Episode Transcript

Daniel Lobell: (00:00)
This podcast or any written material derived from its transcripts represents the opinions of the medical professional being interviewed. The content here is for informational purposes only, and should not be taken as medical advice since every person is unique. Please consult your healthcare professional for any personal or specific needs.

Daniel Lobell: (00:19)
Hello, and welcome to the Doctorpedia podcast. I’m your host, Daniel Lobell, and I’m honored today to be joined on the line by Dr. Bhumi Upadhyay. How are you, doctor?

Dr. Bhumi Upadhyay: (00:31)
I’m doing well. Thank you. How about yourself?

Daniel Lobell: (00:33)
Yeah, I can’t complain. And if I could, I wouldn’t waste the energy. Well, I do it. People don’t need complaints anymore. I’m good. Thank God. So, I’m excited to get into all the things that you do, but as I always do in these interviews, I love to start at the beginning and hear about your childhood and what inspired you to become a doctor. So let me send it over to you to start us off on that.

Dr. Bhumi Upadhyay: (01:01)
Okay, sure, absolutely. So a little bit about my childhood, I was actually born in India and my family moved here when I was five years old, so pretty much I grew up here. And honestly, growing up, I wanted to be an engineer. My dad was an engineer. He was my hero. I love to fix things in the house and stuff. So I actually thought that that’s what I was going to be. And then, my 11th grade year, I actually had an internship at a place, I won’t mention it, but it was with an engineer and it was probably the environment, the engineer was working on his own project, so I got to work with him, but I got no social interaction. So I came home that summer and told my parents, “There’s no way I’m going to be an engineer.” I need more people interactions and so forth. But I said, but I like to fix things. So I’m like, “What am I going to do?” And you know, being from Indian descent, you’re looking at engineering, you’re looking at a doctor and you’re looking at attorneys and accountants, you know, very scientific, mathematical. So I said, “Oh, let me try medicine.” And…

Daniel Lobell: (02:12)
Why do you think — Sorry to interrupt you. Why do you think that is? Why do you think it is that Indian people lend themselves to those jobs specifically?

Dr. Bhumi Upadhyay: (02:19)
I think it just starts off in the roots of — education is just very, very important. Even if you look at India, even now, children go to school and then there’s this big exam at the end of 12th grade where it all depends on how high your percentiles are, and then you go into higher level education. So education has just been one of those things that have been pushed. And when you look at these professions, they’re all higher education professions. So yeah, it’s very interesting, if you’re looking at like my generation and my children, we’re looking at more — gosh, there’s a lot of people with a lot of education, that have other professions. Now you’re looking at the labor service, you’re looking at even entertainment service and things like that, and very, very intelligent people there and not necessarily scientific. But yeah, I think it’s from the roots of just delving into education being so important.

Dr. Bhumi Upadhyay: (03:29)
Yeah, so anyway, so that’s why I went into exploring medicine and eventually when I went into undergrad, I loved it. And so then I decided to continue to pursue medicine, and then I had to decide what I want to do in medicine and I naturally actually loved children. And so I said, “Hey, you know what, let me try pediatrics.” And, you don’t know what I look like, but I’m only five foot one. So I said, I want most of my kids, or most of my patients, to be smaller than me. So I had to go into pediatrics, basically. [Both chuckle]

Daniel Lobell: (04:03)
Before I get into pediatrics, because I have a lot of questions on that, I’m kind of curious to hear a little bit more about your childhood in India, what it was like growing up and when you came to the United States and what that cultural shift was like for you.

Dr. Bhumi Upadhyay: (04:19)
Sure. To be honest, I don’t remember too much about my life in India because it was the first five years. And so most of my memory is talks with my parents and so forth. And we lived in a small town. Not in a big city. And the typical, “Hey, we walked to school,” we came home and had lunch with the family. And just right after school, we were playing outside all day. So, I mean, typically, that’s what our life was like. Our dad was at work the majority of the day. So we spent most of the time with my mom, after school and stuff. It was also a lot of extended family, in the town that we lived, my grandparents were there, uncles were there, so everyone is close by, within like walking distances and stuff like that.

Dr. Bhumi Upadhyay: (05:20)
So that kind of environment is very different than coming here and having to go drive somewhere or people being further apart. So I would say that was probably the biggest difference when you move from a country like India to the United States. And the biggest, I think cultural shock for us was, my mom had to go to work when we first moved here, just to support the family. And so I think that was good and bad. It was, I think for me — well, so I grew up with two other sisters, so there’s three girls. So for us, it was something to see that, “Hey, wow, we have a mother who is now working and raising children.” And I think that really pretty much put a fire under all three of us to say, “Hey, we’re going to work hard. We’re going to try to succeed.” We’re coming from a two working family, barely had much, when you first moved here. And I think that’s what made my sisters and I really want to attain as much success as possible. But I think that was the biggest shock, is to go from that extended family to now just us immediate family. And then also two working parents.

Daniel Lobell: (06:37)
Sure. How did your mom adjust to that transition?

Dr. Bhumi Upadhyay: (06:40)
To this day, I think she’s the strongest woman I’ve ever known. So she took it like a trooper. Honestly, I’ve never heard her complain about anything. And she just, she did it. And she still, in the meantime, taught us how to cook. She would actually sew our clothes. I mean, I still remember in elementary school wearing clothes that my mom made. Of course I’d laugh at it now, but she did all of that. And I think part of it, like I said, the reason we’re so hard working is seeing my mom doing it. And no, she to this day has not complained.

Daniel Lobell: (07:22)
That’s great. Did she teach you how to cook Indian food or was it more like, okay, we’re in America, we’re going to cook American?

Dr. Bhumi Upadhyay: (07:26)
Oh, no. Indian food. She taught us how to cook Indian food. But she did — that’s the other thing that again, without any complaints, so we grew up vegetarian, but then when we moved here, I saw my friends and my relatives eating different types of meat and my mom would make hamburgers for us. That was a shock, but she did it. But —

Daniel Lobell: (07:50)
I’ll take a palak paneer over a hamburger any day.

Dr. Bhumi Upadhyay: (07:54)
[Bhumi laughs] Yes, exactly. But yeah, so she really did teach us how to cook Indian food. And then as we got older, my parents moved over to owning a business. And so they were actually gone out of the house till like 6, 7 PM and my sisters and I would have at least everything prepped for, for dinner, so we knew how to get everything prepped. Make the puris and things like that.

Daniel Lobell: (08:26)
Puri and masala. So good. You’re making me hungry. [Both laugh]

Dr. Bhumi Upadhyay: (08:26)
Oh no.

Daniel Lobell: (08:29)
Ras malai, do you do that too?

Dr. Bhumi Upadhyay: (08:29)
That I don’t know how to make, no. But we know like the gulab jamun, I don’t know if you’re familiar with that.

Daniel Lobell: (08:35)
Yeah. They’re very sweet little dough balls in a syrup.

Dr. Bhumi Upadhyay: (08:39)
Basically, yes. Those donut balls in syrup. Yeah.

Daniel Lobell: (08:44)
I know. And you know about the peshwari naan?

Dr. Bhumi Upadhyay: (08:47)
I do not. We do the plain naan.

Daniel Lobell: (08:51)
Peshwari naan I’ve only seen in the UK, it’s a naan bread filled with like raisins and coconuts.

Dr. Bhumi Upadhyay: (08:56)
Oh, okay. Wow. So we do like stuffed paratha, which is like cauliflower stuffed, which is — it’s delicious with the spices.

Daniel Lobell: (09:07)
All right. I’m coming over right now. [Both laugh].

Dr. Bhumi Upadhyay: (09:13)
Anytime, anytime. We love to entertain.

Daniel Lobell: (09:16)
Thank you. Wow.

Daniel Lobell: (09:18)
So what did your mom wind up working at and also your dad? What did he do?

Dr. Bhumi Upadhyay: (09:22)
Okay, so my dad is an engineer. And so he actually got a job at at a nuclear power plant. And so we actually moved from city to city. As soon as the nuclear power plant was up and running, they would move him to another city. My mom, when we first got to New York, actually worked at a belt factory. And so it just was just a typical shifts job. And then eventually, because my dad was, or the whole family was getting tired of moving, they eventually ended up buying a dry cleaner down in Florida. And so ever since I was in middle school, we lived in Florida.

Daniel Lobell: (10:06)
So she’s still dealing with belts, but a different kinds of belt.

Dr. Bhumi Upadhyay: (10:10)
Exactly, right? So yeah, so they did that all the way through till I was past med school. So yeah, that’s what they ended up doing.

Daniel Lobell: (10:22)
That’s cool. So you almost went into your dad’s business when you wanted to become an engineer. Was he disappointed? Was he like, “Come on, you’re supposed to be an engineer like me?”

Dr. Bhumi Upadhyay: (10:35)
[Bhumi laughs] No, he was not actually, he was actually very excited. He comes from a family, like all his brothers, majority of them are engineers, only one is a doctor. And none of their children and no one had gone into medicine at that point. And so I think it was new and exciting to say, hey, you know what, we have one of our children who’s actually going to be doing that. So no. He was the type of person where, all through high school, he would read every single one of my essays. He would look at every single one of my math papers. And he would be honest, you would be totally honest. He’s like, “Oh, you deserved a B on this one.” I’m like, “Dad, why’d you say that?” So he was like my biggest supporter, and no, I think he was very proud when I finally said I wanted to go to med school.

Daniel Lobell: (11:24)
I think it would be hard to disappoint parents by saying I want to be a doctor! [Both laugh] But you never know. No, it’s funny to me thinking, you said he was an engineer working in a nuclear power plant. And of course my mind went right to Homer Simpson. [Bhumi laughs] I don’t know what else goes on there, but what — do you know what kind of things he did as a nuclear power plant engineer?

Dr. Bhumi Upadhyay: (11:49)
I do not. I mean, he was still doing like mechanical engineering, but I don’t know what he was doing in the power plant. I honestly was too young. And one of those, I didn’t ask, I just thought, “Oh, my dad works at a nuclear power plant.” That’s about it.

Daniel Lobell: (12:05)
He was grading your college papers with a glowing piece of uranium. [Both laugh] So you go into medicine and then you decide, I’m sure for more reasons than height —

Dr. Bhumi Upadhyay: (12:18)
Yes. [Both laugh]

Daniel Lobell: (12:18)
— that you want to be a pediatric doctor. What were some of the other reasons that made you decide to go into pediatric medicine and what are some of the challenges that come along with that as opposed to going into adult medicine? I don’t know if there’s a better word for it.

Dr. Bhumi Upadhyay: (12:36)
No, absolutely. No. And you’re right. I didn’t just right away decide I wanted to go into pediatrics when I first started my, what we call residency, where you graduate from med school and then you do your training. I actually did a combined residency in adult medicine in pediatrics thinking, “Oh, you know what, I’m going to be double boarded, and this is what I’m going to do.” And then once my training started, I realized that, well, one, if you’re going to be a good doctor, you do need to focus on one thing. And I will tell you, I enjoyed pediatrics a lot more than I did the adults for various reasons.

Daniel Lobell: (13:16)
I’d like to hear them.

Dr. Bhumi Upadhyay: (13:16)
Yeah, absolutely. One is, in the environment that I was in, I saw that every time I went in to see adult patients, I felt like I kept getting a roadblock of trying to change. Trying to better your health, trying to help with the preventative diseases that we could do. Versus what the children, whenever I talked about prevention and things to improve, the parents did it right away. Because it’s their kids. We adults care about our children more than we do ourselves.

Dr. Bhumi Upadhyay: (13:53)
And so I just felt like I made a lot more headway and I made a difference in patients’ lives when it was actually dealing with the children. So that was number one. And number two, honestly, was the attendings or the preceptors that we had. I never saw an unhappy pediatrician. Pediatricians were always smiling. They were joking around, they had a lot of energy. And I said, “You know what, if I want longevity in my career, this is what I want to do.” And then of course the last piece was, as a female, especially growing up in a traditional family, I also had to think about, well, I also want to raise my own family one day, but also want to be career oriented. And I saw a lot of pediatrics with part-time jobs or three-quarters time jobs. So I knew that if I ever wanted to do that, I could do that in that field. Now, saying all this, this was 20, 25 years ago, obviously all these fields have part-time and happy professionals and so forth. But what I got to see at that time, I think really swayed me towards the pediatrics.

Daniel Lobell: (15:11)
And did it help you when you were raising your kids, to be able to know how to maybe diagnose them as children?

Dr. Bhumi Upadhyay: (15:17)
I think so. Obviously being a doctor and being a mother are two absolutely different things, but you should see our conversations in the house. I’d be like, oh gosh… Or my son, named Devin, I’m like, “Oh, Devin has this, this, this,” you know, and I’m worried. And my husband would be like, “Well, what would you tell your parent who walked in?” I said, “Oh, I’d tell them this, this and this.” He’s like, “Okay, well, you just answered your own question.” So even though I would not answer for myself for my child, my husband would be like, “Well, just go ahead and just pretend it’s a parent that you’re talking to.” And so, yeah, so it did help a lot. But you also have to be careful, that you can’t be your own child’s doctor all the time. So we had pediatricians for them and if there was any time that it was like, “Listen, I just want to be a mom,” he was wonderful. He’s like, “Just call me and I’ll let you be the mom.” So, it was good. It was good that we had both of those options.

Daniel Lobell: (16:19)
Right, right. Yeah. So you didn’t have to freak out quite as much.

Dr. Bhumi Upadhyay: (16:21)
No. And my husband’s an ER doctor too, so I really didn’t have to freak out.

Daniel Lobell: (16:31)
Oh wow, your husband’s an ER doctor.

Dr. Bhumi Upadhyay: (16:31)
Yes, yes he is. So our kids would go around the house, running around with something. We were like, “Don’t run around, you’ll get hurt if you do this,” they’re like, “Oh, well, how badly would we get hurt? To come to your office or to go to dad’s hospital?” [Both laugh] Like yeah, you guys know the difference.

Daniel Lobell: (16:48)
Yeah. I think they’d be like less risk averse because they’d be like, look, we could get patched up. Both parents are doctors.

Daniel Lobell: (16:58)
So what are some of the most common problems that kids come in to see you for?

Dr. Bhumi Upadhyay: (17:04)
So I would say, obviously pre COVID, most of the common problems are just going to be the natural, the coughs and the colds and ear infections and things like that that are just run of the mill. The things that I think that we as pediatricians make a huge difference with, I think, is more all the preventative. Watching for the development, and we’ve been seeing a lot of that. Speech delays, autism, and we’re also seeing a lot of ADHD behavior. I think that’s where we pediatricians I think make a big, big impact because there’s a lot of teaching involved. That’s one of the differences between pediatrics and of these other specialties. We’re a lot of counseling and teaching versus like procedures kind of thing.

Dr. Bhumi Upadhyay: (17:56)
So sometimes you don’t see that difference until it’s years and years of following those children. Unfortunately I think with COVID, the biggest problems we’ve been seeing I think is like more of depression and anxiety, especially amongst our middle school, high school, pre-adolescent kids. Just with obviously knowing that a lot of the schools were shut down, the social aspect of life was pretty much shortened. And yeah, so I would say those are probably our most recent issues. But in overall, I think in children, general pre COVID, during COVID, is development and behavior.

Daniel Lobell: (18:43)
Man, I’m glad looking back that I didn’t have to deal with COVID at that age. I was depressed already! I would have had a much harder time.

Dr. Bhumi Upadhyay: (18:50)
Oh my goodness. It is, it is. And I think, even with the COVID I think social media and just access to just everything on the internet, it doesn’t help. So as parents or as physicians, teaching parents, it’s a lot of us getting used to. Because it’s going to be a way of life. I mean, I can’t say, “Oh, don’t let your child go onto a computer. Oh, don’t let your child go on the internet.” So it’s more of a, “Hey, how are we going to regulate this as parents?” And be able to teach our children how to appropriately use social media and the internet.

Daniel Lobell: (19:30)
So you brought up autism and ADHD. And I know that these are sort of phenomenons of my generation and generations going forward. You don’t really hear about it in terms of my parents’ generation or my grandparent’s generation, is that because it existed and they didn’t diagnose it, or is it something new? And if so, what — I know everyone has theories about this — what do you think it’s attributed to?

Dr. Bhumi Upadhyay: (19:58)
Well, and again, I don’t think it did not exist. It absolutely existed in previous generations. I think we’re just putting a lot more focus on it and not in a bad way. If we go back 50 years ago, if we go back 75 years ago, we still had children who had autism. But we didn’t diagnose the mildest forms. But now, why are we diagnosing these mild forms is because we have therapies for it. So we know in every generation there’s those people who might be a little shy or might not function properly in a social environment, but they do great in a profession that requires you to work by yourself. So we just accepted that. And I think now we’re looking at a lot more therapies to help.

Daniel Lobell: (21:01)
I’m sorry to interrupt. I just wanted to point out to you, at the beginning, before we started recording and we discussed that I’m a comedian and you’re a doctor, you made the joke that maybe you’d want to switch, I think you may have just wrote a bit. Now I don’t know if it’s really the type of bit that you would want to do on stage, but I can imagine, as you’re saying this, a comedian being up there and being like, “We had a word for autism when we were kids, it was being shy!”

Dr. Bhumi Upadhyay: (21:28)
[Both laugh] Well, not that, no, I don’t want to say every shy child.

Daniel Lobell: (21:33)
No, of course. But that’s how my mind goes. But diagnosing it instead of calling it shyness and saying this is a mild case of autism is beneficial, you’re saying, because there are these therapies now that can help this person.

Dr. Bhumi Upadhyay: (21:48)
And again, I don’t want to use the word shyness because there is truly shyness, but I just want to say slightly socially awkward, where they don’t know how to function in large social environments and stuff. But again, we’re talking about the mild form and yes, why is it better that we are diagnosing it? Because there are occupational therapies that will help these children assimilate to society. But I think part of it is also our society is putting a lot more pressure on everyone being social, just because again, we have so much interconnection right now, through social media, the internet, everyone, when you’re growing up, you need to play this sport and that sport. So I think the pressures of society almost forced us to have to be social and 50 years ago, maybe you didn’t have to do that.

Dr. Bhumi Upadhyay: (22:52)
So I mean, I think part of it is we’re looking for it more, we’re diagnosing it more. But again, yes overall, is there an incident that there is a little bit more increased incidence? I do. Now do I have a scientific theory behind it? I mean, I don’t have proof, but, is there something in my mind that says, “Hey, there’s gotta be a reason why we’re seeing it a little more,” and again, I do think it’s environmental factors.

Daniel Lobell: (23:22)
It’s not the toothpaste?

Dr. Bhumi Upadhyay: (23:22)
[Daniel laughs] No, not necessarily, but you know what, I’m one of those who really, really focuses on trying to be very healthy, and sometimes when I look at things and go, “Gosh, there’s that red dye in it, there’s that blue dye in it, please don’t ingest it.”

Dr. Bhumi Upadhyay: (23:39)
So yeah, so I think that there’s a lot of things in our environment that might’ve contributed. Not one thing. It’s gotta be a culmination of stuff. So I don’t want people to think, oh gosh, cell phones are causing this, or anything like that. It’s more just, I think our environment in general, there’s a lot more preservatives and chemicals and environmental pollutions and everything that you can’t pinpoint it, but yes, there’s gotta be something that’s causing that slight increase.

Daniel Lobell: (24:10)
You mentioned occupational therapy. So OTs are typically the ones who deal with the autism, if somebody like you, a pediatrician diagnosis it, or are there other therapies as well that are there?

Dr. Bhumi Upadhyay: (24:21)
There are. There’s a conglomeration of therapies that we put together. And it just depends on what the deficits are, when we’re looking at autism, if there’s a speech delay with it too, then yes. Then there would be a speech therapist. A lot of the children are very, very picky eaters or have sensory issues with feeding. So then there’s also feeding therapists that would help. Feeding therapists are in the same category as speech therapists, occupational are the ones who deal most with the sensory issues and the behavioral issues. And then there’s also what we call ABA therapy, where they are actually, these therapists actually help with like day to day living and daily functions. And so they usually come into the house and kind of just work with the family to go through, and they sometimes get like 20 hours of therapy a week. And so they kind of integrate everything together.

Daniel Lobell: (25:27)
Wow. It’s a lot of therapy.

Dr. Bhumi Upadhyay: (25:29)
Yes. We have some kids who are like 30 hours a week of everything put together.

Daniel Lobell: (25:34)
And feeding therapy. I’ve never heard of that before, but it makes me want that palak paneer all over again. [Both chuckle] You go to a feeding therapist. “What do you got today? Eggplant parmesan, all right.” [Both chuckle] I love this feeding therapist. So one thing that pops into my mind as somebody who’s not a doctor and certainly not a pediatrician, is that it must be challenging to deal with patients who cannot properly often articulate what is feeling wrong with them. Whereas with adults, I know that one of the challenges that doctors face is that people go on WebMD and maybe misdiagnose themselves and come in with misinformation. I wonder if with children, they come in with no information. Is that more challenging, do you think, than dealing with somebody who’s more self-aware of their audience?

Dr. Bhumi Upadhyay: (26:30)
What a perfect question, because that is actually one of the things that my husband and I go back and forth. Because when I tell him I’m like, “Oh, I don’t know how you deal with these adult patients.” Because again, like you said, they always come in already knowing what they have. And he’s like, “Well, I don’t know how you deal with these patients that can’t talk to you!” [Both laugh] So it’s actually — you nailed it. This is the conversation that we have many times. And I think it’s, again, it’s the approach. I would get more frustrated with someone who already comes in with a known diagnosis or someone who’s not willing to change habits and things like that, or me trying to push them to change their habits. Versus, I actually, I take it as a challenge when someone comes in and I don’t know what’s wrong with them.

Dr. Bhumi Upadhyay: (27:19)
Of course, at least we’ve learned to get the cues. An adult can come in and say, “I have belly pain,” and the child is just crying, but we’ve learned to look at their facial cues. Like when I touch their arm, they just look at me, but when I go touch their belly, they wince. So we actually look for other nonverbal cues, and it’s obviously experience, it’s a learned thing. But to me, I like that challenge. And then yes, you’re right. And I like that clean slate of saying, “Hey, look, this is what we’re looking at.” And then of course the parents being more of a team with us, just because again, their child is the number one thing in their life. Like I said, adults don’t always take care of themselves, but these parents, just, whatever it is they’ll do. So that communication is so good with our parents. I love it. I love that challenge to say, ‘Hey, I don’t know what you have, but we’re going to figure it out.”

Daniel Lobell: (28:26)
Yeah. And when kids come into the office, what’s their temperament like? Are they generally screaming and crying and is a lot of that calming them down initially? Or, what is that like?

Dr. Bhumi Upadhyay: (28:39)
Yeah. You know what, I’d say it’s 50 / 50. Because again, we see the kids that aren’t feeling well, of course, so they’re going to be, I mean obviously if they’re like two or three years old or younger, they might be crying. But again, luckily, parents know how to soothe their children majority of that time. But then we also see these kids for well visits and, and just their regular annual physicals and their vaccines and stuff like that. So we also see those and oh my gosh, those are just amazing. I mean, these kids will say the darnedest things that I leave the room laughing. [Both laugh] Just the other day, I had a parent who, I know this parent from another work environment. And so he was just talking to me about the work and the child’s like, “Well, you know, I want to go home.”

Daniel Lobell: (29:33)
[Both laugh] That lack of filter is so refreshing.

Dr. Bhumi Upadhyay: (29:36)
Yes. Yeah. So, like I said, majority of them are coming in pretty happy. It’s just a regular well visit. And honestly, they, if I’ve known them for years, they are excited to come in and parents are always like, “Oh yeah, they’re coming to us.” And I go by Dr. Bhumi with my first name, because my last name is so hard to say, so they’ll be like, “Oh, we want to go see Dr. Bhumi.” So they’re usually in a happy mood, but then of course the ones who are sick, but, like I said, we have our soothing techniques, the parents have their soothing technique. And we get through the exam.

Daniel Lobell: (30:08)
Yeah. Well, this brings me to my classic question, which is, what do you think are the most important facets of the doctor patient relationship?

Dr. Bhumi Upadhyay: (30:17)
Great question. I would say communication and trust, honestly. I tell people all the time, “Listen. I went to med school. I passed my boards for pediatrics. The doctors I work with have done the same thing. The doctor down the street, who’s a pediatrician, has done the same thing.” So our knowledge base is very, very similar. So now it’s really the communication and the trust that you build with your parents and the patient. When a patient comes into my office, my biggest thing is number one, I want to go through everything that I need to tell them about the development of the child or the eating and the sleeping or everything that I need to teach them, but then I want to be there to let them ask their questions. So all my patients know that they have their phone and they have their list and they just go through the list and we go back and forth answering those questions.

Dr. Bhumi Upadhyay: (31:15)
And then the last thing, my classic thing I say before I leave is, “Hey, do you have any more questions?” Because I don’t want to leave that room with them wondering, “Oh gosh, I forgot this.” or “How come she didn’t go over this?” And then same thing with like a sick patient. I want our families to know, why are we treating your child? Or why are we not treating your child? You came in here and you thought, oh, your child was sick. And I was going to give you an antibiotic. And now I just didn’t give you an antibiotic. Well, that’s because it was a virus. And now I’m going to explain to you why an antibiotic would not work. So to me, it’s so important, basically to educate my parents and my patients, and I’ve seen because I practiced this way for 20 some years.

Dr. Bhumi Upadhyay: (32:00)
That’s what’s brought patients back to me and that’s what, referrals have come my way because of that. And I think it’s just, especially, again, like you said, with parents going or adults going to WebMD and all of those, or just some sites that aren’t even really credentialed. I want to be the one to give them that information so that they know it’s coming from a good source. And I think if most physicians practice that way, which I know a lot do, I think that would be a great doctor patient relationship. So I definitely think that communication is important. And then of course, once you have that communication, that trust automatically builds. So I really do think that’s the most important, of course besides our medical knowledge, which I think most physicians have.

Daniel Lobell: (32:50)
Yeah. I’m a parent myself. I’m a dad. And I’m wondering, as you’re saying all this, if there’s generic advice that you give to parents with regards to their children’s health, are there certain things you say, “You must do these things?”

Dr. Bhumi Upadhyay: (33:07)
As a generic you’re talking about?

Daniel Lobell: (33:11)
Yeah.

Dr. Bhumi Upadhyay: (33:11)
Yes, but it’s always age. It depends on the age. One of the most important things I always say is like, when our infants are starting solid foods, I always say, don’t give juice right now or don’t get them started on processed foods or things like that. So I mean, those kinds of things, absolutely —

Daniel Lobell: (33:32)
Why not? I mean, processed foods I know are not good in general, but why specifically not to get them started on them right away? I haven’t heard that.

Dr. Bhumi Upadhyay: (33:41)
Just because if you start them on fruits and veggies, they’re going to like that, but if you start them on Cheez-Its, they’re really gonna like that. [Bhumi laughs] So just to get that into a good habit, so that eventually when you do give them things, it’s as a treat, so that it’s not something that they think that they’re going to have on a daily basis. So I always try to tell parents, I’m like, “Listen, if your child is going to eat a snack, give them a banana, don’t go into the pantry and get Goldfish or Cheez-Its, or things like that.” And it’s just more, it’s to teach a healthy lifestyle, because the last thing I want to do is have to lecture a five-year-old whose body mass index is climbing.

Dr. Bhumi Upadhyay: (34:23)
And now I have to talk to them about eating healthy. And I almost feel like now they’re going to feel bad themselves, or feel like that they’re being targeted, or I’m lecturing them. So best things about being healthy is preventing future illnesses. And so I do a lot of like absolute things, that those are the kinds of things I teach them. I always ask them about sleep. How are they sleeping? Do you have a nice nighttime routine? I always love to teach them how to do nighttime routines. So again, we set good habits for sleep.

Daniel Lobell: (35:02)
I need a good nighttime routine.

Dr. Bhumi Upadhyay: (35:02)
[Both laugh] Well, number one, put that phone away, put the screens away, put the TV away. Which again, even as adults, we don’t do that. I’m doing my charts at 10:00 at night sometimes. So I think those are like definitely the absolutes I like to talk to parents about. Then of course, other advice is very targeted, depending on what issues and what problems arise for the parents.

Daniel Lobell: (35:39)
Yeah. Have there been any major advances in pediatric medicine that are exciting to you lately?

Dr. Bhumi Upadhyay: (35:46)
I would say, well, right now, I mean, obviously I’m keeping my eye out on the COVID vaccine. So we’re all kind of waiting for to see what the studies are showing for those, the younger kids, but in general, I feel like my passion and what I’m seeing, that I I’m liking is the treatment and the development of ADHD and, again, behavioral issues. I’m fascinated by that. And I just love to see that yes, medications are there, but again, all these behavioral modifications, dietary modifications, are actually showing that they help.

Daniel Lobell: (36:32)
Really. Because I myself have ADHD. I detest the medicines. I find them terrible. I’ve been through so many of them. I see the benefits of them, but the way they make me feel when I come off them, and even on them, I just, I’ve always opted against it ultimately, and every now and then I try it again and I find myself going, “No, I don’t like this.” So what are some of the more naturalistic ways that you’re mentioning to treat it?

Dr. Bhumi Upadhyay: (37:01)
And, you’re absolutely correct. I mean, those are the biggest complaints that we always get is, when we start kids on these medications, I mean, it helps. I mean, they definitely do focus. But it’s those side effects that people are constantly complaining. “I don’t like the way I feel,” or, one of the other things is we see kids who keep losing weight, just because your appetite goes down on those. So yeah, so there’s a lot of complaints on those. The things that we’re looking at with ADHD, and again, this is not gonna work for everybody because there are some who have to have the medication plus these other things, and we’re looking at behavioral modifications, and some of the psychologists now actually have these different video games and video tutorials that actually help with learning how to process and focus.

Dr. Bhumi Upadhyay: (37:57)
And then of course, the dietary changes, those are more we’re looking at aren’t — there’s been articles out, but I can’t tell you there’s enough scientific data on that to say, yes, it’s a cure. But it’s something that we can use as a supplement. And those are more like what we had mentioned earlier is to actually get rid of any artificial dyes that are in your food. So not eating the colored cereals and the colored yogurts and things like that. Colored sports drinks. You can have all those, but just go for the ones that don’t have the added dyes to it.

Daniel Lobell: (38:39)
It’s never the dietary advice I’m hoping to hear.

Dr. Bhumi Upadhyay: (38:40)
Oh, I know!

Daniel Lobell: (38:40)
Like I never hear a study that says steak on a baguette every day. I go, “Really! No kidding.”

Dr. Bhumi Upadhyay: (38:49)
I know, right. And then, yeah. And the preservatives we tell you to get rid of. A lot of people have talked about, “Oh, well, if I get rid of gluten, if I get rid of dairy, will my child focus better?” There’s not enough studies for that. So I usually don’t recommend something like that because those are actually taking away some nutritional value to your diet. So it’s more of the dyes and the preservatives. And then there are some studies that are showing that like omega-3 helps you with the focusing. And if you look at the typical American diet, we are not eating enough of the nuts or the seafood that would give you that omega-3.

Daniel Lobell: (39:38)
You never hear much about omega-4. [Bhumi laughs]

Dr. Bhumi Upadhyay: (39:43)
Because we don’t know anything about it!

Daniel Lobell: (39:43)
That’s interesting. So maybe I’ll increase the omega-3 and see if that works for me a little bit.

Dr. Bhumi Upadhyay: (39:48)
Again, it’s not a miracle cure, it’s all the combination of everything.

Daniel Lobell: (39:52)
Yeah. We briefly touched on this, but let’s go into it a little more. How has COVID changed the way that you interact with your patients?

Dr. Bhumi Upadhyay: (39:59)
Oh, that’s a loaded, loaded question. It has changed tremendously. So when people used to go into the doctor’s, or at least specifically, let’s just put my pediatric office, we used to have them come in. They used to check in and then they would check in, they would go to one side of the waiting room that was sick, one side that was well. Ever since COVID hit, no sick patients were even coming into the building. They were being seen while they were waiting outside in their car. And from March, 2020 to about January 2021, we were seeing them in their car. And we are talking about, we were wearing all our PPE, which means the gown and the gloves and the mask, in a hundred degree Florida weather. So we’re doing — but you know what, it was safest for the patient, it was safest for us. And our office actually went completely… Well, we were already electronic medical records, but everything went electronic. When you checked in, you checked in from home. If you had a copay, you paid from home, if you had any forms we needed you to fill out, it was all electronically from home. So we didn’t actually have — no one was holding a pen and filling out anything in our office.

Daniel Lobell: (41:23)
I wonder how much of that’s going to stick around after COVID?

Dr. Bhumi Upadhyay: (41:26)
Well, I mean, I think a lot of it has… I mean, it was a company that we had used, so we’re still going to continue to use that part of it. Now the car visits have stopped. We’ve actually started bringing patients into the office, but there’s only two designated rooms, and they’re on one side of the office, there is a separate sick entrance. So the sick patients still don’t enter through the front door and they still don’t wait in a waiting room.

Daniel Lobell: (41:56)
That’s scary, the sick entrance. Like, “Oh no, I’m going through the sick entrance!”

Dr. Bhumi Upadhyay: (41:56)
[Both chuckle] And they still wait in their car because we don’t want them lingering around in the office. And I really do feel like that’s going to probably stay for a very long time. And then of course how we go into the rooms, even though the mask mandates are gone in our state, the healthcare facilities still have to wear it.

Dr. Bhumi Upadhyay: (42:25)
And I feel like that’s going to last for a long time, that you probably won’t see your physician without a mask on. So yeah, so the interactions have changed, but I will tell you, everyone has been very patient, they understand, things might go a little slower because every time I go into a different room, we gotta make sure we’re putting on gloves. We gotta make sure we’re putting on gowns. So everyone’s become very patient knowing that it takes time to go from room to room.

Daniel Lobell: (42:55)
Well, I think that’s gotta be challenging too, because especially with kids not getting to see your face, I think makes it so much less personal. My pediatrician’s face is still ingrained into my mind. He was great. Dr. Steven Goldstein. I don’t think he’s still practicing, but he might be. I actually, to tell you just a funny anecdote, I went to him way past the time that you’re supposed to see a pediatrician. I think my first year of college is when he said, “Listen, you’re a little too old to be coming to see me.” And I was like sitting in a room with all kids who are like playing puzzles and little toys that are like, on, something, I don’t even know how to describe them. You know those wires and the toys, you move them along the wire…

Dr. Bhumi Upadhyay: (43:41)
Those beads? Those beads that you move. Yes.

Daniel Lobell: (43:48)
And I’m thinking, maybe I am too old for this, but I love my pediatrician.

Dr. Bhumi Upadhyay: (43:48)
So that actually, I forgot to mention, that there are no toys in the office now. So that’s a little sad.

Daniel Lobell: (43:59)
No toys? Oh, no… What about the Berenstein Bears books, are those still there?

Dr. Bhumi Upadhyay: (44:02)
No. I mean, we don’t have books, we don’t have toys because again, then multiple people are touching it. And this is because of COVID we’re talking about, I forgot to mention that part. So that really took me away from it. I mean, we used to have so many toys around, we had like something called a sensory board. So on the board, we had like felt on there, we had keys on there, so the kids can play with, touch it, see how everything feels differently. So yeah, that’s all gone. So yeah, that made a huge difference. And then of course, you’re right. I have some patients who at 21, I have to tell them, like, “You gotta go. I can’t see you. You’re now 21.”

Daniel Lobell: (44:43)
This breaking up, It’s gotta be tough. “But I’ve been with you my whole life. Why?”

Dr. Bhumi Upadhyay: (44:49)
I know. Oh, I had one family that the mom’s like, I really want you to take a picture with my son, he’s going off to college. And so we take a picture and then she posted on her Facebook, “My son’s last visit.” And someone’s like, “Wow, your son has either gotten really, really tall or you have a really short pediatrician.” And she said both. [Both chuckle] So, but it’s amazing, right? I mean, I see them when they were six pounds and then now they’re like six foot tall.

Daniel Lobell: (45:23)
You must get attached to your patients. And it must — is it tough when they finally, you have to say, “I can’t see you anymore?”

Dr. Bhumi Upadhyay: (45:31)
It is tough. But I will tell you, I think human nature makes it that by the time you’re a teenager, you’re like, yeah, okay. You’re having attitude. It’s time to go. [Both chuckle] I know. I’m just joking. But, yeah, it is tough. Yeah. Because you build a relationship. This child is a competitive dancer or this child… Yesterday I actually had a whole talk with a girl who’s applying to all these colleges. And I was actually telling her which colleges I feel like are going to be well-suited for her. I’m like, “Wow, I get to have this conversation?” So absolutely, it’s a rewarding field in that way that I get to keep up with these kids til 20 years old.

Daniel Lobell: (46:16)
In a way, you get to act as a parent as well, which is good that you are one.

Dr. Bhumi Upadhyay: (46:21)
Right. And then I get to send them home though. [Daniel laughs] I don’t have to keep them disciplined.

Daniel Lobell: (46:27)
[Both laugh] So what is your philosophy as a parent on raising children and what have you learned over the years?

Dr. Bhumi Upadhyay: (46:33)
Oh, well, one of the things I learned is, no one’s a perfect parent, even if you have all the information at your bedside on how to raise kids and how to be a pediatrician. My kids have given me my challenges. As a parent, I think, well, one, consistency, consistency, consistency is the most important. I mean, if you do that, you’ll be somewhat successful. I mean, you’re still gonna hit roadblocks and things. And then as your child gets a little older, I think communication is most important. If there’s a mutual respect, even with your middle school child, you do have to show them that you respect their opinions because their brain is developing. They’re actually going through complicated thought processes. And we as parents have to understand where they’re coming from.

Dr. Bhumi Upadhyay: (47:25)
And listen to them. Listen to them and say, “Hey, you know what, give that information. How did you get to that point? Because that’s not the position I would have made.” And it’s amazing. And I’ll tell you, I mean, I argued with my son one day when he was in middle school. He would wake up in the morning and he’d do his homework that was due that day. And I would be like, “Why do you do your homework in the morning? Why couldn’t you have done it last night, just in case something goes wrong?” And he’s like, “Mom, what are my grades?” I’m like, “Oh, you have straight A’s.” “So you’re upset because I’m doing my homework on my time, not yours.” I’m like, “Wow.” [Bhumi laughs] Like, oh, I just got told off by a middle schooler! [Both chuckle] But the thought process was fine. There was nothing wrong with it, right? So again, I think when our children are young, we just have to provide consistency. But as they get older, I think it’s that communication and understanding of how they think.

Daniel Lobell: (48:27)
I like when you say consistency, consistency, consistency. Cause it’s a very consistent thing to say.

Dr. Bhumi Upadhyay: (48:32)
Yes. [Bhumi laughs]

Daniel Lobell: (48:34)
Consistency, consistency… Conspiracy? No.

Dr. Bhumi Upadhyay: (48:36)
No. How many more times do you want me to say it?

Daniel Lobell: (48:41)
[Both laugh] That’s great advice though. I appreciate that. You are now the CMO of Doctorpedia’s upcoming Pediatrics channel, which is very exciting. Please share with the audience some of the cool things that you are hoping to accomplish with the channel and its content.

Dr. Bhumi Upadhyay: (48:56)
Oh, absolutely. And just so that you know a little background, obviously every time you’ve asked me, I said, “Oh, communication and education. That’s very important to me.” So, when Doctorpedia, the group and I were talking, I’m like, “Wow, this is exactly what I’ve been wanting to do.” And then earlier this year, around January of 2021, I actually had started my own YouTube channel for my patients. And that was, I was making videos on sleep, sleep training, picky eaters, so just all this information that I wanted to give to my parents that I couldn’t give to them on an individual basis. And so then again, when Doctorpedia came up, I’m like “Oh, wow. Now I can do this with a group.” And so this was just, I mean, it was just a great fit.

Dr. Bhumi Upadhyay: (49:46)
And so once we started talking, we were looking at, again, making educational videos, my personal videos were about 20 minutes long. So I think people were probably going to get bored. These are going to be nice and short and concise. And we are trying to categorize them. And so hopefully that’ll be easy for parents or anyone looking to see them. But are they going to be an age group or are we going to do it more by systems? We’re still deciding that. But we’ll just take common topics that we know that someone like you who’s a parent would just want to know, “Hey, when my child’s doing sports, what do I need to worry about with safety?” Or, “Hey, I live in California or I live in Florida, what do I need to know about water and sun safety?” So we’re going to try to take the most important and also most sought out information and try to make them into little video clips. There will also be written articles. But again, as you see our generation, right, we’re now all looking to videos more than we are reading. So I think this is going to be a great avenue to share.

Daniel Lobell: (50:59)
Yeah. I’m looking forward to checking it out myself. And by the way, because I have the cool opportunity of speaking to you directly, my daughter, please God, turns two in October. And she recently decided that she doesn’t like going to sleep anymore. And I’ve been like for two, three hours every night, going back and forth, trying to get her to go to sleep. Any advice for me?

Dr. Bhumi Upadhyay: (51:22)
Consistency, consistency, consistency. [Both laugh] Well, yeah, so actually I do. I actually do a lot of like the sleep talk. I mean, there are some people who will actually hire sleep trainers to come to the house, so you can always do that. But honestly, they usually pretty much just kind of, you want them to say, “Hey, don’t cave in. Don’t cave into your child.” But the biggest thing is having a great routine at night, four or five things that you’re going to do every night. And then that last thing that you’re going to do, you’re just going to give her a big hug and a kiss and say, “Now you need to go to bed and you’re going to stay in your room.” And then — is she the one who keeps coming in and out of the room or is she crying?

Daniel Lobell: (52:06)
No, she screams her head off. And then I wait and wait, and then I’m like, “I can’t take this anymore. I gotta go in and check on her.” I go in there and I take her out and I calm her down and she starts to sort of fall asleep in my arms and I put her back in her crib and she starts screaming again and throws everything out of the crib. That’s what she likes to do.

Dr. Bhumi Upadhyay: (52:27)
Yeah. So yeah, so you need to kind of just move away a little further, so you’re not hearing the screaming, and you need to just let her — and again, you might think that she’s crying for a long time, but a lot of times they’re crying for five minutes and to you, it’s about 30 minutes, but it’s not. And so you do want to do that. Now, if you can’t do the crying out method, there are different types of methods. Like what they call the camp out method, where you actually sit in the room, and you kind of let her hold your hand, but she’s still in the crib, until she falls asleep. And then the next day you just, you move your chair over just a little bit. So now she’s not touching you, but she sees you.

Daniel Lobell: (53:13)
Sneaky. [Both chuckle]

Dr. Bhumi Upadhyay: (53:13)
And then a couple of days later, you move a few feet further away. So you just move further and further away so that you don’t have to technically do the crying out. So yeah, so there’s a couple of different ways to do that.

Daniel Lobell: (53:25)
Months later you’re in Alaska.

Dr. Bhumi Upadhyay: (53:25)
Yeah there you go, well then you’re happy! [Both chuckle] But yeah. So, you can do it. You definitely can. You just have to, again, you have to be able to just let it go. And then, like I said, be consistent. Don’t do one day where you let her cry and then you walked away, but the next day you just gave in, because then you lost. You lost any gains that you made.

Daniel Lobell: (53:50)
It’s like football.

Dr. Bhumi Upadhyay: (53:52)
Yes. [Both chuckle]

Daniel Lobell: (53:55)
Oh, doctor, it’s been an absolute pleasure getting to talk to you today. I’m going to round off this interview with the same question I ask all the doctors to close it out, which is, what do you personally do to stay healthy?

Dr. Bhumi Upadhyay: (54:07)
So I exercise every day. I started with CrossFit and now with COVID I stopped doing CrossFit, but I do it at home now. And then my husband and I go for a walk every single evening. And both of my kids are in college. We make sure we talk to them three, four times a day. Yes they do. They want to talk to us. So I think just making sure that you have a good balance of work. If I wasn’t going to work, I still think that I would be unhappy. So that work balance. And then of course, staying physically fit, eating healthy, and being in touch with your children, I think are the most important.

Daniel Lobell: (54:53)
I think that sounds like great advice. Thank you so much for doing the interview.

Dr. Bhumi Upadhyay: (54:57)
Oh, thank you. It was a pleasure talking to you too.

Daniel Lobell: (55:02)
This podcast or any written material derived from its transcripts represents the opinions of the medical professional being interviewed. The content here is for informational purposes only and should not be taken as medical advice since every person is unique. Please consult your healthcare professional for any personal or specific needs.