March 2, 2026 • 35 mins
What are we still missing when service members come home “intact” on paper but feel amputated in spirit? We sit down with Rachel Howard, a 14‑year Army National Guard combat medic, purple heart recipient, VA program developer, and now U.S. Senate candidate, to trace a path from convoy medicine and CBRN readiness to building one of the first VA post‑deployment respiratory clinics, where patients had real symptoms and “normal” tests. The common theme is service: how identity forms under pressure, why it fractures after discharge, and what it takes to stitch purpose back together.
Rachel breaks down what combat medics actually do, the messy overlap between emergency response and daily primary care needs, and the hidden exposures veterans face: from burn pits to sandstorms and solvents. Our “Quality Questions” segment arms pre‑health listeners with an interview‑ready mindset: listen first, map patterns, and navigate uncertainty without dismissing patients.
Then comes the major pivot: why Rachel left a job she loved to run for office, and why healthcare leaders must shape policy before policy breaks care. Boots‑on‑ground voices understand trade‑offs, workflow, and consequences in a way white papers rarely capture. If you care about veterans’ health, diagnostic blind spots, and smarter healthcare policy, this conversation offers practical insight and a challenge to lead where you stand.
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Ashley Love (00:00):
What are we still missing if our service men and
women are coming home amputated?
But not in the way you mightthink.
Today on Shadow Me Next, I'msitting down with a 14-year
combat medic, Rachel Howard, whosaw this up close, helped build
post-deployment treatmentcenters, and then realized
something even bigger wasbroken.
And instead of complainingabout it, this incredible
(00:24):
warrior stepped up to the plateagain.
If you're pre-med or pre-PA,you've been taught to focus on
performance.
But no one is teaching you howto recognize the blind spots in
the system you're entering.
And if you don't learn to seethem now, you may inherit them
later.
In this episode, we unpack whatwe're missing and what real
(00:46):
service actually demands.
Welcome to Shadow Me Next, apodcast where I take you into
and behind the scenes of themedical world to provide you
with a deeper understanding ofthe human side of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor, and thecreator of Shadow Me Next.
I invite you to join me as wetake a conversational and
(01:08):
personal look into the lives andminds of leaders in medicine.
This is Shadow Me Next withRachel Howard.
Rachel, thank you so much forjoining us on Shadow Me Next
today.
You are a 14-year combat medicin the Army National Guard.
You've been deployed to twolocations that most people don't
holiday at.
(01:29):
You've seen some things whileyou are working as a combat
medic.
We're going to talk about this.
And we are also going to talkabout some major pivots that you
have made that I think aregoing to be really, really
interesting to a lot of people,but primarily our pre-health
students, because they mightask, you know, Rachel, why
didn't you keep working at EMS?
(01:49):
Why did you make this change?
So lots of incredible things totalk about today.
Thank you so much for joiningus.
Rachel Howard (01:55):
Sure.
Ashley Love (01:56):
Love it.
Fantastic.
So if we could go back to youryears working as a combat medic,
is that something that was anecessity for you to work?
Or is that something that youheard about and you thought, you
know what?
This sounds really, reallyinteresting.
Let me see what it's all about.
Rachel Howard (02:11):
It's a little bit of both.
Um, I actually, my high schooloffered an EMT course.
So I was able to take EMT inhigh school.
And I had always already beendrawn to kind of a medical
field, veterinary medicine.
Um, and taking that coursereally it clicked.
I said, this is something thatI really connect with.
(02:31):
This is something that I loveto do.
And so that really kind ofshaped what I wanted my the
trajectory of my life to be.
Uh so after high school, um,after I eventually got my all my
licensures, um I did go to workfor an ambulance company.
It was the private serviceambulance company.
Cool.
And I I loved what I did.
I loved the people that Iworked with.
(02:54):
And at that time, we werelooking, this was the um kind of
2003, 2004, 2005 time frame.
So not that long after 9-11.
And coming from a family thathad a lot of people who served,
the military was always in theback of my mind.
That was that service mentalitywas always kind of ingrained in
(03:14):
us.
And I said, this is something Iwant to do in the military, but
I also love what I'm doing inemergency medicine.
So I went to recruiter andessentially said, I want to
enlist, but I will only enlistif you can do so as a combat
medic.
Amazing.
That's a deal breaker.
You have to have me as a combatmedic.
(03:35):
And they made it happen.
So it was I knew it's what Iwas gonna do.
I'd already kind of been primedfor that.
Um, I went in very eyes wideopen, having already experienced
kind of an emergency medicinesetting.
Right.
And that was sort of thebeginning of a very long
journey.
Ashley Love (03:55):
Oh, yeah, I would imagine one that we are gonna
dive into, and it's just sointeresting to me.
Um, so this is great becauseyou worked in EMS first, and
then and then you worked as acombat medic.
Well, first for for those of uswho might not know, can you
explain to us what it means tobe a combat medic?
(04:15):
I think we'd we'd love to hearthat.
Rachel Howard (04:18):
Combat medicine and with an understanding that
it is different in every branchof service.
Um, you know, what maybe anaval corpsman is doing can be
very, very different than whatan army medic is doing.
Um, and there is a huge scopeeven within within army
medicine.
You may be stationed at ahospital doing kind of hospital
work and you're working as likean ER tech, or you're maybe
(04:39):
working on the floor.
Um, but for my my position, um,I was part of a medical
company.
So we had an entire scope ofessentially anything that you
can imagine doing within athree-day course of care.
So we could care for patientsfor about three days.
And so we had x-rays, we hadpharmacy, we had, we even had
(05:01):
dental.
Ashley Love (05:02):
Wow.
Rachel Howard (05:03):
Um, you know, so we we had a very large resource
available to us.
It was like working for a verysmall kind of urgent care
hospital setting.
And what we ended up doingprimarily was being able to set
up an environment that couldprovide this kind of interim
care before you either needed tomove on to higher level care or
(05:24):
could be returned back to yourduty status.
For myself, I primarily workedon an ambulance within that
setting.
I had a military ambulance thatI could go out.
I would just like normaloperations, I could treat
patients in the field, I couldbring them back for further
care.
Um, we also focused on kind oflike seaburn incidents, so
(05:47):
chemical, biological,radiological, nuclear um kind of
explosion.
We were trained to be able tooperate in that environment in
appropriate hazmat gear,decontamination, and treatment
within that context.
While overseas, I servedprimarily um, you know, briefly
in kind of clinic settings,managing small clinics.
(06:08):
Uh, but also my primary dutywas to go out on convoys, um, on
whatever that mission may be.
I would be kind of embeddedwith a team that would be going
out and I provided medicalservices, um, both for any sort
of emergency circumstance, butalso for your true to medicine,
(06:29):
your kind of boring day-to-day.
Someone's dehydrated, we havetoo many energy drinks, but not
enough water, um, being able towork with some of the local
population in Iraq and orAfghanistan that we would come
across that maybe had medicalneeds or questions.
You know, I could I had a lotof flexibility and a lot of
range in my scope of practice tobe able to kind of test those
(06:51):
boundaries and really exploreother opportunities in your
normal uh medical environment.
Ashley Love (06:57):
And you did this for 14 years.
14 years.
Incredible.
So at that point, did you didyou have a family?
Were you away from your familyfor that stretch of time?
No.
Rachel Howard (07:08):
So I was with the Army National Guard.
So the traditional model is theone weekend a month, two weeks
in the summer.
Um, never in my career did thatever actually work out that
way.
Uh, I was either pulled on fulltime for just other operations
stateside.
Um, I was deployed.
It was it was never one weekenda month, um, which was my
(07:30):
choice.
But I fortunately orunfortunately, I did not have
family aside from you know myparents and my brother.
I was ideal in that sense thatI didn't have a house, I didn't
have kids, I had the flexibilityto kind of go where I wanted
and engage how I chose.
Ashley Love (07:51):
It's amazing.
The reason I ask is because,you know, I was hoping to
discuss some of the differencesbetween working as a combat
medic and working in EMS stateside.
And that's a big one.
You know, I think when we makethese decisions and we think
about what we want our career tolook like, we have to stop and
think about what we want ourlife to look like.
And of course, I know thelisteners might, but I know
(08:12):
right now that you have fourchildren.
So you have quite a largefamily now.
So, you know, it it definitelyinforms some of these decisions
of ours to make these major lifechanges, I think.
Tell us a little bit about whatthat what that looked like,
perhaps um, th those thoughtprocesses for you.
Rachel Howard (08:28):
I I was fortunate, and like I said, that
I didn't have those ties um forthe most the majority of my
military career.
Uh but I I will say that uhreally once I met my husband, I
was at the tail end of mycareer.
I didn't know it was the tailend of my career.
Um, but in hindsight, it was.
I at that point, I had beeninjured overseas in Afghanistan.
(08:51):
So I had a number of medicalissues that I had been kind of
dealing with because of that.
Um, I had for years kind ofmanaged to make it work.
I was injured in 2012.
Um, and I had gone throughwhat's called a med board where
they, you know, really are youfit to continue doing this job?
Which I made it through one,but you're still dealing with
(09:13):
these physical injuries dayafter day.
And I was having a harder timekeeping up.
It was it was a real struggle.
I was really having to pushmyself.
And I had met my husband, youknow, we were engaged, we
decided we want to get married.
He had two kids from a previousmarriage.
Um, we had left it open to uspotentially having having
children, and it came up anothertime for a med board.
(09:35):
And the the question became doI continue to fight this?
Do I really, is that where mylife is meant to go at this
point?
Um and I ultimately made anincredibly difficult decision
because I thought this was mylife's path.
Um, I made the decision that itwas not in the best interest of
(09:57):
the military and it was not inthe best interest of my future
family for me to continue onthis trajectory.
So I did have to make thatchoice, and that was not easy.
That's I still struggle with iton the regular.
Which really, I mean, it speaksso much to your dedication to
(10:17):
service, right?
And and I want to reallyhighlight something that you
just said, and um it was thefirst thing you said, which is
when you made this decision tomake this life-altering change,
the first thought was uh, isthis best for the military?
Is is me, is me being here whatis best for the system in which
(10:38):
I'm working.
And I think that it justhighlights the selflessness of
your thought processes.
And I think in medicine, wealso we also have to make this
decision one day too, you know.
Sometimes it's earlier in ourcareer, sometimes it's much
later in our career.
Um, but it it becomes ourlife's work.
And I think when we start tohave to shift, it's an identity
shift, is what it is.
And I think when we have tomake that identity shift, it can
(11:00):
be um, it can be verychallenging.
And I'm just gonna put in alittle plug for women because I
do think as women, we make a lotof identity shifts, especially
if we have children.
You know, we go from not havingchildren to, and whether
they're our own biologicalchildren or children of our
spouse, for example, to toliterally assuming a new role of
(11:21):
a mother, you know, and Ithink, and and then of course,
careers and and caregivers, youknow, with aging parents.
This also falls to men as well,but I do think that women
especially do these make theseshifts quite well.
Um, so bravo to you for forfirst of all being brave enough
to make that decision, butnumber two, really thinking
about how you play a role in thebigger picture and if your role
(11:44):
in the bigger picture isabsolutely necessary at that
point.
Um, there was something youmentioned that I wanted to go
back to.
I'm sorry to hear that yousustained an injury in service
and and you made a point to saya physical injury.
Um, tell us about otherinjuries that our military
personnel might be experiencingoverseas or anywhere.
(12:04):
It's, I mean, well, it runs thegamut.
Um, you you have a lot ofphysical injuries.
You have a lot of the verycommon mental health issues,
whether that's post-magicstress, post-matic stress
disorder, um, you're lessdiagnosed, uh, or not even
diagnosable, but I think reallycommon is a lack of difficulty
(12:28):
integrating back into society,especially if you leave service.
Um, if you retain your at leasta position within service, you
still have that outlet, youstill have that connection.
But when you leave, it verymuch feels uh isolated.
You feel kind of like this loneindividual floating in this sea
(12:52):
of of noise.
And I think it's something thatthat really isn't recognized
very much, even if you're notdealing with PTSD or anything
kind of very extreme andacknowledged like that, there is
just this sense that you don'tfit in.
And there's what what I like tokind of refer to as a feeling
of amputation, where this partof your identity, um, this this
(13:17):
feeling of service, thisbrotherhood, this mission that
you always put first is suddenlynot there.
You're no longer a part of it.
And it leaves you feeling justbroken.
A part of you feels broken andamputated.
And it can be very difficultfor people to find paths that
(13:38):
allow them that same connection,that same sense of service and
mission.
And it's it's something thathas to be very actively worked
towards, but you have toacknowledge it before you can
work towards it.
So it's it's a very difficultdynamic, I think, for a lot of
people.
Ashley Love (13:56):
Absolutely.
And even before acknowledgingit, you know, these people who
are feeling this way, who havebeen told their whole lives to
be strong and fierce andpowerful, have to express that
too, you know, and we have toeven know it's an issue first.
And this is not one of thefirst problems that you have
identified and really beenworking towards.
(14:16):
Tell us a little bit about thework that you did at the VA.
You have built one of thecountry's first post-deployment
respiratory health clinics.
So, again, an issue that wemight not know is a problem and
you recognized it and you'reworking to fix it.
Tell us about this.
Rachel Howard (14:32):
I I had such an honor of being part of a team
that was working towardsaddressing post-deployment
respiratory issues.
It is an issue that I don'tthink we necessarily think of
very often.
You know, we talk about burnpits and such, and that that is
a big component, but simplythinking about things like
sandstorms, things about thechemicals that you're exposed to
(14:55):
on a regular basis.
Um, you know, we looked at9-11, and there was a lot of
talk about a lot of thecarcinogens that our first
responders were exposed to, orthe people who were in the event
were exposed to, and thoseoutcomes.
And it it kind of falls on deafears after a few years.
You know, after the event isover, it fades into the
(15:16):
background.
It's not sexy anymore.
And it's something thatunfortunately can lead to a life
of issues.
But what we are finding is thata lot of things like that, the
testing, your typical medicaltesting, would come back normal.
Ashley Love (15:32):
This is a great time to pause for quality
questions.
Quality questions is a segmenton the show where pre-health
students get to hear some reallife interview questions that
they might encounter on theirown pre-health interview.
If you're interviewing for aposition in medicine, here is a
question that you might hear.
A patient tells you somethingis wrong, but their labs and
(15:54):
imaging are normal.
How would you respond?
And what would guide your nextsteps?
Now, this is not a medicalknowledge question.
It's a humility question.
It's testing whether youbelieve numbers more than
people.
On Shadow Me Next, RachelHoward discussed how many
patients were dismissed becausetesting did not yet have the
(16:17):
tools to see what was happeninginternally.
So when you answer thisquestion on an interview, do not
rush to diagnostics.
Talk about listening.
Talk about patterns.
Talk about uncertainty inmedicine.
Talk about what you do whenmedicine does not have a clear
answer.
Because the strongestclinicians are not the ones who
(16:39):
know everything.
They are the ones who know howto respond when they do not.
And it doesn't just stop atquality questions.
There are more resources foryou as a pre-health student on
ShadowMeNext.com to include ournewly released application
readiness course.
So head on over tocourses.shadowmext.com and check
(17:01):
it out.
Rachel Howard (17:02):
Despite the fact that you have very clear
symptoms, um, and very commonlyin people who were incredibly
help healthy beforehand.
So it we kind of came to thisrealization that there is
something going on that we asthe medical community cannot
see.
Our testing is not in a placethat can identify this.
(17:25):
But we have been telling peoplefor years either it's in your
head or it's psychological, it'spsychological, it's really your
anxiety.
But we were really alienatingthese individuals by having a
hard time really believing themsimply because our testing
measures were not sufficient toidentify.
(17:46):
And I think it brings up apoint that as providers, whether
you're uh a doctor, whetheryou're a nurse, whether you're
an EMT, it's irrelevant.
We have to acknowledge that wedon't know everything and that
there's a lot out there that wejust don't have the ability to
see, to diagnose, um, and reallytake what we're seeing with a
(18:11):
grain of salt.
You know, it's we don't knoweverything.
There was a study done yearsago that actually showed up, I
believe it was about 70 to 80percent of people that presented
um at mental health clinicswere found to have physical
issues after the fact.
But they were dismissed and itwas pushed into mental health
(18:35):
realm.
Um so we we need to be aware ofour limitations as clinicians.
Ashley Love (18:41):
Absolutely.
And uh just to highlightexactly what you said there, we
have a hard time believing themwhen our testing measures were
saying everything is normal.
And it it's it just feels sobackwards.
I spoke to somebody recentlythat was um on the show, and his
wife, I can't remember if hewas a physician or a PA or MP, I
don't remember, but his wife isa lawyer and she says, you
(19:03):
know, everybody's innocent untilproven guilty, right?
And she says medicine just hasit so backwards.
Yes, and and I do, I feel thatway sometimes, you know, it not
to think that we're walkingaround expecting something to be
wrong with everybody and we'rejust gonna look for what's
wrong, but but if a person istelling us there is something
wrong, it's worth listening,it's worth investigating, it's
(19:23):
worth saying, you know, thingslook normal, but you still don't
feel normal.
And I do think, you know, thisis like a hidden pitch for
functional medicine right now,really is what we're talking
about.
And I'm not, I'm not, I'm notgoing to say that everybody
needs a functional medicineclinician, but functional
medicine really is helping tofill some of these gaps.
Um, have you did you work withthe VA then for a while?
Rachel Howard (19:46):
I worked at the VA for about three and a half
years before I had to leave.
Um, so fortunately our programdealt with a huge range.
You know, we we were integratedwith cardiology, with uh
pulmonary function labs, withobviously respiratory therapy
and pulmonary.
Um we we were doing CPETs andradiological imaging.
(20:08):
Um so it was ENT.
You know, we were connectedwith a lot of ENT and speech
therapy.
So we had the the reallyfortunate ability to um have
connected clinical and researchacross a huge scope of
disciplines to really startlooking into these issues and
(20:30):
trying to find, you know, whatare we missing and where do we
need to start looking morefurther?
Ashley Love (20:36):
Which is just it highlights so nicely your work
now in politics.
And we are going to get tothat, but it's just identifying
issues, even if maybe everybodydoesn't know their issues,
calling them out and workingreally, really hard to see what
we can do about it.
Um, before we jump to thatthough, I do want to talk about
(20:57):
the VA a little bit because me,I'm a PA, which is a physician
assistant, and the VA is thelargest employer of physician
assistants in the United States,right?
And and I I did so many of myrotations at the at the at the
VA, the Veterans Hospital.
And I just I loved it so much.
And um I loved working with ourveterans, they're amazing
(21:17):
people.
Um tell me a little bit aboutsome of the stereotypes, or
perhaps let's call themmisconceptions that people have
about the VA because I don'twork in the VA now, but I hear
all these things and I thinkthat is not my experience as a
clinician, and that is not whatI was hearing our patients
telling us.
And I worked in multiple areasof the VA.
(21:38):
So, for example, I did psych atthe VA, incredible.
I did um uh vascular surgery,my vascular surgery rotation at
the VA, incredible.
Again, so multiple differentvarious things.
Let's talk misconceptions justbecause everybody hears about
the VA, but um, it's not alwaysthe best.
Rachel Howard (21:56):
I think that what we have to remember.
Is very few people and very fewstories that are positive are
ever discussed, and theycertainly don't go viral.
So what people are real quickto read a review on a product
that they're unhappy about, butthey're a lot less likely to
(22:18):
take the time to advertisepositive experience.
So keeping that in mind aboutpretty much anything, that it's
always the people who had a badexperience for some reason.
And I do think we need to behonest though and acknowledge
that the VAA is an incrediblylarge organization.
So when you have a problem, andyou're going to have more of
(22:42):
them, just statistically, youhave a larger organization
treating a larger number ofpeople, you're going to have
more issues, even if when youlook at it proportionally, it's
proportionally low.
You're right.
So doing a little math thereand acknowledging some of some
of those kind of flaws in designon how we look at things.
(23:02):
But the VA, like anyorganization, is gonna have some
inherent flaws and faults, andthings happen.
Unfortunately, things arealways going to happen.
We are human, no system isflawless, no system is perfect.
And what I applaud the VA foris when issues were found within
(23:26):
it.
They took the time to addressit.
To be able to say, we screwedup, mistakes were made.
It should never have gotten tothis point.
What do we need to do toaddress this and move forward?
So I will I give themincredible props for that.
But at the same time, it isreally difficult to reverse
(23:51):
perception.
How long does it take for youreally to convince people like
no that problem existed?
We have done everything we canto address it.
Those problems no longer exist.
Are there some?
Yes, of course there are.
Of course there's issues.
But comparatively, when youwhen you look at, say, the the
(24:14):
private model of healthcare,really, like what are the
standards we're comparing?
Are you comparing wait times?
Well, it took me a year to getinto a doctor on the private
care side.
So is my three-month wait toget in at the VA really an
issue?
Or is it comparatively a greatmodel?
So I mean, there's a number offactors we have to look at.
(24:36):
Um, I personally, both as apatient and as an employee, had
a phenomenal experience.
You know, overall, all thingsconsidered, it was excellent.
And that's where I get my carenow.
Ashley Love (24:51):
Amazing.
Thank you so much forilluminating us on that.
Thank you for talking aboutaccountability, for talking
about perception.
All of these things are soimportant.
And then, of course,perspective.
You know, it's it is, it's allabout perspective, it's all
about how we're looking atthings and where we're coming
from, um, our background withlooking at things, which is a
(25:11):
great segue into this majorpivot that you have made
recently from working inmedicine, from working in public
health.
Um, I think you also have yourmaster's in mental health.
Do you have a master's inmental health?
I have a master's in socialwork.
Social work.
Oh my God.
Okay, so masters in social workas well.
Um you have entered a newarena.
Tell us about that and tell ushow your background has really,
(25:36):
really prepared you to servepeople differently.
Rachel Howard (25:39):
Yeah, it is a pivot, I think, is a very mild
way of putting it.
Um I I've been working foryears now in research, and I
mean, for decades, uh, just as aregular citizen, as a voter, I
was getting more and morefrustrated with just the climate
(25:59):
that we were in, um, at thedirection the country was going,
um, compared to what I thoughtwe should be doing and in the
environment that I expected thisnation to really be fostering.
And it kind of reached aclimax.
In all fairness, um, I blame myhusband.
He called me out.
(26:20):
He I was complaining,admittedly, a lot.
And I think he had just kind ofhad enough, and it was a put-up
or shut up.
You know, um, what are yougonna do about it?
If if you are so unhappy, dosomething about it.
And I think his words were, areyou gonna bitch about it or are
you gonna fix it?
(26:40):
Yes, I've never been moreangry.
And I was angry because he wasright.
It's like I'm doing nothing butcomplaining, but really, what
am I doing to address theseproblems?
And so I made that choice.
I made the decision I had toleave my career at the VA
because it was a conflict ofinterest.
(27:01):
So I had to make the decisionto leave the VA and to run for
United States Senate forMichigan.
And it was an incrediblydifficult choice to make because
I love what I was doing.
And to leave a place that youare happy at, to do something
that you never really wanted todo, anyways, is a really hard
(27:23):
choice.
That was a really hard choice.
It it really became what ismore important to me, my
immediate happiness andcontentment with where I am at,
or my belief that things can bebetter and that I have the
ability to make it better.
And so that that was a veryhard choice.
(27:45):
But I truly believe myexperiences are exactly what is
needed at this moment.
Um, I'm not necessarily onethat believes in like fate or
necessarily divine providence,if you will, but I actually left
um clinical medicine myself onessentially a midlife crisis.
(28:08):
So when I completed myundergrad, I was supposed to be
applying for PA.
That was my goal.
That's what I was going to do.
And when the time came tosubmit applications, I wasn't
completing applications.
I was dragging my feet, I wasfinding excuses.
And it's like, what ishappening to me?
This has been 20 years in themaking.
(28:28):
And now what?
Uh you know, without applyingfor this, who am I even?
And I was panicking and I knewthat if I didn't continue
school, I was I was gonna goout, I was gonna find a job, and
I was never gonna come back.
So I panic applied for socialwork.
I I had I just panicked and Isaid, social work can be used
(28:52):
everywhere.
It'll keep me going until I canfocus.
And so that's what I did.
And I found that this thesystems change and this
leadership and really this macroperspective really resonated
with me, um, which led into thepublic health.
Say, how can I do this?
How can I turn this intosomething that could be big?
(29:13):
And that it was that samemoment when I chose to run.
It was this I can do more.
You know, where I am going isis not necessarily the most that
I can do and the most that Ican be.
Um it's it's been a trip.
So that's the only way I candescribe it.
(29:37):
It's been a trip.
Ashley Love (29:38):
I am so glad that you mentioned your desire and
your apparent calling to be a PAand how that shifted.
Because it is, it was aquestion that I had, which was
so many of our military medicsand corpsmen, they they go to
become P.
This is also how the professionwas invented.
Exactly.
(29:58):
And so I'm sitting herethinking where where was the
shift made?
And that is it's so importantfor our pre-health listeners to
hear this because I think um,and they come to me talking
about a six-year journey or afour-year journey through
college, and they're concernedabout their um pivot, which is
an appropriate term for theirshift.
(30:18):
You're coming with a 20-yearjourney and a 20-year history,
and you make this like absolutechange in things, and um, it's
something that's incrediblyimportant.
We've talked about this on theshow before.
I am entirely averse topolitics.
I it just stresses me out andspeaking with our incredible
healthcare workers, bless yourheart, speaking with our
(30:40):
incredible healthcare workerswho are starting to um enter
politics.
We're seeing a big shift inthis right now.
And and I'm just I'm so excitedabout it now, and I'm so
grateful for um, well, for youguys for really being incredibly
brave and stepping into thisnew arena.
Tell us why do we needhealthcare leaders in politics?
Rachel Howard (31:04):
To me, this is one of those how did we lose
sight of common sense?
We as a nation, manyorganizations, corporations, um,
government agencies, regardlessof the entity you're looking
at, there is a tendency forpeople at the top to think that
they know what the bottom needsto be doing.
(31:28):
And to me, it's a verymicromanagement style.
But the the goal at the top isto set the mission and the
goals.
Yes, by all means, come up withideas, troubleshoot problem
solve, but you need to go toBoots on Ground to say, what are
(31:49):
you experiencing?
Where are the actual problems?
Because this is what we'reseeing up here, but what are you
experiencing on ground?
And what do you need from us asleadership to ensure that you
have what you need to do thejob?
And we we seem to have lostthat.
(32:09):
You know, we're not hearingthose people on ground who are
experiencing this every day, andas a result, we're just
throwing things at the wall andseeing what sticks.
It's not effective, it isincredibly costly, it's taking a
lot of time, and people aresuffering because of that.
So, getting healthcare leaderswho have experience, who truly
(32:34):
understand the system, who'vebeen there, and putting them in
roles like this, that they cansay, you're going about it the
wrong way.
There are so many factors thatyou are not considering that are
going to impact our providers,which by default impacts our
patients.
And that that is something thatis just so incredibly
(32:56):
necessary.
You know, if I have anelectrical problem, I'm not
gonna go talk to a mechanic, anauto mechanic.
I'm gonna call an electricianbecause that's the person that
knows electricity.
It's I don't even know how tosay like it's common sense
without saying it's commonsense.
Ashley Love (33:14):
I love that.
And you're absolutely right.
And I think as as clinicians,especially, we get so frustrated
with the big system changes inmedicine that do percolate down
and directly affect ourpatients.
And yet it's a big shift if wewanted to step into that arena.
And the fact that we havepeople like you who are willing
(33:36):
to do this and make this changeis just incredible.
Guys, if you are interested insupporting her run for office,
please visit her atrachelforussenate.org.
That's R-A-C-H-E-L for USSenate.org.
Um, to hear more about her andher platform and really the
incredible, incredible thingsthat she's doing.
Rachel for US Senate isInstagram and TikTok, and then
(33:58):
YouTube at Rachel for U.S.
Senate Official.
Rachel, you're amazing.
You are incredible.
Thank you so much for doingwhat you do.
Thank you for describing yourjourney, even the really hard
parts.
Um, it is it is incredible.
And um, I'm so glad to havepeople like you still fighting
for us.
Rachel Howard (34:17):
Thank you.
Thank you so much.
I appreciate being here.
Truly.
Um, it's been a pleasure.
It has been a pleasure.
Ashley Love (34:23):
Thank you so very much for listening to this
episode of Shadow Me Next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
Monday.
As always, if you have anyquestions, let me know on
Facebook or Instagram.
Access you want, stories youneed, you're always invited to
Shadow Me Next.
Please keep in mind that thecontent of this podcast is
(34:48):
intended for informational andentertainment purposes only and
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
those of the host and guests,and do not necessarily reflect
the official policy or positionof any other agency,
organization, employer, orcompany.
What are we still missing if our service men and
women are coming home amputated?
But not in the way you mightthink.
Today on Shadow Me Next, I'msitting down with a 14-year
combat medic, Rachel Howard, whosaw this up close, helped build
post-deployment treatmentcenters, and then realized
something even bigger wasbroken.
And instead of complainingabout it, this incredible
(00:24):
warrior stepped up to the plateagain.
If you're pre-med or pre-PA,you've been taught to focus on
performance.
But no one is teaching you howto recognize the blind spots in
the system you're entering.
And if you don't learn to seethem now, you may inherit them
later.
In this episode, we unpack whatwe're missing and what real
(00:46):
service actually demands.
Welcome to Shadow Me Next, apodcast where I take you into
and behind the scenes of themedical world to provide you
with a deeper understanding ofthe human side of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor, and thecreator of Shadow Me Next.
I invite you to join me as wetake a conversational and
(01:08):
personal look into the lives andminds of leaders in medicine.
This is Shadow Me Next withRachel Howard.
Rachel, thank you so much forjoining us on Shadow Me Next
today.
You are a 14-year combat medicin the Army National Guard.
You've been deployed to twolocations that most people don't
holiday at.
(01:29):
You've seen some things whileyou are working as a combat
medic.
We're going to talk about this.
And we are also going to talkabout some major pivots that you
have made that I think aregoing to be really, really
interesting to a lot of people,but primarily our pre-health
students, because they mightask, you know, Rachel, why
didn't you keep working at EMS?
(01:49):
Why did you make this change?
So lots of incredible things totalk about today.
Thank you so much for joiningus.
Rachel Howard (01:55):
Sure.
Ashley Love (01:56):
Love it.
Fantastic.
So if we could go back to youryears working as a combat medic,
is that something that was anecessity for you to work?
Or is that something that youheard about and you thought, you
know what?
This sounds really, reallyinteresting.
Let me see what it's all about.
Rachel Howard (02:11):
It's a little bit of both.
Um, I actually, my high schooloffered an EMT course.
So I was able to take EMT inhigh school.
And I had always already beendrawn to kind of a medical
field, veterinary medicine.
Um, and taking that coursereally it clicked.
I said, this is something thatI really connect with.
(02:31):
This is something that I loveto do.
And so that really kind ofshaped what I wanted my the
trajectory of my life to be.
Uh so after high school, um,after I eventually got my all my
licensures, um I did go to workfor an ambulance company.
It was the private serviceambulance company.
Cool.
And I I loved what I did.
I loved the people that Iworked with.
(02:54):
And at that time, we werelooking, this was the um kind of
2003, 2004, 2005 time frame.
So not that long after 9-11.
And coming from a family thathad a lot of people who served,
the military was always in theback of my mind.
That was that service mentalitywas always kind of ingrained in
(03:14):
us.
And I said, this is something Iwant to do in the military, but
I also love what I'm doing inemergency medicine.
So I went to recruiter andessentially said, I want to
enlist, but I will only enlistif you can do so as a combat
medic.
Amazing.
That's a deal breaker.
You have to have me as a combatmedic.
(03:35):
And they made it happen.
So it was I knew it's what Iwas gonna do.
I'd already kind of been primedfor that.
Um, I went in very eyes wideopen, having already experienced
kind of an emergency medicinesetting.
Right.
And that was sort of thebeginning of a very long
journey.
Ashley Love (03:55):
Oh, yeah, I would imagine one that we are gonna
dive into, and it's just sointeresting to me.
Um, so this is great becauseyou worked in EMS first, and
then and then you worked as acombat medic.
Well, first for for those of uswho might not know, can you
explain to us what it means tobe a combat medic?
(04:15):
I think we'd we'd love to hearthat.
Rachel Howard (04:18):
Combat medicine and with an understanding that
it is different in every branchof service.
Um, you know, what maybe anaval corpsman is doing can be
very, very different than whatan army medic is doing.
Um, and there is a huge scopeeven within within army
medicine.
You may be stationed at ahospital doing kind of hospital
work and you're working as likean ER tech, or you're maybe
(04:39):
working on the floor.
Um, but for my my position, um,I was part of a medical
company.
So we had an entire scope ofessentially anything that you
can imagine doing within athree-day course of care.
So we could care for patientsfor about three days.
And so we had x-rays, we hadpharmacy, we had, we even had
(05:01):
dental.
Ashley Love (05:02):
Wow.
Rachel Howard (05:03):
Um, you know, so we we had a very large resource
available to us.
It was like working for a verysmall kind of urgent care
hospital setting.
And what we ended up doingprimarily was being able to set
up an environment that couldprovide this kind of interim
care before you either needed tomove on to higher level care or
(05:24):
could be returned back to yourduty status.
For myself, I primarily workedon an ambulance within that
setting.
I had a military ambulance thatI could go out.
I would just like normaloperations, I could treat
patients in the field, I couldbring them back for further
care.
Um, we also focused on kind oflike seaburn incidents, so
(05:47):
chemical, biological,radiological, nuclear um kind of
explosion.
We were trained to be able tooperate in that environment in
appropriate hazmat gear,decontamination, and treatment
within that context.
While overseas, I servedprimarily um, you know, briefly
in kind of clinic settings,managing small clinics.
(06:08):
Uh, but also my primary dutywas to go out on convoys, um, on
whatever that mission may be.
I would be kind of embeddedwith a team that would be going
out and I provided medicalservices, um, both for any sort
of emergency circumstance, butalso for your true to medicine,
(06:29):
your kind of boring day-to-day.
Someone's dehydrated, we havetoo many energy drinks, but not
enough water, um, being able towork with some of the local
population in Iraq and orAfghanistan that we would come
across that maybe had medicalneeds or questions.
You know, I could I had a lotof flexibility and a lot of
range in my scope of practice tobe able to kind of test those
(06:51):
boundaries and really exploreother opportunities in your
normal uh medical environment.
Ashley Love (06:57):
And you did this for 14 years.
14 years.
Incredible.
So at that point, did you didyou have a family?
Were you away from your familyfor that stretch of time?
No.
Rachel Howard (07:08):
So I was with the Army National Guard.
So the traditional model is theone weekend a month, two weeks
in the summer.
Um, never in my career did thatever actually work out that
way.
Uh, I was either pulled on fulltime for just other operations
stateside.
Um, I was deployed.
It was it was never one weekenda month, um, which was my
(07:30):
choice.
But I fortunately orunfortunately, I did not have
family aside from you know myparents and my brother.
I was ideal in that sense thatI didn't have a house, I didn't
have kids, I had the flexibilityto kind of go where I wanted
and engage how I chose.
Ashley Love (07:51):
It's amazing.
The reason I ask is because,you know, I was hoping to
discuss some of the differencesbetween working as a combat
medic and working in EMS stateside.
And that's a big one.
You know, I think when we makethese decisions and we think
about what we want our career tolook like, we have to stop and
think about what we want ourlife to look like.
And of course, I know thelisteners might, but I know
(08:12):
right now that you have fourchildren.
So you have quite a largefamily now.
So, you know, it it definitelyinforms some of these decisions
of ours to make these major lifechanges, I think.
Tell us a little bit about whatthat what that looked like,
perhaps um, th those thoughtprocesses for you.
Rachel Howard (08:28):
I I was fortunate, and like I said, that
I didn't have those ties um forthe most the majority of my
military career.
Uh but I I will say that uhreally once I met my husband, I
was at the tail end of mycareer.
I didn't know it was the tailend of my career.
Um, but in hindsight, it was.
I at that point, I had beeninjured overseas in Afghanistan.
(08:51):
So I had a number of medicalissues that I had been kind of
dealing with because of that.
Um, I had for years kind ofmanaged to make it work.
I was injured in 2012.
Um, and I had gone throughwhat's called a med board where
they, you know, really are youfit to continue doing this job?
Which I made it through one,but you're still dealing with
(09:13):
these physical injuries dayafter day.
And I was having a harder timekeeping up.
It was it was a real struggle.
I was really having to pushmyself.
And I had met my husband, youknow, we were engaged, we
decided we want to get married.
He had two kids from a previousmarriage.
Um, we had left it open to uspotentially having having
children, and it came up anothertime for a med board.
(09:35):
And the the question became doI continue to fight this?
Do I really, is that where mylife is meant to go at this
point?
Um and I ultimately made anincredibly difficult decision
because I thought this was mylife's path.
Um, I made the decision that itwas not in the best interest of
(09:57):
the military and it was not inthe best interest of my future
family for me to continue onthis trajectory.
So I did have to make thatchoice, and that was not easy.
That's I still struggle with iton the regular.
Which really, I mean, it speaksso much to your dedication to
(10:17):
service, right?
And and I want to reallyhighlight something that you
just said, and um it was thefirst thing you said, which is
when you made this decision tomake this life-altering change,
the first thought was uh, isthis best for the military?
Is is me, is me being here whatis best for the system in which
(10:38):
I'm working.
And I think that it justhighlights the selflessness of
your thought processes.
And I think in medicine, wealso we also have to make this
decision one day too, you know.
Sometimes it's earlier in ourcareer, sometimes it's much
later in our career.
Um, but it it becomes ourlife's work.
And I think when we start tohave to shift, it's an identity
shift, is what it is.
And I think when we have tomake that identity shift, it can
(11:00):
be um, it can be verychallenging.
And I'm just gonna put in alittle plug for women because I
do think as women, we make a lotof identity shifts, especially
if we have children.
You know, we go from not havingchildren to, and whether
they're our own biologicalchildren or children of our
spouse, for example, to toliterally assuming a new role of
(11:21):
a mother, you know, and Ithink, and and then of course,
careers and and caregivers, youknow, with aging parents.
This also falls to men as well,but I do think that women
especially do these make theseshifts quite well.
Um, so bravo to you for forfirst of all being brave enough
to make that decision, butnumber two, really thinking
about how you play a role in thebigger picture and if your role
(11:44):
in the bigger picture isabsolutely necessary at that
point.
Um, there was something youmentioned that I wanted to go
back to.
I'm sorry to hear that yousustained an injury in service
and and you made a point to saya physical injury.
Um, tell us about otherinjuries that our military
personnel might be experiencingoverseas or anywhere.
(12:04):
It's, I mean, well, it runs thegamut.
Um, you you have a lot ofphysical injuries.
You have a lot of the verycommon mental health issues,
whether that's post-magicstress, post-matic stress
disorder, um, you're lessdiagnosed, uh, or not even
diagnosable, but I think reallycommon is a lack of difficulty
(12:28):
integrating back into society,especially if you leave service.
Um, if you retain your at leasta position within service, you
still have that outlet, youstill have that connection.
But when you leave, it verymuch feels uh isolated.
You feel kind of like this loneindividual floating in this sea
(12:52):
of of noise.
And I think it's something thatthat really isn't recognized
very much, even if you're notdealing with PTSD or anything
kind of very extreme andacknowledged like that, there is
just this sense that you don'tfit in.
And there's what what I like tokind of refer to as a feeling
of amputation, where this partof your identity, um, this this
(13:17):
feeling of service, thisbrotherhood, this mission that
you always put first is suddenlynot there.
You're no longer a part of it.
And it leaves you feeling justbroken.
A part of you feels broken andamputated.
And it can be very difficultfor people to find paths that
(13:38):
allow them that same connection,that same sense of service and
mission.
And it's it's something thathas to be very actively worked
towards, but you have toacknowledge it before you can
work towards it.
So it's it's a very difficultdynamic, I think, for a lot of
people.
Ashley Love (13:56):
Absolutely.
And even before acknowledgingit, you know, these people who
are feeling this way, who havebeen told their whole lives to
be strong and fierce andpowerful, have to express that
too, you know, and we have toeven know it's an issue first.
And this is not one of thefirst problems that you have
identified and really beenworking towards.
(14:16):
Tell us a little bit about thework that you did at the VA.
You have built one of thecountry's first post-deployment
respiratory health clinics.
So, again, an issue that wemight not know is a problem and
you recognized it and you'reworking to fix it.
Tell us about this.
Rachel Howard (14:32):
I I had such an honor of being part of a team
that was working towardsaddressing post-deployment
respiratory issues.
It is an issue that I don'tthink we necessarily think of
very often.
You know, we talk about burnpits and such, and that that is
a big component, but simplythinking about things like
sandstorms, things about thechemicals that you're exposed to
(14:55):
on a regular basis.
Um, you know, we looked at9-11, and there was a lot of
talk about a lot of thecarcinogens that our first
responders were exposed to, orthe people who were in the event
were exposed to, and thoseoutcomes.
And it it kind of falls on deafears after a few years.
You know, after the event isover, it fades into the
(15:16):
background.
It's not sexy anymore.
And it's something thatunfortunately can lead to a life
of issues.
But what we are finding is thata lot of things like that, the
testing, your typical medicaltesting, would come back normal.
Ashley Love (15:32):
This is a great time to pause for quality
questions.
Quality questions is a segmenton the show where pre-health
students get to hear some reallife interview questions that
they might encounter on theirown pre-health interview.
If you're interviewing for aposition in medicine, here is a
question that you might hear.
A patient tells you somethingis wrong, but their labs and
(15:54):
imaging are normal.
How would you respond?
And what would guide your nextsteps?
Now, this is not a medicalknowledge question.
It's a humility question.
It's testing whether youbelieve numbers more than
people.
On Shadow Me Next, RachelHoward discussed how many
patients were dismissed becausetesting did not yet have the
(16:17):
tools to see what was happeninginternally.
So when you answer thisquestion on an interview, do not
rush to diagnostics.
Talk about listening.
Talk about patterns.
Talk about uncertainty inmedicine.
Talk about what you do whenmedicine does not have a clear
answer.
Because the strongestclinicians are not the ones who
(16:39):
know everything.
They are the ones who know howto respond when they do not.
And it doesn't just stop atquality questions.
There are more resources foryou as a pre-health student on
ShadowMeNext.com to include ournewly released application
readiness course.
So head on over tocourses.shadowmext.com and check
(17:01):
it out.
Rachel Howard (17:02):
Despite the fact that you have very clear
symptoms, um, and very commonlyin people who were incredibly
help healthy beforehand.
So it we kind of came to thisrealization that there is
something going on that we asthe medical community cannot
see.
Our testing is not in a placethat can identify this.
(17:25):
But we have been telling peoplefor years either it's in your
head or it's psychological, it'spsychological, it's really your
anxiety.
But we were really alienatingthese individuals by having a
hard time really believing themsimply because our testing
measures were not sufficient toidentify.
(17:46):
And I think it brings up apoint that as providers, whether
you're uh a doctor, whetheryou're a nurse, whether you're
an EMT, it's irrelevant.
We have to acknowledge that wedon't know everything and that
there's a lot out there that wejust don't have the ability to
see, to diagnose, um, and reallytake what we're seeing with a
(18:11):
grain of salt.
You know, it's we don't knoweverything.
There was a study done yearsago that actually showed up, I
believe it was about 70 to 80percent of people that presented
um at mental health clinicswere found to have physical
issues after the fact.
But they were dismissed and itwas pushed into mental health
(18:35):
realm.
Um so we we need to be aware ofour limitations as clinicians.
Ashley Love (18:41):
Absolutely.
And uh just to highlightexactly what you said there, we
have a hard time believing themwhen our testing measures were
saying everything is normal.
And it it's it just feels sobackwards.
I spoke to somebody recentlythat was um on the show, and his
wife, I can't remember if hewas a physician or a PA or MP, I
don't remember, but his wife isa lawyer and she says, you
(19:03):
know, everybody's innocent untilproven guilty, right?
And she says medicine just hasit so backwards.
Yes, and and I do, I feel thatway sometimes, you know, it not
to think that we're walkingaround expecting something to be
wrong with everybody and we'rejust gonna look for what's
wrong, but but if a person istelling us there is something
wrong, it's worth listening,it's worth investigating, it's
(19:23):
worth saying, you know, thingslook normal, but you still don't
feel normal.
And I do think, you know, thisis like a hidden pitch for
functional medicine right now,really is what we're talking
about.
And I'm not, I'm not, I'm notgoing to say that everybody
needs a functional medicineclinician, but functional
medicine really is helping tofill some of these gaps.
Um, have you did you work withthe VA then for a while?
Rachel Howard (19:46):
I worked at the VA for about three and a half
years before I had to leave.
Um, so fortunately our programdealt with a huge range.
You know, we we were integratedwith cardiology, with uh
pulmonary function labs, withobviously respiratory therapy
and pulmonary.
Um we we were doing CPETs andradiological imaging.
(20:08):
Um so it was ENT.
You know, we were connectedwith a lot of ENT and speech
therapy.
So we had the the reallyfortunate ability to um have
connected clinical and researchacross a huge scope of
disciplines to really startlooking into these issues and
(20:30):
trying to find, you know, whatare we missing and where do we
need to start looking morefurther?
Ashley Love (20:36):
Which is just it highlights so nicely your work
now in politics.
And we are going to get tothat, but it's just identifying
issues, even if maybe everybodydoesn't know their issues,
calling them out and workingreally, really hard to see what
we can do about it.
Um, before we jump to thatthough, I do want to talk about
(20:57):
the VA a little bit because me,I'm a PA, which is a physician
assistant, and the VA is thelargest employer of physician
assistants in the United States,right?
And and I I did so many of myrotations at the at the at the
VA, the Veterans Hospital.
And I just I loved it so much.
And um I loved working with ourveterans, they're amazing
(21:17):
people.
Um tell me a little bit aboutsome of the stereotypes, or
perhaps let's call themmisconceptions that people have
about the VA because I don'twork in the VA now, but I hear
all these things and I thinkthat is not my experience as a
clinician, and that is not whatI was hearing our patients
telling us.
And I worked in multiple areasof the VA.
(21:38):
So, for example, I did psych atthe VA, incredible.
I did um uh vascular surgery,my vascular surgery rotation at
the VA, incredible.
Again, so multiple differentvarious things.
Let's talk misconceptions justbecause everybody hears about
the VA, but um, it's not alwaysthe best.
Rachel Howard (21:56):
I think that what we have to remember.
Is very few people and very fewstories that are positive are
ever discussed, and theycertainly don't go viral.
So what people are real quickto read a review on a product
that they're unhappy about, butthey're a lot less likely to
(22:18):
take the time to advertisepositive experience.
So keeping that in mind aboutpretty much anything, that it's
always the people who had a badexperience for some reason.
And I do think we need to behonest though and acknowledge
that the VAA is an incrediblylarge organization.
So when you have a problem, andyou're going to have more of
(22:42):
them, just statistically, youhave a larger organization
treating a larger number ofpeople, you're going to have
more issues, even if when youlook at it proportionally, it's
proportionally low.
You're right.
So doing a little math thereand acknowledging some of some
of those kind of flaws in designon how we look at things.
(23:02):
But the VA, like anyorganization, is gonna have some
inherent flaws and faults, andthings happen.
Unfortunately, things arealways going to happen.
We are human, no system isflawless, no system is perfect.
And what I applaud the VA foris when issues were found within
(23:26):
it.
They took the time to addressit.
To be able to say, we screwedup, mistakes were made.
It should never have gotten tothis point.
What do we need to do toaddress this and move forward?
So I will I give themincredible props for that.
But at the same time, it isreally difficult to reverse
(23:51):
perception.
How long does it take for youreally to convince people like
no that problem existed?
We have done everything we canto address it.
Those problems no longer exist.
Are there some?
Yes, of course there are.
Of course there's issues.
But comparatively, when youwhen you look at, say, the the
(24:14):
private model of healthcare,really, like what are the
standards we're comparing?
Are you comparing wait times?
Well, it took me a year to getinto a doctor on the private
care side.
So is my three-month wait toget in at the VA really an
issue?
Or is it comparatively a greatmodel?
So I mean, there's a number offactors we have to look at.
(24:36):
Um, I personally, both as apatient and as an employee, had
a phenomenal experience.
You know, overall, all thingsconsidered, it was excellent.
And that's where I get my carenow.
Ashley Love (24:51):
Amazing.
Thank you so much forilluminating us on that.
Thank you for talking aboutaccountability, for talking
about perception.
All of these things are soimportant.
And then, of course,perspective.
You know, it's it is, it's allabout perspective, it's all
about how we're looking atthings and where we're coming
from, um, our background withlooking at things, which is a
(25:11):
great segue into this majorpivot that you have made
recently from working inmedicine, from working in public
health.
Um, I think you also have yourmaster's in mental health.
Do you have a master's inmental health?
I have a master's in socialwork.
Social work.
Oh my God.
Okay, so masters in social workas well.
Um you have entered a newarena.
Tell us about that and tell ushow your background has really,
(25:36):
really prepared you to servepeople differently.
Rachel Howard (25:39):
Yeah, it is a pivot, I think, is a very mild
way of putting it.
Um I I've been working foryears now in research, and I
mean, for decades, uh, just as aregular citizen, as a voter, I
was getting more and morefrustrated with just the climate
(25:59):
that we were in, um, at thedirection the country was going,
um, compared to what I thoughtwe should be doing and in the
environment that I expected thisnation to really be fostering.
And it kind of reached aclimax.
In all fairness, um, I blame myhusband.
He called me out.
(26:20):
He I was complaining,admittedly, a lot.
And I think he had just kind ofhad enough, and it was a put-up
or shut up.
You know, um, what are yougonna do about it?
If if you are so unhappy, dosomething about it.
And I think his words were, areyou gonna bitch about it or are
you gonna fix it?
(26:40):
Yes, I've never been moreangry.
And I was angry because he wasright.
It's like I'm doing nothing butcomplaining, but really, what
am I doing to address theseproblems?
And so I made that choice.
I made the decision I had toleave my career at the VA
because it was a conflict ofinterest.
(27:01):
So I had to make the decisionto leave the VA and to run for
United States Senate forMichigan.
And it was an incrediblydifficult choice to make because
I love what I was doing.
And to leave a place that youare happy at, to do something
that you never really wanted todo, anyways, is a really hard
(27:23):
choice.
That was a really hard choice.
It it really became what ismore important to me, my
immediate happiness andcontentment with where I am at,
or my belief that things can bebetter and that I have the
ability to make it better.
And so that that was a veryhard choice.
(27:45):
But I truly believe myexperiences are exactly what is
needed at this moment.
Um, I'm not necessarily onethat believes in like fate or
necessarily divine providence,if you will, but I actually left
um clinical medicine myself onessentially a midlife crisis.
(28:08):
So when I completed myundergrad, I was supposed to be
applying for PA.
That was my goal.
That's what I was going to do.
And when the time came tosubmit applications, I wasn't
completing applications.
I was dragging my feet, I wasfinding excuses.
And it's like, what ishappening to me?
This has been 20 years in themaking.
(28:28):
And now what?
Uh you know, without applyingfor this, who am I even?
And I was panicking and I knewthat if I didn't continue
school, I was I was gonna goout, I was gonna find a job, and
I was never gonna come back.
So I panic applied for socialwork.
I I had I just panicked and Isaid, social work can be used
(28:52):
everywhere.
It'll keep me going until I canfocus.
And so that's what I did.
And I found that this thesystems change and this
leadership and really this macroperspective really resonated
with me, um, which led into thepublic health.
Say, how can I do this?
How can I turn this intosomething that could be big?
(29:13):
And that it was that samemoment when I chose to run.
It was this I can do more.
You know, where I am going isis not necessarily the most that
I can do and the most that Ican be.
Um it's it's been a trip.
So that's the only way I candescribe it.
(29:37):
It's been a trip.
Ashley Love (29:38):
I am so glad that you mentioned your desire and
your apparent calling to be a PAand how that shifted.
Because it is, it was aquestion that I had, which was
so many of our military medicsand corpsmen, they they go to
become P.
This is also how the professionwas invented.
Exactly.
(29:58):
And so I'm sitting herethinking where where was the
shift made?
And that is it's so importantfor our pre-health listeners to
hear this because I think um,and they come to me talking
about a six-year journey or afour-year journey through
college, and they're concernedabout their um pivot, which is
an appropriate term for theirshift.
(30:18):
You're coming with a 20-yearjourney and a 20-year history,
and you make this like absolutechange in things, and um, it's
something that's incrediblyimportant.
We've talked about this on theshow before.
I am entirely averse topolitics.
I it just stresses me out andspeaking with our incredible
healthcare workers, bless yourheart, speaking with our
(30:40):
incredible healthcare workerswho are starting to um enter
politics.
We're seeing a big shift inthis right now.
And and I'm just I'm so excitedabout it now, and I'm so
grateful for um, well, for youguys for really being incredibly
brave and stepping into thisnew arena.
Tell us why do we needhealthcare leaders in politics?
Rachel Howard (31:04):
To me, this is one of those how did we lose
sight of common sense?
We as a nation, manyorganizations, corporations, um,
government agencies, regardlessof the entity you're looking
at, there is a tendency forpeople at the top to think that
they know what the bottom needsto be doing.
(31:28):
And to me, it's a verymicromanagement style.
But the the goal at the top isto set the mission and the
goals.
Yes, by all means, come up withideas, troubleshoot problem
solve, but you need to go toBoots on Ground to say, what are
(31:49):
you experiencing?
Where are the actual problems?
Because this is what we'reseeing up here, but what are you
experiencing on ground?
And what do you need from us asleadership to ensure that you
have what you need to do thejob?
And we we seem to have lostthat.
(32:09):
You know, we're not hearingthose people on ground who are
experiencing this every day, andas a result, we're just
throwing things at the wall andseeing what sticks.
It's not effective, it isincredibly costly, it's taking a
lot of time, and people aresuffering because of that.
So, getting healthcare leaderswho have experience, who truly
(32:34):
understand the system, who'vebeen there, and putting them in
roles like this, that they cansay, you're going about it the
wrong way.
There are so many factors thatyou are not considering that are
going to impact our providers,which by default impacts our
patients.
And that that is something thatis just so incredibly
(32:56):
necessary.
You know, if I have anelectrical problem, I'm not
gonna go talk to a mechanic, anauto mechanic.
I'm gonna call an electricianbecause that's the person that
knows electricity.
It's I don't even know how tosay like it's common sense
without saying it's commonsense.
Ashley Love (33:14):
I love that.
And you're absolutely right.
And I think as as clinicians,especially, we get so frustrated
with the big system changes inmedicine that do percolate down
and directly affect ourpatients.
And yet it's a big shift if wewanted to step into that arena.
And the fact that we havepeople like you who are willing
(33:36):
to do this and make this changeis just incredible.
Guys, if you are interested insupporting her run for office,
please visit her atrachelforussenate.org.
That's R-A-C-H-E-L for USSenate.org.
Um, to hear more about her andher platform and really the
incredible, incredible thingsthat she's doing.
Rachel for US Senate isInstagram and TikTok, and then
(33:58):
YouTube at Rachel for U.S.
Senate Official.
Rachel, you're amazing.
You are incredible.
Thank you so much for doingwhat you do.
Thank you for describing yourjourney, even the really hard
parts.
Um, it is it is incredible.
And um, I'm so glad to havepeople like you still fighting
for us.
Rachel Howard (34:17):
Thank you.
Thank you so much.
I appreciate being here.
Truly.
Um, it's been a pleasure.
It has been a pleasure.
Ashley Love (34:23):
Thank you so very much for listening to this
episode of Shadow Me Next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
Monday.
As always, if you have anyquestions, let me know on
Facebook or Instagram.
Access you want, stories youneed, you're always invited to
Shadow Me Next.
Please keep in mind that thecontent of this podcast is
(34:48):
intended for informational andentertainment purposes only and
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
those of the host and guests,and do not necessarily reflect
the official policy or positionof any other agency,
organization, employer, orcompany.
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