Ditch The Labcoat
Dr. Mark Bonta
Recent Episodes
In this episode he explains how the brain generates real physical symptoms under stress, trauma, and emotional overload. He walks through clinical red flags that differentiate structural disease from functional conditions. He shares stories of patients who suffered for years before receiving the right diagnosis. Dr. Bonta and Dr. Clarke explore why invisible illnesses are often missed in rushed systems. They dig into tools clinicians can use to validate symptoms without over pathologizing them. They highlight communication strategies that restore trust. They also discuss prevention, early detection, and the growing evidence supporting mind-body approaches.
The conversation is practical. Evidence based. Deeply human. Dr. Clarke shows how clinicians can uncover hidden drivers of symptoms and give patients a path to recovery even when imaging and lab work are normal. This episode is designed for anyone who wants to understand the science and psychology behind medically unexplained symptoms and how to improve care for this underserved population.
David Clarke, MD's Website : https://www.symptomatic.me/
Episode Takeaway1. Neuroplastic Symptoms: Real physical sensations created by the brain that can improve with the right approach.
2. Invisible Illnesses: Often missed because standard training focuses on structural disease, not functional mechanisms.
3. Brain Body Pathways: Stress and trauma can activate neural circuits that generate chronic pain and gut symptoms.
4. Diagnostic Clarity: Red flags help distinguish functional illness from conditions that need imaging or procedures.
5. Validation Matters: Patients recover faster when clinicians acknowledge symptoms without dismissing them.
6. Communication Skills: Asking the right questions uncovers hidden emotional drivers behind persistent symptoms.
7. Prevention Tools: Early recognition of neuroplastic patterns reduces unnecessary testing and specialist referrals.
8. Hope in Recovery: Most patients improve once they learn how the nervous system produces their symptoms.
02:46 – Why invisible illnesses elude standard medical training
06:13 – How the nervous system produces real physical symptoms
10:34 – Red flags that separate structural disease from functional illness
14:51 – Communication strategies that validate patient symptoms
19:30 – Trauma, stress and the hidden drivers of chronic symptoms
24:42 – Clinical cases that shifted Dr. Clarke’s diagnostic approach
30:04 – Tools clinicians can use to reduce unnecessary testing
35:57 – Preventing invisible illness through early recognition and education
Drawing from years as Professor at the University of Calgary and Director of the Libin Cardiovascular Institute, he unpacks why perfectionism is so common in medical training, how surgeons learn to mask pain behind composure, and why emotional detachment has long been mistaken for professionalism. Together they explore the unseen burden clinicians carry, the pressure to perform without pause, and the moments when the mask finally cracks.
Dr. Fedak speaks candidly about ego death, vulnerability, and rebuilding a life after losing the work that once defined him. He describes the colleagues who opened up only after he shared his own story, highlighting how connection and honesty can transform a profession built on quiet endurance.
This episode examines the human side of medicine that rarely makes it into textbooks. Identity. Injury. Recovery. Presence. What it means to care for others while trying to stay whole yourself.
A moving conversation for anyone in healthcare or anyone who has ever struggled with the weight of impossible expectations.
Paul Fedak, MD, PhD's website : paulfedak.com
Episode Takeaways1. Surgeons are trained to push through pain, not acknowledge it.
Medical culture rewards resilience and persistence, but that same conditioning prevents clinicians from recognizing and responding to their own injuries.
2. Perfectionism is wired into medical training.
Traits like list making, obsessive task completion, and performance under observation are common in medicine and often go unexamined despite their psychological cost.
3. The mask of competence becomes automatic.
Clinicians become so skilled at hiding distress that even close colleagues fail to notice warning signs. This silence leaves suffering invisible.
4. Vulnerability creates connection and protects lives.
When Dr. Fedak shared his story, dozens of peers came forward with their own hidden experiences. Openness is not weakness. It is safety.
5. Ergonomic injuries in surgery are far more common than most people realize.
The physical demands of operating are intense, yet surgeons lack the protections that other healthcare workers receive.
6. Leadership shows the true burden physicians carry.
Once in leadership roles, clinicians see the depth of burnout, fear, and quiet endurance happening behind the scenes.
7. Losing the identity of “surgeon” creates an existential crisis.
Stepping out of the operating room forced a complete reevaluation of purpose, ego, and self worth.
8. Technical excellence is not the full measure of a doctor.
Relational skill, empathy, presence, and human connection matter just as much as procedural skill.
9. Medicine needs protected space for reflection.
Without pause and presence, clinicians lose touch with themselves and the people they care for. Healing requires time, community, and grounding.
10. System structures shape clinician wellbeing.
The fee for service model rewards quantity over recovery, creating pressures that make self care feel impossible.
11. Paying clinicians to care for themselves could change outcomes.
If mental health visits, ergonomic care, and recovery time were compensated, more clinicians would seek help early.
07:10 How one surgeon’s work related injury forced a career pivot and a deeper conversation about wellbeing.
08:25 The secret stories colleagues shared only after Paul opened up about his own suffering.
10:30 Independent contractor status and why doctors lack the ergonomic protections nurses receive.
13:00 The unseen emotional toll behind surgical careers and what leadership reveals about clinician suffering.
16:00 Training teaches perseverance, but injury demands honesty. The conflict surgeons are never taught to navigate.
17:28 Medical trainees and perfectionism. Why obsessive traits are six times more common in medicine.
19:10 When the mask becomes permanent. How clinicians hide distress even from each other.
20:00 Two tragic losses and the lessons Paul learned about checking in with colleagues.
22:00 Vulnerability as leadership. Why sharing your story opens the door for others to heal.
28:57 Did speaking out come with professional risks. What changed when Paul stopped protecting his own ego.
31:55 Losing the identity of “surgeon.” The ego death that followed leaving the operating room.
33:40 Beyond technical mastery. Why excellence must include human connection, empathy, and presence.
34:46 How medicine can “create space” for reflection, grounding, and real conversations.
37:50 The hidden financial pressures behind surgical work and how billing shapes clinician behavior.
The episode explores how naming emotions reduces amygdala activity, how repressing thoughts can lead to acting out, and why honest conversation promotes neural coupling and lowers cortisol. Together they examine bullying, victimhood, groupthink, and how language can unintentionally shut down dialogue instead of inviting clarity and connection.
Listeners will learn practical tools for navigating political disagreements, managing emotional overload during difficult conversations, and practicing reflective listening to stay grounded and curious rather than reactive.
Dr. Carmichael’s message is simple and powerful. Dialogue matters. Open conversation strengthens emotional regulation, builds healthier relationships, and supports mental clarity. Her invitation to the audience is to have more honest disagreements and to rediscover the psychological value of speaking freely.
Dr. Chloe Carmichael Link : https://www.drchloe.com/
Episode Takeaways1. Free Speech Supports Mental Health: Speaking openly improves emotional regulation, strengthens relationships, and reduces anxiety.
2. Suppressing Thoughts Has Consequences:Bottling emotions disrupts emotional processing and can lead to acting out, stress, and internal tension.
3. Labeling Emotions Lowers Fear Response: Simply naming what we feel reduces amygdala activation and increases clarity and control.
4. Self Censorship Takes a Psychological Toll: Avoiding truthful expression to fit social expectations erodes authenticity and increases distress.
5. Groupthink Is Dangerous: Institutions that suppress debate become vulnerable to poor decisions and intellectual stagnation.
6. Open Disagreement Is Healthy: Learning to disagree politely strengthens community bonds rather than damaging them.
7. Authoritarian Environments Harm Wellbeing: Chronic suppression of speech leads to anxiety, helplessness, and depressive patterns across populations.
8. Language Can Shut Down Dialogue: Words like bullying or victim can be used as shields, stopping rational discussion and reflection.
9. Listening Does Not Mean Agreeing: Separating listening from endorsement allows conversations to stay civil and productive.
01:23 – Dr. Carmichael’s clinical background and early media experience
03:40 – Moving from New York to Florida over masking policies
04:38 – Mark on masking, speech development, and emotional suppression
06:32 – Why naming emotions lowers amygdala activity
07:00 – Emotional suppression and how bottling feelings leads to acting out
10:00 – Media censorship and limiting acceptable viewpoints
13:00 – Listening versus agreeing and the psychology of disagreement
17:00 – Thought replacement as a tool for staying grounded
20:00 – Why political conversations feel dangerous and how to navigate them
24:00 – Groupthink in institutions and intellectual environments
26:32 – How suppressing discussion harms innovation and clarity
27:10 – Authoritarian environments and mental health consequences
28:16 – Living with hidden thoughts and long term anxiety
30:24 – The power of labels like bullying to shut down dialogue
32:00 – Victimhood culture and the upside down bully victim dynamic
35:45 – Why shutting down dialogue creates conflict rather than reducing it
40:16 – Dr. Carmichael’s call for more open, happy disagreements
42:21 – Closing reflections and holiday dinner table dynamics
42:52 – Invitation to join discussion groups with her book purchase
Mark and Matteo explore the difficult reality of dual diagnosis, the limits of our current system, and the lived experience behind manic episodes, depression, and the pull of addiction. Matteo explains how suffering, time, and honest acceptance led him to recovery, and why connection is often stronger than willpower alone.
They discuss the gaps in psychiatry, the trial and error of medications, the danger of self-medication, the unpredictable nature of relapse, and the emotional toll on families who walk beside a loved one in crisis. Matteo also opens up about rebuilding his life, repairing relationships, and using his lived experience to support others who are still trying to find their footing.
This is an honest and deeply human look at mental illness, addiction, and what it truly takes to heal.
Matteo Esposito, Certified Addiction Recovery Coach : https://invisiblechallenge.org/1. Invisible illnesses are often dismissed because they do not show up on scans, yet they can be as disabling as any physical condition.
2. Dual diagnosis is complex. Treating bipolar disorder and addiction separately does not work. Both must be addressed together.
3. Self medication hides deeper problems. Many people use alcohol or cannabis to manage anxiety, insomnia, or early psychiatric symptoms.
4. Mania has clear warning signs. Loss of sleep, high energy, pressured speech, and risky decisions are red flags that should never be ignored.
5. Addiction is a brain illness. It is not a moral failure, not a weakness, and not a lack of willpower.
6. Suffering often precedes change. For many people, the turning point comes only after repeated lows and accumulated exhaustion.
7. Connection is protective. Recovery becomes possible when someone is surrounded by people who understand the journey.
8. Professional guidance matters. Matteo credits his progress to finally following recommendations from clinicians instead of relying on his own judgment.
9. Peer support accelerates healing. Helping others in recovery strengthens sobriety and reduces the risk of relapse.
10. Families carry their own burden. Loving someone with addiction or mental illness is heavy, complex, and often painful.
11. Recovery is a daily commitment. Even years later, it is maintained one decision and one day at a time.
12. Hope is a vital tool. Matteo reminds anyone struggling that change is possible, suffering is not permanent, and no one is alone in the process.
01:27 – Matteo describes entering the mental health system and navigating inconsistent levels of care.
02:21 – Mark breaks down substance use disorders and explains the limits of current treatments.
03:38 – Matteo discusses early experiences with psychiatrists and the difficulty of treating substance use and bipolar disorder together.
04:39 – Matteo explains when his mania first escalated and how substances intensified the symptoms.
05:49 – Matteo talks about the relationship between depression, self-medication, and worsening addiction.
06:11 – Mark explains why people self-medicate with alcohol or cannabis when their mind starts to unravel.
07:11 – Matteo shares how he gained partial stability with bipolar disorder before realizing his addiction was growing.
08:20 – Matteo describes the moment he recognized he had lost control over weed and alcohol.
09:57 – Mark explains the difference between mood disorders and personality disorders and why bipolar is often misunderstood.
10:23 – Matteo identifies the behavioral warning signs of mania, including loss of sleep, pressured speech, and risky decisions.
12:24 – Mark explains mood-stabilizing therapy and how medications level out extreme highs and lows.
12:47 – Matteo reflects on the importance of connection as the opposite of addiction.
14:30 – Matteo explains why suffering and time were the two forces that finally pushed him toward recovery.
15:54 – Mark outlines why addiction treatment has low success rates and why relapse is common.
17:24 – Matteo discusses peer support and how helping others helps him stay sober.
20:47 – Matteo describes how following professional guidance instead of his own instincts became a turning point.
23:13 – Matteo reflects on repairing relationships with family and how addiction strains loved ones.
25:08 – Matteo discusses how families struggle with the line between love and enabling.
27:29 – Matteo shares words of encouragement for people who feel hopeless in addiction or mental illness.
30:45 – Mark and Matteo discuss therapy, lived experience, and the need for ongoing self-awareness in recovery.
In this episode, Dr. Mark Bonta sits down with Dr. Kang Hsu, Chief Medical Officer of Canary Speech, to explore how AI and vocal biomarkers could make the human voice the next vital sign in medicine.
They unpack the science behind this breakthrough, showing how subtle shifts in tone, rhythm, and cadence can reveal early signs of depression, anxiety, Parkinson’s, or cognitive decline long before symptoms appear.
Dr. Hsu shares the origin story of Canary Speech, the research that powers its models, and how voice-based screening is already being used in healthcare, from telehealth visits to smart devices.
It is a look into a future where a 40-second voice sample could help doctors detect disease, personalize treatment, and bring empathy back into digital medicine.
Guest Link : https://canaryspeech.com/
00:00:00 — Welcome and opening reflections
00:00:07 — A candid start: location, context, and conversation
00:01:32 — Meet Dr. Kang Hsu, Chief Medical Officer of Canary Speech
00:02:44 — How voice became medicine: the story behind Canary Speech
00:03:29 — Why this conversation matters to clinicians and patients alike
00:04:05 — Making science accessible: breaking down complex ideas
00:05:59 — Behind the mic: how each episode comes together
00:06:59 — Keeping it real: refining, revising, and staying authentic
00:08:00 — Can your voice reveal your health? The rise of vocal biomarkers
00:12:00 — From telehealth to wearables: real-world applications
00:18:00 — The uphill climb: innovation vs. healthcare resistance
00:24:00 — The road ahead: what the future of voice in medicine could look like
00:30:00 — Closing thoughts and a glimpse into what’s next
1. Voice as a Vital Sign
Your voice holds more data than you realize. Subtle changes in tone and rhythm can reveal early signs of depression, anxiety, or even cognitive decline.
2. Objectivity Through AI
Canary Speech uses vocal biomarkers to turn speech into measurable data, giving clinicians objective insight where surveys and self-reporting fall short.
3. New Frontiers in Telehealth
Voice analysis can run quietly in the background of virtual visits and smart devices, creating a noninvasive way to monitor mental and physical health between appointments.
4. The Challenge of Change
Healthcare moves slowly. Adoption depends on awareness, trust, and showing how accessible technology like this can ease strain on overburdened systems.
5. A Future Built on Listening
In time, voice may join heart rate and blood pressure as a standard vital sign. It can help detect disease earlier and make care more personal, not less.