February 25, 2025 • 60 mins
The discussion focuses on understanding and improving Black men's health through a community-driven approach to wellness. We explored health challenges specific to Black men alongside the importance of holistic living. Dr. John Vassell provided insights into the medical landscape while fostering awareness of the social determinants affecting health.
• Need for community support in navigating health
• Focus on holistic health rather than just ailments
• Understanding how social determinants impact health outcomes
• Importance of proper diet and exercise
• Effective communication with healthcare providers
• Proactive measures for managing common health issues
• Encouragement of cultural identity in dietary choices
• Building a framework for better health management
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Grantley Martelly (00:11):
This is the Real Health Black Men podcast,
where we empower men to takecontrol of their health.
We provide vital informationand build community support.
Join us as we discusseverything from major health
challenges to mental wellness tophysical fitness.
So if you're ready to level upyour health and your life,
you're in the right place.
(00:31):
Let's get started.
Welcome to Real Health BlackMen.
This is a space where we talkabout things that matter to us.
We're building a communitydedicated to empowering black
(00:51):
men to take control of ourhealth.
We're bringing you vitalinformation, cutting through the
noise and giving you the realdeal on everything from major
health issues to mental wellness, physical fitness and
everything in between, becausewe know that real change happens
with support, and that'sexactly what we're here to
provide.
So this is our first fullepisode, and I'm so glad that
(01:15):
you're joining us.
My first guest is Dr JohnVassell, a doctor of internal
medicine, and he's going to giveus an overview of health,
healthcare, healthy living as itpertains to us, and you don't
want to miss a minute of it.
I promise you that you willenjoy this episode and that you
will learn a great deal from him.
So thank you for listening andshare this with a friend or a
(01:39):
family member and help us getthe word out and help us build
our listenership so that we canbe a great support to each other
and we can make sure that wehave the information we need to
take control of our health andto live our life to the fullest.
Today we have the distinct honorof welcoming my friend, dr John
Vassell, an esteemed physicianwith an incredible career
(02:02):
spanning many decades.
An esteemed physician with anincredible career spanning many
decades.
Dr Vassil is an internalmedicine physician in Seattle,
washington and a clinicalassociate professor and
associate dean at the WashingtonState University Elson S Floyd
College of Medicine.
His resume is truly impressive.
He has held leadershippositions at some of the largest
(02:23):
healthcare systems inWashington State, including
Providence, seattle MedicalCenter, swedish Health Services
and president of the Minor andJames Medical Group.
Beyond his clinical experience,dr John has been a tireless
advocate for improving healthaccess and quality for all.
You'll have to look him up tolearn of all the awards and
(02:45):
accolades he has received.
I know Dr John Vassil as themedical voice for the Tacoma
Pierce County Black Collective,where his weekly medical talks
has been transformative inhelping our community members
learn to live healthier lives inclear and simple terms.
So today I'm excited that he'sjoining us and we'll be delving
(03:07):
into Dr Vassell's insights on arange of topics, from navigating
the healthcare system toimproving health outcomes for
Black men.
So let's get right to it andwelcome Dr John to Real Health,
black Men.
Dr. John Vassall (03:22):
Okay, thank you.
Thanks for having me.
I'm a graduate of theUniversity of Washington School
of Medicine.
I did my internal medicinetraining in Atlanta, georgia, at
Emory, at Great MemorialHospital.
I initially started in privatepractice in Decatur, georgia,
came back to work at GroupHealth and then started in
(03:45):
private practice with my bestfriend and roommate, my medical
school roommate Rayburn Lewis,and we practiced together for a
number of years, so I have someexperience both here and in the
South, which I think isimportant because I've dealt
(04:06):
with all kinds of populations interms of my medical training.
However, I'm rooted here in thePacific Northwest and I've been
here for a very long time, so Ithink that's a good background
for people to have in their mind.
Grantley Martelly (04:19):
Well, thank you, Dr John, for that.
Yeah, I'm sure the context isgoing to really help us as we
get into our discussion.
Now I know that you have somespecific information that you
want to share with us and wehave some questions we want to
get through.
This is a big topic.
We're hoping today that we cantouch on some aspects of it, but
we may have to do a follow-uppodcast or maybe a couple as we
(04:40):
go along, because the topic ofblack men's health, to me, is a
significant topic.
So I want to begin to do it Goahead.
Dr. John Vassall (04:50):
Yes, in that regard, I think sort of in terms
of setting the stage.
What I'd like to people tothink about is health and black
men's health, and make a littlebit of a distinction between
health and medicine and medicalcare.
So when I'm talking abouthealth and when we explore
health, we're talking about howto live your life in a healthy
(05:14):
way, in a fulfilling andsatisfying way, and not really
think about it in terms ofdiseases and pills and
supplements and those kinds ofthings.
Think of it in terms of how doyou live your life to its
fullest.
So that's what we're going tobe talking about when we talk
about health, talking about theability to live your life at its
(05:37):
fullest, not impaired bydisease or illness or injury.
And even if you do have thosethings disease, illness, injury
how do you manage those thingsin such a way that you can be
healthy, health again, beingliving your life to its
satisfying fullness.
Grantley Martelly (05:59):
Living to its fullest?
Yes, and that's what we want todo on this podcast is help men
to learn to live to theirfullest and take charge of their
health.
So let's begin by this topic of.
We know men's health isimportant.
We want all men to be healthyand live their life to their
fullest.
But why do you think it'simportant that we talk about
(06:21):
Black men's health as a separatecategory of overall men's
health?
Dr. John Vassall (06:27):
I think it's important for people to focus on
themselves and where they areNow.
That's not to say that weshould be necessarily looking at
men in silos, women in silos,because health is really a
communal thing.
It's hard to be healthy inisolation.
You know health is really acommunal thing.
It's hard to be healthy inisolation.
You know health is part ofhealth is how do you communicate
(06:52):
with other people.
But you know you have to focuson yourself first so that you
can be healthy and you can be ina position to help other people
, including the women in yourcommunity.
Very often, when we talk aboutwomen's health, people think of
reproductive health, they thinkbreast cancer, they think of
those kinds of things.
(07:12):
When they think of men's health, they think of prostate cancer,
heart disease, those kinds ofthings, diabetes, and I think
those things are important andwe can't address them unless we
focus on them.
However, we need to thinkholistically about how all those
(07:34):
things interact and how being amale in this society interacts
with your health.
Now, what I mean by that?
If you're a man in this society, there are certain expectations
and even certain stereotypes.
If you're a black man, there'scertain expectations and certain
stereotypes, and so one of thereasons for focusing on black
(07:56):
men's health is to be aware ofhow those expectations and
stereotypes may affect yourhealth.
Grantley Martelly (08:06):
So let's unpack that a little bit.
We know that, and science hasshown that there is certain
diseases or certain things thataffect people in the Black
population more than in thegeneral population.
We know for Black men also,there are things that affect
Black men more in the Blackpopulation than in the general
(08:27):
population at large.
So let's begin to talk aboutsome of those things.
In terms of health and youframe them as a doctor is where
should we be focusing and whatare the things that we should be
giving attention to when wetalk about health?
Dr. John Vassall (08:44):
for men.
Yeah, thanks for that question.
Here's what I want to makeclear that many of the problems
and diseases and illnesses andtraumas that affect black men do
not affect them because theyare genetically different.
(09:05):
You know, race is not genetic,it's not biological Race and
that doesn't mean it's not real,it's not genetic or biological.
It's a social and economicconstruct and races are
different if you go from countryto country.
But in this society they'vedecided that Black people are a
(09:26):
separate race.
But that does not mean that weare separate genetically.
It does not mean that we'remore genetically prone to some
of these illnesses or diseases.
I'll give you an example.
Now let's start with COVID-19.
It was well known that theimpact of COVID-19 was greater
(09:49):
and the death rate was greaterin the Black community and in
other communities Hispaniccommunity, native American
community than in thecommunities at large.
Does that mean that we aregenetically different?
No, and in fact there were somepeople who were trying to make
the case that that there weredifferent receptors in the nose
(10:09):
that make the virus stick morein black people, which actually
is utter nonsense.
They're getting COVID andgetting more ill from COVID.
That has to do with the socialaspect of being Black.
Many Black folks and Black menare in jobs that expose them to
(10:34):
strangers and strangers.
If you're in your family in acontrolled environment, you're
relatively safer than if you'rein an environment where you're
coming into contact with a lotof strangers.
For instance, if you're a busdriver, if you're a manual
laborer, with other peoplecoming and going, if you're in a
(10:58):
service job, those are thekinds of jobs where you're often
in contact with a lot ofstrangers, many of whom can
carry this disease.
So it's not a genetic thing.
It's your circumstances, yourwork environment or perhaps your
community environment thatmakes you more at risk.
(11:18):
And then if the society hasbeen such that you've been
unable to preserve your health,so you have heart disease,
diabetes, then if you becomeinfected you're more likely to
die and become very sick.
So those are the kinds ofthings that are social, that put
Black men at risk and Blackwomen at risk for diseases.
(11:39):
That is not genetic.
Grantley Martelly (11:42):
Yeah, we call those the social determinants
of healthcare, Right?
One of the things that has alsocome out in this has also been
access.
People are talking about accessto healthcare.
Can you talk about that alittle bit, about how that may
be showing up also in where wesee these things about?
(12:04):
Certainly certain environmentsor certain areas have better
access to health care thanothers.
Dr. John Vassall (12:12):
Yes, I want to talk first about why we need
access, and that's about healthin the larger picture.
Let's talk about some of thedisorders and diseases that we
see commonly in black communityand in other communities, for
instance, okay, hypertension isvery common among all people of
(12:32):
all races.
It's particularly common inblack community.
More so, it's more common inblack men, probably caught the
cause of dietary issues such assalt intake, general health
issues in terms of exercise andphysical movement, but also this
(12:54):
is where access is important interms of being able to be
diagnosed, because it used to becalled the silent killer.
Hypertension is something thatyou don't know that you have
unless you're evaluated andsomebody checks your blood
pressure.
So people can go through yearsand years and years of having
(13:14):
hypertension, suffering itsconsequences, but because they
have not had access to diagnosis, they're not aware of it and
therefore they don't get ittreated.
So that's one example Diabetes.
Diabetes is a situation wherepeople have high blood sugar and
(13:35):
the reason their sugar is highis because their insulin is
either lacking or is ineffective, and insulin is a hormone that
allows the body to process sugar.
Similarly, people can havediabetes and not be aware of it
until a certain point where itbecomes symptomatic.
There are people when you first.
(13:57):
When a person first developsdiabetes, they have no symptoms,
but then over time they maystart feeling themselves thirsty
all the time, drinking a lot ofwater, urinating frequently,
and by the time they'rediagnosed they may already be
suffering organ damage so again,access to medical care is
important.
(14:24):
information, and goodinformation about your health is
important, because you wouldn'tknow what to ask or what to
look for if you're not aware ofwhat's important to keep
yourself healthy.
Grantley Martelly (14:32):
That's a good transition to my next question,
which was you know, some peoplehave the idea that hey, if it
ain't fixed, don't break itright.
Yeah, why do I need to go tothe doctor if I'm feeling fine?
Nothing is bothering me, I'mnot in pain.
You, yeah, why do I need to goto the doctor if I'm feeling
fine, nothing is bothering me,I'm not in pain?
Why should I go to the doctoror the dentist?
Okay, I hope.
Dr. John Vassall (14:51):
I've already partially answered that question
, and it is that you say if itain't broke, don't fix it, but
you don't know if it's brokeunless you look.
Okay, and so there can be somethings that are going on with
your health that you're notaware of unless you actually go
in and get evaluated.
(15:12):
Now, going in and gettingevaluated is easy to say and not
often as easy to do as it is tosay, particularly to Black men.
There are many reasons why andlegitimate reasons why Black men
are concerned about gettinginvolved with the healthcare
system.
There certainly has been somesordid history about what has
(15:34):
happened to Black folks inmedical environments in the
United States, but we have toevaluate that in the context of
the present and in the contextof where we are.
So, yes, people are concernedabout getting into a medical
environment, which is one reasonwhy people should do some
(15:56):
research before they becomeinvolved in the medical
environment.
Who's a good doctor?
Sometimes you have to go bywhat your friends and relatives
have experienced, because veryoften it is, it's your
experience.
So you may be told that Dr Xhas a great resume, has been to
(16:17):
the finest medical schools, etcetera, but that doesn't tell
you how he may treat.
He or she may treat you, butthat doesn't tell you how he or
she may treat you.
So while those things areimportant, it's also important
to know how your friends, yourrelatives, your family, your
community has been treated inthat system or by that physician
(16:38):
.
And once you feel comfortableenough, then you can engage in
that, in that with that person,with that system.
Grantley Martelly (16:47):
Yeah, I mean that that that's been some of
the discussion that has come up.
I've talked to people abouthealth.
Black men's health is about,you know, feeling comfortable
with a physician or with aclinic that they're going to,
and some men has expressed thatthey have not felt that way and
in fact, some of my friends havetold me I've changed doctors
(17:09):
because the one I was going towasn't treating me and that made
me feel comfortable and wasn'tanswering my questions.
So, instead of quitting, Iasked around, like you said, and
I found another doctor whorelates to me.
So, as a physician, you'resaying that relationship is just
as important as a technicalknowledge.
Dr. John Vassall (17:31):
Yes, yes, yes, did I say.
Did I say yes, it's veryimportant because if a person is
scholarly and knows everything,but they don't share that
information with you, or theycan't share it with you in a way
that is useful to you orunderstandable to you, then that
(17:53):
knowledge does you no good.
Does you no good?
Ultimately, it's the patientwho has to make the decisions
day-to-day that impact theirhealth.
The physician can give theminformation and ideas and a
pathway but ultimately it's thepatient who has to make those
(18:14):
decisions, and if the patient isnot getting the information and
the pathway from that physician, then that physician is not
doing them any good.
Grantley Martelly (18:24):
Thanks for answering that question.
So my follow-up question tothat doctor is so we go to the
doctor, we find a good relation,we do the tests, we do our
annual physical and we get thisreport back that has a whole
bunch of stuff on it and some ofthem, you know, has the red,
green and yellow lines and stufflike that that tells you if
(18:47):
you're good or not.
But what's the best way for alayperson to interpret those
results that comes back fromthose blood tests or those
physical and blood work that weget when we go to the doctor?
Dr. John Vassall (19:01):
You know that's a great question because
it actually highlights somethingthat has really changed over
the last few years.
When I started in medicine manyyears ago, physicians tended to
hold on to the information.
So we'd get the test, we'd lookat them and we'd interpret, and
(19:22):
some doctors would share themwith the patients, some wouldn't
, some would share what theythought the patient could handle
and would withhold what theythought they couldn't handle,
and some doctors would interpretthe tests for the patients.
And the physicians kept thenotes in their chart and very
(19:46):
often didn't necessarily sharethat with the patient either.
Over the last several years,those two things have changed.
Now very often you can get yourmedical records online through
a secure portal where you signin and you can look at the notes
in your chart.
The most physicians in largesystems will give you an after
(20:09):
visit summary, which is a pieceof paper that tells you what
they did in that particularvisit, what your vital signs
were, et cetera.
And now, particularly if you'reon some of these electronic
health records where you haveaccess to your records, you may
get the test before thephysician sees them.
(20:30):
It automatically gets posted toyour chart and sometimes the
doctor hasn't even seen theresults before you have, which
can be problematic, becausesometimes it's really scary,
particularly when you see thingsthat say they're abnormal or
they're in a red zone and youdon't really know what that
means.
Sometimes something's in a redzone and it doesn't mean
(20:52):
anything except for that thetest is off, and sometimes it's
in a red zone and it's somethingpretty serious.
So unfortunately well,fortunately and unfortunately,
because it cuts both ways, uh,it's it requires you to take
control of your understanding ofyour health in a way that you
haven't had to in the past.
(21:14):
So how do you do that?
To your question, because someof this stuff is really pretty
technical and it would take alot of explaining just to
explain a single test, whereassome of it is fairly
straightforward and it's notthat hard to figure out.
For instance, if your bloodsugar is 200, it's not that hard
(21:35):
to figure out that that's high,it's too high and you probably
have diabetes.
(21:56):
Whereas some things are muchmore subtle, and I'll give you a
personal example, and that isyour cell counts.
You have white cells and redcells and platelets and others.
My white cell count is low,quote, unquote.
Now it's always been lowbecause it's low white cell
counts run in my family andthere's nothing wrong with that.
Then there's nothing wrong withme.
But I've had to convince someof my doctors to stop looking
for a disease.
I tell them look, my white cellcount has been the same since I
was in college.
(22:16):
So now you're going to belooking for something?
Uh, but I?
But I'm at a level where I canunderstand that.
That's hard to explain to a layperson and and even to some
physicians, because that whitecell count is based on the
average of quote-unquote normalpeople, usually normal white men
(22:37):
.
So that's part of the problem.
So I don't want to make thistoo complicated in terms of your
audience.
And how do you deal with thosetests?
The first thing is you have tohave a general understanding of
what these tests mean.
And again, this is one of thosetimes where you really have to
have a physician who can explainthis to you and who is willing
(22:59):
to explain it to you, andunfortunately, sometimes your
visit is so short that they maynot have time to do that.
But you really need to have ageneral understanding of what is
a high blood sugar, what ishigh blood pressure, what is a
low blood count, and that meansa red blood cell count, which
would be anemia, and some of thechemistries.
(23:22):
What's a normal kidney functiontest look like?
Now, you don't have to knoweverything, you don't have to
know all of this, but I thinkit's really good to know some of
these general things Bloodsugar for diabetes, blood count,
particularly for women withregard to anemia, kidney tests,
(23:44):
liver tests, just those broadareas and get a good sense of
what those things mean.
Grantley Martelly (23:51):
So you said something there in interpreting
the results that really cameback to me.
In my own experience I had twotimes that I got my results back
from the lab before my doctorsaw them.
One of those times was when Iwas diagnosed with prostate
(24:13):
cancer.
I received my biopsy scores twodays before my doctor called me
.
Yeah, and I looked at them andI I didn't know everything about
it, but it says 50% werepositive, 50% were negative.
And then I started doing someresearch and I said, well, if
(24:33):
50% is positive and 50% isnegative, that means I have
something.
And then I started looking upGleason scores on my own and
Gleason scores are four, fourand three and three and four.
The point about it is that I hadthat information for 48 hours
before my doctor even called me.
Yeah, there's a lot of emotionattached to that, but so, even
(24:59):
with technology, sometimes,sometimes I think the technology
gets ahead of you in themedical professions.
You know when we get it soquickly that and then the person
is there struggling with whatdoes this mean?
Until they can have thatconversation, like you said.
You know, in my case I wasright.
I did have it and I told mydoctor that and at the time she
(25:22):
said yeah, that happenssometimes you get the results
and we don't even get them untilafter you.
So I couldn't even call you twodays ago and say, hey, grant
Lee here's what was going on.
Dr. John Vassall (25:36):
Yeah, it's a byproduct of our sort of our
technological error and alsosome of the issues around
patients' rights and theirrights to the information.
Patients own the information inthe chart.
You own the information.
The facility, the doctor, thehospital, whoever they own the
(25:57):
chart and the technology aroundthe chart, the electronic health
record, but you own theinformation.
In other words, you're entitledto all of the information in
your medical record.
Now, when you get it, it can beproblematic, because I think
it's actually cruel to givesomebody information with no
(26:19):
context and no training and noinformation to understand it,
particularly when it comes tocancer, which, you know, the
word itself is scary.
Yes, it is patient's right tohave that information, to know
that information, and yet thehumanity of giving it in a way
(26:47):
that preserves the patient'sability to make decisions and to
understand the information.
Grantley Martelly (26:51):
In my case, my two older brothers had had
prostate cancer before me, so Iwas able to call them and have a
conversation with them aboutyou know what does this mean for
me?
But I can think about someperson who didn't have that or
who didn't have that.
You get this information andthey're staring you in the face
and it's like wow, yeah.
Dr. John Vassall (27:11):
Yeah, let's talk about that, that community
thing again and having thatcommunity of support, because
you had that.
Uh, that's really important.
And let's talk a little bitabout family history too,
because that's also you bring upthat point, which I think is
very important.
Family history is what hashappened before and what has
(27:34):
happened to people in your life.
That is not necessarily destiny.
So the fact that somebody inyour family has had this doesn't
necessarily mean that you willget it.
In your case that was the case,but that's not always the case.
So people need not be afraid oftheir family history or
(27:56):
reluctant to find out about it,because it's not your destiny.
But it can be useful in termsof helping you to think about
what you might expect.
Sometimes it is destiny if it'sa genetic problem.
For instance, with some breastcancers there's a gene actually
that's passed down from woman towoman which can lead to breast
(28:20):
cancer.
So that is destiny, but in somecases it's not.
And prostate cancer it's notnecessarily destiny, although it
does raise your chances.
So it's important to know thatbecause that helps you think
about what you should do in thefuture.
So for your sons and yourbrothers and your nephews and
(28:41):
nieces, your nephews, sorrycousins, male cousins they need
to think about screening forprostate cancer in a different
way than somebody who doesn'thave that family history.
And again, that doesn't meanit's destiny, but it's something
that it puts a different levelof urgency for somebody who has
(29:02):
that in their family.
And on the positive side, youhave that support.
You have that support Peoplewho have gone before who can
tell you what their experiencehas been, and that's a lot
different from reading somethingin a textbook.
Yes, it is, you know has been,and that's a lot different from
reading something in a textbook.
Yes, it is, you know.
(29:25):
And so having that, havingthose people, especially family
members, but it doesn't have tobe family, friends, close
associates who can tell you whatyou might expect, I think
that's very important that'svery important.
Grantley Martelly (29:43):
Let's talk about some of the diseases or
illnesses that seem to beappearing very commonly in
people of color and things thatpeople should be concerned about
.
You've mentioned some of themas we've been going through here
.
We mentioned diabetes, wementioned prostate cancer, we
mentioned hypertension.
I was talking to anophthalmologist the other day
and she was telling me you know,there's also some evidence
(30:10):
about glaucoma.
So what are some of the thingsthat we, as people of color,
need to pay specific attentionto when we go to the doctor or
when we cannot our health.
Dr. John Vassall (30:17):
Yeah, great question, because there's so
much to look at and you can goin a thousand different
directions and not necessarilyget anywhere.
So what I like people to thinkabout again is health as being
able to live your life in a mostsatisfying way, being able to
(30:39):
accomplish the things you wantto accomplish in your life, and
part of that is being able tomake sure you're in physical and
mental condition to takeadvantage of the opportunities
life offers you.
I think people should firstlook at those kinds of things
(31:00):
that might be common andpreventable, because there's no
point in worrying aboutsomething that's uncommon and
you can't do anything about.
But there are certain thingsthat are common and can be
either prevented or managed insuch a way that they don't
impact your life.
So let's start withhypertension, that's, elevated
(31:25):
blood pressure Extremely commonOne in three at least adults.
If you stop any three people onthe street, one of them has
hypertension.
So that's how common it is.
Attention, so that's how commonit is.
And part of it has to do withlife processed foods, lack of
(31:53):
exercise, obesity, et cetera, etcetera.
So you may not be able toprevent yourself from getting it
, but you certainly can manageit by managing those things.
Now, if you so, one, it's verycommon.
Number two it's very manageable.
You know it's manageable withlifestyle changes, watching your
weight, reducing salt intake,exercise and, if necessary,
(32:15):
medication.
Number three if you don'tmanage it, you can be in big
trouble Heart attacks, strokes,ischemic disease, which means
that you have poor circulation,which can lead to amputations,
those kinds of things.
So it's common, it can beserious, it can be managed.
(32:38):
So those are the things I wantyou to look at.
Diabetes common, serious, can bemanaged.
The incidence of diabetes isreally escalating, in part
because of the incidence ofobesity, because type 2
(32:58):
diabetes's highly linked Type 2diabetes is highly linked to
obesity.
It's inability to manage bloodsugar.
If it's not diagnosed andmanaged properly, it can lead to
heart disease, heart attacks,strokes, blindness because of
the blood vessels and the eyesbeing involved, amputations
(33:21):
because of lack of circulation,kidney disease, kidney failure
and dialysis.
So those are some of the thingsthat can happen if it's not
managed.
So, once again, you need to getchecked, have your blood sugar
checked and if you're headingfor diabetes, you need to be
aware of that so that you canmanage it.
(33:42):
It's common, it's manageable,it's serious if it's not managed
.
Heart disease Common right.
It can be serious and it can bemanaged.
Often a heart disease kind of acardiovascular disease we're
(34:03):
talking about.
There are various kinds there'svalve disease, there's
congenital disease that peopleare born with, but we're mostly
talking about atherosclerosishardening of the arteries and
leading to heart attacks, oftencaused in part by elevated blood
cholesterol and other fats inthe blood.
So calm it.
(34:23):
I can't say easily managed, butit can be managed.
How do you manage it?
With cholesterol-reducingmedications if necessary, but
first a plant-based diet, maybewith a little bit of animal
protein if you need to.
But you know there's certainlyvegans, like my sister, who
don't eat any protein whatsoeverand she's perfectly healthy and
(34:47):
she's a weightlifter, by theway.
So you can be very healthywithout animal protein, but that
doesn't mean you can't have any.
But your diet should beprimarily plant-based and
exercise, because that burns offthat excess fat, that excess
cholesterol, and keeps yourblood vessels clear and keeps
(35:07):
your heart pumping properly.
So again, with regard to heartdisease common, manageable,
serious if you don't manage.
Okay.
Grantley Martelly (35:18):
Yeah, that's a good overview, Thank you, and
I like.
I like your, your as far as incommon you know, manageable and
we can do something about it.
You and you got into theimportance of diet and exercise
there as well as part ofmanaging some of these diseases.
So let's talk about diet andexercise, particularly because
(35:41):
you do a really good explanationon what exercise is.
When you say that it's notnecessarily becoming an Olympic
athlete or becoming a CrossFitcompetitor, what do you mean by
exercise for the common personand what they can do to benefit
their health with good exercise?
Dr. John Vassall (36:03):
Yeah, that's a great question.
Thanks.
First of all, I think ofexercise as movement.
So just think about it asmovement.
If you're a slug staying in onespot, not moving, that's not
exercise.
That's the thing.
And sometimes we had a questionon the Black Collective, if you
(36:25):
remember, regarding somemachine that moves for you.
Right, that's not exercise.
So if you're getting some kindof vibrating or torquing machine
that moves you around, that'snot, in my opinion, exercise.
Exercise is movement,self-movement.
If you're not moving, you'renot exercising.
(36:46):
And think of getting enoughmovement to keep your joints in
shape, your muscles in shape andyour heart in shape.
So there's what they callaerobic exercise, which is like
running and swimming and thosekinds of things.
It gets your heart and yourlungs working together toward
(37:08):
their capacity.
So those kinds of exercises,that kind of movement walking,
running, doing stairs, swimming,those kinds of things are very
useful.
We talk about walking a lot,because walking is probably the
best kind of exercise, in thesense that most everybody has
(37:33):
learned how to walk, they knowhow to walk, unless they're
impaired, but they can walk.
You don't need any training,you don't need any special
equipment, except for maybe somegood shoes if you're walking
outside.
So walking, if it's a safeenvironment, has got to be sort
of the rock bed of exercise, youknow, and the faster you walk,
(37:55):
the more you approach running.
But you don't have to run.
Walking briskly and running aresort of rock bed of movement
and exercise.
So for people who can walk,that's great.
And if you can walk briskly andwhen I say briskly that means
(38:15):
you get your respiratory rate uphigher than it is at rest and
you get your heart rate up thenthat's an excellent exercise In
terms of muscular exercise.
I like people to think about whyare you doing this?
You know.
Why are you lifting weights?
You know.
Why are you doing push-ups?
Why are you doing sit-ups?
(38:36):
It's not so that you can domore push-ups and more sit-ups
and lift more weights.
It's so that your muscles arein shape to move you when you
need to be moved and to move youin a way that is useful for you
to maximize your enjoyment oflife.
I like people to think aboutthat.
(38:57):
If you're going to do push-ups,that's great.
It'll get your arms stronger.
But while you're down there onthe floor, roll over on your
back and try to get up off thefloor without using your hands.
You know that's another form ofexercise.
It's not what they teach you inthe gym form of exercise.
(39:20):
It's not what they teach you inthe gym.
But sometimes you may need toget up off the floor and your
hands may be impaired, your armsmay be impaired, you may have
injured yourself.
So think about how can I usethis exercise in the real world.
You know, going up and downstairs.
Forget that elevator.
How about walking up one flightand cashing the elevator from
there?
Because there's going to be atime when that elevator is not
(39:40):
working and you're going to needto use the stairs.
So if you haven't been on astaircase in a year, you may
have a problem.
So you need to think about howdoes this exercise help me?
You're using the stair stepperin the gym, but think about the
real stairs and walking up anddown real stairs so that when
you need to do it, you can do it.
(40:02):
So when I think about exercise,I think about movement and I
think about how can I use thisin the real world, in my real
life, to make my life better.
Grantley Martelly (40:12):
And there has been some research and doctors'
advices that sometimes exercisecan help reduce the likelihood
of some of these diseases wetalked about before developing,
like if you're getting intopre-diabetes you may exercise
things like that.
Dr. John Vassall (40:31):
The importance of exercise in our life.
Grantley Martelly (40:33):
Our sedentary world.
As we get more technologicallyadvanced, everything seems to be
going towards keeping us frommoving.
Dr. John Vassall (40:41):
Right, right, Let me say two things about that
, because that raises two points.
One is, yes, aerobic exerciseexercise where you get your
heart going and your lungs goingalso helps.
This is not technically correct, but for the visual it helps
flush out the stuff in yourblood vessels and that excess
fat that's collecting.
(41:02):
So that's one of the reasonswhy I'm simplifying and
oversimplifying, just so peopleunderstand that that kind of
exercise, aerobic exercise,helps keep your heart, lungs and
your blood vessels clear andfunctioning and that's why it
helps with metabolic diseaseslike diabetes and that's why it
helps with heart disease.
(41:25):
Now, with regard to the muscularexercises that I talked about,
sometimes you need to use yourmuscles in a way that you were
not aware of.
People know that I'm a bigcyclist.
I like to bicycle a lot.
I ride sometimes hundreds ofmiles.
I've been to Portland and backand on a weekly basis.
(41:47):
When I get on the bike Iusually ride 10 or 15, 20 miles
a day, especially when theweather is nice.
But sometimes stuff happens.
I crashed about six years agoand fractured my femur.
Now the thing about that is andI got a surgically repaired on
by now but there was a time whenI had to use muscles in a
(42:09):
different way.
I had to be able to move aroundwith a broken leg and if you
are not in good physical shape,that becomes very difficult.
So one of the reasons to be ingood physical shape is when you
find yourself in a situationwhere you have to use your
muscles in a different way.
You may have to use crutches,which means you need more arm
(42:30):
strength than you usually use.
So, again, that's one of thereasons for doing those push-ups
, so that if you need to useyour arms for crutches, you have
that tricep strength to helpyou.
So again, think about how youcan use this in the real world
(42:51):
and stay in shape for thosetimes when you may not, where
you may need to call on thatcapacity that you haven't had to
call on for physically yeah, Imean that.
Grantley Martelly (43:03):
That resonates with me because when I
had my first back surgery and,uh, I was having really bad
problems with my leg I mean mymy leg actually actually stopped
moving at one point, literallystopped moving at one point, and
I learned in my recovery theimportance of having a good core
(43:24):
.
I found out I had muscles inthat recovery that I didn't know
that I had.
Yep, it was amazing, I wouldtell my wife.
I said I didn't even know I hadmuscles in these places, you
know, just to get up out of abed or cheer, right, I was
feeling things that I hadn'tfelt.
(43:45):
But my doctor said to me if youhad not been going to the gym
and relatively good physicalshape, your recovery would have
been much slower and much moresevere.
Right, your recovery would havebeen much slower and much more
severe.
He says you're learning to usemuscles that you have been
developing.
You're not trying for the firsttime and it was really
important to me because evenwhen I was recovering he said
(44:07):
I'm going to get you back intothe gym as soon as possible
where you can start not liftingstuff but walking on a treadmill
and getting some resistance sothat you can keep your core
built up, because for your backto work properly, your core has
to be good.
That's right.
I learned so much from that.
It was amazing.
Dr. John Vassall (44:28):
Yeah, and one of the things that we've been
doing in medicine more recentlyis what we call prehab.
If somebody's, for instance,going to have knee surgery or
they're going to have hipsurgery, it's elective, we know
we can schedule it out.
We actually start teachingpeople, for instance, how to use
the crutches before they needthem, their joints.
(44:56):
We have them start learning howto walk with just one leg and
crutches before they actuallyare required to do that because
of the surgery.
So that's another way ofthinking about exercise is
preparing you for theunpreparable.
That's right you learn hardware.
Grantley Martelly (45:12):
Yeah, you said something before in one of
our meetings too that I thoughtwas so important and I didn't
think about it until you said it.
But this thing about oursocialization and our family and
where we are from, aboutsometimes our health is affected
by our family, our brain, oursocialization, and the example
(45:37):
that came to me is like, youknow, I love to eat ribs.
I love to eat ribs, but it'snot always the best thing for me
to eat, right?
Or my family has certaintraditions of you know, macaroni
pie, which is macaroni andcheese, or things like that that
we love to eat around theholidays.
(45:59):
But sometimes thosesocializations, if we don't pay
attention to them, can affectour health.
So talk a little bit about that.
Dr. John Vassall (46:09):
Yeah, that's a very important point.
Our relationship to food is animportant one point.
Our relationship to food is animportant one and food is not a
whole bunch of proteins andvitamins and carbs and all that.
Otherwise you could just lineup a bunch of pill bottles and
take a bunch of pills and callit good, and I don't think
(46:30):
anybody's going to do that.
You know food is cultural.
You know food is almostreligious.
You know food is a sharedexperience, is experiential.
Uh, food is identity.
You know I mean I'm from, myfolks are from Jamaica, and you
know saltfish and ackee.
(46:52):
You know green banana andplantain in the morning and
bammy.
I mean that's part of myidentity.
So you can say that for manycultures they were talking about
sake, wine, rice wine that theJapanese drink on the news this
(47:12):
morning.
You know sushi tacos.
You know, you just say it andyou know an image comes to your
mind when you say sushi tacos.
You know you just say it andyou know and an image comes to
your mind when you say sushi,you think of a certain thing.
When I say saltfish and ackeeand bammy, a certain image comes
to my mind.
Yeah, when you say grits andgravy, that certain image comes
to your mind.
So, uh, your food is part of whoyou are and you can't tell
(47:38):
people just eat a Mediterraneandiet when they're not
Mediterranean people.
You know, you hear that theMediterranean diet is the best
heart diet.
Well, it is the best heart dietfor people who live in the
Mediterranean.
So how do you take thosecultural underpinnings and
(47:58):
inform them with what can keepyou healthy?
So, again, it's not a matter ofsaying, well, I'm never going
to eat pork, I'm never going tohave ribs.
That's not going to answer thequestion of how do I incorporate
(48:20):
health into my identity andlive the kind of life, the
satisfying kind of life, that Iwant to live?
So be aware that too much meatprotein is going to be
problematic.
Too much salt is going to beproblematic.
So that means you are going tohave to reduce, maybe, the
amount that you're eating andyou may have to season it a
little bit differently so you'reaware of your blood pressure,
those kinds of things.
But that's the kinds of thingthat people need to do Not give
(48:43):
up your identity and yourculture, but be aware and be
informed about how to modifythose things.
I'll give you an example.
Like I said, I trained inAtlanta.
For example, when I was in,like I said, I trained in
Atlanta and there was a smallblack hospital where I practiced
and we used to, back in thegood old days when we had our
(49:04):
medical staff meetings, thepeople in the kitchen actually
cooked us dinner and we haddinner around those meetings.
Well, the dietician one daydidn't tell us that she was
going to go to a low-salt,two-gram sodium diet.
She changed the way sheprepared the food for our dinner
Because we're black doctorsright, we're black men for the
(49:27):
most part, and we're eatinggrits and gravy and ribs and
everything.
She didn't tell us until afterwe had finished everything and
we're looking at the plates andthen she said guess what?
I modified this so that it'slow salt, low fat.
Nobody noticed.
They'd noticed how good it was,but they didn't actually notice
(49:51):
that she was able to keep,preserve that culture and
preserve that food and thatunity and that brotherhood that
we felt, without negativelyimpacting our health.
So it certainly can be done.
Grantley Martelly (50:06):
Yes, it can and we need to pay attention to
it.
I'm from Barbados, my wife isfrom Bangladesh and all for
those cultures cultures foodlike Jamaica is, I mean, is
amazing.
Right when I go to mymother-in-law's house, I mean
she had food from the time youwalk in the door and the time
you tell you can smell it likeout in the parking lot and it
(50:32):
joins us together.
But I think what we're tryingto say, we've got to moderate it
and make sure that we're takingcare of our health, not just
abandon who we are just becausewe're afraid of getting sick or
something like that when youthink about men's health, you
(50:55):
still have to think about it inthe context of community, and
you have to think in context ofthe women in your life too.
Dr. John Vassall (51:12):
So don't isolate yourself in a bubble of
men's health, thinking that youcan do that without help from
the women in your life.
Grantley Martelly (51:16):
Ok, I'll leave it at that.
Yeah, I mean that's important,right, because I keep getting
back to this.
But I'm in a support groupblack men around the country and
so many times it comes up aboutthe importance of wife and
caregivers.
Some of the men talk about howimportant it is to have their
wives with them when they go tosee their physician and they go
(51:39):
to get report.
They talk about the supportthey have when they come home
and they have to deal with theissues.
So, yeah, I mean, even in oursupport group that is all men
the importance of spouses andwomen and caregivers keep coming
up as a significant part ofmaintaining our health.
As we turn the corner here, Iwanted to go back to one
(52:03):
question and then I want to askyou to wrap it up.
One of the questions that cameup to me that somebody told me
to ask was how do youcommunicate with your physician?
What's the best way tocommunicate with your physician
when you feel as though you'renot being heard or your
questions are not being answered?
Dr. John Vassall (52:24):
You know that's a great question and I
have to give it just a moment ofthought, because what comes to
mind first of all is what wesaid toward the beginning, and
that is first finding thatperson that you can communicate
with, and not all doctors aregood communicators.
(52:45):
I think people know that.
So that's where you have tostart no-transcript, although
(53:22):
you may have to do that fromtime to time.
But again, you don't want it tobe a confrontational, uh
relationship.
The sooner you make that clearthat you two are on the same
page, the better it is.
You know, sometimes I have thisidea in my head and sometimes I
(53:45):
actually tell the patient thatwhen I'm dealing with an issue
with the patient, with a disease, an illness, an abnormal lab
study, and the patients might begetting a little excited and
agitated, emotional, I said youknow what?
There's three people in theroom, three entities in the room
there's me, there's you andthere's the problem.
(54:08):
So let's you and me deal withthe problem together.
It's not you dealing with me,it's not you dealing with me,
it's not me dealing with you.
You and me together are goingto deal with this problem.
So if you physician can do that, can separate themselves, and
(54:29):
if you can separate yourself inthat dynamic and say, here,
we've got a problem here andboth of us are here for the same
purpose and that is to dealwith this problem.
So now let's address that.
Grantley Martelly (54:47):
Thank you.
It's good to hear those wordscoming from a physician.
Right, you deal with it, andsome people are intimidated by
their doctors.
So thanks for the advice.
So, as we look to wrap this uptoday's session, what takeaways
or action points do you want ourlisteners to take with them as
we close this session out?
Dr. John Vassall (55:09):
Yeah, I think it's.
People are, I think, kind ofused to hearing health
discussions and so it's easy tojust kind of listen and turn off
podcasts and keep going aboutyour business.
But what I'd like people to dois think very specifically about
what you can do yourself,something you've specifically
(55:33):
you've heard and a specificaction that you can take to make
your health better, or aspecific idea or understanding
that you've come away with.
Because if you don't getspecific, you're really not
going to actually do anything.
It's like they say, the journeyof a thousand miles starts with
(55:54):
a single step, and a step is aphysical action.
You actually have to dosomething.
So, rather than thinking broadterms oh yeah, I want to run a
marathon Well, you know, if youthink in broad terms like that,
you may never actually get todoing it.
But you think about well, Iwant to be able to move, I want
(56:15):
to be able to run, even if it'sjust a block, blah, let me start
out there and go from there.
So I'd like people to thinkabout this whole conversation.
What is it that you've heard?
That may be different, maybesurprised you, maybe it's
changed your approach to yourthought, the way you think about
something.
(56:35):
Think about that and maybewrite it down.
Then think about what can youspecifically do that's going to
improve your health, and writethat down and then come back to
it and check it off when you'vegot it done.
One of the reasons why peoplefail with their New Year's
resolutions is they're too broadand they're too vague and
(56:58):
they're too ambitious.
So I want people to be specificabout what they've learned from
this and what step they can do.
It doesn't have to be somethingbig.
It doesn't have to be a bigstep, a little step, because
enough little steps add up tosomething big.
Grantley Martelly (57:17):
Yeah, I mean that's great because that's so
important.
You know, we quit when we havetoo big.
There's some person I wastalking to who was talking about
this, about walking, you know,and they were trying to think
about I got to go and walk allthis stuff and I said, no, just
go 15 minutes from your house,walk 15 minutes.
And then you got to come backhome, turn around, come back
(57:38):
home.
Yeah, you do that.
You walk for 30 minutes.
You don't have to find a trackand you don't have to do all
this stuff.
You don't have to walk fivemiles because your neighbor is
walking five miles.
If for you it's 15 minutes,it's 15 minutes.
You know, and I had to do thatfor me, right, what, what works
for me?
Because I was trying to get toocomplicated and one day I was in
(58:01):
the gym and one of the coachessaid to me she said you know,
grant Lee, the goal is not towear yourself out and try to do
too much.
The goal is to modify thingsand do things so that you get
stronger, you get better, youaccomplish your goals.
You're not in competition withanybody, it's just you.
(58:22):
So what is the two things youwant to get accomplished, rather
than trying to deadlift 400pounds.
If you can only deadlift 95pounds, that's good enough.
That's your goal.
I guess I'm saying this becausesometimes we get to that point
where we're also comparingourselves to other people.
This person is doing this andthis person is doing that.
(58:43):
I can't do that, so I'm notgoing to do anything, agree.
So, dr John, thank you verymuch for your time today.
I really appreciate it, andthank you for your great advice.
I think it's going to be verybeneficial to our listeners here
on Real Health Black Men andhelping us begin to get our
hands around these things.
I look forward to our continueddiscussions.
(59:05):
I hope that we can come backtogether again at some point and
maybe talk about maybe one ortwo specific issues that people
may bring up.
I will let you know.
We can go from there, but Ireally want to thank you for
taking the time out of your busyday to do this.
I really appreciate it.
Dr. John Vassall (59:21):
Thanks again.
Okay, well, thank you forhaving me on.
I've enjoyed this.
Grantley Martelly (59:28):
Thank you.
Write us at realhealthblackmenat gmailcom.
Realhealthblackmen at gmailcom.
Realhealthblackmen at gmailcom.
To support this podcast, go tobuymeacoffeecom forward, slash
realhealthblackmen,buymeacoffeecom
(59:51):
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And to become a corporatesponsor, send us an email.
This is the Real Health Black Men podcast,
where we empower men to takecontrol of their health.
We provide vital informationand build community support.
Join us as we discusseverything from major health
challenges to mental wellness tophysical fitness.
So if you're ready to level upyour health and your life,
you're in the right place.
(00:31):
Let's get started.
Welcome to Real Health BlackMen.
This is a space where we talkabout things that matter to us.
We're building a communitydedicated to empowering black
(00:51):
men to take control of ourhealth.
We're bringing you vitalinformation, cutting through the
noise and giving you the realdeal on everything from major
health issues to mental wellness, physical fitness and
everything in between, becausewe know that real change happens
with support, and that'sexactly what we're here to
provide.
So this is our first fullepisode, and I'm so glad that
(01:15):
you're joining us.
My first guest is Dr JohnVassell, a doctor of internal
medicine, and he's going to giveus an overview of health,
healthcare, healthy living as itpertains to us, and you don't
want to miss a minute of it.
I promise you that you willenjoy this episode and that you
will learn a great deal from him.
So thank you for listening andshare this with a friend or a
(01:39):
family member and help us getthe word out and help us build
our listenership so that we canbe a great support to each other
and we can make sure that wehave the information we need to
take control of our health andto live our life to the fullest.
Today we have the distinct honorof welcoming my friend, dr John
Vassell, an esteemed physicianwith an incredible career
(02:02):
spanning many decades.
An esteemed physician with anincredible career spanning many
decades.
Dr Vassil is an internalmedicine physician in Seattle,
washington and a clinicalassociate professor and
associate dean at the WashingtonState University Elson S Floyd
College of Medicine.
His resume is truly impressive.
He has held leadershippositions at some of the largest
(02:23):
healthcare systems inWashington State, including
Providence, seattle MedicalCenter, swedish Health Services
and president of the Minor andJames Medical Group.
Beyond his clinical experience,dr John has been a tireless
advocate for improving healthaccess and quality for all.
You'll have to look him up tolearn of all the awards and
(02:45):
accolades he has received.
I know Dr John Vassil as themedical voice for the Tacoma
Pierce County Black Collective,where his weekly medical talks
has been transformative inhelping our community members
learn to live healthier lives inclear and simple terms.
So today I'm excited that he'sjoining us and we'll be delving
(03:07):
into Dr Vassell's insights on arange of topics, from navigating
the healthcare system toimproving health outcomes for
Black men.
So let's get right to it andwelcome Dr John to Real Health,
black Men.
Dr. John Vassall (03:22):
Okay, thank you.
Thanks for having me.
I'm a graduate of theUniversity of Washington School
of Medicine.
I did my internal medicinetraining in Atlanta, georgia, at
Emory, at Great MemorialHospital.
I initially started in privatepractice in Decatur, georgia,
came back to work at GroupHealth and then started in
(03:45):
private practice with my bestfriend and roommate, my medical
school roommate Rayburn Lewis,and we practiced together for a
number of years, so I have someexperience both here and in the
South, which I think isimportant because I've dealt
(04:06):
with all kinds of populations interms of my medical training.
However, I'm rooted here in thePacific Northwest and I've been
here for a very long time, so Ithink that's a good background
for people to have in their mind.
Grantley Martelly (04:19):
Well, thank you, Dr John, for that.
Yeah, I'm sure the context isgoing to really help us as we
get into our discussion.
Now I know that you have somespecific information that you
want to share with us and wehave some questions we want to
get through.
This is a big topic.
We're hoping today that we cantouch on some aspects of it, but
we may have to do a follow-uppodcast or maybe a couple as we
(04:40):
go along, because the topic ofblack men's health, to me, is a
significant topic.
So I want to begin to do it Goahead.
Dr. John Vassall (04:50):
Yes, in that regard, I think sort of in terms
of setting the stage.
What I'd like to people tothink about is health and black
men's health, and make a littlebit of a distinction between
health and medicine and medicalcare.
So when I'm talking abouthealth and when we explore
health, we're talking about howto live your life in a healthy
(05:14):
way, in a fulfilling andsatisfying way, and not really
think about it in terms ofdiseases and pills and
supplements and those kinds ofthings.
Think of it in terms of how doyou live your life to its
fullest.
So that's what we're going tobe talking about when we talk
about health, talking about theability to live your life at its
(05:37):
fullest, not impaired bydisease or illness or injury.
And even if you do have thosethings disease, illness, injury
how do you manage those thingsin such a way that you can be
healthy, health again, beingliving your life to its
satisfying fullness.
Grantley Martelly (05:59):
Living to its fullest?
Yes, and that's what we want todo on this podcast is help men
to learn to live to theirfullest and take charge of their
health.
So let's begin by this topic of.
We know men's health isimportant.
We want all men to be healthyand live their life to their
fullest.
But why do you think it'simportant that we talk about
(06:21):
Black men's health as a separatecategory of overall men's
health?
Dr. John Vassall (06:27):
I think it's important for people to focus on
themselves and where they areNow.
That's not to say that weshould be necessarily looking at
men in silos, women in silos,because health is really a
communal thing.
It's hard to be healthy inisolation.
You know health is really acommunal thing.
It's hard to be healthy inisolation.
You know health is part ofhealth is how do you communicate
(06:52):
with other people.
But you know you have to focuson yourself first so that you
can be healthy and you can be ina position to help other people
, including the women in yourcommunity.
Very often, when we talk aboutwomen's health, people think of
reproductive health, they thinkbreast cancer, they think of
those kinds of things.
(07:12):
When they think of men's health, they think of prostate cancer,
heart disease, those kinds ofthings, diabetes, and I think
those things are important andwe can't address them unless we
focus on them.
However, we need to thinkholistically about how all those
(07:34):
things interact and how being amale in this society interacts
with your health.
Now, what I mean by that?
If you're a man in this society, there are certain expectations
and even certain stereotypes.
If you're a black man, there'scertain expectations and certain
stereotypes, and so one of thereasons for focusing on black
(07:56):
men's health is to be aware ofhow those expectations and
stereotypes may affect yourhealth.
Grantley Martelly (08:06):
So let's unpack that a little bit.
We know that, and science hasshown that there is certain
diseases or certain things thataffect people in the Black
population more than in thegeneral population.
We know for Black men also,there are things that affect
Black men more in the Blackpopulation than in the general
(08:27):
population at large.
So let's begin to talk aboutsome of those things.
In terms of health and youframe them as a doctor is where
should we be focusing and whatare the things that we should be
giving attention to when wetalk about health?
Dr. John Vassall (08:44):
for men.
Yeah, thanks for that question.
Here's what I want to makeclear that many of the problems
and diseases and illnesses andtraumas that affect black men do
not affect them because theyare genetically different.
(09:05):
You know, race is not genetic,it's not biological Race and
that doesn't mean it's not real,it's not genetic or biological.
It's a social and economicconstruct and races are
different if you go from countryto country.
But in this society they'vedecided that Black people are a
(09:26):
separate race.
But that does not mean that weare separate genetically.
It does not mean that we'remore genetically prone to some
of these illnesses or diseases.
I'll give you an example.
Now let's start with COVID-19.
It was well known that theimpact of COVID-19 was greater
(09:49):
and the death rate was greaterin the Black community and in
other communities Hispaniccommunity, native American
community than in thecommunities at large.
Does that mean that we aregenetically different?
No, and in fact there were somepeople who were trying to make
the case that that there weredifferent receptors in the nose
(10:09):
that make the virus stick morein black people, which actually
is utter nonsense.
They're getting COVID andgetting more ill from COVID.
That has to do with the socialaspect of being Black.
Many Black folks and Black menare in jobs that expose them to
(10:34):
strangers and strangers.
If you're in your family in acontrolled environment, you're
relatively safer than if you'rein an environment where you're
coming into contact with a lotof strangers.
For instance, if you're a busdriver, if you're a manual
laborer, with other peoplecoming and going, if you're in a
(10:58):
service job, those are thekinds of jobs where you're often
in contact with a lot ofstrangers, many of whom can
carry this disease.
So it's not a genetic thing.
It's your circumstances, yourwork environment or perhaps your
community environment thatmakes you more at risk.
(11:18):
And then if the society hasbeen such that you've been
unable to preserve your health,so you have heart disease,
diabetes, then if you becomeinfected you're more likely to
die and become very sick.
So those are the kinds ofthings that are social, that put
Black men at risk and Blackwomen at risk for diseases.
(11:39):
That is not genetic.
Grantley Martelly (11:42):
Yeah, we call those the social determinants
of healthcare, Right?
One of the things that has alsocome out in this has also been
access.
People are talking about accessto healthcare.
Can you talk about that alittle bit, about how that may
be showing up also in where wesee these things about?
(12:04):
Certainly certain environmentsor certain areas have better
access to health care thanothers.
Dr. John Vassall (12:12):
Yes, I want to talk first about why we need
access, and that's about healthin the larger picture.
Let's talk about some of thedisorders and diseases that we
see commonly in black communityand in other communities, for
instance, okay, hypertension isvery common among all people of
(12:32):
all races.
It's particularly common inblack community.
More so, it's more common inblack men, probably caught the
cause of dietary issues such assalt intake, general health
issues in terms of exercise andphysical movement, but also this
(12:54):
is where access is important interms of being able to be
diagnosed, because it used to becalled the silent killer.
Hypertension is something thatyou don't know that you have
unless you're evaluated andsomebody checks your blood
pressure.
So people can go through yearsand years and years of having
(13:14):
hypertension, suffering itsconsequences, but because they
have not had access to diagnosis, they're not aware of it and
therefore they don't get ittreated.
So that's one example Diabetes.
Diabetes is a situation wherepeople have high blood sugar and
(13:35):
the reason their sugar is highis because their insulin is
either lacking or is ineffective, and insulin is a hormone that
allows the body to process sugar.
Similarly, people can havediabetes and not be aware of it
until a certain point where itbecomes symptomatic.
There are people when you first.
(13:57):
When a person first developsdiabetes, they have no symptoms,
but then over time they maystart feeling themselves thirsty
all the time, drinking a lot ofwater, urinating frequently,
and by the time they'rediagnosed they may already be
suffering organ damage so again,access to medical care is
important.
(14:24):
information, and goodinformation about your health is
important, because you wouldn'tknow what to ask or what to
look for if you're not aware ofwhat's important to keep
yourself healthy.
Grantley Martelly (14:32):
That's a good transition to my next question,
which was you know, some peoplehave the idea that hey, if it
ain't fixed, don't break itright.
Yeah, why do I need to go tothe doctor if I'm feeling fine?
Nothing is bothering me, I'mnot in pain.
You, yeah, why do I need to goto the doctor if I'm feeling
fine, nothing is bothering me,I'm not in pain?
Why should I go to the doctoror the dentist?
Okay, I hope.
Dr. John Vassall (14:51):
I've already partially answered that question
, and it is that you say if itain't broke, don't fix it, but
you don't know if it's brokeunless you look.
Okay, and so there can be somethings that are going on with
your health that you're notaware of unless you actually go
in and get evaluated.
(15:12):
Now, going in and gettingevaluated is easy to say and not
often as easy to do as it is tosay, particularly to Black men.
There are many reasons why andlegitimate reasons why Black men
are concerned about gettinginvolved with the healthcare
system.
There certainly has been somesordid history about what has
(15:34):
happened to Black folks inmedical environments in the
United States, but we have toevaluate that in the context of
the present and in the contextof where we are.
So, yes, people are concernedabout getting into a medical
environment, which is one reasonwhy people should do some
(15:56):
research before they becomeinvolved in the medical
environment.
Who's a good doctor?
Sometimes you have to go bywhat your friends and relatives
have experienced, because veryoften it is, it's your
experience.
So you may be told that Dr Xhas a great resume, has been to
(16:17):
the finest medical schools, etcetera, but that doesn't tell
you how he may treat.
He or she may treat you, butthat doesn't tell you how he or
she may treat you.
So while those things areimportant, it's also important
to know how your friends, yourrelatives, your family, your
community has been treated inthat system or by that physician
(16:38):
.
And once you feel comfortableenough, then you can engage in
that, in that with that person,with that system.
Grantley Martelly (16:47):
Yeah, I mean that that that's been some of
the discussion that has come up.
I've talked to people abouthealth.
Black men's health is about,you know, feeling comfortable
with a physician or with aclinic that they're going to,
and some men has expressed thatthey have not felt that way and
in fact, some of my friends havetold me I've changed doctors
(17:09):
because the one I was going towasn't treating me and that made
me feel comfortable and wasn'tanswering my questions.
So, instead of quitting, Iasked around, like you said, and
I found another doctor whorelates to me.
So, as a physician, you'resaying that relationship is just
as important as a technicalknowledge.
Dr. John Vassall (17:31):
Yes, yes, yes, did I say.
Did I say yes, it's veryimportant because if a person is
scholarly and knows everything,but they don't share that
information with you, or theycan't share it with you in a way
that is useful to you orunderstandable to you, then that
(17:53):
knowledge does you no good.
Does you no good?
Ultimately, it's the patientwho has to make the decisions
day-to-day that impact theirhealth.
The physician can give theminformation and ideas and a
pathway but ultimately it's thepatient who has to make those
(18:14):
decisions, and if the patient isnot getting the information and
the pathway from that physician, then that physician is not
doing them any good.
Grantley Martelly (18:24):
Thanks for answering that question.
So my follow-up question tothat doctor is so we go to the
doctor, we find a good relation,we do the tests, we do our
annual physical and we get thisreport back that has a whole
bunch of stuff on it and some ofthem, you know, has the red,
green and yellow lines and stufflike that that tells you if
(18:47):
you're good or not.
But what's the best way for alayperson to interpret those
results that comes back fromthose blood tests or those
physical and blood work that weget when we go to the doctor?
Dr. John Vassall (19:01):
You know that's a great question because
it actually highlights somethingthat has really changed over
the last few years.
When I started in medicine manyyears ago, physicians tended to
hold on to the information.
So we'd get the test, we'd lookat them and we'd interpret, and
(19:22):
some doctors would share themwith the patients, some wouldn't
, some would share what theythought the patient could handle
and would withhold what theythought they couldn't handle,
and some doctors would interpretthe tests for the patients.
And the physicians kept thenotes in their chart and very
(19:46):
often didn't necessarily sharethat with the patient either.
Over the last several years,those two things have changed.
Now very often you can get yourmedical records online through
a secure portal where you signin and you can look at the notes
in your chart.
The most physicians in largesystems will give you an after
(20:09):
visit summary, which is a pieceof paper that tells you what
they did in that particularvisit, what your vital signs
were, et cetera.
And now, particularly if you'reon some of these electronic
health records where you haveaccess to your records, you may
get the test before thephysician sees them.
(20:30):
It automatically gets posted toyour chart and sometimes the
doctor hasn't even seen theresults before you have, which
can be problematic, becausesometimes it's really scary,
particularly when you see thingsthat say they're abnormal or
they're in a red zone and youdon't really know what that
means.
Sometimes something's in a redzone and it doesn't mean
(20:52):
anything except for that thetest is off, and sometimes it's
in a red zone and it's somethingpretty serious.
So unfortunately well,fortunately and unfortunately,
because it cuts both ways, uh,it's it requires you to take
control of your understanding ofyour health in a way that you
haven't had to in the past.
(21:14):
So how do you do that?
To your question, because someof this stuff is really pretty
technical and it would take alot of explaining just to
explain a single test, whereassome of it is fairly
straightforward and it's notthat hard to figure out.
For instance, if your bloodsugar is 200, it's not that hard
(21:35):
to figure out that that's high,it's too high and you probably
have diabetes.
(21:56):
Whereas some things are muchmore subtle, and I'll give you a
personal example, and that isyour cell counts.
You have white cells and redcells and platelets and others.
My white cell count is low,quote, unquote.
Now it's always been lowbecause it's low white cell
counts run in my family andthere's nothing wrong with that.
Then there's nothing wrong withme.
But I've had to convince someof my doctors to stop looking
for a disease.
I tell them look, my white cellcount has been the same since I
was in college.
(22:16):
So now you're going to belooking for something?
Uh, but I?
But I'm at a level where I canunderstand that.
That's hard to explain to a layperson and and even to some
physicians, because that whitecell count is based on the
average of quote-unquote normalpeople, usually normal white men
(22:37):
.
So that's part of the problem.
So I don't want to make thistoo complicated in terms of your
audience.
And how do you deal with thosetests?
The first thing is you have tohave a general understanding of
what these tests mean.
And again, this is one of thosetimes where you really have to
have a physician who can explainthis to you and who is willing
(22:59):
to explain it to you, andunfortunately, sometimes your
visit is so short that they maynot have time to do that.
But you really need to have ageneral understanding of what is
a high blood sugar, what ishigh blood pressure, what is a
low blood count, and that meansa red blood cell count, which
would be anemia, and some of thechemistries.
(23:22):
What's a normal kidney functiontest look like?
Now, you don't have to knoweverything, you don't have to
know all of this, but I thinkit's really good to know some of
these general things Bloodsugar for diabetes, blood count,
particularly for women withregard to anemia, kidney tests,
(23:44):
liver tests, just those broadareas and get a good sense of
what those things mean.
Grantley Martelly (23:51):
So you said something there in interpreting
the results that really cameback to me.
In my own experience I had twotimes that I got my results back
from the lab before my doctorsaw them.
One of those times was when Iwas diagnosed with prostate
(24:13):
cancer.
I received my biopsy scores twodays before my doctor called me
.
Yeah, and I looked at them andI I didn't know everything about
it, but it says 50% werepositive, 50% were negative.
And then I started doing someresearch and I said, well, if
(24:33):
50% is positive and 50% isnegative, that means I have
something.
And then I started looking upGleason scores on my own and
Gleason scores are four, fourand three and three and four.
The point about it is that I hadthat information for 48 hours
before my doctor even called me.
Yeah, there's a lot of emotionattached to that, but so, even
(24:59):
with technology, sometimes,sometimes I think the technology
gets ahead of you in themedical professions.
You know when we get it soquickly that and then the person
is there struggling with whatdoes this mean?
Until they can have thatconversation, like you said.
You know, in my case I wasright.
I did have it and I told mydoctor that and at the time she
(25:22):
said yeah, that happenssometimes you get the results
and we don't even get them untilafter you.
So I couldn't even call you twodays ago and say, hey, grant
Lee here's what was going on.
Dr. John Vassall (25:36):
Yeah, it's a byproduct of our sort of our
technological error and alsosome of the issues around
patients' rights and theirrights to the information.
Patients own the information inthe chart.
You own the information.
The facility, the doctor, thehospital, whoever they own the
(25:57):
chart and the technology aroundthe chart, the electronic health
record, but you own theinformation.
In other words, you're entitledto all of the information in
your medical record.
Now, when you get it, it can beproblematic, because I think
it's actually cruel to givesomebody information with no
(26:19):
context and no training and noinformation to understand it,
particularly when it comes tocancer, which, you know, the
word itself is scary.
Yes, it is patient's right tohave that information, to know
that information, and yet thehumanity of giving it in a way
(26:47):
that preserves the patient'sability to make decisions and to
understand the information.
Grantley Martelly (26:51):
In my case, my two older brothers had had
prostate cancer before me, so Iwas able to call them and have a
conversation with them aboutyou know what does this mean for
me?
But I can think about someperson who didn't have that or
who didn't have that.
You get this information andthey're staring you in the face
and it's like wow, yeah.
Dr. John Vassall (27:11):
Yeah, let's talk about that, that community
thing again and having thatcommunity of support, because
you had that.
Uh, that's really important.
And let's talk a little bitabout family history too,
because that's also you bring upthat point, which I think is
very important.
Family history is what hashappened before and what has
(27:34):
happened to people in your life.
That is not necessarily destiny.
So the fact that somebody inyour family has had this doesn't
necessarily mean that you willget it.
In your case that was the case,but that's not always the case.
So people need not be afraid oftheir family history or
(27:56):
reluctant to find out about it,because it's not your destiny.
But it can be useful in termsof helping you to think about
what you might expect.
Sometimes it is destiny if it'sa genetic problem.
For instance, with some breastcancers there's a gene actually
that's passed down from woman towoman which can lead to breast
(28:20):
cancer.
So that is destiny, but in somecases it's not.
And prostate cancer it's notnecessarily destiny, although it
does raise your chances.
So it's important to know thatbecause that helps you think
about what you should do in thefuture.
So for your sons and yourbrothers and your nephews and
(28:41):
nieces, your nephews, sorrycousins, male cousins they need
to think about screening forprostate cancer in a different
way than somebody who doesn'thave that family history.
And again, that doesn't meanit's destiny, but it's something
that it puts a different levelof urgency for somebody who has
(29:02):
that in their family.
And on the positive side, youhave that support.
You have that support Peoplewho have gone before who can
tell you what their experiencehas been, and that's a lot
different from reading somethingin a textbook.
Yes, it is, you know has been,and that's a lot different from
reading something in a textbook.
Yes, it is, you know.
(29:25):
And so having that, havingthose people, especially family
members, but it doesn't have tobe family, friends, close
associates who can tell you whatyou might expect, I think
that's very important that'svery important.
Grantley Martelly (29:43):
Let's talk about some of the diseases or
illnesses that seem to beappearing very commonly in
people of color and things thatpeople should be concerned about
.
You've mentioned some of themas we've been going through here
.
We mentioned diabetes, wementioned prostate cancer, we
mentioned hypertension.
I was talking to anophthalmologist the other day
and she was telling me you know,there's also some evidence
(30:10):
about glaucoma.
So what are some of the thingsthat we, as people of color,
need to pay specific attentionto when we go to the doctor or
when we cannot our health.
Dr. John Vassall (30:17):
Yeah, great question, because there's so
much to look at and you can goin a thousand different
directions and not necessarilyget anywhere.
So what I like people to thinkabout again is health as being
able to live your life in a mostsatisfying way, being able to
(30:39):
accomplish the things you wantto accomplish in your life, and
part of that is being able tomake sure you're in physical and
mental condition to takeadvantage of the opportunities
life offers you.
I think people should firstlook at those kinds of things
(31:00):
that might be common andpreventable, because there's no
point in worrying aboutsomething that's uncommon and
you can't do anything about.
But there are certain thingsthat are common and can be
either prevented or managed insuch a way that they don't
impact your life.
So let's start withhypertension, that's, elevated
(31:25):
blood pressure Extremely commonOne in three at least adults.
If you stop any three people onthe street, one of them has
hypertension.
So that's how common it is.
Attention, so that's how commonit is.
And part of it has to do withlife processed foods, lack of
(31:53):
exercise, obesity, et cetera, etcetera.
So you may not be able toprevent yourself from getting it
, but you certainly can manageit by managing those things.
Now, if you so, one, it's verycommon.
Number two it's very manageable.
You know it's manageable withlifestyle changes, watching your
weight, reducing salt intake,exercise and, if necessary,
(32:15):
medication.
Number three if you don'tmanage it, you can be in big
trouble Heart attacks, strokes,ischemic disease, which means
that you have poor circulation,which can lead to amputations,
those kinds of things.
So it's common, it can beserious, it can be managed.
(32:38):
So those are the things I wantyou to look at.
Diabetes common, serious, can bemanaged.
The incidence of diabetes isreally escalating, in part
because of the incidence ofobesity, because type 2
(32:58):
diabetes's highly linked Type 2diabetes is highly linked to
obesity.
It's inability to manage bloodsugar.
If it's not diagnosed andmanaged properly, it can lead to
heart disease, heart attacks,strokes, blindness because of
the blood vessels and the eyesbeing involved, amputations
(33:21):
because of lack of circulation,kidney disease, kidney failure
and dialysis.
So those are some of the thingsthat can happen if it's not
managed.
So, once again, you need to getchecked, have your blood sugar
checked and if you're headingfor diabetes, you need to be
aware of that so that you canmanage it.
(33:42):
It's common, it's manageable,it's serious if it's not managed
.
Heart disease Common right.
It can be serious and it can bemanaged.
Often a heart disease kind of acardiovascular disease we're
(34:03):
talking about.
There are various kinds there'svalve disease, there's
congenital disease that peopleare born with, but we're mostly
talking about atherosclerosishardening of the arteries and
leading to heart attacks, oftencaused in part by elevated blood
cholesterol and other fats inthe blood.
So calm it.
(34:23):
I can't say easily managed, butit can be managed.
How do you manage it?
With cholesterol-reducingmedications if necessary, but
first a plant-based diet, maybewith a little bit of animal
protein if you need to.
But you know there's certainlyvegans, like my sister, who
don't eat any protein whatsoeverand she's perfectly healthy and
(34:47):
she's a weightlifter, by theway.
So you can be very healthywithout animal protein, but that
doesn't mean you can't have any.
But your diet should beprimarily plant-based and
exercise, because that burns offthat excess fat, that excess
cholesterol, and keeps yourblood vessels clear and keeps
(35:07):
your heart pumping properly.
So again, with regard to heartdisease common, manageable,
serious if you don't manage.
Okay.
Grantley Martelly (35:18):
Yeah, that's a good overview, Thank you, and
I like.
I like your, your as far as incommon you know, manageable and
we can do something about it.
You and you got into theimportance of diet and exercise
there as well as part ofmanaging some of these diseases.
So let's talk about diet andexercise, particularly because
(35:41):
you do a really good explanationon what exercise is.
When you say that it's notnecessarily becoming an Olympic
athlete or becoming a CrossFitcompetitor, what do you mean by
exercise for the common personand what they can do to benefit
their health with good exercise?
Dr. John Vassall (36:03):
Yeah, that's a great question.
Thanks.
First of all, I think ofexercise as movement.
So just think about it asmovement.
If you're a slug staying in onespot, not moving, that's not
exercise.
That's the thing.
And sometimes we had a questionon the Black Collective, if you
(36:25):
remember, regarding somemachine that moves for you.
Right, that's not exercise.
So if you're getting some kindof vibrating or torquing machine
that moves you around, that'snot, in my opinion, exercise.
Exercise is movement,self-movement.
If you're not moving, you'renot exercising.
(36:46):
And think of getting enoughmovement to keep your joints in
shape, your muscles in shape andyour heart in shape.
So there's what they callaerobic exercise, which is like
running and swimming and thosekinds of things.
It gets your heart and yourlungs working together toward
(37:08):
their capacity.
So those kinds of exercises,that kind of movement walking,
running, doing stairs, swimming,those kinds of things are very
useful.
We talk about walking a lot,because walking is probably the
best kind of exercise, in thesense that most everybody has
(37:33):
learned how to walk, they knowhow to walk, unless they're
impaired, but they can walk.
You don't need any training,you don't need any special
equipment, except for maybe somegood shoes if you're walking
outside.
So walking, if it's a safeenvironment, has got to be sort
of the rock bed of exercise, youknow, and the faster you walk,
(37:55):
the more you approach running.
But you don't have to run.
Walking briskly and running aresort of rock bed of movement
and exercise.
So for people who can walk,that's great.
And if you can walk briskly andwhen I say briskly that means
(38:15):
you get your respiratory rate uphigher than it is at rest and
you get your heart rate up thenthat's an excellent exercise In
terms of muscular exercise.
I like people to think about whyare you doing this?
You know.
Why are you lifting weights?
You know.
Why are you doing push-ups?
Why are you doing sit-ups?
(38:36):
It's not so that you can domore push-ups and more sit-ups
and lift more weights.
It's so that your muscles arein shape to move you when you
need to be moved and to move youin a way that is useful for you
to maximize your enjoyment oflife.
I like people to think aboutthat.
(38:57):
If you're going to do push-ups,that's great.
It'll get your arms stronger.
But while you're down there onthe floor, roll over on your
back and try to get up off thefloor without using your hands.
You know that's another form ofexercise.
It's not what they teach you inthe gym form of exercise.
(39:20):
It's not what they teach you inthe gym.
But sometimes you may need toget up off the floor and your
hands may be impaired, your armsmay be impaired, you may have
injured yourself.
So think about how can I usethis exercise in the real world.
You know, going up and downstairs.
Forget that elevator.
How about walking up one flightand cashing the elevator from
there?
Because there's going to be atime when that elevator is not
(39:40):
working and you're going to needto use the stairs.
So if you haven't been on astaircase in a year, you may
have a problem.
So you need to think about howdoes this exercise help me?
You're using the stair stepperin the gym, but think about the
real stairs and walking up anddown real stairs so that when
you need to do it, you can do it.
(40:02):
So when I think about exercise,I think about movement and I
think about how can I use thisin the real world, in my real
life, to make my life better.
Grantley Martelly (40:12):
And there has been some research and doctors'
advices that sometimes exercisecan help reduce the likelihood
of some of these diseases wetalked about before developing,
like if you're getting intopre-diabetes you may exercise
things like that.
Dr. John Vassall (40:31):
The importance of exercise in our life.
Grantley Martelly (40:33):
Our sedentary world.
As we get more technologicallyadvanced, everything seems to be
going towards keeping us frommoving.
Dr. John Vassall (40:41):
Right, right, Let me say two things about that
, because that raises two points.
One is, yes, aerobic exerciseexercise where you get your
heart going and your lungs goingalso helps.
This is not technically correct, but for the visual it helps
flush out the stuff in yourblood vessels and that excess
fat that's collecting.
(41:02):
So that's one of the reasonswhy I'm simplifying and
oversimplifying, just so peopleunderstand that that kind of
exercise, aerobic exercise,helps keep your heart, lungs and
your blood vessels clear andfunctioning and that's why it
helps with metabolic diseaseslike diabetes and that's why it
helps with heart disease.
(41:25):
Now, with regard to the muscularexercises that I talked about,
sometimes you need to use yourmuscles in a way that you were
not aware of.
People know that I'm a bigcyclist.
I like to bicycle a lot.
I ride sometimes hundreds ofmiles.
I've been to Portland and backand on a weekly basis.
(41:47):
When I get on the bike Iusually ride 10 or 15, 20 miles
a day, especially when theweather is nice.
But sometimes stuff happens.
I crashed about six years agoand fractured my femur.
Now the thing about that is andI got a surgically repaired on
by now but there was a time whenI had to use muscles in a
(42:09):
different way.
I had to be able to move aroundwith a broken leg and if you
are not in good physical shape,that becomes very difficult.
So one of the reasons to be ingood physical shape is when you
find yourself in a situationwhere you have to use your
muscles in a different way.
You may have to use crutches,which means you need more arm
(42:30):
strength than you usually use.
So, again, that's one of thereasons for doing those push-ups
, so that if you need to useyour arms for crutches, you have
that tricep strength to helpyou.
So again, think about how youcan use this in the real world
(42:51):
and stay in shape for thosetimes when you may not, where
you may need to call on thatcapacity that you haven't had to
call on for physically yeah, Imean that.
Grantley Martelly (43:03):
That resonates with me because when I
had my first back surgery and,uh, I was having really bad
problems with my leg I mean mymy leg actually actually stopped
moving at one point, literallystopped moving at one point, and
I learned in my recovery theimportance of having a good core
(43:24):
.
I found out I had muscles inthat recovery that I didn't know
that I had.
Yep, it was amazing, I wouldtell my wife.
I said I didn't even know I hadmuscles in these places, you
know, just to get up out of abed or cheer, right, I was
feeling things that I hadn'tfelt.
(43:45):
But my doctor said to me if youhad not been going to the gym
and relatively good physicalshape, your recovery would have
been much slower and much moresevere.
Right, your recovery would havebeen much slower and much more
severe.
He says you're learning to usemuscles that you have been
developing.
You're not trying for the firsttime and it was really
important to me because evenwhen I was recovering he said
(44:07):
I'm going to get you back intothe gym as soon as possible
where you can start not liftingstuff but walking on a treadmill
and getting some resistance sothat you can keep your core
built up, because for your backto work properly, your core has
to be good.
That's right.
I learned so much from that.
It was amazing.
Dr. John Vassall (44:28):
Yeah, and one of the things that we've been
doing in medicine more recentlyis what we call prehab.
If somebody's, for instance,going to have knee surgery or
they're going to have hipsurgery, it's elective, we know
we can schedule it out.
We actually start teachingpeople, for instance, how to use
the crutches before they needthem, their joints.
(44:56):
We have them start learning howto walk with just one leg and
crutches before they actuallyare required to do that because
of the surgery.
So that's another way ofthinking about exercise is
preparing you for theunpreparable.
That's right you learn hardware.
Grantley Martelly (45:12):
Yeah, you said something before in one of
our meetings too that I thoughtwas so important and I didn't
think about it until you said it.
But this thing about oursocialization and our family and
where we are from, aboutsometimes our health is affected
by our family, our brain, oursocialization, and the example
(45:37):
that came to me is like, youknow, I love to eat ribs.
I love to eat ribs, but it'snot always the best thing for me
to eat, right?
Or my family has certaintraditions of you know, macaroni
pie, which is macaroni andcheese, or things like that that
we love to eat around theholidays.
(45:59):
But sometimes thosesocializations, if we don't pay
attention to them, can affectour health.
So talk a little bit about that.
Dr. John Vassall (46:09):
Yeah, that's a very important point.
Our relationship to food is animportant one point.
Our relationship to food is animportant one and food is not a
whole bunch of proteins andvitamins and carbs and all that.
Otherwise you could just lineup a bunch of pill bottles and
take a bunch of pills and callit good, and I don't think
(46:30):
anybody's going to do that.
You know food is cultural.
You know food is almostreligious.
You know food is a sharedexperience, is experiential.
Uh, food is identity.
You know I mean I'm from, myfolks are from Jamaica, and you
know saltfish and ackee.
(46:52):
You know green banana andplantain in the morning and
bammy.
I mean that's part of myidentity.
So you can say that for manycultures they were talking about
sake, wine, rice wine that theJapanese drink on the news this
(47:12):
morning.
You know sushi tacos.
You know, you just say it andyou know an image comes to your
mind when you say sushi tacos.
You know you just say it andyou know and an image comes to
your mind when you say sushi,you think of a certain thing.
When I say saltfish and ackeeand bammy, a certain image comes
to my mind.
Yeah, when you say grits andgravy, that certain image comes
to your mind.
So, uh, your food is part of whoyou are and you can't tell
(47:38):
people just eat a Mediterraneandiet when they're not
Mediterranean people.
You know, you hear that theMediterranean diet is the best
heart diet.
Well, it is the best heart dietfor people who live in the
Mediterranean.
So how do you take thosecultural underpinnings and
(47:58):
inform them with what can keepyou healthy?
So, again, it's not a matter ofsaying, well, I'm never going
to eat pork, I'm never going tohave ribs.
That's not going to answer thequestion of how do I incorporate
(48:20):
health into my identity andlive the kind of life, the
satisfying kind of life, that Iwant to live?
So be aware that too much meatprotein is going to be
problematic.
Too much salt is going to beproblematic.
So that means you are going tohave to reduce, maybe, the
amount that you're eating andyou may have to season it a
little bit differently so you'reaware of your blood pressure,
those kinds of things.
But that's the kinds of thingthat people need to do Not give
(48:43):
up your identity and yourculture, but be aware and be
informed about how to modifythose things.
I'll give you an example.
Like I said, I trained inAtlanta.
For example, when I was in,like I said, I trained in
Atlanta and there was a smallblack hospital where I practiced
and we used to, back in thegood old days when we had our
(49:04):
medical staff meetings, thepeople in the kitchen actually
cooked us dinner and we haddinner around those meetings.
Well, the dietician one daydidn't tell us that she was
going to go to a low-salt,two-gram sodium diet.
She changed the way sheprepared the food for our dinner
Because we're black doctorsright, we're black men for the
(49:27):
most part, and we're eatinggrits and gravy and ribs and
everything.
She didn't tell us until afterwe had finished everything and
we're looking at the plates andthen she said guess what?
I modified this so that it'slow salt, low fat.
Nobody noticed.
They'd noticed how good it was,but they didn't actually notice
(49:51):
that she was able to keep,preserve that culture and
preserve that food and thatunity and that brotherhood that
we felt, without negativelyimpacting our health.
So it certainly can be done.
Grantley Martelly (50:06):
Yes, it can and we need to pay attention to
it.
I'm from Barbados, my wife isfrom Bangladesh and all for
those cultures cultures foodlike Jamaica is, I mean, is
amazing.
Right when I go to mymother-in-law's house, I mean
she had food from the time youwalk in the door and the time
you tell you can smell it likeout in the parking lot and it
(50:32):
joins us together.
But I think what we're tryingto say, we've got to moderate it
and make sure that we're takingcare of our health, not just
abandon who we are just becausewe're afraid of getting sick or
something like that when youthink about men's health, you
(50:55):
still have to think about it inthe context of community, and
you have to think in context ofthe women in your life too.
Dr. John Vassall (51:12):
So don't isolate yourself in a bubble of
men's health, thinking that youcan do that without help from
the women in your life.
Grantley Martelly (51:16):
Ok, I'll leave it at that.
Yeah, I mean that's important,right, because I keep getting
back to this.
But I'm in a support groupblack men around the country and
so many times it comes up aboutthe importance of wife and
caregivers.
Some of the men talk about howimportant it is to have their
wives with them when they go tosee their physician and they go
(51:39):
to get report.
They talk about the supportthey have when they come home
and they have to deal with theissues.
So, yeah, I mean, even in oursupport group that is all men
the importance of spouses andwomen and caregivers keep coming
up as a significant part ofmaintaining our health.
As we turn the corner here, Iwanted to go back to one
(52:03):
question and then I want to askyou to wrap it up.
One of the questions that cameup to me that somebody told me
to ask was how do youcommunicate with your physician?
What's the best way tocommunicate with your physician
when you feel as though you'renot being heard or your
questions are not being answered?
Dr. John Vassall (52:24):
You know that's a great question and I
have to give it just a moment ofthought, because what comes to
mind first of all is what wesaid toward the beginning, and
that is first finding thatperson that you can communicate
with, and not all doctors aregood communicators.
(52:45):
I think people know that.
So that's where you have tostart no-transcript, although
(53:22):
you may have to do that fromtime to time.
But again, you don't want it tobe a confrontational, uh
relationship.
The sooner you make that clearthat you two are on the same
page, the better it is.
You know, sometimes I have thisidea in my head and sometimes I
(53:45):
actually tell the patient thatwhen I'm dealing with an issue
with the patient, with a disease, an illness, an abnormal lab
study, and the patients might begetting a little excited and
agitated, emotional, I said youknow what?
There's three people in theroom, three entities in the room
there's me, there's you andthere's the problem.
(54:08):
So let's you and me deal withthe problem together.
It's not you dealing with me,it's not you dealing with me,
it's not me dealing with you.
You and me together are goingto deal with this problem.
So if you physician can do that, can separate themselves, and
(54:29):
if you can separate yourself inthat dynamic and say, here,
we've got a problem here andboth of us are here for the same
purpose and that is to dealwith this problem.
So now let's address that.
Grantley Martelly (54:47):
Thank you.
It's good to hear those wordscoming from a physician.
Right, you deal with it, andsome people are intimidated by
their doctors.
So thanks for the advice.
So, as we look to wrap this uptoday's session, what takeaways
or action points do you want ourlisteners to take with them as
we close this session out?
Dr. John Vassall (55:09):
Yeah, I think it's.
People are, I think, kind ofused to hearing health
discussions and so it's easy tojust kind of listen and turn off
podcasts and keep going aboutyour business.
But what I'd like people to dois think very specifically about
what you can do yourself,something you've specifically
(55:33):
you've heard and a specificaction that you can take to make
your health better, or aspecific idea or understanding
that you've come away with.
Because if you don't getspecific, you're really not
going to actually do anything.
It's like they say, the journeyof a thousand miles starts with
(55:54):
a single step, and a step is aphysical action.
You actually have to dosomething.
So, rather than thinking broadterms oh yeah, I want to run a
marathon Well, you know, if youthink in broad terms like that,
you may never actually get todoing it.
But you think about well, Iwant to be able to move, I want
(56:15):
to be able to run, even if it'sjust a block, blah, let me start
out there and go from there.
So I'd like people to thinkabout this whole conversation.
What is it that you've heard?
That may be different, maybesurprised you, maybe it's
changed your approach to yourthought, the way you think about
something.
(56:35):
Think about that and maybewrite it down.
Then think about what can youspecifically do that's going to
improve your health, and writethat down and then come back to
it and check it off when you'vegot it done.
One of the reasons why peoplefail with their New Year's
resolutions is they're too broadand they're too vague and
(56:58):
they're too ambitious.
So I want people to be specificabout what they've learned from
this and what step they can do.
It doesn't have to be somethingbig.
It doesn't have to be a bigstep, a little step, because
enough little steps add up tosomething big.
Grantley Martelly (57:17):
Yeah, I mean that's great because that's so
important.
You know, we quit when we havetoo big.
There's some person I wastalking to who was talking about
this, about walking, you know,and they were trying to think
about I got to go and walk allthis stuff and I said, no, just
go 15 minutes from your house,walk 15 minutes.
And then you got to come backhome, turn around, come back
(57:38):
home.
Yeah, you do that.
You walk for 30 minutes.
You don't have to find a trackand you don't have to do all
this stuff.
You don't have to walk fivemiles because your neighbor is
walking five miles.
If for you it's 15 minutes,it's 15 minutes.
You know, and I had to do thatfor me, right, what, what works
for me?
Because I was trying to get toocomplicated and one day I was in
(58:01):
the gym and one of the coachessaid to me she said you know,
grant Lee, the goal is not towear yourself out and try to do
too much.
The goal is to modify thingsand do things so that you get
stronger, you get better, youaccomplish your goals.
You're not in competition withanybody, it's just you.
(58:22):
So what is the two things youwant to get accomplished, rather
than trying to deadlift 400pounds.
If you can only deadlift 95pounds, that's good enough.
That's your goal.
I guess I'm saying this becausesometimes we get to that point
where we're also comparingourselves to other people.
This person is doing this andthis person is doing that.
(58:43):
I can't do that, so I'm notgoing to do anything, agree.
So, dr John, thank you verymuch for your time today.
I really appreciate it, andthank you for your great advice.
I think it's going to be verybeneficial to our listeners here
on Real Health Black Men andhelping us begin to get our
hands around these things.
I look forward to our continueddiscussions.
(59:05):
I hope that we can come backtogether again at some point and
maybe talk about maybe one ortwo specific issues that people
may bring up.
I will let you know.
We can go from there, but Ireally want to thank you for
taking the time out of your busyday to do this.
I really appreciate it.
Dr. John Vassall (59:21):
Thanks again.
Okay, well, thank you forhaving me on.
I've enjoyed this.
Grantley Martelly (59:28):
Thank you.
Write us at realhealthblackmenat gmailcom.
Realhealthblackmen at gmailcom.
Realhealthblackmen at gmailcom.
To support this podcast, go tobuymeacoffeecom forward, slash
realhealthblackmen,buymeacoffeecom
(59:51):
realhealthblackmen.
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