Dr. Josh Emdur

Dr. Josh Emdur: How Sport And Health Are Ultimately Intertwined


About this episode:
In this week’s episode, Hillary interviews the Chief Medical Officer at SteadyMD and talks with him about how sport and health are intertwined, and about the unique approach SteadyMD is taking with an entirely online personal physician service.

Guest Bio – Dr. Josh Emdur:
Dr. Emdur is a clinician and physician leader with a passion for innovation in primary care. He has held a board certification in family medicine since 2007 and is licensed to practice medicine in over 25 states. He spent over a decade treating the sick in the hospital prior to becoming the Chief Medical Officer at SteadyMD where he launched the world’s first personal physician service especially for runners that is entirely online. While caring for hospitalized patients he learned that health is achieved outside of the hospital. His medical approach focuses on using lifestyle to treat chronic diseases and using medication only when lifestyle modifications aren’t enough.

His interests include using technology to improve the doctor-patient relationship and exploring alternative payment models for health care outside of traditional insurance. When asked what fuels him in life his response is clear “passion”. Whether it is climbing big walls in Yosemite, striving for marathon personal bests, skiing big backcountry lines in the high mountains, or just being the best human he can it is obvious that he is driven by challenges and excellence.

Read More About Dr. Josh Emdur and SteadyMD:

https://www.steadymd.com/doctor-josh-emdur/

https://twitter.com/steadymdrunning

https://www.instagram.com/joshemdur/

Episode Highlights:

  • How sport and health are intertwined
  • Building a support network
  • Identifying stressors that affect performance

Listen to the episode on Apple Podcasts, Spotify, Stitcher, Google Podcasts, or on your favorite podcast platform.

 


Episode Transcription:

Hillary Allen:

Hi guys and welcome to the TrainRight podcast. Today’s guest is Dr. Josh Emdur. Dr. Emdur is a clinician and physician leader with a passion for innovation in primary care. He’s held a board certification in family medicine since 2007 and is licensed to practice medicine in over 25 states. He spent over a decade treating the sick in the hospital prior to becoming a chief medical officer at SteadyMD, where he launched the world’s first personal physician service, especially for runners that is entirely online. While caring for hospitalized patients, he learned that health is achieved outside of the hospital. His medical approach focuses on using lifestyle to treat chronic diseases and using medication only when lifestyle modifications aren’t enough.

Hillary Allen:

His interests include using technology to improve the doctor-patient relationship and exploring alternative payment models for healthcare outside of traditional insurance. When asked what fuels him in his life, his response is clear. It’s passion. Whether it’s climbing big walls in Yosemite, striving for marathon personal bests, skiing big back country lines in the high mountains, or just being the best human he can, it’s obvious that he is driven by challenges and excellence. I hope you guys enjoy this episode today. Dr. Josh, as I call him, he’s become a close friend of mine. I met him in Boulder, Colorado through my coach Adam St. Pierre. He’s actually my doctor through SteadyMD. In this episode, we’re going to talk about SteadyMD, what exactly is that, as well as how much of a badass athlete Dr. Josh is himself. So without further ado, hope you guys enjoy.

Hillary Allen:

Welcome to the TrainRight podcast. Thanks for being on here.

Josh Emdur:

Yeah, thanks for having me. I think in your email, you said that you’re looking for interesting guests, so hopefully I don’t let you down.

Hillary Allen:

Oh my gosh, you definitely won’t let me down.

Josh Emdur:

Thanks for having me on.

Hillary Allen:

Yeah. So I mean, we’ve already had introduction of you, so the guests know who we’re speaking with. But I met you… How did I meet you? I met you through our mutual coach, Adam St. Pierre. Right?

Josh Emdur:

I think that’s probably the first time we met. I had, I had heard about your accident, and being in Boulder, we have a lot of mutual friends. Yeah. It’s probably through Adam. That’s a great thing about being in Boulder. It’s just such a great community of passionate people who are working on goals and love to be outside.

Hillary Allen:

Yeah. Then you’re also known as Dr. Josh, I think how Adam introduced me to you. This is Dr. Josh, and he was telling me about all of these crazy things, how you were super fast on the road, and then I think the first time I met you was actually on skis, so-

Josh Emdur:

Oh, that was the first time I met you. Yeah, at Eldora. Yeah.

Hillary Allen:

Yeah. Yeah. Adam was saying, “Oh yeah, he’s one of these rural runners who actually likes to do mountain things. He’s really fast. But he also likes to do trail running.” He’s like, “I’m going to convert him. It’s fine.”

Josh Emdur:

I didn’t like it all. I love life, and that’s one thing that I really like about being a doctor is being involved in other people’s lives, seeing the ups and downs, the beauty of it, the hardships. With sport, sport is the ultimate expression of life, I think. Whether you’re skier or a climber or a runner, you find your clan of people, and you go out there, and you push boundaries. You see what you can do. As a doctor, it’s amazing to be able to mix those two things, like sport and health. They’re just ultimately intertwined, and that’s why I love where I am right now. You hear this all the time, find a way to live a life of passion and have your career be your passion. I feel like I’m actually doing that right now.

Hillary Allen:

Oh, that’s awesome. Because we’ve had so many deep conversations just sharing either skin tracks and the mountains or runs, I mean. But I think you’re the embodiment of that. You’re so psyched on big-bang goals, but you’re also… I’ve learned so much from you about what it means to care for a community and to care for another human being. I’d like to talk to you about like, “What exactly is this? How have you been able to combine your passion with your career?”

Josh Emdur:

Yeah. So let me just start. You refer to me as Dr. Josh. I think it’s really funny. This is a name that I kind of acquired I think over the past two years. So I’m the son of a physician who will always be the doctor [inaudible 00:05:22] my role model. I spent 10 years working in the hospital, where hospital work, a lot more formal than being a personal doctor online, which is what I’m doing now. With this online practice of mine, patients are always like… Josh, I feel like, “You’re my friend, but you’re also my doctor. What should I call you?” It’s like, “That’s a tough question.” Because it’s like I would prefer that patient just call me by my name, Josh. But there’s something about that doctor that imbues trust and that professional relationship. That is a really important part of what I do. So that’s kind of how I think Dr. Josh has come to be.

Hillary Allen:

I love it.

Josh Emdur:

So getting back to my dad as my role model, I mean, my father has always been that kind of doctor. He’s mid-70s, not to put it out to the world how old my dad is. But he’s still in practice full time, and he’s always been the kind of doctor who, Hilary, you could call him right now and be like, “Hey, Dr. Emdur. I’m a friend of Josh’s. I have this problem,” and he would be there for you because being a doctor is just in his DNA. It’s what he is. It’s what he does. Times have changed now with the newer generation of doctors who are employed. They aren’t out building their own practices. Most primary care doctors now are employed by big companies. They have thousands of patients, and they don’t really have the process in place to be able to have that kind of personal relationship, being able to answer the phone for every patient who calls them just because the model doesn’t work that way.

Josh Emdur:

So with what I’m doing at SteadyMD is having a much smaller panel of around 300 patients who have access to me, and it’s really built on the model of that doctor who you have access to, who knows you, is aligned with your life and has time for you. So that’s a what I’ve been doing, and I think from the patient perspective, it works really well, and from the doctor perspective, it works amazingly well because it’s really in the relationship that you can really have impact on someone’s health. If it’s just like you’re seeing your doctor once every couple of years where you just some blood work and checks the boxes, that’s probably not going to move the needle for your longterm health. But if you have that opportunity to have a continual relationship with a doctor who just kind of understands what you’re going through, it’s really powerful.

Hillary Allen:

Yeah. I think, I mean, you talked about this just in the current age of technology, where it seems like people… I’ve gone into several doctor’s offices, and mostly everything is onscreen. There’s limited kind of interactions, all seems kind of streamline and to computers and stuff like this. I think in a world where that is actually replacing actual physical interactions, I mean, yeah, I can kind of… I don’t know. I think you’ve kind of struck a really cool balance. Because when I first, you are my doctor through SteadyMD and granted maybe I got it a little bit too late after my accident is kind of when I always had a doctor but never really saw them regularly. But it wasn’t until after my accident that I was like, “Okay. Well, if I’m going to be traveling more, especially abroad, it makes sense be able to have someone that I know and trust to be able to like check in with.” I think our actually our first meeting, even though we both lived in Boulder, it was online, which is so funny.

Josh Emdur:

Yeah. That part is always funny.

Hillary Allen:

No. It is a little bit awkward, but actually, for me, it does. It actually feels like it is more personal. You can get to see someone even though it is through a non-face-to-face interaction. It is better than nothing. It actually eliminates, for me at least, if I’m in the physical place of being able to meet with the doctor no matter where I am in the world.

Josh Emdur:

Yeah. Getting to the point of like alignment, the way medical education works, you go to a medical school for four years, then you pick a specialty. My specialty was in family medicine. From there, I was really close to doing a fellowship in sports medicine, where in sports medicine, it’s really training to be a team doctor. I spent a couple of months doing that. Kind of the appeal to sports medicine is always like, “Oh, you can be at the football game every week. You can be on the sidelines taking care of the athletes.” For me, that was just not appealing because I like to participate, not watch. So albeit I’m not boarded in sports medicine, I see what my real value is, is I understand the passion and the crazy of kind of mountain athletes-

Hillary Allen:

I would definitely agree with that.

Josh Emdur:

… and runners because so many of my patients have just been told by their doctors to just stop running. That’s just not good advice for a lot of people. I mean, there’s definitely times when you have to shut it down from an injury or if you’re actually doing damage. But telling people to not run is not a treatment plan. I mean, that is a plan to… When you shut an athlete down, it’s really a road to tightening up more injuries, depression and really not being the person that you want to be. So I really see that as a strength of mine, as like, “Is climbing El Cap a good idea medically?” Definitely not. But if you’re a climber, you’re going to climb. So let’s get you into the safe place so you can accomplish your goals

Hillary Allen:

You have climbed El Cap, no?

Josh Emdur:

I have, yeah. Back when I was a young kid. I mean, I was like 20 years ago now. But it’s still a big part of my life.

Hillary Allen:

No, it’s a huge. I mean, with your wife now, right, you guys were climbing all over the US, traveling and climbing, living out of a van?

Josh Emdur:

No. I mean, in the dream world. My wife and I met when she was in medical school. We have had a lot of great adventures. Climbing definitely isn’t for everyone, and it was never really for my wife either. But she loves to hike and ski. I condo cap with one of my good friend, Andy Wellman, who if you’re listening to this, he’s up in the Pacific Northwest. But that’s a great thing about outdoor adventures, is if you share an epic adventure with someone, and it goes well, you’ll be friends for life.

Hillary Allen:

Oh, man. I mean, even didn’t even have to be an epic adventure. Could just be an epic training run at your back door. I think we’ve had several of those. But I mean, so you touched on this. So for SteadyMD, I mean, it really appealed to me because you are an athlete. You’re a runner. You are a mountain athlete. So you get it. We kind of speak the same language. So could you say that’s the majority of your clients, they are athletes? Yeah.

Josh Emdur:

Yeah. So really, my practice is comprised of people who really value their health. I do have a lot of athletes. But really, I’m just looking to care for people who want to be healthy and be the healthiest versions of themselves. Athletes, I love taking care of athletes, and it’s so important because when you’re pushing, things are going to happen, injuries, illness. Just because you run, and you live active life, it doesn’t make you immune to chronic diseases. You can’t really outrun your genetics a lot of times. So really, the value is having someone who… A good analogy is like a financial advisor. I like to think of myself as like a financial advisor for someone’s health.

Josh Emdur:

So we’re at an interesting age where really anyone can access all the studies, all the medical information that has ever been created by mankind. This is a new thing over the past probably decade. Before the advent of the internet, medical knowledge was kept under lock and key in medical libraries. It was passed on by word of mouth through training programs at medical schools. We’re in a different age now, where my patients, they can learn more about a disease process and I know about it in a matter of a couple of hours at a coffee shop just kind of reading the latest articles.

Josh Emdur:

But too much information is not… Access to information is not always a good thing. You really need a balance with someone who has the expertise and the training to be able to evaluate kind of the science, the known kind of medical conditions and put it all together. That’s where having a relationship with a doctor who gets you and has time for you really pays dividends.

Hillary Allen:

Yeah. It’s like that’s spoken, yeah, the same language. Right? It’s like you find your tribe, you find that community, and I don’t know, you’d get it. I mean, my background, I mean, I feel like we speak the same language on multiple things for science for one and then also for running. But what I love about your approach to medicine is that you want to treat chronic disease with lifestyle, and using medication is kind of a last resort, but more so evaluating how your lifestyle kind of impacts your health.

Josh Emdur:

Yeah. The biggest example of this, especially with middle age athletes is helping people with that work-life balance, which is… I’m sure we’ll get into later. I mean, it’s almost a misnomer because I think it’s kind of impossible. But really looking at the stressors, whether that stressor is emotional, whether it’s from work stress, whether it’s from training, stress at the end of the day is all stress, and stress can manifest itself as really a symptom on every organ system in the body. Stress, it’s really a disease in itself because if it goes unmanaged, it just snowballs out of control into real diseases like, severe, debilitating depression, anxiety. Then from there, it’s been correlated with heart disease, stroke, everything you can think of.

Hillary Allen:

Yeah. I mean, I was talking to a friend of mine. Actually, I was reading some article, I forget what it was. But mentioning how loneliness can actually be a really big indicator and basically correlative to serious diseases that we have maybe scientific quantification for heart disease or anxiety or something like this but really how loneliness can actually contribute to that too.

Josh Emdur:

It’s amazing. There’s a condition called Takotsubo cardiomyopathy, and it’s also known as broken heart syndrome. So when I was working in the hospital, we’d see this not uncommonly, where a 70, 80-year-old couple, one of the people would suffer a heart attack, and two days later, just from the stress, the other partner would have a heart attack as well. What’s interesting about that condition is there’s not really a medical explanation for it. You can take those people to the cath lab, and you can look at their heart arteries, and their heart arteries will… There won’t be the usual blockages that you see in a typical heart attack, where you get a ruptured plaque. Just for whatever reason, the body just stops working.

Hillary Allen:

Man, that’s so crazy. Like you said, from my background in neuroscience and physiology, we create these scientific… Mine is more biochemistry research. We’re studying these disease models, like something like Alzheimer’s or schizophrenia, which there’s an actual imbalance in the ion channels in the brain. We would put on these “stressors”, right, into these like cell culture. But yeah, how you mentioned, stress is stress is stress. It can manifest in any way, whether it… People, I think now maybe we’re thinking of it more as a mainstream disease but depression and mood disorders, I think those actually can be fixed too with changes in lifestyle.

Josh Emdur:

For sure. That’s the first place to look at it, I mean, the root cause. If you hate your job, you hate your life, let’s talk about it. Let’s see. Let’s get you talking to the right people. What I really love about working with CTS athletes in particular is being able to provide athletes with a team of support because then they are not alone. They have a coach monitoring their training, watching their training stress. You can have a doctor who’s there when the wheels start falling off and things actually have to be done, whether it’s getting them into the right orthopedists, getting in for blood work to treat anemias or other micronutrient deficiencies, managing illness. Then also, in the ideal world, having no nutritionists, dietary support, and also sports psychologists when it’s needed.

Hillary Allen:

Yeah. I mean, this is so crazy. But I think it sounds like maybe a lot of moving parts. But I think it can be as simple as just getting connected to the right people, right, having that network and that support system. I think that’s where you can be obviously the expert, but also the liaison or someone that can point you in the right directions. How have sports influenced how… Have they influenced how you approach medicine?

Josh Emdur:

No, that’s a great question. They have. When going back to my life working in the hospital, one of my main mantras was always move it or lose it. As we age, that’s even more true. A week in the bed when you’re 20 years old, you’re going to have to get back and work to get back to where you were. Weak in bed when you’re 60 or 70 years old, that can be catastrophic where, if you don’t really have the will to push through it, you might not ever get out of that bed again. I think 60 is probably pushed, more 70, 80. But it’s all on a continuum. So as an athlete, I still have that same mantra, where I’m a huge believer in active recovery.

Josh Emdur:

So if you do have an injury, really being careful and deliberate about returning to sport and really trying to ride that line of when it’s safe to get out and return to when it needs to be shut down, that can really make or break an athletic career, quite honestly. If you got an extra month of shutting someone down and not being able to get that month of training, just slowly ramp back up into a racing a condition for that race, that goal race, that’s four or five months out from injury can have a huge impact on that professional athlete’s career. So being really mindful of knowing you might not be able to run, but let’s get you in the pool. Let’s get you on the spin bike. Let’s do whatever it takes to keep you moving and keep those soft tissues loose. Because as you know probably better than anyone else, when things start tightening up, it’s just a battle to get the soft tissues to release and get back to before you were injured.

Hillary Allen:

Oh my gosh. Yeah. Oh, man. I know that far too well. I mean, I equate the move it or lose it. I love that. That’s one of Newton’s laws of motion.

Josh Emdur:

Yeah. So it’s so obvious. But we do it all the time, where we tell people to bed rest. It used to be one of the treatments for back pain. You say, “Oh yeah, bed rest for like a week.” Then after a while, the study showed that was just bad advice to give people. You’ve got to keep moving.

Hillary Allen:

Yeah. Or even with ankle sprains. I remember that the protocol used to be rest and elevate. But now, I mean, you want to be… I mean, even after my ankle injury and I had surgery, I was still like I needed to do passive range of motion on that to kind of get the tissue moving again. I was in the pool as soon as the incision site healed. Yeah. It’s all about that. It’s about having people like yourself. I’ve had many discussions with you about, “Hey, what do you think about this paper?” What do you think about… I mean, we had a discussion member that got maybe quite heated or how you usually discuss quite with a lot of passion. But we were discussing about CBD and what effects could that potentially have. But we don’t have to get into that. It’s okay.

Hillary Allen:

But my point of mentioning that is just that, I mean, it’s important to have someone who is able to read all this information that we’re… It’s the information age. There’s so much information. But then to be able to tease that out and say, “Okay. Well, it’s not doing nothing.” I think that’s what you said for CBD. It’s like, “Well, we’re not sure that it does all of these things, but it does something.” I think that’s a refreshing perspective to have as a doctor.

Josh Emdur:

Yeah, no, I couldn’t agree with you more. I think working with athletes, it’s really taught me, reinforced, I should say, the importance of just listening carefully and really knowing what the goals are. So going back to a goal race example, if we know it’s a goal race, really kind of using that and kind of listening to the fact that this is their goal, as their team member, I’m going to do everything I can to get them to that starting line that’s legal and not going to hurt them. We make that clear. But supporting that, it’s tough, especially working with ultra endurance athletes like, “Dr. Josh, do you think I should start this a hundred mile race in two weeks.” It’s like, “Probably not, but I know you’re going to do it anyways. So let’s just do everything we can to keep you safe and try to set you up for success as best we can.”

Hillary Allen:

Yeah. I like that.

Josh Emdur:

That’s a big thing. That’s a big thing that I’ve learned. It’s not like these absolutes don’t work with passionate people like, “Oh yeah, don’t run, don’t do this.” Yeah. That’s not a healthy relationship. It’s just like doing the best you can to give people the information so they can accomplish their goals and try to stay as healthy as they can through the process.

Hillary Allen:

Well, speaking of these crazy people that have these… They’re super confident and they have these big goals. You’re one of these people, and it’s something I admire you greatly for it because, I mean-

Josh Emdur:

Thanks.

Hillary Allen:

… you have a family, you have this crazy busy career. But then also, you are a killer athlete as well. I mean, you are. So I mean, you just ran Boston? No, Boston last year. You just ran CIM, no?

Josh Emdur:

I did CIM. Being an athlete, running in particular, I love how you can set a goal and chase that, train for it, and then execute on race day and not risk your life doing it. So back in my younger days, in my 20s, sitting back in El Cap Meadow, looking up at El Cap and being like, “Oh God, that’s crazy. I can’t believe I’m going to go do that.” And then do it, not in the best of style, but getting it done safely. That felt great. But I found that with the marathon in particular, I’m able to fit running the marathon in my current life. Is the ultimate sport for me? No, it’s not. But for me, that distance and that endeavor, in my busy life, I figured out working with the coach really focusing on quality workouts, I know that I can run a respectable marathon with a couple hours a week of training.

Josh Emdur:

The hard part is I know I could do better if I devoted more time. That’s where I don’t think the balance really fits. I mean, I think that it’s all about stages in life and what your goals are. Right now, I’m building a business. I’m also the medical director at a nonprofit clinic right outside of Denver, where we care for the uninsured, which is just amazing work. It’s so rewarding. I really feel like I’m able to change lives on a daily basis. Giving that up for a personal endeavor like running, I just can’t do that right now. But a goal of mine is to always kind of stay consistent, stay moving.

Josh Emdur:

So when I do have that time in my life to ramp up, to crush a hundred-mile race and really go all in or go all in the marathon. I want to be in a position where I can do that when the time arises. So balance, I don’t know. I think people spend too much time worrying about balance. It’s really about picking a couple things and doing your best and being there for your family, being there for your friends, checking the boxes and being responsible person and then making sure that you still have time for yourself and your own wellbeing. That’s what running has taught me. It’s given me that hour and a half this morning to spend some time running the local trails. So just relax, not worry about work, not worry about all the notifications that are always going off. So then I can be better at all my other things.

Hillary Allen:

Yeah. I love that. So you would say there is no balance. So what is your best advice for someone who is trying to balance a career with athletic goals and family and all this stuff?

Josh Emdur:

I think you have to pick maybe a top three things. I’m not an absolute person. I think that things are always moving, and you have to be very perceptive to that in your life. If it’s a time to really hunker down at work, your athletic goals should probably not be number one because there’s a time that when you can work really hard at your job professionally and then dial it back and harvest all that hard work, well, you have more time to really focus on athletic goal or other personal goals with your family. So I think you can have balance by kind of dialing it back and forth through a couple of things.

Josh Emdur:

But when people just have a lot on their plate, I think it’s a recipe for unneeded stress and can really impact people’s health and wellbeing. If you’re so razor focused on an unrealistic goal that you aren’t set up for success for, you’re going to hurt yourself. You’re not going to be happy with the results, and at the end of the day, you probably aren’t going to feel great about it.

Hillary Allen:

Yeah. Burning the candles at both ends, do that.

Josh Emdur:

I know, Hillary. You have to give yourself more credit. I’ve really had an opportunity… With social media, it’s amazing, and especially as a doctor, where this is very debatable, following your patients on social media. If I was at a medical school right now, they’d be like, “Oh, Dr. Josh.” I don’t know about that. But I beg to differ. When I’m following my patients on social media, I’m seeing their true selves. Now, I’m seeing my athletes posts that runs to Strava. I’m seeing my athletes post when they’re lifting weights. I get a good sense of where people are mentally and physically from their social media, as weird as that sounds. It’s kind of the truth.

Josh Emdur:

I’ve seen you do a great job of going from times when you had some really big challenges and working through those and not burning the candle at both ends because you’ve gotten to the point in your career where you’ve realized that going too hard is not good for you. Do you agree?

Hillary Allen:

Yeah. I would definitely agree. Well, thank you. That makes me feel better. But it’s crazy. I mean, maybe some would argue that it’s a conflict of interest, but I don’t because yeah, people that I coach, I follow them on social media too, and you can kind of get a… I mean, I’m not a doctor, but I think those interpersonal relationships, whether you’re coaching someone or whether you’re someone’s doctor, it’s more about just, “Okay. Do this workout to get the most fit for this race.” It’s more about how you see them as a person, how they’re doing on a whole to making sure they’re in a good place mentally to attack these goals.

Hillary Allen:

An athlete that I’m working with, he’s dealing with an injury. A lot of our conversations and we touch base, it’s not about the training plan. Yeah, that’s there. But it’s more about mentally, how he’s doing, how is he handling this? It’s okay to take a step back and have this period of time not be focused on training your body [crosstalk 00:35:01]-

Josh Emdur:

[crosstalk 00:35:01] you did look in your social media. I mean, you really brought to the world that it’s okay to have a off season. You need a off season, where you don’t need to wake up and crush it every morning. I’m a huge fan of the book Peak Performance by Magness and Stulberg. In that book, they present this growth equation, that growth equals stress plus rest. The only way to grow is to have stress, but it needs to be balanced with rest. If you aren’t getting that, then if you’re just stressing yourself, you’re going to wither away and die, whether that’s training stress, life stress, not sleeping, not eating. But it’s the stress that does make us stronger as long as we’re recovering from it. That’s what I love about that equation because it just gives it out.

Hillary Allen:

I love that. I’m going to have to pick up that book. I haven’t read it.

Josh Emdur:

It’s worthwhile. That and also the Passion Paradox is another one [crosstalk 00:36:10].

Hillary Allen:

Ooh.

Josh Emdur:

Both of those books sit near and dear to my heart.

Hillary Allen:

I really like the Passion Paradox. I think one of the best things when I was reading this to just fall in love with the process of training and what that looks like and whether or not it means your best performance or not, the failures are as much a part of the process as the successes. That’s what drives passionate people, I think.

Josh Emdur:

Yeah. But then the other part of it, I guess, we’re both passionate people is passion isn’t necessarily a good thing either.

Hillary Allen:

No.

Josh Emdur:

There is a dark side of passion. All through history, passion was tied to religion and had a lot of negative connotations. So it’s really about harnessing that passion to do good and be happy and somewhat contempt with yourself. Because the hard part is when you don’t live up to your own expectations. As an athlete, that’s the hardest thing. So setting realistic expectations, so at the end of the day, you feel good about the work that you’ve put in. You feel good about the process. Getting back to what you mentioned, the last marathon that I did, CIM. When I signed up for it six months before the race, I was like, “You know what, I’m going to PR this race. I want to go under 2:45. I know that I can do it.”

Josh Emdur:

Three months out, I was like, “You know what? I don’t have this in me right now.” I just have too much going on with work, and I just wasn’t psyched on it. So instead, I put in mediocre training, and I had a good result, but it wasn’t my potential. No. But I had a great time with it. I’m glad that I trained for it. I had a great race, got to run it with a friend of mine. We went on three holidays.

Hillary Allen:

Which we’re videoing, live-Instagramming the whole time.

Josh Emdur:

Well, it was amazing. I was getting messages from my coach like, “Put the phone away.” I was like, “No. This is fun. I [inaudible 00:38:27] doing this.” I mean, there’s still always those demons at the end like, “Oh, maybe I shouldn’t have lived it, Instagrammed it, and I should have gone a little bit harder.” But no. That wasn’t the point. That wasn’t what it was about that day. I don’t think I was in shape to run much faster than I did. Maybe I could’ve gone a couple minutes faster or something. But the end of the day, you got to love the life that you live, and you have to be good with your choices, and you can’t be too hard on yourself. That’s something that I see all too often in my practice is just patients who are just hard on themselves.

Josh Emdur:

It gets into this point where it’s like, “I have diabetes, and I’m not following a diabetic diet at all. I’m bingeing on sugar. I’m not taking my medicine, and I’m depressed.” It’s like, “You know what? Yes. You’re not being a good patient, and you’re making me look like a horrible doctor.” I’m like, “Let’s get over that. Let’s have you just kind of embrace the decisions that you made and realize we all make decisions.” I don’t try to be prescriptive. I just give people the information. It’s like you can continue to make these bad decisions, and the consequences are X, Y, and Z. But those are your decisions to make, and that’s a beautiful thing about life is we can all make bad decisions.

Josh Emdur:

But you should at least feel good about them. Own your bad decisions and be like, “You know what, I wanted to eat. I wanted to drink that bottle of Coke and not take my medicine and have donuts.” It’s like, “Well, okay. But if you develop new end stage renal disease and need dialysis, you just have to be okay with that. Here’s the information, and I’m documenting that we had this conversation, and that’s how it goes.” But I really like it when my patients make me look like a good doctor. That is a goal of mine.

Hillary Allen:

No. I mean, obviously, that is goal number one. But no. Like you said, it’s like that’s the kind of the point of everything is you’re not defined by your mistakes, and then also, if I’m dealing with a person I’m coaching, and they’re not following whatever directions, or they’re overtrained or not doing enough, it’s like, “Yeah, okay. Well, you’ve got to then own it in your decision when either you drop out of the race or you’re not as well prepared as you thought you should be or you don’t reach your goal. But it’s also just like yeah, that conversation of being open and honest, and yeah. It’s the beautiful thing about life, and it’s… I don’t know. I think it’s also how we are constantly humbled by life too.

Josh Emdur:

Yeah, we are. Getting to the coaching example, I was always guilty of this, just as athlete, always go in too hard. That’s something that I do also try to help my patients with who are runners, where it’s like, “Why am I getting slower?” It’s because you’re racing all the time, and you’re pushing all the time. The body doesn’t work like that. Isn’t that fascinating that people just don’t get it, no matter how many times you go around, and it’s like just go down and smell the roses. You don’t have to do a 5K every day. You don’t have to be on this streak. It’s like, “What do you mean I don’t have to be on the streak? It’s like my goal. It’s like…” “Well, is it actually adding things to your life? Because I’m not sure that it is.” It’s like, “Well, it’s my streak.” It’s like, “That’s great. I get it. But I don’t know. What are you trying to get out of it, having these hard conversations?”

Josh Emdur:

I think that’s something where we do have similar conversations with other humans about this, which are… They’re fascinating.

Hillary Allen:

But I think, yeah, it’s the process that everyone goes through. So I’ve got a question for you as we’re wrapping up. I have a few more to end with. But just to get a sense of who we’re dealing with, Dr Josh, can you tell me one of your favorite adventure stories? I think you’ve gotten into a lot of trouble in the mountains. Not it might be into trouble. But I mean, I remember one when you were dealing with this. You were saying to me how you’re trying to encourage me. This was actually when I broke my ankle, and you were telling me these stories about when you had certain injuries and maybe another example of what not to do, but also of just how you will get through it. This was a particular one in like in Breckenridge and Skiing, something like this, but-

Josh Emdur:

Oh, I don’t like that one.

Hillary Allen:

Okay. We don’t have to go to that one.

Josh Emdur:

Lesson with that one is that speed can be your enemy, even though it’s so fun. I love to ski. I’ve been skiing my whole life. It’s definitely one of my main passions. Really, any kind of skiing. Probably, the more dangerous, the more I like it, unfortunately. But the story that Hillary is talking about, I had the worst injury of my life skiing powder at Breckinridge five years ago. It was a great day until it wasn’t. I was just skiing waist deep powder and then skied into a bunch of buried rocks and just [inaudible 00:44:05] forward and broke my neck. It was hard. But really, with every injury, I think there’s stuff that you can learn. With that, fortunately, I was able to avoid a neck fusion surgery. I was a really good patient. I was in a neck brace for like six months, so wasn’t really doing so much.

Josh Emdur:

But looking back at it, would I not want that injury under my belt? The answer’s no. That injury, we all learn from these challenging parts of our lives. So, with that, I learned really to be humble and grateful for our health because it can all change in just an instant. You can be having a great day skiing powder to not even able to move in just a blink of an eye. I also learned that there’s other things to keep you busy. So really got into reading, got into… I found a love in remote control cars and was building remote control cars and racing them at a track. It was really fun. Got into video games. I haven’t really done any of those since I recovered from the injury, but it wasn’t bad.

Josh Emdur:

Probably another big kind of… Probably the biggest epic adventure I ever had was, on my first big wall climb in Zion National Park, climbing a route called Space Shot and was climbing with a friend of mine and really kind of underestimated kind of the efforts. The amazing thing about Space Shot is it’s a overhanging wall, and it’s really committing because once you get a couple pitches up, you can’t repel back down because it’s so steep that when you repel, you’re just dangling out in space, probably hence the name Space Shot.

Hillary Allen:

Yikes.

Josh Emdur:

So we were climbing in a group of I think four people, which was just a bad idea, a bad plan. I finished the pitch that was really committing, where we couldn’t retreat. Find out that the other two people who had all the supplies, all our water, all of our food, all of our warm clothes decided to turn around.

Hillary Allen:

Oh, no.

Josh Emdur:

So my partner at the time, a much stronger climber than I was was like, “Oh, no big deal. We’ll just top it out and finish it in a day.” So I was like, “Well, I guess that’s the plan. That’s what we’re doing.” We ended up not finishing it in a day. We ended up being totally exhausted, dehydrated, hungry, cold 150 feet from the top of the rim on the sole of a ledge called Earth Orbit Ledge. At the time, we thought it was a great idea to rest for a little bit to kind of get the strength to finish the climb. But as soon as we stopped, we got so cold and stiff that there was no way that we were going to get moving again.

Josh Emdur:

So we hunkered down for the night. We put the ropes over us and just cuddled and were really, really cold. The worst part of that is our van and our friends, they could see us just down-

Hillary Allen:

Oh my God.

Josh Emdur:

… whatever, 2,000 feet below us from the road. But here we were really orbiting the earth on this ledge. I have asked myself a really… I’ve never been so cold in my life. Fortunately, we made it through the night, the next morning. It was in March in Zion. So it was kind of drizzling rain, sleet on us. The next morning. Fortunately, the sun came out, and I kid you not, I’ll never forget… This was over 20 years ago now. I’ll never forget the feeling of that first sunbeam kind of hitting me because it was like, “You know what? I’m alive, and I feel the heat from that one sunbeam.” We got up, and we finished the climb, and we made it down. But it could have very easily gone the other way.

Josh Emdur:

So big lessons. When you’re on the mountains, don’t get separated from your gear. Have better plans. Have friends that don’t bail, really trust your team. Carry good communication. I mean, nowadays with satellite communication, it’s really irresponsible to go out in the big mountains without a way to call for help and let people know that you’re okay. So a question that I always get as a doctor is like, “What do you have in your first aid kit?” It’s satellite communication or a cellphone. Because when things go wrong in the mountains, sure. It’s nice to have a bandaid, but get out of there. Make sure people know where you are. Apply pressure.

Hillary Allen:

Oh my God. I love that.

Josh Emdur:

It helps. Yes.

Hillary Allen:

I love that. That’s good. Oh my gosh. Those big adventures, I mean, yeah, I mean, I think it’s part of the grand jury of it that appeals to us. But it’s also just makes me feel so small and appreciate the small things. That’s what I love about even when the seasons change, running in the cold, and then you get home, and sometimes you just have the screaming barfies in your feet and in your hands. But then you want it to stop, but then you endure, and then at the end of it, you get to have that warm cup of coffee, and it’s just those little things.

Josh Emdur:

Well, what it is really, it’s like that feeling that you’re alive. It’s like that discomfort. So much of our society is trying to isolate us from the discomforts of being human but really embracing that, embracing that, “You know what? If you push too hard or you do this, you get hurt, that’s that line that we’re choosing to run on.” It’s exciting. It can be healthy. But it can also be very unhealthy. Going back to adventure sports, there’s no doubt in my mind that they’re addictive. It’s a drug. Going back to the neurochemistry behind it, you just get used to… Once your brain is used to one dose of all those happy chemicals and endorphins, the next time, it’s just looking for an even bigger hit of it.

Josh Emdur:

So just keeping that in mind. I like there is balance there, looking at amazing athletes like Alex Honnold, other people who are in that space, it goes back to that dark side of passion that the greats are… They don’t lose sight of it. You can’t lose the fear. You can’t lose the respect for going for a mountain run where you aren’t going prepared, especially in the Alps. The Alps are no joke. I’ve had some amazing ski adventures, skiing the glaciers in the peaks of the Shamini Region. I appreciate that if I were to spend any significant amount of time there, especially when I was younger, I probably wouldn’t be here doing that podcast with you. It’s a dangerous game, and there, it is important to have that balance and to never lose the respect.

Hillary Allen:

Yeah. Well, I’m super glad that you’re my doctor because we can talk about all of these things. I’m glad that, through my setbacks and injuries, I’ve learned an immense amount about myself, but also about yeah, just what balance looks like for me. I think, yeah, we’ve had many good conversations about this, and hopefully, I mean either… I mean, it’s different for everyone. But it’s important just to have someone that you can talk to about that. I think my final question for you today is just to kind of wrap up things with SteadyMD. I think it’s been the feature that, I mean, I’ve used… whether I’m racing internationally, and I’m constantly on the move, and it doesn’t have to be with racing, but if someone has a busy job and they’re traveling all the time and something pops up, it’s wonderful to be able to have access to a doctor. So how can people get set up with SteadyMD or-

Josh Emdur:

Thanks for asking. So I’m about two and a half years into this. Really, what we offer is a personal doctor online who’s aligned with your life and has time for you. So you can check out our website. It’s www.steadymd.com, and we have a matching quiz, which is really, really neat because what it does, it just takes a couple of minutes. But really, what it does is it matches patients with doctors who have similar interests, and there’s really no other service in the world that I know is doing anything like this. I’m getting matched with the doctor. Then from there, you have an initial visit, which is done via video call. Then from there we have a HIPAA secure messaging app to kind of keep the conversations going, and we’re able to order medications, labs, imaging, and then really be that team member for athletes. So when there is something that comes up that does need to be seen in person, we get them in to see the right local specialists.

Hillary Allen:

Yeah. I remember the moment that I broke my ankle, you were the first person that I called. I mean, not only… Obviously, your friend, Dr. Josh, dah, the nickname. But yeah, you got me right in to see the specialist that I needed to, got my ankle fixed right up. So-

Josh Emdur:

That was not a good day. Again, all these injuries, and we’re all human. When you’re pushing the line and sports with life, having a doctor on your team to make sure that you’re doing it in a healthy way is what we’re all about.

Hillary Allen:

Well, thanks so much for being on the podcast today. It was such a pleasure chatting with you.

Josh Emdur:

Thanks for having me, and hopefully, we’ll be able to share some trail miles in the near future or some skiing or other adventures.

 

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