Episode Transcript

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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. Hello, and welcome back – or welcome for the first time – to the Doctorpedia Podcast. I am your host Daniel Lobell and today I’m honored to be joined on the line by Dr. Donald Mayes. Dr. Mayes, welcome to the show.

Dr. Donald Mayes: (00:41)
Well, thank you. My pleasure to be here. It’s definitely an honor to be part of this program and I look forward to chatting with you.

Daniel Lobell: (00:49)
Well, before we started recording, you mentioned to me that you listened to a few of them, so I can tell you that I’m honored to hear that – that’s pretty cool.

Dr. Donald Mayes: (00:58)
Well, thanks. Yeah, it’s interesting as a psychiatrist, getting to hear different perspectives on different specialties and different illnesses and all these different personalities out there, and you add a nice comedic flavor to the whole program. It’s definitely enjoyable.

Daniel Lobell: (01:18)
Thank you. Now, that’s a good sign because you’re not saying I need to be immediately medicated after having listened. [Both laugh].

Dr. Donald Mayes: (01:25)
We probably all need a little medication, but I don’t think any more than the next guy.

Daniel Lobell: (01:33)
[Laughs] That depends who the next guy is, I suppose.

Dr. Donald Mayes: (01:36)
True. That’s a good point.

Daniel Lobell: (01:38)
[Laughs] If he’s some crazy cult leader

Dr. Donald Mayes: (01:41)
[Laughs] They’re out there for sure.

Daniel Lobell: (01:45)
So you’re based in Las Vegas, Nevada. Is that where you grew up?

Dr. Donald Mayes: (01:51)
No, but I feel like I’ve been here forever. I’ve been here about 17 years.

Daniel Lobell: (01:56)
I feel like I’ve been in Las Vegas forever when I’m there for three days.

Dr. Donald Mayes: (02:01)
[Laughs] Yeah, that’s a bit much, especially in the summer. Three days is a good cutoff point to get out of here.

Daniel Lobell: (02:08)
I can’t even imagine that many years. Wow.

Dr. Donald Mayes: (02:12)
Oh, I know. I can’t believe it myself. I’m still trying to figure it out – how I ended up here 17 years, but it is what it is.

Daniel Lobell: (02:18)
Do you have lizard skin at this point? [Laughs] How do you survive?

Dr. Donald Mayes: (02:23)
[Laughs] Well, that’s the thing. I try not to go outside. That’s probably a good thing. It’s so hot all the time and I just tend to stick in the air conditioning the way God intended it to be, right?

Daniel Lobell: (02:38)
[Laughs] That’s right. Otherwise, why would God have had us invent air conditioning?

Dr. Donald Mayes: (02:43)
Exactly. Come to think of it, where I live right now, one of the air conditioners needs to be fixed and they can’t find the part for it in all of this supply chain craziness. So I’m like, “I gotta have that by June or else I’ll be dying.” It’s already 95 out here. It’s ridiculous.

Daniel Lobell: (03:02)
Good luck on that one.

Dr. Donald Mayes: (03:04)
Tell me about it.

Daniel Lobell: (03:05)
Where are you originally from?

Dr. Donald Mayes: (03:08)
I always say Idaho, but it’s a little complicated. I was born in a little town called Eureka, California.

Daniel Lobell: (03:19)
“Eureka!” Is that how people say it there?

Dr. Donald Mayes: (03:21)
Pretty much. When I say Northern, I mean Northern California – people think San Francisco is Northern California. It’s – from my perspective – more central. Eureka is almost near the border of Oregon. It’s beautiful up there. It’s right on the coast – all the Redwood trees, forest, all that stuff up there. Beautiful place. Unfortunately my parents divorced when I was younger. My mother moved out to Idaho, where her family is at, but I always had a connection to California with my dad. I ended up spending most of my time in Idaho – did all of my schooling down there, did my undergrad at Idaho State University in a town called Pocatello.

Daniel Lobell: (04:02)
That’s another good name.

Dr. Donald Mayes: (04:02)
Yeah. They love the Indian names up there. Very unique. You’ve got Boise, Idaho, Pocatello, Idaho, and they have one they call Blackfoot, Idaho. That’s kind of interesting. It was a good experience. I ended up eventually obviously going to medical school. I ended up going to a Caribbean medical school on an island called St. Maarten.

Daniel Lobell: (04:29)
Was that just because you just wanted a vacation while you went to medical school?

Dr. Donald Mayes: (04:33)
[Laughs] In hindsight, I should have spent more time on the beach, honestly. When you’re in med school, you get so competitive that you’ve got to beat the next guy, but at the end of the day, as long as you all pass and you get through it, you get through it. There’s always that competitive spirit back then.

Daniel Lobell: (04:50)
But what made you decide to go to the Caribbean for med school? If not for that?

Dr. Donald Mayes: (04:53)
Well, that’s the great question. I went through college and I wasn’t sure I was going to be a doctor at first. I had a lot of – let’s say – negative advice, negative people around me. Of course, that can influence one to the negative side of things. Of course, when you’re younger, you’re even more influenced by these kinds of things, but at the time there were a lot of negative thoughts about being able to get into medical school. Applications at the time were a record. I’m hearing things like, “oh, this guy had a 4.0 and couldn’t get a single interview” and all of these things. Back then, I worked in college and my grade point average wasn’t bad – it was like a 3.5, 3.6, something like that. But I really felt I didn’t have a chance to get into medical school. A friend of mine started talking about chiropractic school and I thought, well, that’s interesting. I had a good experience when I was growing up. I had some scoliosis with my back and they fixed it and it was great. I ended up going to a school in Texas for chiropractic school and I did it for about a semester. Then I met somebody who graduated from my school and I had no idea about these schools outside of the country. I started asking this person about their experience and how it was and everything. I came to find out that at that time they didn’t require what’s called the MCAT, the medical college admission test. I didn’t care so much about taking that. The next test – they had specific dates to take the MCAT – and the next test date was like nine months out. I really wanted to jump into this idea of getting into medical school. At the time, my school didn’t require the MCAT – they do now, of course – but I applied to the school, talked to some other graduates from the school and said, “wow, this looks amazing and I can kind of get a jumpstart on medicine.” Long story short, I went to this island for almost two years. You do your book work, your studies there – the school’s been around since 1978.

Daniel Lobell: (07:18)
Amazing.

Dr. Donald Mayes: (07:19)
They put out a lot of graduates over the years. Eventually when you finish the first two years of the book work, you go to the clinical work. They have different affiliations with different hospitals, not only in the United States, but the United Kingdom, Ireland. I ended up in Bakersfield, California, of all places.

Daniel Lobell: (07:41)
[Laughs] Okay.

Dr. Donald Mayes: (07:47)
Not the best part of California – no offense to the Bakersfield listeners.

Daniel Lobell: (07:51)
You were probably hoping to wind up at Kokomo medical center. [Laughs]

Dr. Donald Mayes: (07:55)
[Laughs] Yeah. Something like that. But it was beautiful.

Daniel Lobell: (07:58)
That’s where they tell you to take it slow.

Dr. Donald Mayes: (08:02)
Yeah, exactly. Kokomo. That was the Beach Boys song, right?

Daniel Lobell: (08:08)
Yeah. You get there faster if you take it slow.

Dr. Donald Mayes: (08:11)
Exactly. In Kokomo.

Daniel Lobell: (08:14)
That’s kind of your approach to medical school. [Laughs]

Dr. Donald Mayes: (08:17)
Exactly. Unfortunately there were some students that took a little too slow there and a little too much time at the beach and at the beach bar and didn’t finish, unfortunately.

Daniel Lobell: (08:27)
Majored in margaritas, I suppose.

Dr. Donald Mayes: (08:29)
Exactly. Majored in partying. For sure. Thankfully, that was never a big thing for me.

Daniel Lobell: (08:37)
I can imagine that’s a pretty big trap when you go to The Bahamas for school.

Dr. Donald Mayes: (08:43)
Yeah. It was an island called St. Maarten, which is about 150 miles roughly from Puerto Rico. It’s the smallest island divided between two countries – a little piece of trivia. It’s divided between the Dutch and the French. I lived on the French side, I went to school on the Dutch side each day. It was kind of strange. They had people all over Canada, United States that were going to school there. There was a guy from Russia, I believe. It was fascinating. I got to meet people from all over. In hindsight, it was the best experience of my life. I really loved it because there’s really nobody local to that school. There were a couple people that were local, but the vast majority of the people that were there were from different states and countries. I made some amazing friends and experiences. I grew up in Idaho, which – not a lot of experiences going on in Idaho, so it was kind of a culture shock for me at first, but a great experience, man. I’d do it all over again if I had to. Not up against going to Harvard, but this was a good experience.

Daniel Lobell: (09:54)
I’m starting to feel like I should do it.

Dr. Donald Mayes: (09:55)
[Laughs] Let’s get you in there. Let’s do it.

Daniel Lobell: (10:00)
That’s pretty wild that you would start on the French side and then you went to school on the Dutch side. How vastly different were the French side from the Dutch side?

Dr. Donald Mayes: (10:14)
You know, it’s funny. It wasn’t a huge difference, but you could definitely tell a few things with how the roads are laid out. Obviously the French language – the Dutch side was primarily English spoken. It just seemed, as far as living there, the utilities were a little bit more reliable on the French side, on the Dutch side, you have these rolling blackouts and in the Caribbean heat–

Daniel Lobell: (10:37)
Because everything there was running on windmill power, probably.

Dr. Donald Mayes: (10:40)
Trust me. You need air conditioning – that’s worse than Vegas down there with that humidity. It was brutal. Trying to study with no air conditioning – good luck with that.

Daniel Lobell: (10:54)
Otherwise it sounds like a great experience though, being out there.

Dr. Donald Mayes: (10:57)
Oh yeah, I loved it. Certainly humbling at times. Being on an island, you think, “oh, it’s gorgeous” and it is, it’s absolutely gorgeous, but most people are there for a week, maybe two weeks for vacation or a honeymoon or whatever. But when you’re there for about two years and I had one trip back home, you find the definition of island fever, for sure. That island got really small, man. Let me tell you. Holy cow. But I still don’t regret it. It was fun.

Daniel Lobell: (11:31)
So, you studied there, you wind up being transferred to Bakersfield – kind of a culture shock right there, I would imagine.

Dr. Donald Mayes: (11:38)
Yeah. All of it. For sure.

Daniel Lobell: (11:40)
Did you go right into practice?

Dr. Donald Mayes: (11:47)
Yeah, pretty much. That’s the thing with third year medical students, they typically start their clinical years in the third year. That’s when you’re actually seeing patients and you’re outside the books finally. It’s exciting, but also so intimidating. My first rotation was with orthopedic surgery and usually that’s a fourth year medical student rotation, but they didn’t have enough spots in another rotation. I guess they thought that I would be okay in there – and I was [Laughs], but it was a little trial by fire experience at first. The first day, I walked in there and we all were supposed to meet in a certain area. It’s basically, we go over the previous night’s cases. A lot of it’s like car accidents and different things when it comes to orthopedics. They’re really good, these attendings, what you would call the teacher, basically, the attending’s the top dog of the medical field. Right. They’re really good at picking out somebody who has the deer in the headlights look, and I’m sure I had that look. Of course he picks me. He puts this x-ray up and it was just of a hand basically. He points to a bone in the wrist and I can’t remember how many bones were in the wrist, about eight or so. He points to a fracture in the bone and goes, “what bone is that?” And I’m like, “um…” I threw out, I think scaffoid or something. He’s like “no, try again.” I threw out another name and I’m starting to sweat, get real nervous. There were probably five or six people around us at the time – other residents and medical students. And he goes, “is it left or right hand?” [Laughs.] I go, “right.” “No, it’s left.” I couldn’t even get the right hand.

Daniel Lobell: (13:57)
You had a 50/50 on that one, at least.

Dr. Donald Mayes: (13:58)
Yeah, exactly. I was like 50/50 – I’ve got a pretty good shot here, hopefully, and I still couldn’t get it right. So that’s my humiliating first day on the clinical wards and it’s a brutal experience. It really is. It really cuts you down a lot. But I think in the long term it serves a good purpose, I think. It makes you tougher, for sure, and you’ve got to be tough to get through residency. There’s no doubt about it. No matter what specialty you do, I think.

Daniel Lobell: (14:24)
Yeah. I’m surprised they ask you about that when you’re going into psychiatry, too. Why do you need to know about the hand?

Dr. Donald Mayes: (14:34)
That’s the thing, I’ll just explain this a little bit better too. With medical school, when you do the last two years of clinical years, all medical students, regardless of specialty will do certain required rotations. I’m trying to remember this correctly. For my medical school – and it’s usually the same for most – is 12 weeks of general surgery, 12 weeks of internal medicine, six weeks of pediatrics, six weeks of OB/GYN, and then six weeks of psychiatry. Then the fourth year you do what are called electives and you pick other little specialties – I picked like pathology, neurology, radiology. The idea is that hopefully by your third or fourth year, you can figure out what specialty you fit in, what you’re interested in. That’s how you figure out what you want to do. I originally thought I was going to do pathology, of all things, and ended up switching to psychiatry.

Daniel Lobell: (15:41)
The study of paths.

Dr. Donald Mayes: (15:43)
[Laughs] The study of dead bodies. That’s the thing, man. I like my patients alive. [Both laugh] I like them talking to me. It’s a little more entertaining when they’re talking.

Daniel Lobell: (16:01)
Well, it’s probably even more entertaining when you think they’re dead and then they start talking.

Dr. Donald Mayes: (16:06)
That would probably be a big problem. I was always fascinated with the science of pathology, looking in the microscope and figuring out are these cells cancerous and figuring out the disease process. That’s one of the big things that attracted me to medicine, but I assisted on about 12 autopsies and I thought, well, after 12, and I’m not getting used to this, I think the writing’s on the wall. I love psychiatry – it’s definitely the perfect choice for me, honestly, so no regrets whatsoever.

Daniel Lobell: (16:47)
So tell me, tell the listeners a little bit about being a psychiatrist – more than what our rudimentary understanding of it might be.

Dr. Donald Mayes: (16:58)
That’s a good question. That’s a very good question.

Daniel Lobell: (17:01)
I try to have one every interview. [Both laugh]

Dr. Donald Mayes: (17:03)
It is a great question. Psychiatry can be different things depending on the situation. Unfortunately we’re living in the managed care world, which is where most people live. In the psychiatry world on an outpatient basis, most people will see a psychiatrist for medication checkups and they might see a doctor on a first visit for say 45 minutes, maybe an hour, and then the follow- up visits are usually no more than 15 minutes. So it’s a pretty rapid pace. Getting into the nitty gritty of all the psychological things going on with a patient can be pretty difficult. That’s a frustrating thing with my kind of work, is the managed care part. However, there’s the other side. There are some psychiatrists that do work outside of that box and do regular psychotherapy along with medication management. Those appointments usually are way longer – typically an hour, if not longer. That can be very fulfilling, but at the same time expensive. It just depends on what one person can afford and do. Unfortunately it’s just reality in our medical world. I work in a hospital right now, so I’m not as constrained in that. I try to spend more time – as much time as I can – with a patient to try to get to know them and know what really is going on, rather than just, “you must be bipolar, here’s a med to make you feel better.” I always want to really see what’s going on with somebody. One of the biggest complaints I get from patients, unfortunately, is, “my doctor doesn’t listen to me.” I find that is a sad state of affairs, sometimes – especially with a psychiatrist. Your psychiatrist is not listening to you? If one doctor’s supposed to listen to you, it should be your psychiatrist.

Daniel Lobell: (19:06)
Right, yeah.

Dr. Donald Mayes: (19:06)
Unfortunately I see a lot of misdiagnoses and mismanagement at times.

Daniel Lobell: (19:12)
In a way, any psychiatrist really should have some element of psychotherapist to them.

Dr. Donald Mayes: (19:19)
Yeah, preferably. With psychiatry, it’s human behavior and there’s a lot of quirks, cultural things, little human behaviors that we do that aren’t easy to interpret and you can’t learn in a book. Having those skills to be able to identify when somebody says something that may or may not… should be taken seriously. That’s a good thing to be able to recognize those things.

Daniel Lobell: (19:56)
Sometimes you’re talking to an absolute psycho, in which case it’s psychopsychotherapy.

Dr. Donald Mayes: (20:01)
[Laughs] Oh yeah.

Daniel Lobell: (20:03)
It’s stupid, but… Do you do psychotherapy? No, I specialize, I do psychopsychotherapy.

Dr. Donald Mayes: (20:19)
All patients need some form of therapy in a way, whether it be severe psychosis, they’re going to need just the simple basics of stuff to try to get their lives together and function, hopefully stay on the medications and maybe eventually get a job if they can keep things together. But you always have to start at the rudimentary basics, unfortunately, but that’s where they’re at. And you try to find where the patient’s at. Sometimes I’ve seen patients that are really high functioning, they’re up there at the high level executives in one of the casinos and their spouse brings them in: “Steve here won’t give me any time a day. He’s always at work, he’s working 90 hours a week and blah, blah, blah. And he only needs to sleep four hours a day.” I’ll say, well he only needs four hours a day. He’s not tired. He’s working 90 hours a week. He’s bringing in all this money. I can medicate him, because he is a little bipolar, but you might want to be prepared for less income. He’s not going to probably be working as much and usually the answer is “well, that’s okay.” Because a certain level of bipolar can be, in my opinion, beneficial, I wouldn’t mind being a little hypomanic. If I could sleep four hours a day, that would be a superpower in my opinion.

Daniel Lobell: (21:54)
The Steve in that example, I’m assuming, was Steve Wynn? [Both laugh]

Dr. Donald Mayes: (22:02)
Not quite, but we’ll say that. I did meet Steve Wynn once though at a hockey game. That was interesting.

Daniel Lobell: (22:09)
Oh yeah? Is there a story there?

Dr. Donald Mayes: (22:12)
Not a big one. I just kind of brushed by him. We were going down to the VIP area after game. I think it was the playoffs a couple years back when we got our hockey team. He said something in the elevator. It was kind of funny, but this was right around the time when he was going through the – what was it? Some accusation of inappropriate behavior, I guess and I think it was a sexual joke and it was kind of like, “it’s probably not the best time to be doing that, Steve.”

Daniel Lobell: (22:50)
Give him your card and you say, “hey, if you need to be medicated through this, I got you.” [Both laugh]

Dr. Donald Mayes: (22:53)
Yeah, exactly. I look behind and his wife is just rolling her eyes at him going, “oh God, here he goes.”

Daniel Lobell: (23:01)
If I was him, I’d walk around with free buffet cards on me all the time. Anytime you meet someone – “go have a buffet on me at the Wynn.” How many people could do that? He could.

Dr. Donald Mayes: (23:14)
Right. Yeah. He could every day, just do it. [Both laugh]

Daniel Lobell: (23:23)
That’s probably why I’m not Steve Wynn in life, because my ambition would be to give out buffet cards.

Dr. Donald Mayes: (23:28)
I know. That would be cool. If I was a billionaire, I would probably give away a lot of free crap too.

Daniel Lobell: (23:36)
It’s even on your business card, if you even have one at that point – you’re a billionaire with a business card and on the back, it’s a free buffet.

Dr. Donald Mayes: (23:44)
That would be cool. I like that idea. Good publicity.

Daniel Lobell: (23:46)
I can do consulting if anyone’s interested out there.

Dr. Donald Mayes: (23:50)
I love it.

Daniel Lobell: (23:56)
You get what you pay for.

Dr. Donald Mayes: (23:58)
There you go.

Daniel Lobell: (24:00)
We talked a little bit already about the doctor-patient relationship when you talked about complaints that you get from patients that their doctors don’t listen to them. Are there other things that you would add to that, that you would say are vital to the doctor-patient relationship?

Dr. Donald Mayes: (24:17)
Yeah. For sure. Just from my specialty by itself and it probably applies to a lot of other specialties and I think we can learn. As part of being a physician, I don’t ever want to be in a place where I stop learning. We should always be learning. Everything’s evolving, this world’s crazy and evolving, so we’ve got to learn and get better for our patients. That’s what it’s all about. But I would say what I’ve noticed and learned is that as far as psychiatry goes, we don’t educate our patients enough about their illness, about medications, and what they should do. We just kind of pat ’em on the back and send ’em out the door. “Here’s your Prozac, have a nice day. What you’ll see often is a patient will take the Prozac for a couple weeks and say “this crap doesn’t work”, so they’ll throw it away and they stop taking it. Well, we forget to say that this medication could take at least a month, if not even up to a couple months to really fully start to do something. You’ve got to be really patient. That’s on us. We can’t blame the patient that didn’t take their medicines. Well, we didn’t educate on that part. We need to educate that part. The other thing, too, in my specialty is patients stopping medications when they shouldn’t. Another issue is they start to feel better, and so after a couple months, “oh, I don’t need this Prozac anymore.” So they toss it away. That’s another thing – if you stop the medications too soon, you have a high risk of relapsing with severe depression or anxiety, whatever is going on. With the Doctorpedia thing, this seems so interesting to me to get involved with because we can really make a difference in that educating part. People like to click on videos. Hey, I do it – YouTube, podcast, whatever. I’m constantly watching stuff to educate myself on different things. I think it’s a great medium to be able to do that. I’m happy to just be a part of this and get things rolling.

Daniel Lobell: (26:41)
I’m happy you’re a part of it as well. Tell us: how did you wind up finding out about Doctorpedia, and what is your role in the company going to be? Where can people find you on the website? More on that.

Dr. Donald Mayes: (26:57)
Okay. I got involved. It was kind of random, honestly. I got an email through LinkedIn. I can’t remember her name, but a very friendly lady. Most of the time, unfortunately I don’t read most of my emails on LinkedIn. I’m totally guilty of that, but it looked interesting. I somehow happened to read this particular one and then started looking into it. And then I said, “well, that seems interesting.” I looked at the website and found the podcast and thought “wow, this is pretty neat.” I already had an idea of the mission of Doctorpedia. Then I ended up meeting Jeremy through the zoom and was impressed, shot some questions and answers back and forth. They seemed to like me and I liked them, and here we are. That’s just started about a month ago, I think, that we’ve got things going here. I don’t even know if I have a Doctorpedia page yet because I have to set up my profile and all that other stuff. I’m due to do that here very soon.

Daniel Lobell: (28:10)
All right. Well, a lot for us to look forward to there.

Dr. Donald Mayes: (28:13)
Yeah. Thanks. Definitely

Daniel Lobell: (28:15)
Exciting to have you on board.

Dr. Donald Mayes: (28:16)
I had some visitors this last couple of weeks to Vegas. That’s another thing about living in Vegas – you’ll find friends and family you never, ever knew you had. [Both laugh] “Hey, are you busy?” “No, I guess not.” “I’m coming, I want to visit.” “Okay.” I’ll play chauffeur and entertainer for a couple weeks. I don’t mind that, don’t get me wrong. It’s just, sometimes it gets a little overwhelming at times when everybody wants to show up at the same time.

Daniel Lobell: (28:45)
Right. Yeah. That is also the good thing about Vegas is that you don’t get lonely if you live there, people are always gonna come and visit you.

Dr. Donald Mayes: (28:53)
Exactly. Exactly. I am definitely not short on friends.

Daniel Lobell: (28:58)
Yeah, and I’m sure as the casinos keep getting more expensive, your guest room’s going to become more and more popular.

Dr. Donald Mayes: (29:04)
Oh yeah, absolutely – and I live in a condo high rise near the strip. You can literally walk right over to Aria and blow all of your money there, I guess.

Daniel Lobell: (29:16)
Do you have any openings next weekend? [Both laugh]

Dr. Donald Mayes: (29:24)
Sure, let’s schedule you in. I’ll have to double check. I take Visa, Mastercard, American Express. Yeah, it’s an interesting place to live for sure. But I’m done with the heat, though. I’m ready for something else, but I’m probably not moving for a while.

Daniel Lobell: (29:43)
Yeah. You mentioned some of the things where you feel like maybe there are some shortcomings in psychiatry – what are some of the things you’re excited about that are on the horizon in the field?

Dr. Donald Mayes: (30:01)
Another, another great question.

Daniel Lobell: (30:03)
I’m knocking them out of the park tonight. [Laughs] I’m on fire baby. Can’t be stopped. Won’t be stopped.

Dr. Donald Mayes: (30:09)
Boom, boom, boom. All the way. As with most specialties, the research that’s going on out there is really, really cool. New medications, new novel treatments as well. They just had approved this ketamine for treatment resistant depression, which is pretty cool. It’s pretty amazing.

Daniel Lobell: (30:33)
Can you tell me about that? Why is that cool and exciting?

Dr. Donald Mayes: (30:38)
Well, ketamine has been around for quite a while. It’s actually been used in the past, generally speaking for an anesthetic in surgery and whatnot. Not frequently used because sometimes there would be side effects with it, like hallucinations, that kind of thing. That’s not what we’re looking for with psychiatry. We don’t want hallucinations, but some people can’t tolerate the typical anesthesia, so ketamine would be an excellent alternative for certain people that needed surgery. They’ve found that over time, certain people are less depressed with this medication and they’ve done some really good studies on this and found that patients have some significant improvement with a certain number of treatments with ketamine. It’s a really novel approach. Unfortunately, ketamine is habit forming. It’s typically done in a clinic and monitored with a physician, who hopefully has kind of a nice zen-like situation with some good music, with the lights down a little bit.

Daniel Lobell: (31:52)
One of those little fountains with the rocks that keeps perpetually running.

Dr. Donald Mayes: (31:55)
Exactly, nice water in the background. There you go. Giving me ideas, there you go. They’re supposed to relax for a couple of hours and just monitor blood pressure, vital signs, all that good stuff, and just make sure they don’t have any untoward reactions with the medication. They have a delivery system where it’s like a nasal spray, basically, like an allergy medicine – you shoot it in there. In the past, usually you had to go in and get hooked up to an IV line and all of this other business, which could be pretty expensive depending on the clinic. This makes it hopefully a little bit more affordable for people. The medication itself is still pretty expensive, but at the same time when people are suffering so badly with severe depression and they’ve been on every medication and all of these different things, then it’s a great opportunity to get them some of their life back. Depression can be so debilitating and just destroys people’s lives, and other people’s lives around them as well. The progress that we’re seeing in psychiatry is really exciting and new in novel approaches and thoughts on different things, thinking outside the box a little bit.

Daniel Lobell: (33:20)
Absolutely.

Dr. Donald Mayes: (33:22)
I like it. With the brain, you’ve got to think outside the box and think new sometimes.

Daniel Lobell: (33:27)
All right. I agree. I don’t see who wouldn’t, but I agree. [Both laugh] What’s the biggest compliment that a patient could give you?

Dr. Donald Mayes: (33:41)
At least it is that you care, you listen to me, that I’ve affected their life in a positive way and they somehow think it’s me. I always look at it as a collaborative effort. I always have some humbleness if somebody tells me that and it kind of touches the heart for sure. It’s definitely a great thing to hear and it makes the job worth it. We all have bad days, whatever we do, but that’s what I like to hear.

Daniel Lobell: (34:26)
Even those of us who are killing it are having bad days, you know.

Dr. Donald Mayes: (34:31)
Oh my gosh. Yeah.

Daniel Lobell: (34:32)
We all suffer that from time to time.

Dr. Donald Mayes: (34:36)
Absolutely. Money is great, but it’s definitely not the key to happiness. But it helps. I’m not saying it’s a bad thing by any stretch.

Daniel Lobell: (34:49)
Maybe money is not the key to happiness, but no money might be the key to misery. [Both laugh]

Dr. Donald Mayes: (34:54)
Yeah. Well, it’s a good part of it, I’m sure it doesn’t help. Being poor does suck.

Daniel Lobell: (35:06)
Or at least the money might be helpful in buying the key to happiness if it’s not the key itself.

Dr. Donald Mayes: (35:14)
At least you could buy some good massages if you’re rich, at least you feel a little better that way.

Daniel Lobell: (35:21)
Makes most people happy to get a nice massage.

Dr. Donald Mayes: (35:23)
Yeah, exactly. You usually feel better at least for a while after that.

Daniel Lobell: (35:28)
Right. For sure. Yeah. I can’t argue with that. Did COVID affect the way you do your job and is it still playing a role, if so?

Dr. Donald Mayes: (35:41)
Yeah. It did, in a sense. What a crazy experience that was, huh? It was interesting. For a while, when it first started, a lot of patients that are already paranoid and have some delusional stuff got ramped up, it was like on steroids. The government shutting down and all of these things – “the world’s gonna end and blah, blah, blah.” It seemed like the world’s going to end there for a little while. I mean, just everything shutting down is just just madness.

Daniel Lobell: (36:17)
It was definitely the end of the world as we know it. [Sings] It’s the end of the world as we know it… [Laughs]

Dr. Donald Mayes: (36:20)
True. Nothing’s back to the same, that’s for sure. That ramped up and then it was kind of weird when everything locked down, we got less patients for a while – I think just because everyone was so freaked out. I don’t know, everyone was hiding out somewhere. We get a lot of homeless folks and I don’t know what happened to them – they’re just hiding away in the shelter or wherever they’re at, it was weird. Later on we started getting some folks that had COVID that had like a psychotic break after, almost this kind of manic-y psychosis that at least so far doesn’t seem to be going away. They’re responsive to the medication treatment, but it seems like the COVID may have triggered this illness. Maybe they’re predisposed the whole time and COVID just was the match that lit the fire or whatever.

Daniel Lobell: (37:24)
I’m not surprised to hear that at all. In fact, I’m only surprised that you don’t hear more of that.

Dr. Donald Mayes: (37:30)
Yeah. Well, it’s probably not as recognized either. It’s kind of tough to link the two together sometimes, but there was definitely for sure some that right after they were sick, they had these never before seen symptoms of voices and paranoia, somebody was going to kill ’em and not sleeping for days at a time and just miserable. These are people in their mid thirties, late thirties sometimes. Usually those kinds of symptoms are younger usually when they start – not always – but it’s been a hell of a ride. It’s unbelievable the scourge, what that’s caused and the amount of suffering – not even from the virus, I mean the extraneous effects and depression and people losing their jobs. The other thing is too, is the amount of substance use, like alcohol and drugs. Suddenly people are at home all the time and certain marriages work better when they’re not home all the time. There’s all this marital conflict, people start drinking. Or they just have extra time on their hands, they start drinking or they start popping pills, whatever it is they’re doing. A lot more detoxes are coming in the hospital and the severity of it, too, seems to be higher.

Daniel Lobell: (39:10)
Wow.

Dr. Donald Mayes: (39:12)
It’s a sad state of affairs out there, too, but at the same time, it seems like things are starting to finally get at least some semblance of normalcy, whatever that may be in a psychiatric hospital way.

Daniel Lobell: (39:27)
Yeah. Hopefully.

Dr. Donald Mayes: (39:32)
Yeah. No kidding. [Sighs]

Daniel Lobell: (39:35)
I heard that sign and I’m like, I agree. [Laughs]

Dr. Donald Mayes: (39:41)
It’s one of those subjects I don’t think any of us like to talk about much. We’ve all lived through this hell on earth the last couple years. It’s obviously been way worse for some people, they’ve lost family members and thank God that’s not happened on my end. But I’ve seen a lot of people that have.

Daniel Lobell: (39:59)
Yeah, that’s sad.

Dr. Donald Mayes: (40:01)
Horrible.

Daniel Lobell: (40:01)
Lets shift gears for a second, then. Let’s talk a little bit about technology. How is it changing health and wellness, and do you think it’s for the better?

Dr. Donald Mayes: (40:13)
Yes and no, actually.

Daniel Lobell: (40:16)
So then it’s a draw! [Both laugh]

Dr. Donald Mayes: (40:17)
Yeah, definitely. I would say in the positive, I would say – and especially for psychiatry – I would say the telemedicine part, the zoom calls and all that has really exploded since the whole COVID thing – I did that for about a year before COVID, and helped out a clinic that was in a rural area. It’s a great way to deliver services to a small town that doesn’t have access to a psychiatrist, because we’re in high demand everywhere. That’s a great thing. Electronic prescribing is pretty cool. We can send a script over directly to Walgreens and you don’t have to turn your script in and wait an hour and then come back or whatever. Those are cool things. The drawback, in my opinion is it seems like, there’s this push and I know a lot of it is government regulations, there’s a push towards electronic medical records, which again is good in one sense – you can at least read the doctor’s handwriting. [Both laugh] Or typing. Bad in a sense, in my opinion, is that a lot of times they’re so clunky and inefficient is a good way to put it, depending on the program, that you spend a lot of your attention on the darn computer program. If you’re trying to document what’s going on and you’re seeing a patient, it’s hard to do both at the same time and I think it does affect the doctor-patient relationship in a negative way, in that regard, because we’re trying to click these boxes that we have to click because they say we have to click these boxes. You spend your attention clicking stupid boxes rather than really getting those little senses of what’s going on with the patient that you might miss because your attention’s on the computer program. Those are little frustrating things. Yes and no. I mean it’s a toss up on that one, for sure.

Daniel Lobell: (42:23)
Well for good reasons. Yes and no there. What are some common misconceptions about psychiatrists?

Dr. Donald Mayes: (42:33)
That’s a good question as well. [Both laugh]

Daniel Lobell: (42:38)
I’m starting to feel like there’s a trophy that should be appropriate at this point.

Dr. Donald Mayes: (42:41)
Definitely, you’re nominated for sure.

Daniel Lobell: (42:47)
Thank you.

Dr. Donald Mayes: (42:49)
Common misconceptions. There’s a good number of psychiatrists that might have, depending on their training, a dry presentation, and that can come from just the way they’re trained. A psychoanalytically trained psychiatrist might have a really flat affect, and so they might to a patient seem very cold, but that’s just how they’re trained. In my experience, that’s their affect, though. That in and of itself sends a message to the patient – positive or negative, whatever it may be. But the idea of having that sense of flatness and no emotional response – the idea is to not bias the patient towards the doctor, but the flat effect is going to bias the patient towards the doctor. There’s some of these misconceptions that a lot of us aren’t approachable, that certain egos are out there that you can’t talk to your doctor about certain things. I think that that’s for the most part not true. I think most psychiatrists are open to and want to hear things about what’s going on with somebody. Even if it might be embarrassing to them, they want to know to help, if it’s something we can use to help them in their treatment. I also think a lot of psychiatrists are just from a personal perspective, looked at as boring. They sit in an office all day and read books and don’t ever leave and do nothing outside the office. I think that’s definitely not true for most of my friends that I know that are in psychiatry, they tend to get out and live life.

Daniel Lobell: (44:49)
Clearly not true for you either, obviously, for anyone listening to this interview for sure.

Dr. Donald Mayes: (44:56)
Definitely not. Need to get out and live life a little bit and have other interests – that’s good, no matter what you do.

Daniel Lobell: (45:03)
What are some of those other interests?

Dr. Donald Mayes: (45:07)
Honestly, I would say number one would be my daughter. I have an eight year old kiddo. I split time with the mother of my child. We share and I have her 50/50, so whenever I have my daughter, she’s the primary motivation, all my time spent on her basically. My enjoyment is going to as simple a thing as a park, going down the slides and pushing her on the swing or taking her down to Legoland or Disney or whatever, she’s kind of spoiled.

Daniel Lobell: (45:52)
Sounds like you’re a good dad.

Dr. Donald Mayes: (45:54)
Little princess there. Definitely spoiled her a little bit too much. When she’s not around, I have an interest in astronomy and a fascination with this whole UFO thing going on out there.

Daniel Lobell: (46:08)
Oh yeah, me too. Me too. What is going on with that? What’s your take?

Dr. Donald Mayes: (46:15)
I don’t know, man. I swear, when the whole 2020 thing was going on with the lockdown – like I said, I’m in a high-rise condo and I’ve got some great views and I had some views of the Western mountains here in Vegas. I swear there was something that was out there. I got a video of it on my phone. I don’t know. It’s probably just something silly, but that’s been my experience. The government says they exist, they just don’t know what they are. So who knows? I think it’s fascinating.

Daniel Lobell: (46:41)
It’s reassuring when they say that kind of thing. [Both laugh]

Dr. Donald Mayes: (46:43)
We’ve got these crazy things that do all sorts of weird behaviors and we don’t know what they are.

Daniel Lobell: (46:50)
After years of telling us they don’t exist, too.

Dr. Donald Mayes: (46:53)
Yeah, exactly.

Daniel Lobell: (46:54)
They exist, we just don’t know. Go about your lives.

Dr. Donald Mayes: (46:58)
Exactly. They exist, but don’t worry about it. [Both laugh]

Daniel Lobell: (47:01)
It’s all good. We may be getting invaded by another planet, but just make sure you show up to work on time.

Dr. Donald Mayes: (47:09)
Exactly. Don’t worry. It’s all good.

Daniel Lobell: (47:12)
Don’t bother anybody and say the wrong thing or something, in the meantime, there might be an alien invasion coming.

Dr. Donald Mayes: (47:21)
After 2020, I’m ready for the alien invasion. That’s the one thing that I think could maybe top this whole thing, let’s just have the alien invasion now, get it over with. Come on guys. Let’s get it going.

Daniel Lobell: (47:39)
Yeah. What if the alien invasion is just like, they get here and they try to sell us stuff? That’s almost the most likely thing. If they have better technology than us, they’re probably clever, and then they’re probably trying to make a little international bucks. They’ve invaded the market more than they’ve invaded anything else.

Dr. Donald Mayes: (48:05)
That’s very true. That’s a good point. They’re clearly smarter than we are.

Daniel Lobell: (48:11)
I’m gonna see a headline: “Aliens say they now take Bitcoin.” [Both laugh]

Dr. Donald Mayes: (48:15)
“Bitcoin now 1 million dollars”. That would be interesting. I’m sure we’ll see that headline soon enough.

Daniel Lobell: (48:26)
I’m sure we will.

Dr. Donald Mayes: (48:27)
Maybe the aliens created Bitcoin. Maybe that’s what it is. I don’t know.

Daniel Lobell: (48:30)
[Both laugh] Then we find out who’s really behind it. Dr. Mayes, it’s been a real pleasure getting to interview you today. I hope that it’s not the last time. I’ve really enjoyed our conversation.

Dr. Donald Mayes: (48:47)
Yeah, Daniel. It’s been my pleasure as well. I’m looking forward to the future with everything and getting to listen to your podcast in the future. I’ve seen some of your stuff online, and scoping you out online and I’m impressed, man.

Daniel Lobell: (49:09)
Oh really? That’s nice.

Dr. Donald Mayes: (49:09)
That’s nice. I think I saw a picture of you with Ralphie May, the comedian?

Daniel Lobell: (49:12)
I used to open for him for many years.

Dr. Donald Mayes: (49:14)
That dude is hilarious. You’re funny too, of course.

Daniel Lobell: (49:17)
He’s dead, but yeah thank you.

Dr. Donald Mayes: (49:17)
I know. Poor guy. Yeah. I know. When did he pass away? Five years ago or something like that?

Daniel Lobell: (49:23)
Something like that. He was a lot funnier when he was alive. I’ll tell you that much.

Dr. Donald Mayes: (49:26)
Oh yeah. Yeah. Definitely. That usually helps. [Both laugh]

Daniel Lobell: (49:29)
I’ve noticed that about people soon – as soon as they die, they get way less laughs. But he was a wonderful guy and a good friend.

Dr. Donald Mayes: (49:39)
Gosh. Yeah. He was so funny. My goodness. It’s so ironic that I came across that because I literally was just listening to a couple of his bits online and I was just dying. Oh my gosh.

Daniel Lobell: (49:53)
That’s great.

Dr. Donald Mayes: (49:54)
That guy. He had a way with it for sure.

Daniel Lobell: (49:57)
Yeah, he did. Let me ask you this to round off the interview, which I pose to all the doctors, which is: what do you personally do to stay healthy?

Dr. Donald Mayes: (50:08)
That’s a good question as well. [Both laugh]

Daniel Lobell: (50:10)
Nice! That was the last one, too.

Dr. Donald Mayes: (50:12)
Rocking it all the way there.

Daniel Lobell: (50:14)
Strong ending. Close big.

Dr. Donald Mayes: (50:18)
There you go, man. Personally, physically I try to go to the gym. I try to work out five days a week, do the treadmill – three miles a day. I’ll admit COVID set me way back with the gyms being closed and everything. I’ve got a lot of weight to get off, but that’s always a battle. I try to do that part. I don’t do the smoking thing or I don’t drink heavy, all that good stuff. I try to just have good interests outside of work. I try to leave work at work and when I’m at work, I’m fully in it and when I’m not at work–

Daniel Lobell: (51:01)
–You’re fully out of it. [Both laugh]

Dr. Donald Mayes: (51:02)
Exactly, man. I’ll have a nurse call “patient so-and-so – remember? They were here a week ago–“. “No.”

Daniel Lobell: (51:14)
I’m out of it. [Both laugh]

Dr. Donald Mayes: (51:14)
I’ll have to go look it up because literally I like to erase that data from my brain.

Daniel Lobell: (51:18)
That’s funny.

Dr. Donald Mayes: (51:19)
Yeah. That’s just me, but for me, that’s what works and I have to have that let down and have other interests and that keeps me sane. The exercise helps me with my feeling sane too, it helps with the mental and the physical.

Daniel Lobell: (51:37)
Yeah, I’m sure.

Dr. Donald Mayes: (51:38)
Just the whole well-rounded thing.

Daniel Lobell: (51:42)
That’s great. Well, thank you so much for doing the show.

Dr. Donald Mayes: (51:47)
Yeah, Daniel.

Daniel Lobell: (51:48)
Keep getting healthy, get back out there and do what you need to do. Get that COVID weight off. I’m trying to do the same thing. I’m in the same boat, in that respect, but I was also trying it before COVID, so COVID was tough for all of us.

Dr. Donald Mayes: (52:03)
Me too, buddy. Me too. It’s up and down, up and down. It’s always a good battle to fight, though.

Daniel Lobell: (52:09)
Thank you so much. Thanks for doing the show.

Dr. Donald Mayes: (52:12)
Of course, Daniel. You got it, buddy. It was good to meet you.

Daniel Lobell: (52:18)
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.

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