan that I got when I was eight years old returned to the Jedi. Uh, um, and so a few years ago, um, my wife and kids and I, we went down to Disney and, um, On on the way out.

[00:24:35] Uh, I picked up a one of these, uh, Hasbro licensed, you know, kind of more or less screen, accurate replicas of, uh, a lightsaber. And, um, just by my nature, uh, I like, I. Can’t leave things alone. I have a, uh, an array of tools. Like I like tinkering with stuff and, and always have ever since I was a little kid, right.

[00:24:56] I’d take my toys apart. Um, so what am I going to [00:25:00] do right within a couple of months? Um, I’m I ripped the lightsaber apart and, uh, go online and start looking at like, um, You know, hacking and customizing these things and there’s a whole community, uh, as you might imagine, right? Uh, uh, probably unsurprisingly there’s, uh, uh, uh, you know, I guess relatively, anyways, a large community of people who do this stuff, either hobbyists or people who, you know, do it as they’re living.

[00:25:26] Right. Um, and, uh, so I started doing a lot of research and, um, Kind of got it back together, but in a way that was heavily customized. Right. And from there I started like started, um, down the track to where I am now, which is like, I’ll, um, I don’t have like a lay there, a CNC or anything, so I can’t build my own hilt.

[00:25:48] So I ordered the, uh, like I’ll order the machine Hilts and, um, get, uh, get parts together. Some of them are like 3d printed. Um, but, uh, I. [00:26:00] Install it with this, um, an Arduino board, uh, this guy, uh, Frederick Cuban that, um, was the sort of creator of these things are made in small batches, but they’re just these little Arduino boards basically that you can use, um, to power the whole thing.

[00:26:17] Uh, and, uh, you can customize the code. Like you’ve got to compile it and install it, right. Upload it, using the R um, Arduino. Uh, ID, um, but you can, you can make it do just amazing things. Uh, so like the blades that she’s put in there, they’re, uh, they use Neo pixel, uh, for the lighting. And I think the blades I’ve been making have, Oh gosh, a little under 280 individual pixels.

[00:26:47] Um, in there, so it’s like, you can make it right. So like, when it turns on, it kind of extends outward, like it does in the movies. Right. But, but you can program it to do anything, right. Like, you know, rainbow kind of, [00:27:00] uh, flowing along the blade or, or, uh, mimics like clashes and, uh, like, uh, blast or bolt blocks, like all the things that you see them do in the movie you can make with that.

[00:27:12] Um, so it’s just really fun. It’s a good, um, Like, I always have some kind of hobby going. I usually switch every couple of years, I’ll go in like full force and then switch to something else. Um, but, uh, it’s a good way at the end of the day, like with the little free time I have to kind of go home and after, you know, the kids are in bed or something like that, go out there and, and tweak and work on it.

[00:27:34] Um, I have, uh, really refined my soldering skills. I’m a Ninja with a soldering iron now. Um, these are incredibly like tiny pads. You’ve got to get and super, super small gauge wiring, but, uh, I just got a new one in the mail last week. So I’m excited to start getting to work on that.

[00:27:54] Brett: [00:27:54] Have you ever seen these toys that, uh, you, you they’re like lights that you [00:28:00] wave through the air and in the kind of after trail, it spells words.

[00:28:05] Howard: [00:28:05] Yeah, you can do that with these.

[00:28:07] Brett: [00:28:07] that would be amazing.

[00:28:09] Howard: [00:28:09] Yeah. Some, some dude, uh, I’ve only, I, I think I’ve only seen one of the videos where, um, some guy did it where, when he waved it back and forth. Yeah. It would spell out star Wars. Yeah.

[00:28:21]Brett: [00:28:21] You could make it, do the opening crawl. That would be amazing.

[00:28:24] Howard: [00:28:24] That would be intense. Yes.

[00:28:27] Brett: [00:28:27] So, so do you find, uh, picking up new skills, like, uh, soldering for example, do you find that beneficial overall to your kind of cognitive mental health?

[00:28:39]Howard: [00:28:39] Um, yeah. Yeah. So if we separate out cognitive and mental health, actually into two separate pieces. Right. Um, and, and so, you know, like I said, on the mental health side, it’s good at the end of the day, just to kind of switch off and do something different. Um, but also like on the cognitive side of things, I [00:29:00] guess there’s a couple of points there, like, as you.

[00:29:03] Probably have experienced or might be fully aware of, right. There might be a problem that you’ve just been slaving over and you can’t solve it. Right. Um, you, you, you get to a point of diminishing returns and you’re like, I’m getting nowhere and frustrated and all this. And, and so often the best medicine is to walk away and, you know, do something else.

[00:29:22] And the problem just sort of. Boom. Yeah. Yeah. Um, so, you know, good for that. Just like switch off and do something different. Don’t keep thinking about these other things over here. Um, but uh, I I’ve come to, I was, I’m pleased to find out that, um, over the course of my training and of course, like ongoing, right.

[00:29:43] We have to do continuing education, um, in order to. One keep up current with the latest and greatest knowledge to the benefit of our patients, hopefully. Right. Um, but, but, uh, also just for self edification, uh, along the way, find that, you know, uh, as [00:30:00] research continues to develop, we see that, um, in, uh, in, in that cognitive sphere, uh, that.

[00:30:08] That people. It’s an interesting problem. I’ll characterize as best I can, but, um, there’s, there’s some good evidence that people who continue to learn new skills over the course of their life, um, are, we’ll say like less likely or less susceptible, uh, less likely to develop, um, Cognitive difficulties later in life, things like Alzheimer’s disease.

[00:30:34] Um, right. And, and it’s, you know, we’re not sure if it’s like, okay, well, is it a top-down or a bottom-up thing? In other words, is the person already sort of predisposed to want to learn more things and new things, right? Autodidacts right. Self-teach self-taught um, or is it the act of learning the new thing itself that.

[00:30:55] Um, acts as this sort of prophylaxis, protective factor against things [00:31:00] like Alzheimer’s that part’s not quite as clear. Um, but there is good evidence that, um, in middle a age, uh, you know, forties, fifties, et cetera, kind of adults, we see that the mastery of a new skill, um, actually might, um, promote the, uh, Like connectedness of a specific type of neuron in the brain that we previously thought were just like structural and didn’t do anything.

[00:31:29] Um, so that’s relatively new stuff within the last five, 10 years, um, has really started coming up.

[00:31:37] Brett: [00:31:37] yeah. Actually I was reading, um, There was an article that showed, I don’t remember what the article itself was about. It was about Alzheimer’s in general, but, um, it showed that, um, uh, people who, uh, switched careers, their brain scan could show so full on. Alzheimer’s like that big black area in the middle of the brain [00:32:00] scan and they would display no symptoms.

[00:32:03] Like there was enough left and they had trained enough new neural pathways. Like it’s all kind of theoretical right now. They’re still trying to figure out why, as you say, but, but it it’s fascinating that that there’s that much extra brain that we could circumvent something as destructive as Alzheimer’s.

[00:32:23]Howard: [00:32:23] Yeah. Um, The brain, I mean, just sort of broadly, right. Is a fascinating, fascinating thing, bang. Um, and certainly it’s what drew me into the field I’m in, you know, never a dull moment kind of thing. Right. It’s um, each, each patient is unique, um, and, and the, the, the challenges and changes that they manifest, um, Keeps you on your toes.

[00:32:53] Um, but, but yeah, the brain is, you know, you see some interesting things, like, I mean, you’ll, you’ll see [00:33:00] imaging studies, I’ll, I’ll look at imaging studies that have been done and it, you know, there’s, the brain looks healthy, but the person, um, Behaviorally or cognitively is showing serious signs of impairment.

[00:33:11] And then you get the inverse, right. Which is like you say, it’s like the image might show this really degenerated, uh, degraded brain tissue. Uh, and we would expect all these problems, but clinically we don’t see that corollary. Right. We don’t see the clinical correlated version. Um, the it’s a fascinating.

[00:33:35] Fascinating topic. I think, um, you know, this idea of what can we do to help prevent it or stave stave off, uh, this cognitive decline. And so, yeah, if, if something like learning new skills, mastering new skills, changing careers, um, is a benefit then, um, that’s really, really useful, uh, useful information.

[00:33:57] Brett: [00:33:57] Um, are you familiar at all with the [00:34:00] latest in the brain scanning technology that actually, uh, fixes magnetic sensors, like a hundred, some magnetic sensors to the scale?

[00:34:09]Howard: [00:34:09] Um,

[00:34:11] Brett: [00:34:11] It’s like a pet scan, but yeah, I won’t go into it cause I don’t have all the details either, but, uh, it actually uses, uh, some form of quantum computing to offer. New analysis of brain function that has never been possible before.

[00:34:27]Howard: [00:34:27] so not off the top of my head. And boy, if we’re getting into, like, I would. I’ll have to go and see if I can dig some of that up because the quantum computing realm is in of itself still nascent.

[00:34:41] Brett: [00:34:41] yeah.

[00:34:41]Howard: [00:34:41] so yeah, the short answer is no, I’ve not super familiar with that. And that probably the best reason for that is that, uh, clinically like they’re there.

[00:34:51] So MRI, for example, is a much older, uh, or is an older, uh, imaging technology. And, um, there are different weights [00:35:00] that, um, An MRI can be run out. In other words, like the resolution, uh, improves like the higher, the number of there’s T1, T2, et cetera. Um, and it was sometime last year, we on our listserv, somebody was sharing some images of a T 11 weighted MRI, which is like not safe for use in humans, basically.

[00:35:21] Uh, but it’s this just, you know, I mean, just drop dead, amazing high resolution image of the brain. Nothing like I’d ever seen before. Um, but, but the point being is like the newer cutting edge research, et cetera, kind of techniques for brain imaging are the kinds that I’m least likely to see because we don’t use them

[00:35:43] Brett: [00:35:43] Oh, sure. Yeah.

[00:35:44] Howard: [00:35:44] Yeah. Yeah. So, but I’ll have to go I’ll I’ll

[00:35:47] Brett: [00:35:47] Yeah, I was more curious if you were familiar with the technology, not so much, like using it in your clinic or anything.

[00:35:53] Howard: [00:35:53] no, I’m, I’m not, I wish I could keep up with everything like that. Um,

[00:35:58] Brett: [00:35:58] I watch a lot of [00:36:00] YouTube. It’s it’s it’s my, I don’t play video games. Uh, when I, when I need that distraction, I go and my watch history is such that, uh, Brain science and politics are always in my recommended videos. And, uh, I, I do enjoy, Oh, in history, like I’ve gotten really into, um, prehuman or like early human history, like prehistory, prehistory.

[00:36:28] Like a hundred, a hundred thousand, 200,000 years ago, like studying, like what the world would have been like, uh, what flora and fauna and early, early man, that stuff has been super fascinating to me. And I’ve found like, it’s we go on walks every evening. Um, my, my girlfriend and I, and that’s, that’s how I want to talk about

[00:36:50] Howard: [00:36:50] Check out. Um, your YouTube history sounds fairly similar to mine. Uh, but, but check out, uh, if you haven’t already run across it, I mean, I feel like you might [00:37:00] have, but, uh, PBS

[00:37:01] Brett: [00:37:01] Ian’s yup, totally. EV almost daily. I watch an Yans video. Love that stuff.

[00:37:08] Howard: [00:37:08] I did. Yeah. That’s a good one. I’ve got, I subscribed to that when, and

[00:37:11] Brett: [00:37:11] I really should. I really should like sign up Patrion, whatever they, I watched so many of those videos, I should support them. They have t-shirts now. Get an Ian’s t-shirt. Yeah. All right. Well, if you don’t, I’m going to take a break to talk about, uh, this week sponsor one. I think you’ll appreciate, um, it’s one of my favorite apps, text expander.

[00:37:35] If you want to get ahead of your productivity for the new year text, expander is going to be your new best friend text expanded, removes the repetition from your work. So you can focus on things that actually matter. Say goodbye to repetitive text entry, spelling and message errors, as well as trying to remember the right thing to say at the right time.

[00:37:52] When you use text expander, you can say the right thing and just a few keystrokes. You, you save all of your repetitive tasks and you trigger it [00:38:00] with your own, whatever a short snippet works for you. Uh, it offers you flexibility and consistency for your communications. It’s better than copy and paste and better than scripts and templates.

[00:38:12] TextExpander snippets allow you to maximize your time by getting rid of the repetitive things you type while still customizing and personalizing your messages, using things like fill-ins. Text expander can be used on just about any platform in any app, anywhere you type. So take your time back in the new year and increase your productivity with text expander, systematic listeners.

[00:38:33] Get 20% off their first year. Uh, visit Tex expander.com/podcast. To learn more and a big thanks to smile for their continued support of my work and all my podcasts.

[00:38:45]Howard: [00:38:45] right on. I’m just sitting here looking at my, uh, text expander snippets statistics. Right now. I get the monthly

[00:38:55] Brett: [00:38:55] Yeah. Yeah,

[00:38:56] Howard: [00:38:56] Uh, stats and, um, [00:39:00] man there, I forget most recent, but, uh, I think my most recent was like 10 hours saved the last month or something like that.

[00:39:07] Brett: [00:39:07] See, so my, I, I do really advanced stuff with it. Um, I shouldn’t, that sounds like I’m tooting my own horn. I just do. I script, I script things. It accomplishes the stats measure. Basically how many words I typed versus how many words it output.

[00:39:26] Howard: [00:39:26] Yeah. Yeah,

[00:39:27] Brett: [00:39:27] But when, when I’m running a script, that saves me the trouble of like one that, uh, gives, uh, new licenses to Mark customers who want to cross grade from the Mac app store version.

[00:39:40] So basically I can just type comma, comma, M L I C. And it will replace the work of verifying the, the Mac app store license, going to the paddle website, going to the license page, generating a new license, copying it, coming back to the email, writing [00:40:00] out here’s your new license. Here’s where you download, pacing it in and sending.

[00:40:04] And I can do that with like five characters now. And it’s, it’s it. That saves me easily. Like six, seven minutes every time. And it doesn’t think it’s saving that much. So my report feels, feels undervalued.

[00:40:18] Howard: [00:40:18] Hello lighter than it should be. Yeah, absolutely. Yeah. It doesn’t tell you that. Yeah. It, like you said, it just bases it on the, like, here’s what you did versus what you would have typed strictly, um, yeah. Between, I’m going to tell you like, one of the nice things about being in private practice is that like, And one of the driving factors behind that choice was like, I didn’t have to, um, or rather I could set things up the way that I wanted to.

[00:40:42] And thankfully I have these like amazing employees who have been very careful with, I’m going to segue this into something else of interest maybe to you, but I’m, uh, very careful to not super foist my system. And way of doing things onto them entirely that said, um, they, [00:41:00] they do have to learn some new tricks as it were.

[00:41:02] Um, but yeah, between Tex expander, um, keyboard, Maestro, uh, launch bar, right? Like you say, to execute these things that would normally take so much more time above and beyond just simple typing. Um, like I can’t imagine knowing how going through my training and knowing how other. Neuropsychologists and similar clinicians everywhere get their work done.

[00:41:27] I couldn’t wait to start doing it my way. And I cannot imagine going back and doing it kind of the old way or the way that everybody else does. Like, I, I don’t know how people get things done the way they do Um, and um, if I can take just a, just a moment here, a minute, I’m looking at the clock, so I’m not gonna take too much time.

[00:41:49] To make a case for marked two here, just for a second. Um, because I read, uh, one of your, I guess it was one of your recent posts [00:42:00] about the, um, transition over to big Sur, right? Like the w the roadblock you ran to about blurry PDFs and everything. Um, And, uh, my, my clinic runs off of all Apple hardware and, um, and I’ve got it all except for my computer.

[00:42:17] Um, it’s all set up in jams. So like I have, when I read that I like immediately jumped in and changed my profiles to make sure that the operating systems would definitely not update date because I, I don’t know. I mean, I might be a little bold in saying this, but I would wager that. That collectively between all of us, we probably use marked to on a day-by-day basis, more than most people.

[00:42:44] Um, because we generate my entire workflow. Like I scripted out with a bash, you know, kind of shell script that out my own, um, electronic medical records management system. And, um, it’s, everything [00:43:00] is text-based and, and everything that goes out into the wide world is a PDF. Right? So step one was make all my files readable and universal, um, because most of these electronic management systems use like proprietary file types.

[00:43:15] Right. Um, and, and I didn’t want that, um, Previous result get into, but, but everything that gets converted into PDF from text runs through Marx too. All right. Um, so going all the way back to the script, right. That, that generates all the patient directories and everything like that. Like we hinge where we’re hinging on that.

[00:43:37] So,

[00:43:38] Brett: [00:43:38] I will get it fixed as quickly as possible.

[00:43:40] Howard: [00:43:40] pulling for you,

[00:43:42]Brett: [00:43:42] Yeah. That, that, that adds even more pressure. But I’ve already, I’m beholden to a lot of people who, who do, I mean, that is one of Mark’s best features is the PDF second output and how easy it makes that. So I

[00:43:57] Howard: [00:43:57] right. Well,

[00:43:58] Brett: [00:43:58] I’m struggling [00:44:00] my first, my first, my first solution.

[00:44:03] Didn’t pan out. Um, so I’m, I’m working on another, I may end up incorporating something like Prince XML to do it now, but uh, got to deal with OEM licensing on that. So it’s coming, I’m working hard on it.

[00:44:17] Howard: [00:44:17] Yeah, no, no pressure. Right? Like I said, we’re all rocking on Catalina for the time being. And I mean, I wouldn’t, honestly, since they’re all production machines, you know, I don’t tend to update the OS until usually at least six months out anyways. Um, and, uh,

[00:44:34] Brett: [00:44:34] I’ll keep you posted

[00:44:36] Howard: [00:44:36] I have faith. I’m not, I’m not worried. I have faith.

[00:44:40] And, uh, thank you for making such a fantastic product. And we, and we do use the setup version. So

[00:44:47] Brett: [00:44:47] no, thanks for the kind words and for the, uh, the continued support that that provides.

[00:44:52] Howard: [00:44:52] yeah, man.

[00:44:53] Brett: [00:44:53] All right. Well, that brings us to our top three picks. Uh, why don’t you go ahead and kick it off with your first one.

[00:45:00] [00:45:00] Howard: [00:45:00] All right. Um, my first one is something we didn’t even talk about at all, but well kind of gets into the vein of having to switch off every now and again. Um, my number one pick is the orange micro dark, uh, Brett, you not talk before you’re, you’re a bass player. I’m a bass player, but, um, I got a guitar, a six string, uh, a couple of years ago and I didn’t have an amp.

[00:45:22] Um, Since I’m not a guitarist per se, and didn’t really want to go out. And, you know, I didn’t have justification to sink a bunch of money into an amp. I did some research and found the orange micro dark. It is a, um, what they call like lunchbox style head. Um, the power supply is an outboard kind of, um, Not a wall wart, but it’s one of the like intermediary wall warts.

[00:45:46] Right? Um, the, the head literally, I think it weighs just so for a pound and it’s a hybrid, it’s a tube pre-amp solid state power amp. it’s got three knobs, volume gain and a tone shaping control. Um, I’m [00:46:00] a big fan of like a minimal pathway signal pathway. Um, I have a couple of pedals out that I use outside, but it’s also got a buffer.

[00:46:07] It affects loop, which is fantastic. Um, And I think it retailed for. Uh, like 190 bucks, it was under $200. Um, yeah. Yeah. And I originally had the little cabinet that’s supposed to sort of go with it and eight inch speaker, but I recently, finally, um, took the plunge and bought the orange, like single 12 inch.

[00:46:28] And this thing is amazing. Like, I can not be in the same room if I have it even close to turned up. Um, it’s super loud. Beautiful, clean tone, great distortion. I mean, it’s just, uh, Miracle lineage, orange,

[00:46:44] Brett: [00:46:44] That is good to know. I, uh, I, so the, the amp I used to use when I actually played out in that and was playing bass, uh, I, I pawned for drugs a long time. Long time ago. Um, so [00:47:00] basically I had just had this practice amp, uh, for years, and then kind of the advent of, uh, phone-based effects boxes happened. And I found like I’m not playing out.

[00:47:13] So a lot of the, a lot of the playing I do is either into headphones or directly into my computer for recording. Um, so I haven’t haven’t needed per se an amp, but I have missed having an amp because sometimes you just, you want to play it loud, right?

[00:47:31] Howard: [00:47:31] That’s where it is. Yep.

[00:47:33] Brett: [00:47:33] Yeah.

[00:47:34] Howard: [00:47:34] I was doing the same thing as you. Yeah.

[00:47:36] Brett: [00:47:36] Yeah. Cool.

[00:47:37] Howard: [00:47:37] Yeah, so, and it’s a good, it’s a good, like, you know, fairly economical, right? Like, especially from a bang for the buck kind of perspective. Yeah. So I have it set up in the back. I have an extra off a room in the back of my clinic.

[00:47:51] Um, and I’ve got my like stereo and all my LPs and CDs and set up back there along with my bass amp, and now the guitar amp. And [00:48:00] so every now and again, when I’m here in the evenings or sometimes even between patients, I can go back there and crank up for a couple of

[00:48:06] Brett: [00:48:06] rock and roll. All right. What’s number two.

[00:48:10] Howard: [00:48:10] number two is a group.

[00:48:14] Um, From South Korea. And I saw this only recently, I think it was a YouTube ad, but I, I know I saw it on TV also. Um, it’s like, uh, a tourism ad for South Korea. It was playing on it and, um, and, and this tune was just like, it immediately grabbed me. So I went online and dug it up quickly. But the name of the band is Lena algae, L E E N a L C H I M.

[00:48:42] There. Band camp page I dug up, you know, started diving in and the band camp page gives a good description of them. But I mean, they’re, they’re not, K-pop, um, not, not like, you know, BTS and whatever. Uh, this is more like an old older school kind of synth based, you know, synth pads [00:49:00] kind of pop, um, and. I mean, I just, I was enthralled with the music, um, and the album, if I’m mispronouncing this, I mean, w what am I going to do, I guess is a

[00:49:14]Um, but it’s, uh, the whole album, it’s like, it’s a concept record and it is telling this tale. So Gunga is a, uh, um, Uh, not apparel maybe, but, uh, a story. Um, and so the whole album kind of works through the, the elements of the story. It’s all in, it’s all in Korean. I mean, the lyrics aren’t translated or anything like that on through iTunes, but, uh, like I said, if you look on the band camp page, it kind of describes a little bit about that.

[00:49:40] So, uh yeah.

[00:49:42] Brett: [00:49:42] Yeah. Send me a link. I’ll check that out.

[00:49:44] Howard: [00:49:44] Yeah. You better believe it. I will.

[00:49:46] Brett: [00:49:46] Um, not having heard it. So this may or may or may not be related, but have you ever heard the band kite?

[00:49:52]Howard: [00:49:52] No.

[00:49:54] Brett: [00:49:54] you’re, if you like kind of haunting synth pop. Checkout [00:50:00] kite they’re on Spotify.

[00:50:02] Howard: [00:50:02] All right. I’m making a note right now. If you can either keys, uh, um, I will.

[00:50:08] Brett: [00:50:08] um, I actually found them because they came to play in lacrosse, Wisconsin. I think they’re from they’re from some Nordic country, but they had made friends with. A friend of mine who has a local band here, and they had come and played a show at the warehouse and the cross. And it was the first time I’d ever heard them.

[00:50:27] And I was just transfixed, uh, delete singers, voices, a theorial and the music is it’s. Yeah, it may be one of those bands that like, I love because of the live show that I first saw them at. You know, how like you develop associations. With like, uh, the olfactory senses and the lighting. And, but, uh, but I think, I think he might.

[00:50:51]Howard: [00:50:51] I am excited. I’m always, it’s hard to, I dunno, for a few different reasons. It’s hard to [00:51:00] discover new, like good music, um, for, for me right now. So I’m always like, kind of on the hunt. So I appreciate that and I will absolutely go check it out.

[00:51:10] Brett: [00:51:10] All right. Number three.

[00:51:12] Howard: [00:51:12] Uh, number three, um, I dunno, it’s kind of pedestrian in some sense.

[00:51:18] And, um, maybe elicit some eye-rolling and, and others, I don’t know, but for me, uh, I’ve got it stable right now as the combination Phillips you home kit, um, like one and the reason I dig it so much and I, I S I’ve had it fairly stable and set up for over a year now, I guess. Um, But like, I hate overhead lights.

[00:51:42] Right. Um, and, and my clinic, you know, of course is stocked. It’s just, nothing came with nothing, but the overhead fluorescent bosses, uh, which is, you know, I think pretty much everyone can agree. So it’s just categories of the worst lighting. Um, so I’ve got lamps everywhere. In the [00:52:00] office, right. Floor lamps, and table lamps and everything like that.

[00:52:03] And it would just, I mean, this is first world problems, you know? No, no hate mail, please. Like, but coming in in the mornings, um, and switching on, I think it was a dozen different lamps here, right. Was just, it only took a minute or two. Right. But this was just like, ah, I be nice thing to eliminate. So.

[00:52:22] Brett: [00:52:22] for sure.

[00:52:23] Howard: [00:52:23] One day, I finally bit the bullet and went down to best buy and, um, and, and just started snatching up hue bulbs.

[00:52:29] And I got a, um, a home pod for the clinic to, um, keep it running as a base cause home kit kind of for geo-fencing and so forth. And, uh location-based right. And you didn’t need a base going, but yeah. So now I have it set up where, when I pull up to the clinic between X and X hours, the lights. Are on when I walk in and they turn off, when I work out, I mean, it was my white whale.

[00:52:53] Right. Um, and so that, and I did the justification because I realized how [00:53:00] much money I was spending on these damn things. Excuse me. Um, but, uh, I was like, okay, two minutes a day and dah, dah, dah. So it pays for itself after this time. Um, but that was a big, I dunno, that was a game

[00:53:13] Brett: [00:53:13] So did you get whites or color or Hughes?

[00:53:16] Howard: [00:53:16] Um, for the clinic here they are.

[00:53:20] Um, there’s the intermediary one, right? There’s the one that’s just like fixed white and then there’s the, um, color ones, but then there’s the ones that can whew between like white and orange. Um, yeah, so I have that one set up. And actually I should point this out too, especially at the clinic. Cause I have it all set up at my house too.

[00:53:39] And I have a couple of color ones there. Um, but at the clinic it is really useful because I will get some patients who have had. Um, a brain injury or something like that, or they have migraines and they’re photophobic right. They’re light sensitive. And so for those people, um, I can automatically, I can just say, Hey, you know, [00:54:00] uh, turn the lights at 50% or set this particular preset that changes the hue and the brightness of it, um, to accommodate those patients.

[00:54:11] Um, and, uh, and I dig being able to do that, but, uh, yet at the house I’ve got a couple of car lights and like a strip around the TV, you

[00:54:20] Brett: [00:54:20] Yeah, I just, I just got a, uh, kit. That’s supposed to be the LEDs around the back of the TV and then it plugs into the HTMI and it’s supposed to like chase the colors from the edge of your screen around on your wall. I have not had the, I’ve not had the motivation to actually set it up. I apparently paid for it years ago and it took them this long to ship the Kickstarter.

[00:54:45] Howard: [00:54:45] no way.

[00:54:46] Brett: [00:54:46] But that’s how so, how I got my, my better hacking keyboard or ultimate hacking keyboard. I, I bought it and then forgot about it. And then two years, maybe three years later they shipped it and I [00:55:00] didn’t even remember ever seeing the Kickstarter, but I got this keyboard in the mail ended up being my favorite keyboard I’ve ever had.

[00:55:06] Uh,

[00:55:07] Howard: [00:55:07] a nice surprise

[00:55:08] Brett: [00:55:08] yeah. Yeah. So it’s kind of, it’s kind of like giving yourself a gift in the future, but. Yeah, no. Lighting is a huge lighting is huge for me. I, uh, my mood is very, very effected by even just lighting color. So I’m super picky about what bulbs I buy. Uh, the, the hue bulbs, the ones that are just in the white range from cool to warm, um, are all I really need, cause there’s really never a time.

[00:55:34] I need like green or purple lights. But being able to shift from like a daylight down to a super warm uh, it’s. It it’s huge for my mood, so yeah.

[00:55:46] Howard: [00:55:46] yeah, no, I, I do it here in the morning time. I have a certain setting. That’s the more cool blue and in the afternoons, I switched it over to the warmer.

[00:55:54] Brett: [00:55:54] Yeah, for sure.

[00:55:54] Howard: [00:55:54] Uh, yeah, no mission critical for sure. Um, uh, [00:56:00] I’m, I’m, I’m I’m right there with you. Yeah. I I’d looked at Phillips makes the, uh, an, an accessory product that allows you to change the TV color light strip, but it seemed impractical and it was like 200 bucks.

[00:56:13] And just for the sheer ability to chase that color just didn’t. Yeah, it didn’t strike me as worth it, so, yeah. Um, yeah.

[00:56:24] Brett: [00:56:24] Well, people can find you at H button on Twitter and, uh, S C neuro.com. Anywhere else you want to mention.

[00:56:33]Howard: [00:56:33] Um, nah, nothing of any, you know, no, no, nowhere else really particular. Um, I’m we still have that. We still have a neuro-psych, uh, blog kind of website set up, but we have a buddy of mine set up a few years ago. He and I sat a few years ago called neuro-psych now, but we haven’t posted to it in a couple of years because.

[00:56:53] At the time at the time we set it up, we both were, we both had a lot more time on our hands. [00:57:00] Um, and, uh, and now we don’t, uh, we’ve we both got more, a lot busier, but, uh, yeah, the, yeah, the H button on Twitter is probably the best way to, um, To, to follow me anywhere. And, uh, yeah, if anybody needs a neuropsychologist in South Carolina, especially in the Charleston area where, uh, we are open and, uh, taking new patients on an ongoing basis.

[00:57:26] Brett: [00:57:26] Are you accepting out of town? Uh, tele help at all?

[00:57:30] Howard: [00:57:30] We see, yeah. Out of town, like in person sometimes because South Carolina is effectively like an underserved population, as we say. Right. So, I mean, I’ve seen people from parts of Georgia and North Carolina and all over South Carolina.

[00:57:42] Brett: [00:57:42] do you have to be licensed in the various States to do telehealth with people?

[00:57:48]Howard: [00:57:48] good. Good question. Um, the short answer is according to the federal government, the short answer is that those restrictions have been relieved. Um, but there are still some like [00:58:00] insurance and billing requirements that are contrary to that. Uh, this is part of the ongoing struggle we have here in the clinic, uh, or in the clinical world.

[00:58:09] Is keeping up with all these changes, um, uh, like their codes that have been added that we can bill for to account for some of the extra work we have to do over the pandemic, um, that had been approved by the federal government and all the regulating agencies that insurance companies still won’t allow us to bill for.

[00:58:26] Right. It’s weird stuff. Um, but, uh, yeah, usually you do, but right now you sort of don’t. Um, but, uh, yeah, uh, yeah, it’s case by case kind of thing.

[00:58:37] Brett: [00:58:37] all right. Well, thanks for taking the time today. Next time you come back, you get the five timers club jacket.

[00:58:44] Howard: [00:58:44] nice. Nice.

[00:58:46] Brett: [00:58:46] we’ll all look forward to that.

[00:58:47] Howard: [00:58:47] that.

[00:58:48] Brett: [00:58:48] Yeah. All right. Well, thanks again.

[00:58:51] Howard: [00:58:51] Hey, I really appreciate it. I had a great time and it was great talk. It was a super fun talking to you again.

[00:58:55] Brett: [00:58:55] Rock on.

[00:58:57] Howard: [00:58:57] All right. Cheers.