73 Questions with a Cardiologist | ND MD

Hello, hello. What's up? How are you? I'm well, man. Welcome in. Thank you. It's a little chilly in Atlanta now. It's very chilly here. Winter is here. Are you ready for your 73 questions? I am ready. Let's go. This one is a long-awaited one, so I'm super excited. Thank you for choosing me. I can't wait. I couldn't think of anyone better, so let's get started. What is your name? Eddie Hackler III. And your specialty? Cardiology. Awesome. And I guess, how many years have you been practicing or attending hood now? So it's been a year and six months since I have a graduate fellowship and started my attendant job. And how's it compared to being a fellow or a resident? So much better. Look, anybody in residency or a fellowship, you have something to look forward to, because there is light at the end of the tunnel. And yeah, I've enjoyed it. Man, I need it. I'm about to enter the fray. So where did you go to undergrad? I went to Bowling Green State University in Bowling Green, Ohio. Right. And medical school? Meharry Medical College in Nashville, Tennessee. And residency and fellowship? Residency was at UT Southwestern in Dallas. And fellowship was Case Western University in Cleveland, Ohio. Great places. Yeah, yeah. I've been around the world. It's like a little triangle, I'd say. Exactly. Did you take any gap years before going to medical school? So I did take a gap year. I actually did a post-bac program. And it was at, actually, Meharry. And what we did was we took the MCAT again. I took the MCAT twice. The first time I took the MCAT was not really good. I didn't study or anything. I just went and took the test. And I realized, you know what? No, we need to prepare better for this. So I got into the post-bac program. We took courses with the first-year medical students. And you had to get a certain GPA. You had to get a certain MCAT score. And then you would get a conditional acceptance into the program. Oh, whoa. I don't think that program exists anymore. We were the very last class to do that. Now they have master courses for that. Gotcha. That's sweet, actually. It was a blessing. So once you got into medical school, what was your favorite part of medical school? Honestly, my favorite part of medical school was socializing. I mean, to be around like-minded individuals who are all going towards the same goal, it was just I just had a really good time. And I think back a lot to my med school experience. And I wouldn't trade it for the world. All right, well, let's reflect more on that med school experience. What specialty did you think you were going to go into on your first day of med school? I thought I was going to be an oncologist on my first day of medical school. What changed your mind about that? Learning about oncology and tumors and realizing that there's not one big cure for cancer. Every cancer is very different. There's so many different mutations. It's very, very malicious. You got to be very meticulous. And then also just dealing with the concept that, yeah, most of my patients may die, that didn't sit well with me when I thought about it more. Well, were there any specialties you immediately out the gate said, absolutely not for me? Oh, I knew automatically that I did not want to be a surgeon. So one thing, I hate being cold. So being in the OR, I was always freezing. I'm like, yeah, I can't do this. It's cool to watch. And I definitely have all the respects for surgeons. But I knew that from the jump that I definitely didn't want to do it. That's more than a lot of people know going into it. Well, what first made you fall in love with cardiology then? So it was my second year of medical school at Meharry Medical College. It's an HBCU, Historically Black College University. At most HBCUs, there's a campus king and queen. And they're the face of the school from a social perspective. At Meharry, that was called Mr. Meharry, which I was my second year of medical school. And it was a social, it was a social, it was a social, I'm trying to think of the best way to describe it. I think mostly my job was basically to find ways that we can go out to the community and kind of just serve. So it was a way for us to set that up. So during that time, I decided to do a men's health outreach. So where Meharry was, it was a street full of barbershops. And I had just read about the barber study. I thought that was so cool. And I was like, you know what, let's implement that here in Nashville. Like literally, if you walk down, I think it was Jefferson Street, you can literally find eight different barbershops. So what we did was I gathered up a group of men and women, and we went to different barbershops. We talked to the men about health. We wanted to see how many of them went to the doctor. And if they didn't go to the doctor, why they didn't go to the doctor. And then the ones who did, like what was common reasons for them going to the doctor was whatever they wanted to share. And the most common thing that we heard was hypertension, high blood pressure. So I did more research and I realized that one, high blood pressure is very prevalent in most communities, specifically the black community. And that most people are gonna die from heart disease. So at that point, I thought that was the best way for me to do the most good for the most people by, I guess, by deciding to do something where most people will probably perish from it and then having that impact there. Attacking it right at the source. Right, right. Awesome, and of course, I mentioned that this is a very highly anticipated one. A lot of people wanting to go into cardiology. So for those people, how long does your training take after med school? After medical school, you have to do three years of internal medicine. Then you do three years of residency. And then, oh, I'm sorry. I said that wrong. You do three years of residency and then you do three years of fellowship. So it's at least six years. And if you wanna do any further training after that, it just depends on what specialty in cardiology that you wanna go into. But yeah, that would depend. But I think on average, it's two. Did you ever consider getting any other degrees, like an MBA or like an MPH at all? Oh my goodness, yes. I wanted to get an MBA. I still have desires of getting an MBA. But I was going to do a joint program that Meharry has with Vanderbilt to get an MBA. You would have to stop your third year of med school to start taking your MBA courses and then come back, I think, your fourth year to then finish up med school. And I just didn't want to break up my training in that way. So I decided to think about it at a later date. Gotcha. So now what would you say is the most unique part of your specialty? The most unique part of my specialty? So one thing about cardiology that I love is that there's so much research and so much data in cardiology that it's very, one, it's very exciting. And there's always something new, something coming out. But I think there's a lot of guidance for things. We're not doing a lot of things just because, you know, someone say, oh, this is the way to do it and this works the best. No, there's actual data that supports why you're doing something. So I think patients feel a lot more comfortable when you tell them, hey, this is what the research shows. And I think you get a lot more satisfaction from what you're doing because you know that it's been proven to work. Yeah, I remember being on the cardiology service and they're spinning off like these different crazy acronym trials left and right. Bonus question, what's your favorite trial acronym name? I think probably the OAT trial. Just because it has nothing to do with what you think the name is. That's usually how these guys, but anyways, I digress. So I always let people kind of sell their specialty to all the brilliant pre-meds and medical students watching. So why should someone choose your specialty? Like I mentioned earlier, most people are gonna die from heart disease. So if you wanna join a field where you can have a huge impact in saving lives, cardiology is a great field. It's a vast field. There's so many ways that you can serve in this space. General cardiology, you can do interventional cardiology, you can do heart failure, you can do electrophysiology, you can do imaging, you can do research. There's so many things that you can do and that makes the day-to-day just very fun because you're not doing the same thing. It's just a mixture of a lot of different things that you can do that will be fulfilling overall. Yeah, flip it around. Why should someone not choose your specialty? If you don't wanna help people, do not do cardiology. It's as simple as that. I think that applies to medicine in general, but fair enough. Are there any stereotypes of your specialty? So typically what I hear is that cardiologists are usually like know-it-alls, can be arrogant. Usually like, because we think we're the smartest people in the room or in the hospital. But those are the stereotypes that I've heard. Are they true? I'm gonna throw in the cardiology versus nephrology. Man, continue to LASIKs. It doesn't answer if they're true or not. But no, I don't think so. Just like any specialty, you're gonna have people have a certain personality, you're gonna have people who have a very different personality. So yeah, I can only control me and I don't think I'm any of those things and I continue to strive not to. Great answer. Now this is always a fun one. With any stage of medical training, from third year med student to second year resident, there's this concept of on-the-spot quizzing of knowledge called pimping. So what is the craziest question that you've ever been asked by an attending, either as a resident or even fellow? I remember when I was in medical school and I was doing an away rotation at a specific place that was pretty known for cardiology and the attending asked us what was the number of people, not the percentage of people, but the number of people who died from heart attacks every year. Of course, no one on the rotation knew the answer. He was so upset that we didn't know. We didn't know this epidemiologic answer that he was asking for and yeah, that was probably the craziest thing because I didn't know how to prepare for that. I'm like, oh, I didn't really look that up. It's always numbers or nothing. Right. But all right, now that you're an attending, what does an average day look like to you? So my average day changes, which I love. So in average, I work four and a half days a week. We get a half day off per week. And most days I'm working about eight to five, 50% inpatient, 50% outpatient. So on one day I may be in clinic. I have two different clinic sites. So one day I'm in one clinic site. The next day I may be at the other clinic site. The following day I may be in the hospital doing transesophageal echocardiogram or the next day after that, I may just be reading echoes and stress tests and supervising the stress lab. Another day, another week, I may be rounding in the hospital all week on outpatients. I mean, our inpatients. And then another day I may be doing consults. So I may just be the consult doc and I'm just seeing all the new patients who are coming in and who need some type of cardiovascular help. And yeah, so I think that's pretty much the gamut of everything, but it just, it changes from week to week and it keeps me on my toes, so yeah. What would you say on average the amount of patients you see in a day? And I know that changes depending on inpatient and outpatient. Yeah, I'll say outpatient. Right now I'm up to about 18 to 20 patients in a day. And on an inpatient day, ooh, it can be anywhere from 15 patients all the way up to 30 patients sometimes. What's the most amount of patients you've ever seen in a day? The most amount, ooh, probably like I think 32 patients that I saw in a day. There you go. Yeah, that was a brutal weekend call. Oh yeah. What procedures do you do or like what are kind of the most common procedures that you get to do? So the only procedure that I do currently is transesophageal echocardiogram, which is an invasive procedure. We go through the esophagus to look at the heart. A lot of times we're doing this if we're concerned that someone may have a PFO, they've had a stroke, or if we're gonna cardiovert someone and we wanna check for a clot prior to cardioverting them, we'll do a TE. Or if somebody has really bad valvular disease and you wanna get better imaging to get better data because they may need surgery, we'll do that. So that's the only procedure that I actually do. So what are the most common diagnoses or problems you see patients for? I know you touched on a couple of these already. Hypertension, palpitations, coronary artery disease, heart failure, chest pain. Yeah. And shortness of breath. All, yeah. Yeah, I'm thinking back to my three weeks on the cardiology service for IM and I think the average ejection fraction on that floor was like seven. So that sounds like an advanced heart failure floor. Yeah, so. Oh, this is a fun one. Any emerging tech or advancements that you find exciting and promising in the field of cardiology? Yes, so actually right now there's a lot of studies behind renal denervation, which are procedures in an effort to decrease the blood pressure in people who have resistant hypertension. And as I mentioned before, hypertension is one of the biggest risk factors for heart disease. So I think if this procedure shows some promise, that's another added benefit that we have to help decrease cardiovascular disease overall. Yeah. And what is one thing people misunderstand about the field of cardiology? That's a good question. Well, I think one thing is it's not a one, it's not a one fit all type of specialty. I think that just because the book tells you that because your patient has heart failure, they should be on a beta blocker, that you have to give it to them all the time. You have to take into consideration the patient. If the patient, if heart rate is already 40 and the blood pressure is 90 over 50 at baseline, it may not be okay to start that. So I mean, that probably can go into a lot of other fields, but taking each person and realizing that they're a human, and just because you have all these things that you're supposed to do, you don't necessarily have to do. Yeah, very well said. In your opinion, what's the toughest part of your job? The toughest part of my job sometimes is dealing with the insurance company. Or there's something that a patient may need that I think that would be beneficial, but for whatever reason, they can't afford it, and the insurance doesn't wanna cover it, or whatever reason that may be. So then having to fight back and forth is tough because it's like, okay, well, I'm trying to prove to you that this is beneficial for this patient's well-being. I don't think it's a, I don't think it's a question, but that is definitely the hardest part of my job. Now, what's the most rewarding part of your job? The most rewarding part of my job is seeing a patient, typically in the outpatient setting, and we're coming up with a goal for them, and they come back in three to six months, and they've achieved that goal, whether that's a target blood pressure, whether that's increasing their physical activity, whether it's decreasing their salt intake, or it's weight loss to a certain amount. I love when patients reach their goals because it's like a light in their eye that you can see. As soon as you walk through the door, I immediately can tell, like, oh, you've been doing what you're supposed to be doing, and you've actually accomplished something because the smile that you get when you see these patients is just, it's tremendous. So, all right, now we're going into some quick-fire, kind of work-lifestyle questions. How many hours do you work in an average week? Four. What time do you normally wake up? Five. What time do you normally leave the hospital? Five. How many hours of sleep are you typically working on? Eight. Good, how many hours of sleep are you working on right now? 10. Nice, that's a good day. It's a great day. I know you answered this kind of previously, but do you have to take call? Yes. Any opportunity for further sub-specializing? Well, when I was in fellowship, I actually thought about doing interventional cardiology. However, the on-call life for interventional cardiologist didn't necessarily fit with the lifestyle that I wanted for myself. Being woken up at 2 a.m. to rush into the hospital to save someone, and ideally, it's amazing, but realistically, it wasn't something that I thought that I would enjoy doing, not for long, at least. So, I didn't decide to do that. So, at this point, I think I'll just stick to being a general cardiologist. I enjoy that. For sure. Of course, interventional, I think there's EP, oh gosh, the electrophysiology guys can look at an EKG and triangulate where you need to ablate. It's insane. Yeah, and they can locate and all these things. Electrophysiology is an amazing field, and it's just, it's an additional two years after your cardiology fellowship, and my hat goes off to those guys. It's just great work. So, a lot of opportunities. How long does it take for you to chart at the end of your day? So, one thing that I learned early on in residency was being efficient. So, I think I'm pretty efficient, whereas I'm pretty much charting throughout the day. So, I'm not left with just a big, massive amount of charting at the end of the day. That's overwhelming to me, so I try to avoid that as much as possible. So, yeah, I don't really have to sit down for much time to chart at the end of the day. Good, so I don't have to read your question, but one that's necessary. Okay. So, who are you most thankful for on your care team? Who am I most thankful for on my care team? Well, that's hard, because I am thankful for everyone. I have, I work very closely with nurse practitioners and nurses who make my job very easy. They do a lot of the groundwork for us, and I think they're like the eyes and the ears for us. If I'm on call, they're the ones in the hospital at that moment doing the hard work, and I'm very appreciative of everything that they do, honestly, so I think I would probably say, my nurse and then my advanced practitioner. So, that's PAs and nurse practitioners. What's the most common medical advice you give to your patients? So, my biggest advice is 80% of heart disease is preventable, so the choices that you make, lifestyle choices that you make, directly affect your cardiovascular health. So, it's 100% up to you on how well you want your heart to function. Very good, thanks. Now, do you have a most impactful patient encounter? So many, but. Choose one. Does it have to be cardiovascular? No. Okay, so in residency, I was an intern on my ICU rotation, brutal, brutal days, and there was a woman who was, she was admitted for, oh, interstitial lung disease. She had some type of cancer, and she got treatment, but one of the side effects of the treatment was IOD, and she got it really bad, so she was on a massive amount of oxygen, but every time I came into her room, she would smile, and she would tell me how proud of me she was, and how happy she was to see me, and it would just make me feel good, because at five in the morning, when I'm trying to rush to get things ready for rounds, just that little piece of humanity is enough to kind of make you stop and remember, like, oh, man, thank you, I love that. But it was impactful, because she brought her sons in, who I think at the time were probably 14 or 15, because she wanted them to meet me, and that just made me feel really special. In a rotation where you sometimes don't necessarily feel special, that you're making that type of an impact, but she reminded me of the humanistic part of medicine, and I'll never forget her, and I'll never forget that experience that she gave me. That's awesome. All right, so we've talked a lot about life inside the hospital, how about your life in the clock house? So what's your favorite thing to do when you're not working? I love to do so many things when I'm not working. I love working out, so I typically like to start my day with a workout, so I wake up at five, I try to be at the gym at five, I enjoy reading, I enjoy eating, so that's cooking, and that's trying out new restaurants. Here in Atlanta, there's so many different places where you can eat, so I enjoy that. I love hanging out with my family and my friends, so any opportunity that I get to hang out with them, I will definitely take that. And last but not least, one of my most favorite things I love to do is to travel, and that's anywhere, like domestic, international, I will quickly hop on a flight. Does your family ever ask you for random medical advice? Oh, yes, even before I was a doctor. This is R.S., he's a doctor. I'm like, oh, I'm in my second year of med school. What's the weirdest question family or friend has ever asked you, medical-wise? So, I don't necessarily, I can't think of a weird family or friend that's asked me a question, but I do have one from a patient, can I say that? Sure, okay, so I had a patient who came in and asked me how much cocaine could he do that was safe before he would have a heart attack or a heart failure. The answer is zero. This is zero. It was such a shocking question that I literally just like, oh, wow, he really just asked me that, and he was serious, he wasn't joking, very serious. Yeah, the serious answer is zero, a zero amount. Any pets? No, no pets. I think I'm allergic to dogs, and I've realized this because my friends all have dogs, and whenever I play with the dogs, I throw it in my throat, and my nose starts running, and they're like, oh, no, my dog's hypoallergenic. I'm like, uh, yeah, but they're not non-allergenic, so. It's an issue for me, so no pets for me. Well, then, what's your favorite animal, not a dog or cat? My favorite animal is a tiger. Tiger? Yeah. How about that? Tigers are majestic. Of course. Yeah, my high school mascot was a tiger, too, so I feel like it's always been kind of embedded in me. My goal is to go to Thailand, and go actually play with some safe tigers, take some pictures with them, and just kind of be in their energy, in their space. Safe tigers, I think. Right. It's the oxymoron. All right, if you could have dinner with anyone in history, who would it be? Dinner with anyone in history. Who? Michael Jackson. Ooh. What would you guys be eating at said dinner? Ooh, where would we be eating? What would you guys be eating? Oh, what would we be eating? We would probably be eating pasta. Nice. So, what's your favorite dish to eat, then? So, my favorite dish is probably, hmm, chicken and shrimp Alfredo. I love it. I love it, love it, love it, love it. This sounds incredible right now. All right. Any favorite restaurants around here? So, I love Indian food. There's a restaurant called Blue India that I frequent probably weekly. So, I would definitely say Blue India. Nice. Coffee, tea, or soda? Neither, none. I can't pick either or none of them. Oh, all right. I drink water pretty much all day. That's the healthiest answer, honestly. All right, speaking of that, how much water should you be drinking every day? I feel like this changes all the time, but I typically would tell my patients, depending on who they are, but in general, about 64 ounces of water. Favorite meal from the hospital cafeteria, if you have one? They make a fire-joked jerk chicken that I really enjoy, yes. You make me hungry. Right. All right, top three favorite music albums? Good Kid, Mad City, Kendrick Lamar. Usher, Confessions, The Deluxe Album. The Deluxe Album, you gotta make sure. The Deluxe Album. Ooh, this is tough for this last one, but I'm gonna give it to Nipsey Hussle, Victory Lap. All of it, all great albums. Favorite song at the moment? It's a song by, what's her name? Tyla, Water. Make me sweat, make me hotter. Great one. Yeah, I love hearing that song whenever I'm outside. I know we talked about food for a little bit, but controversial question, pineapple on pizza, yes or no? Yes. Be prepared to be judged by the internet, both in a good and bad way. Any artistic hobbies you keep up with? Artistic, I play the violin, so that's probably the most artistic hobby. Yeah, you do have a little bit of a social media gig I'm sure I do. Well, yeah, yeah, I guess I am, or what? They call it a medical influencer, so yeah, yeah. I guess that is art. You know, you do these things and you don't necessarily put a label on it, but yeah. It's art, man. Believe me, I've been doing this for a while, it's just art, you know, I love it. Favorite movie or TV show? Titanic. Classic, classic. One random task you wish you could be better at? One random task that I wish I could be better at? Responding to emails. Yeah? Yes. That's up there. It is very much up there. What's the best way that you relax after a long day? So, after a long day, sometimes I will, sometimes I'll meditate. I've been meditating a lot more, so, or doing breath work. I like listening to health and wellness podcasts, so I'll do that, and sometimes literally doing nothing. Like, just sitting in stillness and calmness is a great way for me to relax. Very healthy. Night in or go out in the town kind of person? It depends on my mood, but I'm more extroverted than introverted, so I'm gonna say I'm going out. Indoors or outdoors? Outdoors. Beach or mountains? Beach. And we touched on this in a sec earlier, but would you consider yourself more of an introvert or an extrovert? Yeah, I'm an extrovert. Was that personality trait a factor in you choosing your specialty? No, I don't think so. So, all right, we're real close to the end. Okay. So, these are the wrap-up reflective ones that I always love asking, so you ready? Yeah, yeah, I'm gonna sit up for this, let's go. All right. Get my posture right. So, first one, what did you think you were gonna be when you grew up as a kid? I've always wanted to be a doctor. The dream, you dream to choose? Yeah, yeah. So, is there a different specialty you think you could have done? I do think that I could have done an aphesiology. I'm not partial at all. Not for good, unbiased. If you didn't do medicine, what do you think you'd be doing right now? I think I would be a stylist. I love clothes, I love fashion, I love putting things together. Well said from the all-white setup here. This is all ad-dyed, too. Who's on accident? Oh, yeah, yeah, yeah, wait, what do you mean, this? Oh, we're all white, I'm gonna get me. Looks fantastic. Thank you, Jay, thank you. Now, everybody knows that it's not an easy path to becoming a physician, whether that be taking the MCAT multiple times, I did it as well, applying multiple cycles. So, were there any times you doubted that you would make it as a doctor? So, I think when I was in residency, I did have some doubts. My first year of my intern year, just making it as a practicing physician. Intern year is very hard, very stressful, very dark time for a lot of us. And during that time, I did let some doubts creep into my mind. Yeah, it's, ah, I'm looking forward to it. Ah, you're gonna love it. Right after, yeah, it was a pretty doubtful time. It was a pretty doubtful time, I'm sure, I love it. So, I know that. A new character. Yeah, I'm waiting for it to be built. Now, if you could change one thing about the medical field right now, what would it be? Ooh, our healthcare system. I think we need some type of healthcare for all, some type of, some type of system where everyone is insured and it's not based on your class and it's a universal system that will give everybody their basic needs. Okay, healthcare is a right. Very much so. Now, what can a medical student do right now to prepare to go into cardiology? One, I think just being a good person. So, that means just living in a way where you're doing good for people. But studying as hard as you possibly can. Just taking in as much as you, as much as you're able to. One day, you think that you won't have to remember one random fact that has nothing to do with cardiology and you feel it's tied in to the system that you wanna be a part of. So, I would say learn as much as you possibly can. And knowledge is wasted. Very much learned that as well. I think a lot of us, we don't realize that, well, one, we don't get the result of our actions like right away sometimes. So, you think that you're doing all this studying and that it doesn't mean anything. But you don't realize that, look, five years down the line, that piece of information that you thought was useless at the time or didn't do much for you is now helping you save someone's life. Now, if you were to go back, would you change any of your experiences that got you to where you are right now? No, I would not change anything. The best part of this is the journey. Your journey is yours for a reason. It makes you who you are. You wouldn't be who you are without the journey and it's yours because it's meant to lead you in a certain direction and that direction is where you're supposed to do stuff. I would never change that part of me. Very common theme across basically every position. All right, finally, last question, 73. Let's go. So, what would you say to the aspiring cardiologists right now? We need you, we want you, and we can't wait to have you. So, put the work in now and I'll see you another time. Ooh, there we go, biggest sales pitch. So, thank you so much. Oh man, thank you, I love what you're doing. Keep doing it. Thank you, Ryan. I know you're already inspiring so many future cardiologists on your own platform and I'm thankful you're able to share your story on mine. Oh no, no, thank you, I appreciate it. All right, let's go. Let's get some food.