January 28, 2025 • 48 mins
Hey Heart Buddies. This episode is so important. I welcome Julia Hotz, whose book, "The Connection Cure," is revolutionizing the way we approach healthcare. This episode takes a deep dive into how social prescribing—a practice that includes non-medical treatments such as art, movement, nature, and community involvement—can significantly enhance heart health and overall well-being. Julia shares compelling data and heartwarming stories about individuals who've transformed their lives through these holistic measures. Hear how simple, yet powerful, prescriptions for happiness and connection can make all the difference in your journey towards thriving post-heart surgery. You won't want to miss this enlightening conversation that bridges the gap between modern medicine and soulful living.
About Julia and how to get your own copy of The Connection Cure: THE CONNECTION CURE Book — Julia Hotz
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:01):
We're not saying that. Throw out all the pills, throw out all the
surgeries, throw out all the therapies. We need all of that, too. This
is about putting another option onto the healthcare menu.
And I think it's this type of thing that the more we normalize it,
the more we talk about health as something that is the product of our
connections, the more we can accept that,
(00:23):
yeah, social prescriptions make a lot of sense.
Welcome to Open Heart Surgery with Boots, where we explore
the journey of heart health through the eyes of those who live it every
day. I'm your host, Boots Knighton, and in season
five, we're focusing on what it truly means to
thrive. We'll dive into cutting edge medical advances,
(00:45):
share powerful stories from both sides of the stethoscope,
and learn how to be better advocates for our own health.
From candid conversations with cardiac patients to
insights from dedicated healthcare professionals, each
episode brings you closer to understanding the complex world
of heart health. Whether you're navigating your own cardiac
(01:08):
journey or supporting someone who is, you're in the right
place. So let's get to today's story.
I thank you for being here, for
supporting this podcast, for showing up in the
world and shining your bright light. It is not
easy being a heart patient, and if you are new to me
(01:29):
and this podcast, I welcome you with open heart and
open arms. I started this podcast
for all heart patients worldwide and as of this
recording, I have now been downloaded in 65
countries, which is just really astonishing to
me and so thank you. I love you,
(01:51):
I see you, I hear you. I am here for you.
Please send an email
bootsheheartchamberpodcast.com that was the
original name of this podcast and I want to hear from you. If
you're just now finding this podcast and tell me what you need to hear
more of what you need support with and then find us on
(02:11):
Patreon at Open Heart Surgery with Boots.
And that is a great way to support the show and
get involved with the community that I'm slowly getting going
as I still continue to navigate my own heart.
Hello, welcome to Open Heart Surgery with Boots.
Oh, man, I tell you, I. I have been so
(02:34):
fired up about 2025 for a while because
I knew who I had on the roster. I
have taken so much care this year to bring
you a curated list of guests
who are thriving after open heart
surgery or who are contributing to the world of open heart
(02:56):
surgery or who are helping us think
outside the box of the medical field.
I have said in past episodes that we need,
we need more than like a cardiologist and a general
practitioner on our team. We need a nutritionist. We
need an ob gyn if you're a female.
(03:18):
We need a pelvic floor specialist. I'm bringing the whole
month of February, I'm bringing, bringing you pelvic
floor health because our pelvic floor is so
impacted by heart surgery. But today
I'm going to be doing this. Throughout the year, I'm going to be highlighting various
authors who have written books about health
(03:41):
care in various ways. And today is the first
author I'm bringing to you for 2025.
Julia Hotz, welcome. Has written
the most impactful book I have read in a
while and I'm going to show it to you because I
am hoping to start putting some more videos up of whole podcast.
(04:03):
So this is called the Connection Cure. I love
the title of the book. I love the COVID And
this book, the, the subheading is a
better way of thinking about medicine and healing. And
that's, that's what really touched me because the whole
impetus of this podcast has been there's gotta be
(04:25):
more than just my surgeon telling me to go live my
best life to clear my sternotomy. It's healed.
Now just go out into the world and go on about your life. I found
that then I just was kind of like lost in the
shuffle. And I've had to figure out how to thrive. Not just
survive, but thrive post open heart surgery. Lo and
(04:47):
behold, this past summer, this book comes
across my feed and thank goodness it did. And I've been
implementing it into my life and I just went straight to the
source and like cold emailed Julia and was like,
will you please come on my podcast? And then maybe we could be friends.
So here we are today. So, Julia, thank
(05:10):
you. And Julia, I just want you to brag on
yourself who you are. You are just contributing so much of
your writing to the world. So I had like a writing crush on you. Tell
us about who you are and set the scene before we dive into your really
important book. Well, back at you,
boots. And if I can just brag about you for a second, as I'm
(05:32):
sure all your listeners know, you know, this book that I've written and everything
I stand for is all about the power of connecting with
others. It's about the power of connecting with our outdoor
environments, our artistic lives, our inner self.
And every listener of this podcast must know that you embody that
message so well. So the honor is really mine.
(05:55):
The way that you've Touched so many people with your story,
and I think we are sort of kindred soul sisters in a way. I
think we're both really interested in what
is it that we're all here for. Right. And in those tough moments,
whether it's heart surgery or any sort of medical
challenge, what can that teach us about ourselves in the
(06:17):
world and what really matters? So it is such an
honor to be here and to talk about my book, the Connection Cure, which,
thank you for reading and being a super fan of it means
so much to me. Thank you. And, you know, I'm inspiring
author myself, and I know what it takes to birth a book and get it
into the world. And you had to
(06:40):
really travel the entire world, it
seems. And I. I'm really
amazed at what you. The qualitative and
quantitative data you gathered. I mean, you put so much heart and
soul into this book, and I'm sold on it. And it' it really is an
amazing read. And, you know, it's the prescriptive power of
(07:02):
movement, nature, art, service and belonging. And
I feel like we've lost that along the way. And I just
reflect back to my experience in the hospital,
and, you know, they would come in, they would barely touch me. They
would scan my wrist, the wristband, and then just prescribe
pills. And it was not. The diet wasn't very well thought out, the
(07:24):
nutrition. And then, you know, it just seemed so
fragmented, diluted, you
know, just lacking soul.
And our experience as heart patients, you know,
it is our heart is our soul. That's where our soul is.
And. And to have such an impactful surgery and
(07:46):
then not to be prescribed any of this, and then just to be
in this, like, silo, it doesn't set us up for
wholehearted living. You know, pardon the pun, but it's true.
And so, you know, your book is helping me re,
like, rekindle my wholehearted living. Oh,
wow. Well, so much to unpack there. Thank you for
(08:08):
that. I think you always had it in you, but I think
you must know better than anyone and your listeners know better than
anyone that, yeah, the process of
medicine today really makes us question a lot
about how did medicine come to be this way, you know, because it struck
me, as you were speaking 2500 years ago, the
(08:31):
earliest philosophers and scientists and
thinkers, no matter where they were in the world, whether it was
ancient Greece or Nepal or the Middle east, they sort of
converged on this idea that medicine
has an art and a science to. To it. Right. It's not as
simple as I treat the diagnosis you as a person are
(08:52):
more than the sum of your parts. The way
that you feel, the emotions you have,
the aspirations you have, the experiences you have, that is all
part of medicine, too. You know, it's even in our Hippocratic
oath that people entering the US Medical profession take
that our jobs are not just to treat with the
(09:15):
surgeon's knife, but the surgeon's heart as well.
So it's really only within recent
years that medicine has become this, as you say,
fragmented and cold. And listen, I have a lot
of empathy for people working in the profession. I'm sure you do, too.
It's not easy to be a cardiologist or work in
(09:38):
any kind of health care today. The pressures on them are tremendous, and
it is still a tremendous sacrifice to even enter medicine in the
first place. But the problem is that the system
right now doesn't set up those people for
success. It sets us up to be treated. A term
that kept coming up in the book is almost like a factory, right?
(10:00):
Where medicine becomes this sort of factory approach. We're
repairing machines rather than healing people.
And you know the other word I'm thinking of? Sterilized.
Yeah, sterilized. What was the word I was searching for
earlier? But, yeah, and it. And. And that factory
analogy does come out in patient care. Like I was just saying, they
(10:22):
come in, they scan your wristband, you know, then they enter into the
computer and it's. They're. They're facing away from you and
like, doing computer stuff, and they might look at you for a couple
of minutes. That's been my experience.
And so my heart surgery was four years ago. As of
tomorrow, during. We're recording this on January 14,
(10:44):
2025. And that, you know, that was in the heart of
COVID And then just last
year, I broke my leg and then had some
complications and was in the hospital. And I
remember all the nurses saying how fried
they were, burned out, exhausted, how so
(11:05):
much had changed that they didn't enjoy their job.
And it. It was really disheartening as a patient to hear
that. I mean, I appreciated that they were being honest, but I.
I'm worried. I'm worried for us as a society. I'm worried
about our. Our healthcare providers. And yes, I have an amazing
amount of respect for them that they continue to try to serve
(11:28):
patients. But, yeah, there's a real disconnect. And I just keep
thinking about how do we have to take it into our. We have to take
our health into our own hands and be our own CEOs,
and just not Rely on the system.
Well, you are certainly not alone. You know, as you said, as we're
recording this there in the wake of not only post
(11:50):
Covid, but also, frankly, like an
administration where there's been some skepticism about health
care, which, you know, for the record, is that
we. We could say a lot about that, but we won't go there. All this
to say that I think what you have felt and what you're sensing is really
valid, and it really kind of makes sense how it happened. Like, you think
(12:12):
about how any sort of
profession develops. Right, let's take
medicine. And there's this sort of
consensus that in medicine, we want the best
medicine available. We want the best tools, we want the best technology.
We want to be able to be more precise with
(12:34):
understanding disease and symptoms and how to treat it.
It's almost like we're getting more and more narrow with our focus.
And I think there's a lot of beauty to that. I say in the book,
but of course, you know, modern medicine is wonderful for
many reasons. I think at the same time, though, as we've
become more narrow and more focused and more specialized,
(12:57):
we've sort of, as I say in the book, thrown the baby out with the
bathwater. We're losing the fact that actually
so much of our health, up to 80% of it, is determined
by our environment. And that could be true in a hospital, in a clinical
setting, as well as outside of it. And it almost
feels, I say that 80% statistic because sometimes when I'm
(13:18):
talking about this stuff among people in the profession, it almost
feels soft, like it feels almost
unscientific to say that we need the warmth
of connection and purpose, a reason to wake up in
the morning. But there is a tremendous amount of data
supporting this, all kinds of data showing that how
(13:40):
connected we are to our environments and to one another
is a predictor of our longevity, our mood, how we do in
life. So I think we're at this breaking point now with
everything you've described. And there is more of a consensus now that,
okay, we need to go back to
basics, we need to restore the art in medicine. And one way this
(14:02):
is happening is through this thing called social prescribing.
Right. Which is just so beautiful. And so I want to
get into that. How did you originally
learn about this? Because I only know this because of your beautiful
book. Yeah, well, thank you. I
also hadn't heard of it, and nobody I'd known in
(14:25):
the United States have heard of it. But my job is, you know, I'm A
journalist. And specifically we call ourselves solutions
journalists, people who sort of take a look at the widely felt problems
around us and investigate what other places have done a good job
of addressing this problem. And before I was a journalist, I was
actually a grad school student. And the year I was there in England,
(14:47):
it was 2017, 2018, and
the UK had just become the first nation in the world to
establish a Minister of Loneliness, like a government
appointed position for loneliness. And I
thought, what the heck is this? Are we really at
a point where we need to invest government funding into addressing
(15:09):
loneliness? And sure enough, that became my
research topic. And I found out, yes, we absolutely do. Because in the
UK there's data on this and I'm sure it's similarly
true in the US up to 1 in 5 doctor's
appointments are made for purely social reasons.
So much data suggests that loneliness is a predictor of
(15:32):
anxiety, depression, chronic pain, stress, premature
mortality, cancer, you name it. Something is telling
us that the way we are living is not
conducive to our health. And so I learned about this because I was
investigating, okay, what is this minister going to do? What are some
solutions? And it was through that that I first
(15:53):
came across this concept of social prescribing, which just to define it
for everyone, is a pro practice through which doctors,
therapists, teams of health workers will literally
prescribe non medical,
local community activities and resources the
same way they prescribe pills and therapies. So in my book
(16:15):
that means, you know, cycling courses, it means art
classes, it means these nature and hiking
excursions, volunteer gigs, even just phone
call conversations for people who can't leave their homes. And it
comes from this kind of understanding that, look, our health is
more than just the sum of our molecules and
(16:37):
chemical reactions. It also is very much dependent
on our connections. And
so, yeah, I first learned about it that way and I learned that this wasn't
just a good idea, but there was actually some data suggesting
that when someone is given a social
prescription, it not only helps address whatever
(16:59):
the underlying medical condition is, whether that's, you
know, type 2 diabetes, depression, chronic pain,
it also reduces pressure on the healthcare
system. Because all those people, and especially in a
place like the uk, where healthcare is nationalized, taxpayers
pay for it, there's not enough care, you know, to go around for everybody
(17:20):
who needs it, when they need it, they found that social prescribing
actually reduces the number of emergency room visits, primary
care visits, spending overtime. Doctors are really
a fan of it. So there was just a lot of data suggesting
that, yeah, this is a timely idea for everything we're
seeing in health and healthcare
(17:44):
and. All right. I mean, all of
that, please. But I'm just thinking. I'm just thinking from the
patient's perspective and how much I
hate going to the er. I've been way
more than is a normal amount. Not there really should be
ever a normal amount, but I'm not sure why it said that.
(18:06):
But I'm just thinking about. Or make up that there's just less
suffering that way. I'm always thinking about
people's emotions and mental health through all of
this, and the amount of needless
suffering that can be
lessened through social prescribing. Right. That's where my heart goes when I'm
(18:29):
hearing you say all that. Absolutely,
absolutely. And, you know, I think that
maybe there's this thought, I know a lot of people, and I'm one of them.
When I first heard about social prescribing, they thought, really, why do we need
a doctor to tell us to go join a cycling course? Or,
you know, can this really help with things that I've
(18:50):
understood to be purely biomedical conditions like
chronic pain? I think that impulse is understandable
because every experience we've probably had in healthcare throughout our lives
has confirmed that. You know, most of us here in the United States, our
early experiences with the healthcare system is like, we have strep
throat or an ear infection, and we go to the doctor, they run
(19:12):
a test, they tell us, yes, you have this infection, here's an antibiotic, boom.
But this idea of actually saying, hey, there are
some pains for which you have that are very real, they're not
in your head, they are causing some sort of chemical reaction your
body. But maybe they're not best addressed by,
you know, some kind of medication or even clinical
(19:35):
therapy. Maybe they're best addressed or
partially addressed right. By what's in your community.
Because, look, we're not saying that throw out all the pills, throw out
all the surgeries, throw out all the therapies. We need all of that, too. This
is about putting another option onto the healthcare menu.
And I think it's this type of thing that the more we normalize it,
(19:58):
the more we talk about health as something that is the product of our
connections, the more we can accept that, yeah,
social prescriptions make a lot of sense. You know, what I'm hearing
is empowerment. Yeah. Yeah,
that's exactly it. That was a big theme that
came up in all the different patients I interviewed who received social
(20:20):
prescriptions. Like, they felt really hopeless. And, you
know, Everyone who's ever been in a situation
where they needed medical care, they're very vulnerable.
How awful is it when you're taking this
underlying, you know, vulnerability, fear,
discomfort and you're trying all these different medications
(20:42):
and therapies or maybe nothing has been tried
and you're feeling like, wait a minute, I
don't have any power here. If the doctor doesn't know what's wrong or if these
things aren't helping me, how am I ever gonna get better? And
I think what social prescribing does is, you know,
the, the catchphrase in this is flipping
(21:05):
from what's the matter with you? To what matters to you.
So in that sense it is so empowering. Let us prescribe
you what matters to you
and let's see how, if you are given
the resources and support
and accountability to engage in that
(21:27):
way. Let's see how you feel. And spoiler alert,
they all got better to some level. Yeah, yeah.
And, and we can't rely on this as the one magic pill
or actual pills to be the magic pill. Right. It's.
I have learned through my own journey that it's a multitude of
things coming together to, to make, to help me
(21:49):
heal and thrive. Another thing, let's see, you
mentioned the, the healthcare providers I think were like, or people were like. Why
should we rely on people to social prescribe?
Well, think of it this way. It's hard to keep track of
things when I, I know for myself when I'm in, when I was in
fear of my heart, it was hard to remember to take care of
(22:12):
myself. And it is completely okay to, to
rely and go to a doctor, coach,
therapist to help you keep remembering to, you
know, wake up, chop wood, carry water. Right. Like all
the simple things, there's no, there's no shame in like
someone saying, you know, try painting today. Here's why. It
(22:33):
will do wonders for your nervous system which will then
positively impact your heart. So I'm, I
understand the hesitancy there,
but we just. There. It's no different than having a post it note to
remind you to, to do the things right.
So true. Definitely. I mean there's a lot that
(22:55):
happens when you elevate from just, you know, I should probably do
this thing to. No, I have a social prescription to do this
thing. Like number one, you're sort of getting that authority from the
medical system. You're understanding that this is like a science
backed medicine. It's not just a nice to have.
You're also getting the accountability of that medical professional who,
(23:17):
you know, after I say, okay, boots, I'm prescribing you a 10 week sea
swimming course. I'm checking in at the end of that 10 weeks, and I'm checking
in maybe even during that 10 weeks and seeing how it's going. But
where I think the most powerful accountability comes from
is the other people in the group as well. And also
the sheer enjoyment of the thing. Like what I know
(23:38):
about you. You know, you were a ski instructor, you've
taught, you're a book lover. Everyone could tell from your
backgrounds you also have that intrinsic motivation to
be doing what matters to you. But then how great is that when
then you're meeting somebody who also loves to ski or
read or engage with nature. And in those
(24:01):
moments, your engagements in this thing that's prescribed through
healthcare are not about what was the matter with you, what
got you sick, but are about what matters to you. And
just that environment and positive mindset
really can drive a change in your health.
Well said. And speaking of mindset, if I could plug a
(24:23):
previous episode because it just pairs so well here,
although I'm finding it's going to pair with every episode, is my
interview with Dr. Lara Suarez
Pardo. She's the cardiac psychiatrist at the
Mayo Clinic. And I aired her interview in December of
2024. I got to meet her in person at the Mayo when I was
(24:45):
there for the Women Heart Conference this past fall. And
she talks about making those small changes and like how
hard it can be. And she addresses why it's hard
and then how to move through the hard. And you know,
it's, it's okay to ask for help. It's okay that it's hard. It's
okay that I stumble. And the beautiful thing
(25:07):
about the social prescribing is that it's mostly free
or at least low cost. Right. So, yeah,
you travel far if you don't want to. And yeah, so it
just, it seems more attainable to me.
Absolutely, A hundred percent. And, you know,
I mean, we could talk about the challenges with social prescribing. And I'll say
(25:30):
that this is not always true, but in many, many cases,
not only is it free, but it's covered by your insurance or it's
covered by a grant or, you know, it's very
rarely a cost to the user. And the other
thing is that especially if we talk about older populations
where transportation might not be that easy, in many
(25:52):
cases, transportation is arranged like one of the chapters in
the book goes into this farm
for people with dementia. And this
woman I Interviewed such a firecracker, so funny, so full of
life. Has pretty significant
dementia, which means she's not able to drive, which also
(26:14):
means she's stuck at home all day with her husband, who, to
use her words, says she talks too much. So one of the
best things about this social prescription for her to go to
this care farm is that not only
the activities on the farm, engaging with other people, but
she actually is picked up in a van and driven to and from
(26:36):
there. That's not only helping her, that's also helping her
husband have a little relief from the caregiving elements of this
too. So, yeah, in an ideal world, a social prescription,
it is going way beyond that recommendation
of, hey, you should exercise more or garden more. It's giving you
all the tools you need to actually follow through with that. Right. And
(26:58):
it obviously impacts the whole community. Right. It like
talking about the husband and probably helps the farm. And
yeah. So we, in 2025, in
the, in the time of where I feel like we're maybe the most
disconnected we've ever been, you know, we have got to keep
reminding ourselves and each other that we actually really are meant to be
(27:20):
connected and that we aren't meant to be in these silos in our houses
behind a screen all the time. So
our, I want to jump to, let's actually
talk about some examples. And the ones I want to talk about
are, and these are the ones that myself as a heart
patient and other heart patients I've had the privilege of meeting,
(27:42):
all have struggled with. I'm going to give the overview and then we'll break down
each one real quickly. Loss of connection, dealing with
an upsetting event, ruminating on a said event,
and then just loneliness. You detailed
in the book, those are four separate issues that
you can, you can prescribe a social
(28:05):
subscription for. So can you, can we break each of those
down? We definitely can. And you
know, I, I, I think it goes without saying, like, all these are
very related. And just as, you know,
feeling a loss of connection can lead you to
ruminate and can lead to more
(28:27):
upsetting events or you interpreting more events as upsetting. The
opposite is also true that when you're in an environment where you
feel connected, you feel engaged, you
feel like you're that setting event, it didn't unhappen,
but it's not in the top of your mind. All of these related
benefits come too. This is why in our healthcare
(28:49):
system, people are very rarely just lonely or
just depressed or just, you know,
have a congenital heart effect. All of these Things are related. When
one part doesn't work, many parts don't work. And just as when
one part is healed, many parts can heal.
So in the book, I break down the social
(29:11):
prescriptions. Social prescriptions in terms of
the five core ingredients that were really common around
the world. These are movement, nature, art,
service and belonging. And even though all of them
can sort of be used interchangeably, I tried to break it down
in terms of what does the science suggest is most
(29:34):
effective for what kinds of ailments. So let's
start with ruminating, which, you know, I talk about really in the
first two chapters of the book when I'm talking about the power of movement
and nature. Now, I know you're a nature lover, too, and so I'm sure this
isn't surprising to you, but one unique
property of nature is that it has
(29:56):
the ability to capture our attention. We're
something called soft fascination. We're fascinated by nature
without taxing it. And I'm sure
you felt this when you're skiing, when you're hiking, when you're
cycling, if you're in an environment
that is beautiful because, you know nature is beautiful.
(30:20):
The problems with which you had before you entered
that environment, something you might be ruminating on, an upsetting event
that might have happened to you, that goes in the back
burner. And how do we know this? We know that nature
and movement are effective for treating symptoms of depression, which
is very closely related to rumination
(30:42):
as well as anxiety, both related to rumination
and dealing with an upsetting event. And so
my book talks about, for example, this woman
Amanda, who had a lot of upsetting
events happen in her life. Her mother passed away, she found
out her husband was having an affair. She lost her job,
(31:03):
she had to move to a place where she knew nobody. And this was all
during the pandemic itself. So the big five, as she calls it,
five upsetting events. And during that time,
how she describes this is she
couldn't stop replaying the events of the
affair, the events of losing her job, those
(31:25):
last moments with her mother, all of these painful things.
So she was ruminating, and she describes her state as
feeling like her mind was enclosed in a helmet and she
couldn't get out of this pain, deep, dark place. Now, when
Amanda reports these symptoms to her mental health nurse, you know,
she's diagnosed with major depression. And she's put on an
(31:46):
antidepressant, the maximum dose. And I'll say for
Amanda, she would say that that really helped her with some of
the symptoms. But there was still, through all of this, that
loss of connection, think about it, she'd had all of these
connections in her old home, her husband, her mother, to none of them.
That was something that an antidepressant couldn't solve
(32:09):
for. So she gets prescribed a 10 week
sea swimming course. And I talk about this in the book. But sea
swimming is particularly interesting because, you know, you're moving your body,
you're doing something physically challenging, and evidence suggests
that movement is related to production of serotonin and
endorphins and all these feel good chemicals.
(32:31):
But you're also in this beautiful natural
environment where your attention is being restored.
There's a lot of science in the book about how that works as well.
So what happens for Amanda? She goes on the sea swimming course,
which, by the way, cold water, winter time. Her
and like 10 other women are doing this and they're learning safety, but they're
(32:54):
also literally going in this freezing cold water. She
first of all makes these wonderful friends who she now meets up with
not only to swim, but also to have tea with. She has
this hobby that she loves. The way she describes it, she feels like she wants
to wake out of bed in the morning. She has much more energy throughout her
day and she feels like, in her own words, her
(33:16):
life became bright again. And after all
of that, Amanda was able to go from the maximum dose of the
antidepressant to the minimum dose because. Because what happened to
her? She felt connected again, she felt less lonely.
She, yes, still had these upsetting events, but
she had an outlet to deal with them. She had an outlet to
(33:39):
deal with the rumination, whereas before she
didn't. So that's just one example that really
combines those four. But, you know, I would say
also art. There's a lot of data suggesting that art
is real, really powerful for rumination in particular,
because much like nature, it takes our attention to
(34:01):
something else. It helps us sort of zoom out, put
our upsetting event into perspective and feel
like, you know, maybe we're not the only ones who went through
this. So that's, that's a little insight into
those four. But I could totally understand how for a
heart pitch patient, it is all four of those things at once.
(34:23):
And so it's important to think about all of those
medicines together. Right. And thank you for that. And I love
that story in the book. And even though I've never met Amanda, I
was, I was right there with her and you set the scene so well. I
can picture her putting her wetsuit on and I'm so happy for
her that she found that that road.
(34:45):
That there was a practitioner who was willing to. To think a little outside
the box of norm, of the normal medical system
and help her. We all deserve to thrive and
we all. It is make. I think it was like make
caring cool again or it's cool to care. And the
COVID days. And you know, even though
(35:07):
Amanda lives far from me, I still want her to be happy.
Right? We. We're all energetically connected and
I don't think we talk about that enough. So I'm so happy to
hear that she. That her suffering has. Cause it sounds like she really
was suffering, that it has lessened a lot. You
can't. You can't take back any of those events. But
(35:28):
yet there is. There is a way to stop ruminating.
And you know, I. Because of your book, I've started
doing more intentional art. And what was really interesting
is when I was waiting for heart surgery, I had
to wait like five months because of COVID It was so
hard. And a colleague gave me a set of
(35:50):
watercolors and I had never done watercolor.
And I. That's all I could do. And I
look back at my art then with such fondness
because it reminded me that I was loved. It reminded me that I could still
do something. And I was ruminating because it
gave me. I want to talk about that because I think it's important for
(36:13):
me. What I've learned through my therapeutic journey with my amazing
therapist is sometimes rumination.
It gives you this sense of control.
So I over researched my different defects. I
over researched where to go. I mean, I really like
beat the dead horse. And I figured if I
(36:36):
learned as much as I could, I could save my life. And if I thought
enough about it, I would save my life. And I can tell
you all that did was hurt my actual heart because
it raised my cortisol, which we know is not healthy.
And so that art, that watercolor, as
rudimentary as it was, because, like, it's not my first strength. It did
(36:58):
get my head out of it. And now I'm doing it
more for sense of connection with others. And
I am so amused at what I'm
choosing to paint. I'm like just choosing like little animals and
it is cracking me up and I cannot stop
laughing. And then it makes my friends laugh. And then I'm giving all my
(37:20):
very rudimentary animals to other friends for them to put on their
refrigerators. So like, I've been painting like hippos and
like, anyway, so here I am like 46 years old. Right.
And I love it. Your inner
child. Yeah. And I cannot believe I bring all this up because I
can't believe how much better I feel. And, you know, and I'm like, in
(37:42):
all sense of the word, I'm doing pretty well. Right. But I. Yeah, there
was room for improvement. Oh, my gosh.
Wow. Absolutely. You know, so much to unpack there.
But first of all, just so glad you found that your
inner child is telling you something. And you know what's so great
about all of these things, whether it's your water coloring or Amanda C.
(38:05):
Swimming lessons, is that unlike medication, which, you know,
you take for a certain point and then you stop, this is something you can
rely on for the rest of your life because, you know, guess
what? There probably are going to be more upsetting events that
happen in your lifetime, and there's no way we can control for that.
And everything you did there know,
(38:27):
reacting to your
diagnosis and wanting to know everything you could know and
wanting to have the best possible care you could have, and feeling
stressed, having your cortisol raised at the prospect
that maybe there's something you could be doing better or more
controlling. That is so. I don't.
(38:48):
I hate the word normal, but that is so in our human nature. I
mean, we evolved to want
to protect our lives, extend our lives.
And that was a big insight for me. Maybe this is like common
sense to everyone else, but I had always sort of thought
about stress, depression, anxiety, these
(39:10):
chronic pain, even these sorts of things as, like,
random and very much driven by chemicals. And
it's true that these conditions can change our chemical
makeup. But actually, to be anxious or to be
depressed or to ruminate or to feel stress
is a reaction to an environment that is
(39:31):
threatening you. So you did everything you evolved
to do there. And what is, you know, so wonderful about these
social prescriptions and you rediscovering watercoloring
is. I. I mean, I'm sort of like tongue in cheek. But I think there
is something here about reconnecting to your inner child. Because
when we were kids, like, we kind of just accepted that we didn't
(39:54):
really have a lot of control. We sort of just did what felt right to
us. Yeah, we asked questions. But I think as we get older
and we have the Internet and WebMD and, you
know, an abundance of resources available,
there's this temptation to sort of like, outsmart
our stress and fear, and there's less
(40:15):
of a willingness to accept that there are just some things we can't control.
Control. So the Fact that you boots
were able to recognize the wisdom of your
inner child there. That water coloring is something that feels
good to you. It's something that continues to feel good to you in both stressful
times and non stressful times, has been a source of connection for your
(40:37):
community. That is so beautiful. And that is what I hope everyone
listening can take away. Yeah. Thank you. And
I learned through my therapist that, you know, that's parts work. We all have
parts to sell, you know, so inner child,
firefighter, the manager, and yeah, my
firefighter was running around with my hair on fire. And if you watch
(40:59):
the. Oh, shoot. What's the movie? It's parts one
and part two now. Where it's inside out. Thank you.
Yes. And inside out too. Oh, I just love that movie.
And it, it is, it is the best. It is the best example
of parts work. And it's also just adorable. And
anxiety, that moment where I don't want to spoil it for
(41:22):
others, but there's just a part of the movie where anxiety takes
over. And that was me when I found
out that I had all these different defects and I got stuck in
anxiety. So watch the movie. It
will make your year. It is. It is. Oh, gosh. Yeah. Turn off the
news. Watch that. Maybe before we
(41:44):
run out of time, there was one other really crucial topic I wanted
to just touch on, and that is the
dance between artificial intelligence and its
role in medicine versus or in.
I don't know what the right connective word is there, versus or in conjunction
with or in tandem, who knows, with some social
(42:05):
prescription. So can we just briefly touch on that?
Such a great question. And yeah, it's, you
know, it's something that I'm continuing to think about,
I'll be honest, and maybe I'll get some pushback for this. Totally understand.
You know, after writing this book, I get a lot of, like,
(42:26):
inquiries and, and notes from people who are working
in AI or the app space. And they
said human connection is so important. Yeah, yeah, yeah. And here we have this
app or this tool that's trying to simulate human connection.
And I have to say, my brother, it's funny,
this is like a big debate for us every year. My brother
(42:49):
works in AI. Love talking with him about this
because he just brings so much more insight. And maybe there is a future in
which the AI will get so, so good that we actually will
be able to supplant human connection
with this. My take, though, is that
there's a lot of hype about AI right now and for good reason.
(43:11):
Like when it comes to diagnostics, when it comes to,
I think this is a general rule for AI. When there is
some repetitive task that doesn't necessarily feel human
and would best be solved by a ton
of data addressing, then AI
in medicine is great because here's the thing, if we have
(43:33):
AI doing more of that diagnostic work, that probably
is not the reason why, you know, somebody got into healthcare in the first
place, is to run all these tests and, and do all this precision stuff.
That's great because it frees that healthcare provider
up a bit more to, to better tap into the human
part of medicine. And my response to all this would
(43:56):
be we have to see. But my
instinct is we have
these tremendous opportunities and outlets for connection that have
been a source of healing for us for
thousands and thousands of years. I would like to see more of
medicine focus on that rather than this thing that we're
(44:17):
sort of like, kind of taking a chance on. You know, it's
sort of like, why would you reinvent the wheel? We have this thing in all
of its human imperfections. So that's my two
cents. Acupuncture. Pretty well established, if we
could say. And I just saw like
yesterday somewhere where AI data centers
(44:39):
and how resource intensive they are
and how much water it takes to keep them, them cool
and all the electricity it uses. And I'm just thinking about,
you know, California at this moment, LA is on
fire. And, you know, there's also like, environmental
implications. I had no idea till just yesterday. So
(45:01):
it's. But I, I like what you just said. Yeah,
let's, let's, let's go with what is proven.
And then I'm gonna air, you know, we're gonna. This is airing
in January and in March, I'm airing an incredible interview with
a cardiologist who really is looking to expand AI
and heart health. And it's just such an interesting, like, other
(45:24):
take on things. And so, you know, it's this,
the role of this podcast is just to present you with varying
perspectives. But I, I challenge him. I
challenge him on the soul connection and I challenge him on
the role of AI on our wrists when we're, you know, when our
watches are monitoring our hearts and how that actually caused health
(45:46):
anxiety for me and I needed stop wearing it. So.
Yeah. Oh my gosh, a hundred percent, yes. I
think that's a great point about the environmental as well. I
think that's absolutely it. Like with all this stuff,
just as you're not going to use a social prescription for everything, I don't think
AI should be used for everything. I think there are some things, like
(46:08):
health professionals right now, they do have way too much to do. There
was a study that found it would take a primary care physician
in The United States 26.7 hours in a
day to do everything they had to do in terms of preventative care,
administrative management. And you're thinking, yeah,
there's not 26.7 hours in a day. So
(46:30):
insofar as AI can, like, support some of
that administrative work that everybody hates,
that's great. But I do think that what you're
saying about your own experience of feeling like you were
sort of a machine when you're being treated with
so many machines, we can't discount that that
(46:53):
is real. That can have health consequences. So as usual, Boots,
I'm with you a hundred percent. Well,
Julia, this has just been an amazing conversation and we could go
for probably the rest of the day, but you have
more, more things to do today, so we are going to let you
go. But before you do, will you please tell us all the ways we
(47:15):
can find you? I will also have it in the show notes, but verbal is
also good. Well, Boots, thank you so much. Such an
honor to be here. We've been wanting to do this for, I think almost six
months, close to a year now, so it's such an honor.
Hope this is the first of many. And my the best
way to find me is through my socials. I'm
(47:37):
at Hot Stuff thoughts on Instagram x
hotsthoughts.com and for folks who are interested in learning
more about the Connect Secure and social prescribing,
encourage you to visit the book website at Social Prescribing
co. Thank you. And please encourage your bookstores to
get this book if they don't have it already. Encourage your local libraries
(47:59):
to order the book. It it just it should be
necessary. Read reading. It's rare that I feel that way about books,
but I feel like I have some street credit here with knowing that this
book really is part of the answer to us thriving
as a society. So thank you, Julia and
thank you listeners. And if you haven't already, will you please subscribe
(48:21):
to this podcast. That way you don't miss another episode.
And then lastly, will you please make my year and leave a
review? Your reviews matter and it helps tiny
podcasts like mine get seen and known around the world.
We're already downloaded in 75 countries, which just
blows my mind. But I want even more heart patients to
(48:44):
find this podcast. So thank you listeners for being here.
I wouldn't be here without you. I love you. You
matter and your heart is your best friend.
We're not saying that. Throw out all the pills, throw out all the
surgeries, throw out all the therapies. We need all of that, too. This
is about putting another option onto the healthcare menu.
And I think it's this type of thing that the more we normalize it,
the more we talk about health as something that is the product of our
connections, the more we can accept that,
(00:23):
yeah, social prescriptions make a lot of sense.
Welcome to Open Heart Surgery with Boots, where we explore
the journey of heart health through the eyes of those who live it every
day. I'm your host, Boots Knighton, and in season
five, we're focusing on what it truly means to
thrive. We'll dive into cutting edge medical advances,
(00:45):
share powerful stories from both sides of the stethoscope,
and learn how to be better advocates for our own health.
From candid conversations with cardiac patients to
insights from dedicated healthcare professionals, each
episode brings you closer to understanding the complex world
of heart health. Whether you're navigating your own cardiac
(01:08):
journey or supporting someone who is, you're in the right
place. So let's get to today's story.
I thank you for being here, for
supporting this podcast, for showing up in the
world and shining your bright light. It is not
easy being a heart patient, and if you are new to me
(01:29):
and this podcast, I welcome you with open heart and
open arms. I started this podcast
for all heart patients worldwide and as of this
recording, I have now been downloaded in 65
countries, which is just really astonishing to
me and so thank you. I love you,
(01:51):
I see you, I hear you. I am here for you.
Please send an email
bootsheheartchamberpodcast.com that was the
original name of this podcast and I want to hear from you. If
you're just now finding this podcast and tell me what you need to hear
more of what you need support with and then find us on
(02:11):
Patreon at Open Heart Surgery with Boots.
And that is a great way to support the show and
get involved with the community that I'm slowly getting going
as I still continue to navigate my own heart.
Hello, welcome to Open Heart Surgery with Boots.
Oh, man, I tell you, I. I have been so
(02:34):
fired up about 2025 for a while because
I knew who I had on the roster. I
have taken so much care this year to bring
you a curated list of guests
who are thriving after open heart
surgery or who are contributing to the world of open heart
(02:56):
surgery or who are helping us think
outside the box of the medical field.
I have said in past episodes that we need,
we need more than like a cardiologist and a general
practitioner on our team. We need a nutritionist. We
need an ob gyn if you're a female.
(03:18):
We need a pelvic floor specialist. I'm bringing the whole
month of February, I'm bringing, bringing you pelvic
floor health because our pelvic floor is so
impacted by heart surgery. But today
I'm going to be doing this. Throughout the year, I'm going to be highlighting various
authors who have written books about health
(03:41):
care in various ways. And today is the first
author I'm bringing to you for 2025.
Julia Hotz, welcome. Has written
the most impactful book I have read in a
while and I'm going to show it to you because I
am hoping to start putting some more videos up of whole podcast.
(04:03):
So this is called the Connection Cure. I love
the title of the book. I love the COVID And
this book, the, the subheading is a
better way of thinking about medicine and healing. And
that's, that's what really touched me because the whole
impetus of this podcast has been there's gotta be
(04:25):
more than just my surgeon telling me to go live my
best life to clear my sternotomy. It's healed.
Now just go out into the world and go on about your life. I found
that then I just was kind of like lost in the
shuffle. And I've had to figure out how to thrive. Not just
survive, but thrive post open heart surgery. Lo and
(04:47):
behold, this past summer, this book comes
across my feed and thank goodness it did. And I've been
implementing it into my life and I just went straight to the
source and like cold emailed Julia and was like,
will you please come on my podcast? And then maybe we could be friends.
So here we are today. So, Julia, thank
(05:10):
you. And Julia, I just want you to brag on
yourself who you are. You are just contributing so much of
your writing to the world. So I had like a writing crush on you. Tell
us about who you are and set the scene before we dive into your really
important book. Well, back at you,
boots. And if I can just brag about you for a second, as I'm
(05:32):
sure all your listeners know, you know, this book that I've written and everything
I stand for is all about the power of connecting with
others. It's about the power of connecting with our outdoor
environments, our artistic lives, our inner self.
And every listener of this podcast must know that you embody that
message so well. So the honor is really mine.
(05:55):
The way that you've Touched so many people with your story,
and I think we are sort of kindred soul sisters in a way. I
think we're both really interested in what
is it that we're all here for. Right. And in those tough moments,
whether it's heart surgery or any sort of medical
challenge, what can that teach us about ourselves in the
(06:17):
world and what really matters? So it is such an
honor to be here and to talk about my book, the Connection Cure, which,
thank you for reading and being a super fan of it means
so much to me. Thank you. And, you know, I'm inspiring
author myself, and I know what it takes to birth a book and get it
into the world. And you had to
(06:40):
really travel the entire world, it
seems. And I. I'm really
amazed at what you. The qualitative and
quantitative data you gathered. I mean, you put so much heart and
soul into this book, and I'm sold on it. And it' it really is an
amazing read. And, you know, it's the prescriptive power of
(07:02):
movement, nature, art, service and belonging. And
I feel like we've lost that along the way. And I just
reflect back to my experience in the hospital,
and, you know, they would come in, they would barely touch me. They
would scan my wrist, the wristband, and then just prescribe
pills. And it was not. The diet wasn't very well thought out, the
(07:24):
nutrition. And then, you know, it just seemed so
fragmented, diluted, you
know, just lacking soul.
And our experience as heart patients, you know,
it is our heart is our soul. That's where our soul is.
And. And to have such an impactful surgery and
(07:46):
then not to be prescribed any of this, and then just to be
in this, like, silo, it doesn't set us up for
wholehearted living. You know, pardon the pun, but it's true.
And so, you know, your book is helping me re,
like, rekindle my wholehearted living. Oh,
wow. Well, so much to unpack there. Thank you for
(08:08):
that. I think you always had it in you, but I think
you must know better than anyone and your listeners know better than
anyone that, yeah, the process of
medicine today really makes us question a lot
about how did medicine come to be this way, you know, because it struck
me, as you were speaking 2500 years ago, the
(08:31):
earliest philosophers and scientists and
thinkers, no matter where they were in the world, whether it was
ancient Greece or Nepal or the Middle east, they sort of
converged on this idea that medicine
has an art and a science to. To it. Right. It's not as
simple as I treat the diagnosis you as a person are
(08:52):
more than the sum of your parts. The way
that you feel, the emotions you have,
the aspirations you have, the experiences you have, that is all
part of medicine, too. You know, it's even in our Hippocratic
oath that people entering the US Medical profession take
that our jobs are not just to treat with the
(09:15):
surgeon's knife, but the surgeon's heart as well.
So it's really only within recent
years that medicine has become this, as you say,
fragmented and cold. And listen, I have a lot
of empathy for people working in the profession. I'm sure you do, too.
It's not easy to be a cardiologist or work in
(09:38):
any kind of health care today. The pressures on them are tremendous, and
it is still a tremendous sacrifice to even enter medicine in the
first place. But the problem is that the system
right now doesn't set up those people for
success. It sets us up to be treated. A term
that kept coming up in the book is almost like a factory, right?
(10:00):
Where medicine becomes this sort of factory approach. We're
repairing machines rather than healing people.
And you know the other word I'm thinking of? Sterilized.
Yeah, sterilized. What was the word I was searching for
earlier? But, yeah, and it. And. And that factory
analogy does come out in patient care. Like I was just saying, they
(10:22):
come in, they scan your wristband, you know, then they enter into the
computer and it's. They're. They're facing away from you and
like, doing computer stuff, and they might look at you for a couple
of minutes. That's been my experience.
And so my heart surgery was four years ago. As of
tomorrow, during. We're recording this on January 14,
(10:44):
2025. And that, you know, that was in the heart of
COVID And then just last
year, I broke my leg and then had some
complications and was in the hospital. And I
remember all the nurses saying how fried
they were, burned out, exhausted, how so
(11:05):
much had changed that they didn't enjoy their job.
And it. It was really disheartening as a patient to hear
that. I mean, I appreciated that they were being honest, but I.
I'm worried. I'm worried for us as a society. I'm worried
about our. Our healthcare providers. And yes, I have an amazing
amount of respect for them that they continue to try to serve
(11:28):
patients. But, yeah, there's a real disconnect. And I just keep
thinking about how do we have to take it into our. We have to take
our health into our own hands and be our own CEOs,
and just not Rely on the system.
Well, you are certainly not alone. You know, as you said, as we're
recording this there in the wake of not only post
(11:50):
Covid, but also, frankly, like an
administration where there's been some skepticism about health
care, which, you know, for the record, is that
we. We could say a lot about that, but we won't go there. All this
to say that I think what you have felt and what you're sensing is really
valid, and it really kind of makes sense how it happened. Like, you think
(12:12):
about how any sort of
profession develops. Right, let's take
medicine. And there's this sort of
consensus that in medicine, we want the best
medicine available. We want the best tools, we want the best technology.
We want to be able to be more precise with
(12:34):
understanding disease and symptoms and how to treat it.
It's almost like we're getting more and more narrow with our focus.
And I think there's a lot of beauty to that. I say in the book,
but of course, you know, modern medicine is wonderful for
many reasons. I think at the same time, though, as we've
become more narrow and more focused and more specialized,
(12:57):
we've sort of, as I say in the book, thrown the baby out with the
bathwater. We're losing the fact that actually
so much of our health, up to 80% of it, is determined
by our environment. And that could be true in a hospital, in a clinical
setting, as well as outside of it. And it almost
feels, I say that 80% statistic because sometimes when I'm
(13:18):
talking about this stuff among people in the profession, it almost
feels soft, like it feels almost
unscientific to say that we need the warmth
of connection and purpose, a reason to wake up in
the morning. But there is a tremendous amount of data
supporting this, all kinds of data showing that how
(13:40):
connected we are to our environments and to one another
is a predictor of our longevity, our mood, how we do in
life. So I think we're at this breaking point now with
everything you've described. And there is more of a consensus now that,
okay, we need to go back to
basics, we need to restore the art in medicine. And one way this
(14:02):
is happening is through this thing called social prescribing.
Right. Which is just so beautiful. And so I want to
get into that. How did you originally
learn about this? Because I only know this because of your beautiful
book. Yeah, well, thank you. I
also hadn't heard of it, and nobody I'd known in
(14:25):
the United States have heard of it. But my job is, you know, I'm A
journalist. And specifically we call ourselves solutions
journalists, people who sort of take a look at the widely felt problems
around us and investigate what other places have done a good job
of addressing this problem. And before I was a journalist, I was
actually a grad school student. And the year I was there in England,
(14:47):
it was 2017, 2018, and
the UK had just become the first nation in the world to
establish a Minister of Loneliness, like a government
appointed position for loneliness. And I
thought, what the heck is this? Are we really at
a point where we need to invest government funding into addressing
(15:09):
loneliness? And sure enough, that became my
research topic. And I found out, yes, we absolutely do. Because in the
UK there's data on this and I'm sure it's similarly
true in the US up to 1 in 5 doctor's
appointments are made for purely social reasons.
So much data suggests that loneliness is a predictor of
(15:32):
anxiety, depression, chronic pain, stress, premature
mortality, cancer, you name it. Something is telling
us that the way we are living is not
conducive to our health. And so I learned about this because I was
investigating, okay, what is this minister going to do? What are some
solutions? And it was through that that I first
(15:53):
came across this concept of social prescribing, which just to define it
for everyone, is a pro practice through which doctors,
therapists, teams of health workers will literally
prescribe non medical,
local community activities and resources the
same way they prescribe pills and therapies. So in my book
(16:15):
that means, you know, cycling courses, it means art
classes, it means these nature and hiking
excursions, volunteer gigs, even just phone
call conversations for people who can't leave their homes. And it
comes from this kind of understanding that, look, our health is
more than just the sum of our molecules and
(16:37):
chemical reactions. It also is very much dependent
on our connections. And
so, yeah, I first learned about it that way and I learned that this wasn't
just a good idea, but there was actually some data suggesting
that when someone is given a social
prescription, it not only helps address whatever
(16:59):
the underlying medical condition is, whether that's, you
know, type 2 diabetes, depression, chronic pain,
it also reduces pressure on the healthcare
system. Because all those people, and especially in a
place like the uk, where healthcare is nationalized, taxpayers
pay for it, there's not enough care, you know, to go around for everybody
(17:20):
who needs it, when they need it, they found that social prescribing
actually reduces the number of emergency room visits, primary
care visits, spending overtime. Doctors are really
a fan of it. So there was just a lot of data suggesting
that, yeah, this is a timely idea for everything we're
seeing in health and healthcare
(17:44):
and. All right. I mean, all of
that, please. But I'm just thinking. I'm just thinking from the
patient's perspective and how much I
hate going to the er. I've been way
more than is a normal amount. Not there really should be
ever a normal amount, but I'm not sure why it said that.
(18:06):
But I'm just thinking about. Or make up that there's just less
suffering that way. I'm always thinking about
people's emotions and mental health through all of
this, and the amount of needless
suffering that can be
lessened through social prescribing. Right. That's where my heart goes when I'm
(18:29):
hearing you say all that. Absolutely,
absolutely. And, you know, I think that
maybe there's this thought, I know a lot of people, and I'm one of them.
When I first heard about social prescribing, they thought, really, why do we need
a doctor to tell us to go join a cycling course? Or,
you know, can this really help with things that I've
(18:50):
understood to be purely biomedical conditions like
chronic pain? I think that impulse is understandable
because every experience we've probably had in healthcare throughout our lives
has confirmed that. You know, most of us here in the United States, our
early experiences with the healthcare system is like, we have strep
throat or an ear infection, and we go to the doctor, they run
(19:12):
a test, they tell us, yes, you have this infection, here's an antibiotic, boom.
But this idea of actually saying, hey, there are
some pains for which you have that are very real, they're not
in your head, they are causing some sort of chemical reaction your
body. But maybe they're not best addressed by,
you know, some kind of medication or even clinical
(19:35):
therapy. Maybe they're best addressed or
partially addressed right. By what's in your community.
Because, look, we're not saying that throw out all the pills, throw out
all the surgeries, throw out all the therapies. We need all of that, too. This
is about putting another option onto the healthcare menu.
And I think it's this type of thing that the more we normalize it,
(19:58):
the more we talk about health as something that is the product of our
connections, the more we can accept that, yeah,
social prescriptions make a lot of sense. You know, what I'm hearing
is empowerment. Yeah. Yeah,
that's exactly it. That was a big theme that
came up in all the different patients I interviewed who received social
(20:20):
prescriptions. Like, they felt really hopeless. And, you
know, Everyone who's ever been in a situation
where they needed medical care, they're very vulnerable.
How awful is it when you're taking this
underlying, you know, vulnerability, fear,
discomfort and you're trying all these different medications
(20:42):
and therapies or maybe nothing has been tried
and you're feeling like, wait a minute, I
don't have any power here. If the doctor doesn't know what's wrong or if these
things aren't helping me, how am I ever gonna get better? And
I think what social prescribing does is, you know,
the, the catchphrase in this is flipping
(21:05):
from what's the matter with you? To what matters to you.
So in that sense it is so empowering. Let us prescribe
you what matters to you
and let's see how, if you are given
the resources and support
and accountability to engage in that
(21:27):
way. Let's see how you feel. And spoiler alert,
they all got better to some level. Yeah, yeah.
And, and we can't rely on this as the one magic pill
or actual pills to be the magic pill. Right. It's.
I have learned through my own journey that it's a multitude of
things coming together to, to make, to help me
(21:49):
heal and thrive. Another thing, let's see, you
mentioned the, the healthcare providers I think were like, or people were like. Why
should we rely on people to social prescribe?
Well, think of it this way. It's hard to keep track of
things when I, I know for myself when I'm in, when I was in
fear of my heart, it was hard to remember to take care of
(22:12):
myself. And it is completely okay to, to
rely and go to a doctor, coach,
therapist to help you keep remembering to, you
know, wake up, chop wood, carry water. Right. Like all
the simple things, there's no, there's no shame in like
someone saying, you know, try painting today. Here's why. It
(22:33):
will do wonders for your nervous system which will then
positively impact your heart. So I'm, I
understand the hesitancy there,
but we just. There. It's no different than having a post it note to
remind you to, to do the things right.
So true. Definitely. I mean there's a lot that
(22:55):
happens when you elevate from just, you know, I should probably do
this thing to. No, I have a social prescription to do this
thing. Like number one, you're sort of getting that authority from the
medical system. You're understanding that this is like a science
backed medicine. It's not just a nice to have.
You're also getting the accountability of that medical professional who,
(23:17):
you know, after I say, okay, boots, I'm prescribing you a 10 week sea
swimming course. I'm checking in at the end of that 10 weeks, and I'm checking
in maybe even during that 10 weeks and seeing how it's going. But
where I think the most powerful accountability comes from
is the other people in the group as well. And also
the sheer enjoyment of the thing. Like what I know
(23:38):
about you. You know, you were a ski instructor, you've
taught, you're a book lover. Everyone could tell from your
backgrounds you also have that intrinsic motivation to
be doing what matters to you. But then how great is that when
then you're meeting somebody who also loves to ski or
read or engage with nature. And in those
(24:01):
moments, your engagements in this thing that's prescribed through
healthcare are not about what was the matter with you, what
got you sick, but are about what matters to you. And
just that environment and positive mindset
really can drive a change in your health.
Well said. And speaking of mindset, if I could plug a
(24:23):
previous episode because it just pairs so well here,
although I'm finding it's going to pair with every episode, is my
interview with Dr. Lara Suarez
Pardo. She's the cardiac psychiatrist at the
Mayo Clinic. And I aired her interview in December of
2024. I got to meet her in person at the Mayo when I was
(24:45):
there for the Women Heart Conference this past fall. And
she talks about making those small changes and like how
hard it can be. And she addresses why it's hard
and then how to move through the hard. And you know,
it's, it's okay to ask for help. It's okay that it's hard. It's
okay that I stumble. And the beautiful thing
(25:07):
about the social prescribing is that it's mostly free
or at least low cost. Right. So, yeah,
you travel far if you don't want to. And yeah, so it
just, it seems more attainable to me.
Absolutely, A hundred percent. And, you know,
I mean, we could talk about the challenges with social prescribing. And I'll say
(25:30):
that this is not always true, but in many, many cases,
not only is it free, but it's covered by your insurance or it's
covered by a grant or, you know, it's very
rarely a cost to the user. And the other
thing is that especially if we talk about older populations
where transportation might not be that easy, in many
(25:52):
cases, transportation is arranged like one of the chapters in
the book goes into this farm
for people with dementia. And this
woman I Interviewed such a firecracker, so funny, so full of
life. Has pretty significant
dementia, which means she's not able to drive, which also
(26:14):
means she's stuck at home all day with her husband, who, to
use her words, says she talks too much. So one of the
best things about this social prescription for her to go to
this care farm is that not only
the activities on the farm, engaging with other people, but
she actually is picked up in a van and driven to and from
(26:36):
there. That's not only helping her, that's also helping her
husband have a little relief from the caregiving elements of this
too. So, yeah, in an ideal world, a social prescription,
it is going way beyond that recommendation
of, hey, you should exercise more or garden more. It's giving you
all the tools you need to actually follow through with that. Right. And
(26:58):
it obviously impacts the whole community. Right. It like
talking about the husband and probably helps the farm. And
yeah. So we, in 2025, in
the, in the time of where I feel like we're maybe the most
disconnected we've ever been, you know, we have got to keep
reminding ourselves and each other that we actually really are meant to be
(27:20):
connected and that we aren't meant to be in these silos in our houses
behind a screen all the time. So
our, I want to jump to, let's actually
talk about some examples. And the ones I want to talk about
are, and these are the ones that myself as a heart
patient and other heart patients I've had the privilege of meeting,
(27:42):
all have struggled with. I'm going to give the overview and then we'll break down
each one real quickly. Loss of connection, dealing with
an upsetting event, ruminating on a said event,
and then just loneliness. You detailed
in the book, those are four separate issues that
you can, you can prescribe a social
(28:05):
subscription for. So can you, can we break each of those
down? We definitely can. And you
know, I, I, I think it goes without saying, like, all these are
very related. And just as, you know,
feeling a loss of connection can lead you to
ruminate and can lead to more
(28:27):
upsetting events or you interpreting more events as upsetting. The
opposite is also true that when you're in an environment where you
feel connected, you feel engaged, you
feel like you're that setting event, it didn't unhappen,
but it's not in the top of your mind. All of these related
benefits come too. This is why in our healthcare
(28:49):
system, people are very rarely just lonely or
just depressed or just, you know,
have a congenital heart effect. All of these Things are related. When
one part doesn't work, many parts don't work. And just as when
one part is healed, many parts can heal.
So in the book, I break down the social
(29:11):
prescriptions. Social prescriptions in terms of
the five core ingredients that were really common around
the world. These are movement, nature, art,
service and belonging. And even though all of them
can sort of be used interchangeably, I tried to break it down
in terms of what does the science suggest is most
(29:34):
effective for what kinds of ailments. So let's
start with ruminating, which, you know, I talk about really in the
first two chapters of the book when I'm talking about the power of movement
and nature. Now, I know you're a nature lover, too, and so I'm sure this
isn't surprising to you, but one unique
property of nature is that it has
(29:56):
the ability to capture our attention. We're
something called soft fascination. We're fascinated by nature
without taxing it. And I'm sure
you felt this when you're skiing, when you're hiking, when you're
cycling, if you're in an environment
that is beautiful because, you know nature is beautiful.
(30:20):
The problems with which you had before you entered
that environment, something you might be ruminating on, an upsetting event
that might have happened to you, that goes in the back
burner. And how do we know this? We know that nature
and movement are effective for treating symptoms of depression, which
is very closely related to rumination
(30:42):
as well as anxiety, both related to rumination
and dealing with an upsetting event. And so
my book talks about, for example, this woman
Amanda, who had a lot of upsetting
events happen in her life. Her mother passed away, she found
out her husband was having an affair. She lost her job,
(31:03):
she had to move to a place where she knew nobody. And this was all
during the pandemic itself. So the big five, as she calls it,
five upsetting events. And during that time,
how she describes this is she
couldn't stop replaying the events of the
affair, the events of losing her job, those
(31:25):
last moments with her mother, all of these painful things.
So she was ruminating, and she describes her state as
feeling like her mind was enclosed in a helmet and she
couldn't get out of this pain, deep, dark place. Now, when
Amanda reports these symptoms to her mental health nurse, you know,
she's diagnosed with major depression. And she's put on an
(31:46):
antidepressant, the maximum dose. And I'll say for
Amanda, she would say that that really helped her with some of
the symptoms. But there was still, through all of this, that
loss of connection, think about it, she'd had all of these
connections in her old home, her husband, her mother, to none of them.
That was something that an antidepressant couldn't solve
(32:09):
for. So she gets prescribed a 10 week
sea swimming course. And I talk about this in the book. But sea
swimming is particularly interesting because, you know, you're moving your body,
you're doing something physically challenging, and evidence suggests
that movement is related to production of serotonin and
endorphins and all these feel good chemicals.
(32:31):
But you're also in this beautiful natural
environment where your attention is being restored.
There's a lot of science in the book about how that works as well.
So what happens for Amanda? She goes on the sea swimming course,
which, by the way, cold water, winter time. Her
and like 10 other women are doing this and they're learning safety, but they're
(32:54):
also literally going in this freezing cold water. She
first of all makes these wonderful friends who she now meets up with
not only to swim, but also to have tea with. She has
this hobby that she loves. The way she describes it, she feels like she wants
to wake out of bed in the morning. She has much more energy throughout her
day and she feels like, in her own words, her
(33:16):
life became bright again. And after all
of that, Amanda was able to go from the maximum dose of the
antidepressant to the minimum dose because. Because what happened to
her? She felt connected again, she felt less lonely.
She, yes, still had these upsetting events, but
she had an outlet to deal with them. She had an outlet to
(33:39):
deal with the rumination, whereas before she
didn't. So that's just one example that really
combines those four. But, you know, I would say
also art. There's a lot of data suggesting that art
is real, really powerful for rumination in particular,
because much like nature, it takes our attention to
(34:01):
something else. It helps us sort of zoom out, put
our upsetting event into perspective and feel
like, you know, maybe we're not the only ones who went through
this. So that's, that's a little insight into
those four. But I could totally understand how for a
heart pitch patient, it is all four of those things at once.
(34:23):
And so it's important to think about all of those
medicines together. Right. And thank you for that. And I love
that story in the book. And even though I've never met Amanda, I
was, I was right there with her and you set the scene so well. I
can picture her putting her wetsuit on and I'm so happy for
her that she found that that road.
(34:45):
That there was a practitioner who was willing to. To think a little outside
the box of norm, of the normal medical system
and help her. We all deserve to thrive and
we all. It is make. I think it was like make
caring cool again or it's cool to care. And the
COVID days. And you know, even though
(35:07):
Amanda lives far from me, I still want her to be happy.
Right? We. We're all energetically connected and
I don't think we talk about that enough. So I'm so happy to
hear that she. That her suffering has. Cause it sounds like she really
was suffering, that it has lessened a lot. You
can't. You can't take back any of those events. But
(35:28):
yet there is. There is a way to stop ruminating.
And you know, I. Because of your book, I've started
doing more intentional art. And what was really interesting
is when I was waiting for heart surgery, I had
to wait like five months because of COVID It was so
hard. And a colleague gave me a set of
(35:50):
watercolors and I had never done watercolor.
And I. That's all I could do. And I
look back at my art then with such fondness
because it reminded me that I was loved. It reminded me that I could still
do something. And I was ruminating because it
gave me. I want to talk about that because I think it's important for
(36:13):
me. What I've learned through my therapeutic journey with my amazing
therapist is sometimes rumination.
It gives you this sense of control.
So I over researched my different defects. I
over researched where to go. I mean, I really like
beat the dead horse. And I figured if I
(36:36):
learned as much as I could, I could save my life. And if I thought
enough about it, I would save my life. And I can tell
you all that did was hurt my actual heart because
it raised my cortisol, which we know is not healthy.
And so that art, that watercolor, as
rudimentary as it was, because, like, it's not my first strength. It did
(36:58):
get my head out of it. And now I'm doing it
more for sense of connection with others. And
I am so amused at what I'm
choosing to paint. I'm like just choosing like little animals and
it is cracking me up and I cannot stop
laughing. And then it makes my friends laugh. And then I'm giving all my
(37:20):
very rudimentary animals to other friends for them to put on their
refrigerators. So like, I've been painting like hippos and
like, anyway, so here I am like 46 years old. Right.
And I love it. Your inner
child. Yeah. And I cannot believe I bring all this up because I
can't believe how much better I feel. And, you know, and I'm like, in
(37:42):
all sense of the word, I'm doing pretty well. Right. But I. Yeah, there
was room for improvement. Oh, my gosh.
Wow. Absolutely. You know, so much to unpack there.
But first of all, just so glad you found that your
inner child is telling you something. And you know what's so great
about all of these things, whether it's your water coloring or Amanda C.
(38:05):
Swimming lessons, is that unlike medication, which, you know,
you take for a certain point and then you stop, this is something you can
rely on for the rest of your life because, you know, guess
what? There probably are going to be more upsetting events that
happen in your lifetime, and there's no way we can control for that.
And everything you did there know,
(38:27):
reacting to your
diagnosis and wanting to know everything you could know and
wanting to have the best possible care you could have, and feeling
stressed, having your cortisol raised at the prospect
that maybe there's something you could be doing better or more
controlling. That is so. I don't.
(38:48):
I hate the word normal, but that is so in our human nature. I
mean, we evolved to want
to protect our lives, extend our lives.
And that was a big insight for me. Maybe this is like common
sense to everyone else, but I had always sort of thought
about stress, depression, anxiety, these
(39:10):
chronic pain, even these sorts of things as, like,
random and very much driven by chemicals. And
it's true that these conditions can change our chemical
makeup. But actually, to be anxious or to be
depressed or to ruminate or to feel stress
is a reaction to an environment that is
(39:31):
threatening you. So you did everything you evolved
to do there. And what is, you know, so wonderful about these
social prescriptions and you rediscovering watercoloring
is. I. I mean, I'm sort of like tongue in cheek. But I think there
is something here about reconnecting to your inner child. Because
when we were kids, like, we kind of just accepted that we didn't
(39:54):
really have a lot of control. We sort of just did what felt right to
us. Yeah, we asked questions. But I think as we get older
and we have the Internet and WebMD and, you
know, an abundance of resources available,
there's this temptation to sort of like, outsmart
our stress and fear, and there's less
(40:15):
of a willingness to accept that there are just some things we can't control.
Control. So the Fact that you boots
were able to recognize the wisdom of your
inner child there. That water coloring is something that feels
good to you. It's something that continues to feel good to you in both stressful
times and non stressful times, has been a source of connection for your
(40:37):
community. That is so beautiful. And that is what I hope everyone
listening can take away. Yeah. Thank you. And
I learned through my therapist that, you know, that's parts work. We all have
parts to sell, you know, so inner child,
firefighter, the manager, and yeah, my
firefighter was running around with my hair on fire. And if you watch
(40:59):
the. Oh, shoot. What's the movie? It's parts one
and part two now. Where it's inside out. Thank you.
Yes. And inside out too. Oh, I just love that movie.
And it, it is, it is the best. It is the best example
of parts work. And it's also just adorable. And
anxiety, that moment where I don't want to spoil it for
(41:22):
others, but there's just a part of the movie where anxiety takes
over. And that was me when I found
out that I had all these different defects and I got stuck in
anxiety. So watch the movie. It
will make your year. It is. It is. Oh, gosh. Yeah. Turn off the
news. Watch that. Maybe before we
(41:44):
run out of time, there was one other really crucial topic I wanted
to just touch on, and that is the
dance between artificial intelligence and its
role in medicine versus or in.
I don't know what the right connective word is there, versus or in conjunction
with or in tandem, who knows, with some social
(42:05):
prescription. So can we just briefly touch on that?
Such a great question. And yeah, it's, you
know, it's something that I'm continuing to think about,
I'll be honest, and maybe I'll get some pushback for this. Totally understand.
You know, after writing this book, I get a lot of, like,
(42:26):
inquiries and, and notes from people who are working
in AI or the app space. And they
said human connection is so important. Yeah, yeah, yeah. And here we have this
app or this tool that's trying to simulate human connection.
And I have to say, my brother, it's funny,
this is like a big debate for us every year. My brother
(42:49):
works in AI. Love talking with him about this
because he just brings so much more insight. And maybe there is a future in
which the AI will get so, so good that we actually will
be able to supplant human connection
with this. My take, though, is that
there's a lot of hype about AI right now and for good reason.
(43:11):
Like when it comes to diagnostics, when it comes to,
I think this is a general rule for AI. When there is
some repetitive task that doesn't necessarily feel human
and would best be solved by a ton
of data addressing, then AI
in medicine is great because here's the thing, if we have
(43:33):
AI doing more of that diagnostic work, that probably
is not the reason why, you know, somebody got into healthcare in the first
place, is to run all these tests and, and do all this precision stuff.
That's great because it frees that healthcare provider
up a bit more to, to better tap into the human
part of medicine. And my response to all this would
(43:56):
be we have to see. But my
instinct is we have
these tremendous opportunities and outlets for connection that have
been a source of healing for us for
thousands and thousands of years. I would like to see more of
medicine focus on that rather than this thing that we're
(44:17):
sort of like, kind of taking a chance on. You know, it's
sort of like, why would you reinvent the wheel? We have this thing in all
of its human imperfections. So that's my two
cents. Acupuncture. Pretty well established, if we
could say. And I just saw like
yesterday somewhere where AI data centers
(44:39):
and how resource intensive they are
and how much water it takes to keep them, them cool
and all the electricity it uses. And I'm just thinking about,
you know, California at this moment, LA is on
fire. And, you know, there's also like, environmental
implications. I had no idea till just yesterday. So
(45:01):
it's. But I, I like what you just said. Yeah,
let's, let's, let's go with what is proven.
And then I'm gonna air, you know, we're gonna. This is airing
in January and in March, I'm airing an incredible interview with
a cardiologist who really is looking to expand AI
and heart health. And it's just such an interesting, like, other
(45:24):
take on things. And so, you know, it's this,
the role of this podcast is just to present you with varying
perspectives. But I, I challenge him. I
challenge him on the soul connection and I challenge him on
the role of AI on our wrists when we're, you know, when our
watches are monitoring our hearts and how that actually caused health
(45:46):
anxiety for me and I needed stop wearing it. So.
Yeah. Oh my gosh, a hundred percent, yes. I
think that's a great point about the environmental as well. I
think that's absolutely it. Like with all this stuff,
just as you're not going to use a social prescription for everything, I don't think
AI should be used for everything. I think there are some things, like
(46:08):
health professionals right now, they do have way too much to do. There
was a study that found it would take a primary care physician
in The United States 26.7 hours in a
day to do everything they had to do in terms of preventative care,
administrative management. And you're thinking, yeah,
there's not 26.7 hours in a day. So
(46:30):
insofar as AI can, like, support some of
that administrative work that everybody hates,
that's great. But I do think that what you're
saying about your own experience of feeling like you were
sort of a machine when you're being treated with
so many machines, we can't discount that that
(46:53):
is real. That can have health consequences. So as usual, Boots,
I'm with you a hundred percent. Well,
Julia, this has just been an amazing conversation and we could go
for probably the rest of the day, but you have
more, more things to do today, so we are going to let you
go. But before you do, will you please tell us all the ways we
(47:15):
can find you? I will also have it in the show notes, but verbal is
also good. Well, Boots, thank you so much. Such an
honor to be here. We've been wanting to do this for, I think almost six
months, close to a year now, so it's such an honor.
Hope this is the first of many. And my the best
way to find me is through my socials. I'm
(47:37):
at Hot Stuff thoughts on Instagram x
hotsthoughts.com and for folks who are interested in learning
more about the Connect Secure and social prescribing,
encourage you to visit the book website at Social Prescribing
co. Thank you. And please encourage your bookstores to
get this book if they don't have it already. Encourage your local libraries
(47:59):
to order the book. It it just it should be
necessary. Read reading. It's rare that I feel that way about books,
but I feel like I have some street credit here with knowing that this
book really is part of the answer to us thriving
as a society. So thank you, Julia and
thank you listeners. And if you haven't already, will you please subscribe
(48:21):
to this podcast. That way you don't miss another episode.
And then lastly, will you please make my year and leave a
review? Your reviews matter and it helps tiny
podcasts like mine get seen and known around the world.
We're already downloaded in 75 countries, which just
blows my mind. But I want even more heart patients to
(48:44):
find this podcast. So thank you listeners for being here.
I wouldn't be here without you. I love you. You
matter and your heart is your best friend.
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