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: (00:25)
Hello and welcome to the Doctorpedia podcast. I’m your host, Daniel Lobell and today I have the great honor of speaking with Dr. Catrina Luca. How are you?

Dr. Catrina N. Luca: (00:35)
I’m well, and you?

Daniel Lobell: (00:37)
I’m doing good. Thanks for asking. I think you’re the first psychiatrist we’ve had on the show. We’ve certainly had psychologists on the show, I know it’s similar.

Dr. Catrina N. Luca: (00:47)
You’ve been missing out.

Daniel Lobell: (00:47)
We’re missing out. I did read a little bit about you and I saw that you’re in Florida. Is that correct?

Dr. Catrina N. Luca: (00:55)
That is correct.

Daniel Lobell: (00:56)
Is that where you were born and raised?

Dr. Catrina N. Luca: (00:58)
I was actually born in California, but I’ve spent the bulk of my life here in Florida.

Daniel Lobell: (01:02)
Okay. So what part of Florida? You’re in Gainesville now, right?

Dr. Catrina N. Luca: (01:06)
I’m in Gainesville now, but I grew up in Orlando and then I spent high school and then all the way through medical school down in Miami.

Daniel Lobell: (01:13)
Wow. I was just in Florida with my wife not long ago. It’s pretty nice there. We love Miami and we even spent some time in Orlando with friends that moved there. We live in California, but they moved from LA to Orlando to get away from the exorbitant prices.

Dr. Catrina N. Luca: (01:29)
It depends on what part of Florida you’re in because we have so many different lifestyles. So Miami is definitely going to be more metropolitan while Orlando has got that tourist feel. Then you come here to Gainesville where I ended up for residency and fellowship. And that’s definitely more Southern, I guess you’d call it a little bit more rural. We’re a smaller town here and then you go to the panhandle. That’s a different experience. And so it just depends what part of Florida you’re in and what you’re looking for.

Daniel Lobell: (01:56)
Yeah. What made you decide to go into psychiatry?

Dr. Catrina N. Luca: (02:01)
I didn’t start off medical school interested in psychiatry. I went into medical school and I always wanted to be a physician very early on, wanting to be an obstetrician-gynecologist. And then I got into medical school and then considered some other things. But what was consistent amongst all of my experiences throughout medical school was that my patients were always telling me their business. I remember being on a surgical rotation and I’m just trying to check this man’s urine output, check his wound, make sure the sutures are doing what they’re supposed to be doing. It’s five o’clock in the morning. And this person wants to tell me all about how his marriage is falling apart and how he’s been doing. And so I started to realize that that was the part of medicine that really caught my attention, that people were willing to be that vulnerable with someone who is essentially a stranger. And so I now spend my life doing is giving space and opportunity for people to be vulnerable so they can be healed.

Daniel Lobell: (03:05)
It sounds noble to me.

Dr. Catrina N. Luca: (03:05)
It’s a little more voyeuristic on one end as well – Let’s just be honest. [Laughs.] I have to sit there and listen to some things that most people would be like, “Okay, could you not share that? Could you not tell me that ever again?” It’s a very interesting position to be in.

Daniel Lobell: (03:17)
So how do you handle hearing all this stuff that most people wouldn’t want to hear, as you said, and then going home and living your life and not going crazy?

Dr. Catrina N. Luca: (03:27)
Well, I have a fantastic spouse who is what I call psychologically minded. There are times that I need to process some of this, but during residency and fellowship, you get a lot of opportunities to learn how to work and deal with this and you just begin to get really good at leaving things at work that need to stay at work. Now, is that a hundred percent? Absolutely not. There’s always going to be that story, that life experience, that someone shares where you really think, “Wow, the ability for the human being to be so resilient and to walk through that and come out on the other side, still intact – That’s an amazing feat.” And so you get to see the seedy side of human nature in this field. But what you learn really quickly is, “This is not my life. I have people in my life that still need me and I can’t give everything away at work and not have anything for my family at home.”

Daniel Lobell: (04:26)
When you talk about the seedy side of human nature, what does that mean? Give us an example.

Dr. Catrina N. Luca: (04:35)
Because I’m a child and adolescent psychiatrist as well, I hear stories of abuse, abandonment, mistreatment, maltreatment, poor choices. It’s certainly a little more difficult to hear that when it’s someone who doesn’t have control over that environment, children don’t get to control who their parents are. On the flip side, I have grownups that you’re like, “Really, that’s what you did?!” And I’m not certain I’d ever want that to be my life – It could be some really poor choices.

Daniel Lobell: (05:08)
It’s almost be like being a priest in a confession booth. … who gives out medicine.[Laughs.]

Dr. Catrina N. Luca: (05:11)
In a lot of ways I am. Honestly, I’m actually humbled at times, like “Nobody knows this, your spouse doesn’t know this. You’ve never told anyone,” and I’m humbled that they’re willing to be that vulnerable in this setting and that they allow me the opportunity to come in and say, “Okay, well, here’s what we need to do next.”

Daniel Lobell: (05:34)
What qualities about yourself do you attribute to the fact that people are so willing to open up to you?

Dr. Catrina N. Luca: (05:44)
I don’t do a lot of pretense. If I think what you did was dumb, I’m probably going to say in some way, shape or form, “That was really dumb,” but I’m also quick to tell you, “Hey, that’s amazing. I am so proud of you for making that decision in that moment.” So I’m very honest about what we’re doing in this process. I think people value the candor. They value the honesty without being cruel. I’m not here to make you feel too bad. However, I do know that there really isn’t going to be a whole lot of change unless there’s some discomfort.

Dr. Catrina N. Luca: (06:27)
Sometimes I provide that discomfort by being very honest, like, “Hey, you do realize you are doing your children a disservice with your attitude? It’s really crappy.”

Daniel Lobell: (06:37)
My wife and I were having this conversation recently where we were saying most people we know that didn’t change in their twenties, just don’t change. Do you think we’re onto something there? [Laughs.]

Dr. Catrina N. Luca: (06:54)
I think it has to do with motivation. We are creatures of habit. Unless there’s a great strong motivator, and it’s the whole concept of when the pain of staying the same outweighs the pain of change, you’ll change. So I do think it has to do with motivation – the older we get, the more set in our ways we get – it takes some pretty intense things to say, “Maybe I’m not doing this right. Maybe this isn’t the best way to do this,” but there is hope. I just talked to an 85 year old man today, and he said, “I want to be better at loving my wife” and he is willing to put in the work.

Daniel Lobell: (07:38)
That’s pretty cool. That’s a pretty powerful statement hearing that when I’m much less than 85 years old.

Dr. Catrina N. Luca: (07:53)
No pressure at all. [Laughs.]

Daniel Lobell: (07:56)
[Laughs.] But it is so hard to change. I’ll make it personal. And since you’re good at listening to people, I have struggled with my weight my entire life. I’ve been through diets and then lifestyle changes if you want to call them that because you’re not supposed to call them diets and different programs and therapies. I have not been able to conquer this and it bothers me so much. And once again, I’m trying something now. I ask myself this question all the time, “What is it going to take for you to change? What is it going to take for you to conquer this?” And I don’t know the answer to that. And I always hope the answer is not that you get really sick, you know?

Dr. Catrina N. Luca: (08:40)
Well, that’s the ultimate motivator – The fear of death is a great motivator in a lot of situations. But one of the first things I would wonder for you is what does food mean to you beyond just nutrition? There’s something there that it does for you that you haven’t found a way to do any other way.

Daniel Lobell: (08:58)
It’s some type of comfort that I haven’t been able to provide for myself otherwise, but it’s also got a kind of an exciting element to it because when I eat nutritiously, I don’t feel hungry and I miss the sort of excitement that it gives me.

Dr. Catrina N. Luca: (09:24)
So you’re a natural foodie. You like food.

Daniel Lobell: (09:24)
I find it boring sometimes if I’m like, “Oh, I’m doing well, I’m losing weight,” but there’s some excitement that I get out of these foods and I don’t know if it’s excitement or if it’s some kind of a stimulant.

Dr. Catrina N. Luca: (09:48)
Probably a little bit of both – food and eating is a very social thing. It goes beyond just nutrition. And so I’m always impressed with people who genuinely view food as fuel. I don’t know if that’s a good thing or a bad thing. I’ve never been that person. Sorry. I enjoy food. I actually would say I love food. I think about it. I think about what I want to eat. I think about those things because I also enjoy the whole process. I enjoy cooking. I enjoy seeing my kids and my family’s face when they eat well. I enjoy knowing that I’m able to put something in their bellies that they really love, and I enjoy good tasting food.

Dr. Catrina N. Luca: (10:31)
I grew up with a mom who cooked and catered and baked, and it wasn’t that she was a stay-at-home mom. She was just really good. So I know what good food tastes like. So again, if you find yourself not happy with how you are managing things, when I’m dealing with something similar, I always think “What does this mean to me? What is it doing for me? What does it serve? What purpose is it serving?” And then from there, figure out, are you willing to change that? And if not, then either get happy with being larger than what you’d like to be or say, “You know what? This is what I’m willing to change. This is what I’m not willing to change,” but I don’t think it should be a lifelong thing of you not liking how you’re doing stuff. That’s no fun. You’re missing out on all the good stuff, you’re missing out on the emotional portion of it, the peace and the joy and all the things that come along with breaking bread with family and friends.

Daniel Lobell: (11:30)
Well, I’ve tried to do that too, just being like, “I’m good with it,” but then I just [think] that I’m unhealthy and obesity and is bad. I’ll add one more point to this and then I’ll throw it back to you. I may as well be completely honest since you’re used to that. And who’s listening to this? Only potentially millions of people. So I’ll just throw it out there. I think I have an addiction to consumption, which manifests itself in terms of other things too. I was cleaning out my garage this week and I have way too much stuff. And I’m getting rid of this stuff from my garage and it’s so difficult for me to get rid of stuff. And I think I’m just holding on to all this stuff in my body, outside my body. I’ve just been accumulating stuff. And I’m overstuffed from within, and I’m overstuffed around myself. It’s an addiction of some sort.

Dr. Catrina N. Luca: (12:39)
How much therapy have you had?

Daniel Lobell: (12:44)
[Laughs.] I feel like you’re either saying way too much or not enough.

Dr. Catrina N. Luca: (12:51)
No, no. I just want to know how much therapy have you had. You talk like someone who’s really had some time to be insightful and to really think about this. It wasn’t a dig, I promise. [Laughs.]

Daniel Lobell: (13:06)
[Laughs.] I know, I know.

Dr. Catrina N. Luca: (13:06)
Because again, I have to come back to the point that if you start chasing symptoms, you’re never going to win. And I think everything you’re describing is a symptom. I don’t believe the diagnosis is an addiction, meaning I don’t believe that’s the core issue that we’re dealing with. Is that a symptom? Absolutely. Can you address that? Absolutely. But you need to get down to what’s driving this and what comes to mind when I’m listening to you is fear of not having enough. So whatever that’s been born out of, I don’t know. I don’t know you well enough to say all that, but I’m always wanting to know what’s the deeper issue. Because if I run around treating symptoms, nobody wins and we never see the fullness of things getting better.

Daniel Lobell: (13:55)
So let’s go with your theory. Because it sounds pretty spot on – fear of not having enough. And I think that probably stems from growing up in a household where there was a lot of worry about money. And my dad always saying, “What if we all go homeless?” and stuff like that. So I think there’s a lot of that there.

Dr. Catrina N. Luca: (14:18)
Yeah. So I think that’s your money spot right there. Right there, dealing with that fear, dealing with the idea that I’m not going to have enough, so I’ve got to do it now. I got to consume it all now .I have to buy it all now.

Daniel Lobell: (14:35)
So what’s the answer? Give me the answer. [Laughs.]

Dr. Catrina N. Luca: (14:39)
I don’t have an answer. When I ask the question, how much therapy have you had, maybe it’s time to address that portion. That’s a big deal. And that occurred at a very pivotal in your life, right? So this is why I went into child adolescent psychiatry in particular. Because number one, they’re still young enough that I can shape and mold them. I can have an impact that lasts going forward the rest of their life. But number two, it made me a better adult psychiatrist. So that when I’m talking to you and I’m hearing this, I could jump in and say, “That’s the addiction. But hold up, wait a second. It’s fulfilling something for you. It’s placating something. It’s satiating something. What is that?”

Daniel Lobell: (15:29)
I think you’re obviously great at what you do. I never really felt like there is such a thing as an adult psychologist. I feel like any psychologist I’ve ever been to is always addressing your inner child or your childhood, but they’re never interested in talking to the adult. They’re always wanting to talk about the child because that’s when everything went down, I guess.

Dr. Catrina N. Luca: (15:51)
No, in psychiatry, we talk to adults all the time and there are times that we don’t even talk about your childhood. I just want to talk about why you made that poor decision over and over again. Let’s just stop that first.

Daniel Lobell: (16:04)
You don’t think it all stems from childhood?

Dr. Catrina N. Luca: (16:05)
It absolutely does, but not everybody’s willing to go there. So in psychiatry, I think we do our patients a disservice when we go mucking around in someone’s past with big clunky boots without taking into account what that is going to dredge up for them. So now we’re getting into the concept of trauma. You want to be mindful. So if someone comes in, I may not always dig that deep. I’m constantly pinging my patients emotionally. I’m trying to figure out how deep we can go. How far can I push this to get them where they need to be? Some people will let you know, “Don’t touch that.” And with them, you don’t go any further. You honor that. And when they’re ready to give you more, you allow them to give you more because if you don’t honor their request, you may very well trigger a whole cascade of re-emergence of trauma symptoms that they had just learned how to manage well. I want to honor where someone is.

Daniel Lobell: (17:10)
You can re-traumatize them.

Dr. Catrina N. Luca: (17:13)
Yeah, you can. If they’re not ready to deal with it. I’m not here to make somebody do anything. My job, my responsibility is to come along and give my expertise. “Hey, I think this is a good idea. I think you should do this. I think this medication would be a good fit for what you’ve described to me based on my experience.” But at the end of the day, when I’m dealing with adults, and even when I’m dealing with children, there still has to be a choice made. So at no point am I making anyone do anything. And I want to always make sure that people feel empowered and they know that.

Daniel Lobell: (17:49)
How important is the medication part of it versus the working stuff out part? And part of that question is does the medication sometimes become a crutch for people to not dig deeper into themselves and organically, so to speak, work out things that they need to work out?

Dr. Catrina N. Luca: (18:12)
Medication has its role. And because I am an integrative psychiatrist, which means I look at the whole person – I do integrative medicine along with my psychiatric care – I want to weigh all of those things. There are times that absolutely medication is necessary, but let me be transparent. My medications aren’t going to cure you. That’s not what we do in psychiatry. There’s nothing that I prescribe right now that cures anybody. What it does do is it decreases the intensity of those symptoms to allow you to become more functional. So you can do the hard work if it’s necessary. Case in point, If I have depression: I can’t get up and go to work. I can’t do any deep therapy because I’m hurting too badly. I prescribe an antidepressant. I made sure they’re eating right and sleeping right. If they have any kind of nutritional deficiencies, I’m fixing those as well. I’m putting them in the best possible position to get up, go to work, be functional. And now let’s do some therapy. You’re strong enough to get through that now. And it’s not going to hurt as much when you start talking about those things that are really painful.

Daniel Lobell: (19:32)
So the medication is to get you through a certain period. Most patients hopefully don’t need to continue with it in the long-term.

Dr. Catrina N. Luca: (19:43)
That depends on the diagnosis. If we’re talking depression, yes. If we’re talking anxiety, that’s a little bit more touchy because anxiety tends to be an enduring personality trait as well. It’s how you cope with the world. You’re an anxious person. And the moment I take away that medication, that anxiety tends to come back unless you’ve developed some coping skills, unless you’ve done therapy to teach you how to manage your anxiety.

Daniel Lobell: (20:09)
I once heard anxiety described as a lack of faith. And I thought that was a really interesting observation.

Dr. Catrina N. Luca: (20:17)
Well, you’re heading down a path that a lot of people and psychiatrists don’t talk about.

Daniel Lobell: (20:22)
[Laughs.]

Dr. Catrina N. Luca: (20:22)
Come on, man. I just met you . You going to put me on the spot like that? [Laughs.] Come on. I’m not even going to touch that with a 10 foot pole [Laughs]. Good try. I will say though, we do ourselves a disservice when we don’t acknowledge the fact that we have a body, we have minds, but we also have the spiritual portion that has to be addressed. It’s just the human nature that we need to know there is something beyond ourselves. And I’ve not seen people do well when they haven’t been able to incorporate that into their life but that’s all you’re getting from me on that. [Laughs.]

Daniel Lobell: (21:13)
[Laughs.] It wasn’t a trap by the way, it wasn’t supposed to be.

Dr. Catrina N. Luca: (21:18)
Going back to the diagnosis, if we’re talking about a bipolar patient who’s having a manic episode, they need their medication. This is not one of those “you just need some more therapy” kind of things. If we’re talking about schizophrenia, they need their medication. Like I’m not going to sit there and tell you, “Oh, you just need more therapy or you need more faith.” We’re not going to do that. So we want to meet people where they are. And my philosophy is, “If I can use less medication, I will do my best to do so.”

Daniel Lobell: (21:52)
When we talk about things like schizophrenia and bipolar disorders, are these things that we can now measurably see, like with a scan: is there any way of measuring it physically?

Dr. Catrina N. Luca: (22:08)
There isn’t and I wouldn’t diagnose that way. Are there things that we can look at to support what we think may be going on? That’s a growing body of science that’s coming together slowly, but our brain is so intricate and there’s so many things that go into why we respond the way we do. Why does this person develop bipolar disorder and this person doesn’t. There are multiple genes involved. There’s the question of whether certain genes are turned on because of life events. There’s so many ways to look at this. I don’t believe we’re anywhere near being able to say “We’re going to run this scan and that’s going to tell me exactly what’s wrong with you.” We’re just too nuanced when it comes to mental health.

Daniel Lobell: (22:51)
So that’s probably a really tough part of what you do. With a virus, you could do a test or a swab, and then it shows up positive for a virus, or with a broken bone, you can do an x-ray and you see a broken bone. With schizophrenia, you just have to be like, “I recognize this. This behavior is schizophrenia.”

Dr. Catrina N. Luca: (23:14)
Well, we’re actually wizards. We have our magic wands. They don’t work very well, but our colleagues tend to look at us and go, “Could you please work your black magic? I don’t know what’s going on. I don’t want to touch it.” We’ve gotten really good in our field with being okay with the nebulous and really just treating what’s in front of us. The way that we diagnose really is phenomenology: What does it look like? Does it quack like a duck? Does it walk like a duck? Well, that works great most of the time, but then that’s where experience comes into play. Because as time goes on, you are going to come across those people who don’t look like the typical and yet that’s exactly what you’re working with.

Daniel Lobell: (24:01)
And with regards to curing these things, is that even in the works?

Dr. Catrina N. Luca: (24:11)
I’m going to go on a limb and speak on behalf of every physician who gets into medicine. That is always our heart’s desire. We want to see people whole and healed. The bigger question is, “How do we get there?” And I think in psychiatry, there are so many roads that lead to illness. For example, I had a young man come into my office, looking depressed as all outdoors. When I say depressed, I mean talking slowly, moving slowly, thinking slowly.

Daniel Lobell: (24:45)
I want the punchline to be, “He was a turtle.”

Dr. Catrina N. Luca: (24:50)
[Laughs]. Funny.

Daniel Lobell: (24:51)
Silly.

Dr. Catrina N. Luca: (24:51)
But the punchline was that he had hypothyroidism, meaning his thyroid wasn’t functioning correctly. I just happened to run some labs before jumping in to give him medication because he’d never been on medication. And it came back that his thyroid was not functioning the way it should. So I referred him to endocrinology. He went and got his thyroid managed better and then he came back to me and didn’t need to see me anymore.

Daniel Lobell: (25:17)
Wow.

Dr. Catrina N. Luca: (25:18)
I wish every story was like that. But I showcase that to show that unlike other fields of medicine, I actually have to interact and integrate with other fields of medicine because they impact what I’m seeing from a psychiatric standpoint.

Daniel Lobell: (25:34)
So interesting. I never even considered that it could be physical and not mental when somebody comes in.

Dr. Catrina N. Luca: (25:42)
So that’s why I say we’re wizards. No, I’m teasing. [Laughs].

Daniel Lobell: (25:44)
[Laughs]. All right. I’m going to turn it back on you because I got personal.

Dr. Catrina N. Luca: (25:53)
Go ahead.

Daniel Lobell: (25:53)
What in your childhood do you think spawned this person who is so good at empathizing and diagnosing and listening to other people?

Dr. Catrina N. Luca: (26:06)
I’m going to say it’s been two-fold and just for everybody to understand this, he did not preload me with questions. I promise. I’m going to say it’s two different things. My father was instrumental in my early educational years. Back in the day they used to send home something like questionnaires, like a little form for your parents to complete, to say, “What do you want to work on? What do you want your child to work on this year in school?” Like “We’re going to be focusing in on the educational needs of your child, what do you want to see?” And invariably, I remember my father checking off leadership over and over again. That was his thing. He wanted to see his daughter excel in being a leader. That was my dad’s role. I love that about him. He saw something in his daughter that he wanted to see cultivated and he wasn’t afraid to say, “This is what she needs.”

Dr. Catrina N. Luca: (27:02)
On the other hand, my mom was the consummate salesperson, hated sales, but that was her gift. And so what I learned from her over and over again was a very good work ethic, but also her ability to connect with people that she was selling to in a genuine way. So she never went into something selling. She went in to look and see, “How can I fill a need?” When you’re looking to fill a need, when you’re looking to serve the other person, what comes out of that is way better than if you come in there trying to force sell anything. And so the idea of customer service and serving those people that I’m there to help was what she drilled into me over and over again.

Daniel Lobell: (27:44)
That’s such a great quality and it’s such a rare quality that we see in salespeople, unfortunately, but I think that’s pretty admirable. And it sounds like you have some (or had, I don’t know, I’m not going to assume), some amazing parents.

Dr. Catrina N. Luca: (28:01)
Well, yes. My father is still around. He’s down in South Florida, but my mom did pass.

Daniel Lobell: (28:09)
Sorry. It sounds like you had a pretty good childhood. Am I out of line jumping to that conclusion?

Dr. Catrina N. Luca: (28:18)
I would say I grew up probably what’s considered middle class, with some very interesting non middle class experiences that definitely shaped who I am, but I had parents who had no hard time showing me how much they love me. And I think that when you have parents who are willing to show you how much they love you over and over again, that will compensate for any kind of other shortcomings.

Daniel Lobell: (28:48)
So do you find it difficult to relate when you have children coming in, who come from horribly abusive homes where the parents are nothing like what you grew up with? Hearing them talk from that perspective, is it tough to put yourself in their shoes?

Dr. Catrina N. Luca: (29:09)
It’s not. I’m a first generation physician, neither one of my parents went to college. So their own upbringings were nothing like mine. I had their perspective on what they came from. And then I also had the perspective of how they worked hard to provide for me and my brother. So I kind of got a chance to see both worlds. My parents were not shy about what they grew up with, what they went through. I don’t have a very good poker face, and I don’t know if that’s a good thing or a bad thing, but there’s very little that I can hear these days that either I haven’t heard before, I’ve had my parents share with “This is what it was like”, or that I haven’t heard in the course of doing this job for the last 10 to 15 years that still shocks me where I can’t be in the moment with that person, if they’re baring their soul.

Daniel Lobell: (30:22)
I saw a picture of you and your kids online. Really, it looks like a lovely family.

Dr. Catrina N. Luca: (30:30)
[Laughs.] Stalking us.

Daniel Lobell: (30:30)
[Laughs.] Well, it’s researching, it’s not stalking.

Dr. Catrina N. Luca: (30:34)
Okay. That’s just stalking with a purpose and someone pays you to do it. So high five.

Daniel Lobell: (30:39)
[Laughs]. There you go. I guess you get paid to eavesdrop by that definition.

Dr. Catrina N. Luca: (30:45)
I’m paid to be a voyeur. I’m no better.

Daniel Lobell: (30:49)
But anyway, my point being that it looks like you have a very lovely family and how many kids do you have?

Dr. Catrina N. Luca: (30:57)
We have a blended family of six children.

Daniel Lobell: (31:00)
Yeah. Quite a few. So I am a father of one currently and one on the way.

Dr. Catrina N. Luca: (31:08)
Congratulations.

Daniel Lobell: (31:09)
Thank you. I thought for myself and also for the many listeners out there who either are young parents or prospective parents, as somebody who deals with kids and has seen the worst of parenting and hopefully the best of parenting at home, what advice would you give?

Dr. Catrina N. Luca: (31:33)
I will keep that advice very simple and make it just a one pointer: Parent from a parent-centric perspective.

Daniel Lobell: (31:43)
What’s parent-centric?

Daniel Lobell: (31:47)
We have become a very child-centric society, everything we do, every decision we make – they are the primary focus. What we seem to have forgotten is that children need to know where the boundaries are. They need to know that someone is in charge, they need to know that you have it under control. So if we’re constantly deferring to them on what’s the next best thing to do, we’re not providing that consistent stable environment for them. So case in point, I’ve got six kids. If I parent from a child-centric perspective, do you know how many meals I would make? How many times I would change clothing? Oh my gosh, it would never work. And we’re outnumbered. So when you parent from a parent-centered standpoint, it’s, “Here’s what I can do. I know you want to do 15 things after school. That’s not going to happen. Why? Because guess who still has a home to take care of and work to go to the next day? And I’m only cooking one meal tonight. So you’re going to pick three things that I can realistically get you to.” – So I’m not running all over and then we’re going to enjoy our family time when we have it.

Daniel Lobell: (33:15)
How important is family time? I think I know the answer, but …

Dr. Catrina N. Luca: (33:21)
You know the answer.

Daniel Lobell: (33:23)
I think I’m asking for other people to hear it.

Dr. Catrina N. Luca: (33:26)
Yes. It’s absolutely important. Going back to that parent-centric concept, you and your wife are the first adults your children are ever going to know. So a lot of how they view the world, a lot of how they become adults themselves, they’re going to pattern after you. What you then need to do is provide them with the pattern you want to see replicated. So you want them to see you and your wife in a family setting. What does it look like to be married? What does it look like to have a healthy relationship? How do we teach you how to be a good parent? I’m going to model it for you. That means you’re going to hear ‘no’ sometimes, but I’m also going to model for you that you are important to me, important enough that I’m going to put my phone down. I’m going to set aside time where I’m going to focus in on us: Me, you mom, family, because you’re that important to me.

Daniel Lobell: (34:22)
So wise, so important. It’s so true because my daughter, who’s two, copies me so much. It’s scares me. I’m like, “What are you doing?” I’m like, “Oh, you learn that from me. Okay.” [Laughs.]

Dr. Catrina N. Luca: (34:38)
“I learned it from watching you.” [Laughs.]

Daniel Lobell: (34:38)
[Laughs.] Yeah. I’m like, “Wow. She really is paying attention.” It’s pretty wild.

Dr. Catrina N. Luca: (34:42)
They’re little sponges.

Daniel Lobell: (34:45)
My stuff is important to her, which is odd. She brings me stuff like daddy’s keys, daddy’s hat and she just hands it to me like “Daddy’s hat.” I’m like, “Wow, that is my hat.” And I don’t know why, but that gets me a little bit emotional. She notices I have a hat. And I don’t know if I’m conveying to the listeners why that’s important – it’s because everything about me is significant to her, which I think was lost on me. I think we need to realize that “Oh, wow, I am significant.” And a child is teaching it to me.

Dr. Catrina N. Luca: (35:29)
There is something humbling when that little person trusts you with their whole world. They are dependent upon you for everything. And so unlike us as adults who can say, “You know what, if you don’t get it for me, if you don’t feed me, if you don’t bathe me, if you don’t provide these things, I will figure out how to get it for myself.” In a really healthy home, your kids learn they can trust you. And if you can establish that and establish it well, early on, there’s a whole lot less of that adolescent pushback later on because you’ve deemed yourself trustworthy.

Daniel Lobell: (36:15)
So right now I’m laying the groundwork for her to listen to me when she’s a teenager.

Dr. Catrina N. Luca: (36:19)
Absolutely. Now on the flip side, and this is the part that I think people get uncomfortable with, part of that parent-centric upbringing does mean that we do establish that I am the authority figure in your life. Because if I don’t teach you how to manage being under someone’s authority and do it well – You don’t get to lead unless you know how to follow well, leaders who lead well have learned to follow well, then what happens when you leave my home and now you have to have a job and I haven’t made you listen when you need to listen. Or I haven’t given you consequences when you don’t do what I’ve asked of you appropriately, you’re going to be on someone’s job, giving them the stink eye and all types of attitude, and you’re going to be unemployed.

Daniel Lobell: (37:04)
It seems like your dad was right when he wrote the leadership stuff, because you got it down.

Dr. Catrina N. Luca: (37:13)
It’s how we’re wired. If you want to know a pet peeve of mine, it’s when I hear parents who are bribing their children and parents who are focused on being friends with their children. I’m looking at them going, “You have no idea what disservice you’re doing your child. You are not babysitting your kid. You are raising adults. So the behaviors that you’re seeing now – think about those behaviors when they’re an adult: do you want to see that go on? If you don’t, you have to handle it when they’re younger, but you can’t let them act ridiculous when they’re young and then expecting to be these great adults who know how to handle themselves appropriately. That’s just unrealistic.

Daniel Lobell: (38:10)
We’re really programming them.

Dr. Catrina N. Luca: (38:14)
Also programming.

Daniel Lobell: (38:16)
Wow, man, I’m going to stop bribing my daughter now.

Dr. Catrina N. Luca: (38:21)
Now, if you’re potty training, I give you complete permission. Bribe away. Gummy bears. M&M’s. [Laughs.] It’s a very pivotal point.

Daniel Lobell: (38:29)
So when do I stop the bribes? [Laughs.]

Dr. Catrina N. Luca: (38:34)
When they’re smart enough to start negotiating for the bribes, like, “So if I do this, what do I get?” “You get nothing. You get the pleasure of doing what I asked you to do. That’s what you get right now.” [Laughs.]

Daniel Lobell: (38:46)
So I can keep bribing for now. [Laughs.]

Dr. Catrina N. Luca: (38:50)
Just a a little bit longer. [Laughs.]

Daniel Lobell: (38:52)
All right. That’s good. It makes my life a little easier for now. What’s more difficult, diagnosing adults for medication or children?

Dr. Catrina N. Luca: (39:16)
Children.

Daniel Lobell: (39:17)
That’s what I thought.

Dr. Catrina N. Luca: (39:19)
Yes. It is more complicated. It’s more complicated because they are more entrenched in a system. They’re not independent agents. So their entire lives are very intimately connected with those adults in their life who are responsible for them. So when I have a child presenting with depression or anxiety or some sort of behavior, not only do I have to look at this kid and go, “Okay, what is going on with you?” I also have to look at their parents because the chances of them having a major influence on what’s going on with their child is very high and they may not even be aware of it.

Daniel Lobell: (40:04)
So it’d be easy to misdiagnose based on behaviors that are possibly because of the parents?

Dr. Catrina N. Luca: (40:15)
That, and because adolescent brains are in flux, right? The whole concept of adolescence is flux. Everything’s changing, everything’s growing, they’re becoming smellier. They’re getting taller. They are growing hair in places they didn’t have before and all that good stuff. Well, in their brains, there’s a whole lot of work going on as well. Their brain is growing neurons and firing neurons. And so sometime they’re emotional or they’re frustrated.

Dr. Catrina N. Luca: (40:44)
Well, that translates in how they present. I just had a healthcare provider who is very concerned about his daughter. And as he’s talking to me, it’s like a neon sign because I see it all day long. This is what I do. I’m like, “She’s depressed.” And I had to give him credit for his comeback because he’s in healthcare. He said, “But she doesn’t look depressed.” I said, “Well, that’s because she’s an adolescent. So you think that she’s just being a snotty teenager, when in fact she’s just really irritable and she’s not sleeping well and this is her expression of depression.” So I think the hardest part is that it doesn’t look like adults. Kids are not just little mini adults, adolescents aren’t just mini adults

Daniel Lobell: (41:30)
Before I move on, why did you think that was a good comeback? I didn’t get that.

Dr. Catrina N. Luca: (41:36)
Because the dad was presenting the situation as if there was something wrong with his daughter and that it was very unique. And I was like, “No, actually. Sorry. I think you missed it with her.” Because he felt very confident that he knew what the problem was. So he was making sure that I knew what the problem was so I could do the right thing and just fix it. And I was like, “But we’re missing a key point. And that is your daughter is very depressed. And if we don’t help her with that, we can’t do any of these other things that she may actually need. I agree with you. She may need some of the things you’re presenting, but if we don’t handle that depression, she’s not available.”

Daniel Lobell: (42:15)
So another challenge is you also have the parents diagnosing before you come in.

Dr. Catrina N. Luca: (42:21)
Oh yes!

Daniel Lobell: (42:23)
So what do you think are some of the most valuable tactics that you can use to build trust in the doctor-patient relationship?

Dr. Catrina N. Luca: (42:32)
Listening is one thing, validation is huge. I think I spend a lot of time validating. A lot of people feel guilty for how they feel and they need to know, “No, I can validate how you feel. Now let’s see how we can help this not get in the way”, but people really want to know that they’re heard and that they’re validated in how they’re feeling, what they’re going through. And they want to know that they’re not by themselves, they’re not having to navigate this by themselves.

Daniel Lobell: (43:06)
Yeah. I imagine that’s probably pretty huge because when you have a problem just to yourself, it’s very scary, especially when you’re younger, because you feel like nobody else has this. I remember feeling that way when I was younger. I don’t remember specifically what about, but just feeling things about myself, like no one else would understand, nobody else has this. Of course, that wasn’t true.

Dr. Catrina N. Luca: (43:33)
And that’s sometimes when I tell my teens. I say, “You know, your brain lies. It doesn’t intend to, but it lies to you sometimes. Its primary job is to protect you. Let’s say you had a bad experience. And the way that you interpret that experience is that it’s really, really bad. I don’t ever want to do that again. Well, your brain goes, “Okay, I’m going to put that in the algorithm. We’re never gonna do that again. And so if anything comes up that looks just like that, I’m going to avoid it at all costs. If that means I have to be angry and storm off, if that means I have to be sad and cry, I’m just not going to deal with that because I don’t want to do that anymore.””

Daniel Lobell: (44:10)
So don’t trust your lying brain.

Dr. Catrina N. Luca: (44:14)
I think it’s better to look at our brain as a great informant like there’s something going on when you get that little tingle, like, “Something’s wrong.” I don’t think you want to say “Don’t listen to that.” But I also don’t want it to be, “Oh, that must be the truth,” because our brain doesn’t always get it right.

Daniel Lobell: (44:32)
Yeah. I agree. [Laughs.]

Dr. Catrina N. Luca: (44:38)
You sound like you’re agreeing, like “Oh yeah, I’ve been there.” [Laughs].

Daniel Lobell: (44:42)
Oh yeah. I am. My brain has lied to me many times.

Dr. Catrina N. Luca: (44:47)
It said “That Big Mac is going to taste good.” And it doesn’t. I’ve been there by the way, when you go, “Oh my gosh, I haven’t had one of those in so long” and then you get it and you’re like, “That so wasn’t worth it.” But now I’ve got to finish it because I got it.

Daniel Lobell: (45:03)
And on a bigger level, it lies to you in terms of major things in life.

Dr. Catrina N. Luca: (45:13)
Can I trust this person? That’s a big one. Can I trust this person? Well, if that person has any kind of characteristics of someone in your life that was proven untrustworthy early on, what are the chances of you treating them just like that other person?

Daniel Lobell: (45:30)
Yeah. I used to work in adolescent rehab centers as a group leader, doing comedy with kids often with severe drug addictions. So I remember this is bringing back a lot of stuff for me. I really miss doing that. I really loved it.

Dr. Catrina N. Luca: (45:52)
It had to be rewarding.

Daniel Lobell: (45:53)
It was great. I wonder how much of that do you deal with in Florida? Because I know there’s a lot of drugs there.

Dr. Catrina N. Luca: (46:01)
That’s a very good question. There’s a lot of it and there aren’t a whole lot of resources, particularly for adolescents when it comes to substance. So that tends to get a little tricky.

Daniel Lobell: (46:19)
Yeah. I guess you can’t really put kids on drugs when they’re on drugs. Well, I guess you can because they did it, the rehab where I worked.

Dr. Catrina N. Luca: (46:26)
Yeah, you’re spot on. There are some limitations we can “get away with”, because it’s helpful and they’re close enough in age and we’ve gotten consent from their parents of course. Then there are some things you just can’t because we don’t have approval for that.

Daniel Lobell: (46:48)
And it makes it a lot more difficult.

Dr. Catrina N. Luca: (46:51)
It does. Believe it or not, we do a lot of off-label treatment in child psychiatry because a lot of the medications that we have at our disposal, they didn’t do the original trials on children. So we tread lightly. I take it very seriously when I need to prescribe for a kid because I want to make sure that I’m making the right choices for them.

Daniel Lobell: (47:15)
All right. I’ll bring it back to me again. I was diagnosed as a kid with ADD which I think is now called ADHD. Because everything is HD now. I still have it and I’ve been prescribed different medications and I’ve never done well with any of them.

Dr. Catrina N. Luca: (47:37)
What happens?

Daniel Lobell: (47:38)
I get very anxious. I get angry coming off them, like very tense. First of all, what is going on with ADD, because I’m sure you deal with that a lot? What’s going on in the brain and what hope is there for me?

Dr. Catrina N. Luca: (48:00)
Zero hope, so you can stop holding your breath. I’m just joking.

Daniel Lobell: (48:05)
[Laughs.]

Dr. Catrina N. Luca: (48:05)
I actually really love treating ADHD. I have some of the most fun with those patients, because the way their brain works is just so interesting to me and because it occurs on a spectrum. So I often tell people when I’m talking to them about their diagnosis, “Look, ADHD is a neuro-transmitter problem and a neurodevelopmental problem. Your brain does not produce enough norepinephrine or dopamine to be able to listen well, to pay attention well, and to be able to block out those non-essential things well.” So it’s a receptor issue. An example of this is that I’m not able to take in the sound of what I want to hear. The frequency and the volume are not enough and there’s a lot of distraction.

Dr. Catrina N. Luca: (49:09)
When we treat ADHD, we’re looking to restore function. So for all those parents out there who may be listening, when your kid is telling you, “I can’t focus,” please believe them. They really aren’t pulling your leg. When they tell you that they forgot, at the very least, let’s entertain it for just a second. If they’re saying they forgot a lot, or they’re losing items all the time, dig a little deeper. So that’s what’s going on in your brain. There’s not enough norepinephrine and dopamine. ADHD doesn’t magically disappear. So when adult ADHD became a thing, maybe five or ten years ago, where we began to be really more aware, or at least acknowledge it, those of us in child psychiatry were like, “I’m so glad you guys are catching on because we’ve been seeing this already.” We know that just because someone turns 18, they don’t magically lose their ADHD diagnosis – I now have an adult who has difficulty with executive functioning and it has a lot of ramifications. One of the statistics that really blows my mind is the number of young ladies who deal with teenage pregnancy when they are untreated for ADHD. Really, what great decision gets made in the heat of the moment when you’re all hot and bothered, in a neuro-typical brain? Sprinkle on a little impulsivity and not planning ahead. It’s a recipe for disaster.

Dr. Catrina N. Luca: (50:49)
So I don’t view ADHD as an optional thing to treat. I think it’s imperative that it’s treated. You’ve got a bunch of people who are running around, who don’t have the ability to organize, to plan ahead, to function, to get to a place on time. In some cases, they have difficulty paying attention to the extent that they can’t even drive. They have multiple tickets, multiple accidents. So it’s not just “Oh, they can’t focus in school.” It’s, “Can they pay their bills? Can they get to work on time?”

Daniel Lobell: (51:23)
It’s hard. It’s always been a challenge for me, all these things you’re talking about.

Dr. Catrina N. Luca: (51:28)
Yeah.

Daniel Lobell: (51:28)
That’s it. You’re doing it. You’re validating. [Laughs.]

Dr. Catrina N. Luca: (51:35)
Yes, I’m validating you.

Daniel Lobell: (51:35)
I know your tricks. [Laughs.]

Dr. Catrina N. Luca: (51:38)
[Laughs.] But with that being said, not everybody responds well to a stimulant. The gold standard medication for treating ADHD is a stimulant, but that is not the gold standard treatment plan for ADHD. So for all of you listening, if someone has a diagnosis of ADHD, that does not mean they need to be on medication. It does mean they need assistance with living their life and with executive functioning. And that may translate into their needing a planner or needing to be more organized or needing to learn some skills, they might have multiple alarm clocks. If that’s what they need to function, that’s awesome – They may not need medication. It’s not required.

Daniel Lobell: (52:24)
Are there medications that don’t make you want to rip your skin off? I once saw a meme floating around about life on Ritalin. And it was so my experience with it, like, “Food looks like glass, like all these kinds of things. And by the way, when I’m on those medications, I lose weight until it wears off and then I binge eat. But I don’t eat at all, all day on them. I’m just not interested in food at all, which is really interesting to me because as somebody who overeats, a tiny little blue pill could make all of that go away. But again, when you come off of it, it’s like all that hunger from the whole day hits you at once and it’s nuts.

Dr. Catrina N. Luca: (53:14)
Well, if we’re talking about you, going back to why you overeat, I would say the following: That should be an indicator that it’s not really about the food. So let’s just put that there off to the side. Coming back to the ADHD portion, I would say the reason why we get paid the big bucks (and that is totally joking), but the reason why we are physicians in what we do, is we are trying to figure out the best stimulant for that person. So not all people respond the same to that stimulant, it depends on what you’re prescribing. One of the things that pops into my mind as I’m listening to you is how much underlying anxiety do you deal with separate from your focus? Because that tends to bubble to the surface pretty strongly. If I’ve got someone with anxiety in the background and I try to give them a stimulant, it may actually amplify that anxiety, which is going to override any kind of focus that I’m trying to achieve and make them feel miserable.

Dr. Catrina N. Luca: (54:12)
When I have somebody that I’m diagnosing with ADHD, I still have to ask all the other questions because I want to make sure I’m not missing something else because most of our diagnoses travel with friends. So if I’ve got ADHD, I’m looking for anxiety. If I look at ADHD, I’m looking for ticks. If I’m looking for ADHD, I’m looking for Oppositional Defiant Disorder. I’m looking for some other things because I know they run together.

Daniel Lobell: (54:39)
Part of the crew.

Dr. Catrina N. Luca: (54:41)
They’re part of the crew. And then I have to decide which one I am going to address first.

Daniel Lobell: (54:48)
Hmm. I don’t think I’m a very anxious person, but I know what happens when I take the little blue pill. [Laughs.]

Dr. Catrina N. Luca: (55:00)
Well, it also happens when you smoke the weed. So it just depends on what you’re talking about. [Laughs.]

Daniel Lobell: (55:04)
Well, I don’t do that.

Dr. Catrina N. Luca: (55:07)
That’s a possibility when people smoke weed, there’s might have very high anxiety.

Daniel Lobell: (55:11)
Yeah. I had my phase with that in my early twenties and it did make me anxious.

Dr. Catrina N. Luca: (55:26)
Dude, the reality is that for those who have ADHD, a little bit of anxiety goes a long way in getting things done.

Daniel Lobell: (55:36)
That’s true. When I was on those pills, I did get a lot done.

Dr. Catrina N. Luca: (55:43)
I’m talking about without medication. [Laughs.]

Daniel Lobell: (55:52)
[Laughs.]

Dr. Catrina N. Luca: (55:52)
This lets us know where your head is at. Go ahead.

Daniel Lobell: (55:54)
Well, this interview is on behalf of Doctorpedia. So I want to bring up the online health space. What are your thoughts in general on the online health space? I know we talked a little bit about parents coming in with diagnoses. Of course, people diagnose themselves online as well and that can be an issue. What is your general feeling towards online health stuff?

Dr. Catrina N. Luca: (56:31)
So the first one is I actually have a mug that sits on my desk that says, “Please do not confuse your Google search with my medical degree.” My husband bought it for me. He was like, “Honey, I can’t tell you how many times I hear patients who call in to make an appointment who are telling me or wanting to tell you what’s wrong.” Second thing is, I feel like it’s the wild, wild west out there. I feel like because the internet is just this huge platform, everybody has the ability to jump on there and give their two cents. And so when I came upon Doctorpedia, I was like, “This is brilliant. This gives physicians the opportunity to speak clearly. And there’s no mediator. There’s no one in between them and the patient and conveying that information.” And that is huge because when I go online and I look up something, I don’t know who wrote the article and unless I’m savvy enough to look, I may be surprised at who the person on the byline at the end of an article on Diabetes is.

Dr. Catrina N. Luca: (57:45)
I would love for that to be my MD, who does this on a regular basis who actually prescribes insulin, who has this conversation day in and day out and has been doing this and is good at it, than to have someone who has a peripheral role in the treatment of diabetes, but is speaking as an authority figure.

Daniel Lobell: (58:04)
Or just some guy who owns a liquor shop. [Laughs.]

Dr. Catrina N. Luca: (58:08)
I hope and pray that is not happening. [Laughs.] But I love the idea of having one place that someone can come and they know that what they’re hearing is coming directly from a doctor. There’s no intermediary. There’s not someone having to translate it for you. There’s none of that. I think that conveys a whole lot of confidence and hopefully it will allay a lot of fear.

Daniel Lobell: (58:38)
Well, we’re excited to have you as part of Doctorpedia. Can you tell the listeners what role you’re playing in Doctorpedia and what can we hope to look out for on the website from you?

Dr. Catrina N. Luca: (58:51)
Well, first and foremost, I will be involved in the psychiatric portion of it, where information for both adults and children and adolescents will be available. So for parents who are looking for information about depression for teenagers versus children, for adults who are wondering, “Is this ADHD?” I will be involved in that field for Doctorpedia. I’m also involved as the chief brand officer, which I think is really like a fancy way of talking about like PR right, that front-facing piece of Doctorpedia, where we make sure that what we intend to convey – our vision, our mission, who we are – we stay true and faithful to that, and that we’re able to share it with fidelity. We want to share it in such a way that if we say this is who we are, this is exactly who we are. And here’s what it looks like. So hopefully that’s not too short.

Daniel Lobell: (59:54)
No, that sounds good. So is there a psychiatry channel currently on Doctorpedia?

Dr. Catrina N. Luca: (01:00:02)
Yes, there is and we are in the process of expanding that. I’ll be working alongside some other psychiatrists to make sure that we are all speaking the same language.

Daniel Lobell: (01:00:16)
The language of psychiatry.

Dr. Catrina N. Luca: (01:00:16)
You’re right. [Laughs.]

Daniel Lobell: (01:00:18)
[Laughs.]

Dr. Catrina N. Luca: (01:00:18)
Funny, funny, you know, wizardry, we have our own language. but that we’re speaking the same language and that what we’re putting out there is truth. And that it’s clear and it’s concise and people can understand it. So that’s always my hope. I find that when patients have a better understanding of what to expect, they just do better. They not as concerned about what comes next because they know what comes next. Hey, when you have depression, this is what you expect when you take this medication, here are some possibilities.

Daniel Lobell: (01:00:54)
So true. I’m not a big fan of roller coasters, but whenever I’ve been on one, the first time is terrifying. The second time I’m like, “I know what’s coming.”

Dr. Catrina N. Luca: (01:01:06)
That’s the idea behind it.

Daniel Lobell: (01:01:07)
That’s my equivalency for all of medicine. It’s just a roller coaster.

Dr. Catrina N. Luca: (01:01:12)
That’s a very deep and meaningful way to explain it. I appreciate it.

Daniel Lobell: (01:01:20)
[Laughs.] Yeah.

Daniel Lobell: (01:01:25)
Dr. Luca, it’s such a pleasure speaking with you today. I’m going to round off the interview by asking you the same question I end all of these with, which is, “What do you personally do to stay healthy?”

Dr. Catrina N. Luca: (01:01:38)
I spend time with my family. I’ve got six different personalities at home with my kids and not to mention my husband, who is a character in and of himself and they keep me grounded. They remind me that I am still just Catrina Luca, who has her own wants, her own, needs, her own desires, her own family and not take myself too seriously.

Daniel Lobell: (01:02:07)
I love it. So that’s one we haven’t gotten before, but I think it’s a very important one – just family is medicine in and of itself. So hopefully I’ll keep building my family.

Dr. Catrina N. Luca: (01:02:24)
I’m excited for you. The fun is just about to start dude. Right now you have one, right? And you’re expecting another one. Yeah. With one, all eyes are on that one, with two, you and your wife are going to have such a great time. And if you go for a third, that’s when the real fun starts.

Daniel Lobell: (01:02:41)
I’m not sure if by fun, you mean that in a facetious way? [Laughs.]

Dr. Catrina N. Luca: (01:02:46)
[Laughs.] The answer is yes, either way you want to take it. The answer is yes.

Daniel Lobell: (01:02:52)
But it is also literally fun.

Dr. Catrina N. Luca: (01:02:55)
It really, really is, especially when they start talking and they have lots to say, and sometimes it really is not that important, but it’s important to feign importance, like, “Oh yes. Some dogs are brown.” [Laughs.]

Daniel Lobell: (01:03:13)
[Laughs]. Thanks so much for your time. I really enjoyed speaking with you.

Dr. Catrina N. Luca: (01:03:18)
Thank you. Thank you for having me. And we’ll see how the small unfolds on this rollercoaster.

Daniel Lobell: (01:03:22)
Have a good one.

Dr. Catrina N. Luca: (01:03:25)
You too.

Daniel Lobell: (01:03:33)
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.

‍