An Interview With Dr. Mike Hansen
What type of Doctor are you?
I am a medical doctor, meaning MD. I am board certified in internal medicine, pulmonary disease, and critical care medicine.
How did you know you wanted to be a doctor?
I didn’t know I wanted to be one until my junior year of college. But I was always curious about the human body, even as a kid. My imagination ran wild. When I had an asthma attack at age 10, I was breathing so hard, it felt like I was breathing through my skin. I wondered if air was passing through my skin to get to my lungs.
Of course I was wrong, but that curiosity was always there. And it’s like, the more you learn, the more you want to learn. The human body is a huge puzzle that can never be completely solved.
And I also loved running around, playing sports. My dad would motivate me to exercise. He would make me do 10 pushups for a “nutter butter” cookie, so I bang out 30 at a time. But I would notice my veins are bulging, and its like…. “why, are they like that?”
And BTW, I think if everyone stuck to a formula of 10 pushups for every cookie, obesity would vanish.
(chuckle) Yeah, probably. Did your asthma affect your ability to exercise?
Yes and no. My asthma mainly flared up while exercising in cold weather. That’s why growing up in CT, I was limited to playing only 1 year of football in high school. Inhalers and medicine helped, but could only do so much. So during winters, my exercise was indoors.
What were your favorite subjects in high school?
Definitely gym class. I loved competing in sports, and part of gym class consisted of working out in the weight room. And I truly believe that it’s the most important class of any high schooler, or even middle schooler for that matter. The importance of exercise from an early age can not be overstated. It’s great for mind and body, and setting that tone at a young age is crucial.
Was physical education your major in college?
Only for a very brief time. I took physiology of sport and exercise, and had this super intense professor. I loved learning from him, but that was around the same time I started leaning toward going into medicine. So I switched my major to biology, and minored in biochemistry.
So you go to med school, and then you have to pick a specialty. Why did you choose Internal Medicine?
The way I see it, internal medicine is a field of promoting a healthy adult life, meaning preventative medicine. Internal medicine is also a field of solving medical mysteries (some are easy, some are hard), and knowing the optimal treatments for individual adult patients.
And then you chose to further specialize (subspecialize) in pulmonary disease & critical care medicine?
Yeah it seems like in a way, it all circled back to my own experience with asthma and my passion for exercise. And it all ties into the relatively new and fascinating field of CPET.
And critical care medicine is, for me, the ultimate challenge. It forces you to be at your best under pressure, when a patient needs you most.
What is the most rewarding part of being a critical care physician?
There are times when people have difficult to diagnose and/or difficult to treat conditions, especially in the intensive care unit. When you study and work your butt off for so long, and you have to apply that knowledge in order to save someone’s life, and you see your patient pull through, it’s a giant feel-good, totally fulfilling high that is shared with a lot of people.
I’ll never forget this patient of mine, a 29 year old female, who just gave birth. Within minutes of giving birth, she had worsening shortness of breath, and was in respiratory distress, and she was only able to see her baby for like 30 seconds. This is because we urgently had to intubate her, and put a central line in her.
So she had respiratory failure, kidney failure, and liver failure. Basically, knockin on heaven’s door. Husband and father must have asked me 10 times over, what are her chances? Etc. Her diagnosis turned out to be HELLP syndrome, and we ended up treating her with dialysis and plasmaphoresis. But without a working liver, you can not live. So we were in discussions for a liver transplant, but in that time, her liver bounced back, and she ultimately got better, and had her healthy baby in her arms. You don’t always have those feel good stories in the ICU, but when they happen, it has a real impact on you.
What is the most frustrating thing about being a critical care physician?
Working hard to get the desired outcome, but sometimes no matter what you do, or how hard you try, the end result doesn’t change. Telling this to a patient or a loved one is the hardest part of the job. It’s also frustrating seeing the end result of many people not taking care of themselves for years.
Smoking. Alcohol. Lack of exercise. Poor diet. Obesity. Not taking appropriate medications. It takes its toll on the body, and I see the end result of that all too often. More times than not, there is nothing more that can be done for them.
What can be done to change that?
This relates back to the field of internal medicine, specifically preventative medicine. Most people vastly underestimate the importance of preventative medicine, specifically exercise, eating healthy, sleep, age and sex appropriate screening and checkups, limiting alcohol, quitting smoking, etc. These things not only affect your physical health, but mental health as well. The most important thing you have in this world is your health, and taking care of it should be your priority.
We know what should be done, but how do we get people to do what they should do? Something that they don’t teach in med school, or residency training, is how to positively influence others. Although people ultimately have to take responsibility for themselves, health care providers have a role in educating their patients, and this ties into the ability to positively influence them to take action that will be to their benefit.
We live in a different time now with the doctor-patient relationship. Before it was like marriage, now it’s more like dating, which means there is not as much trust, which means less ability to positively influence. On the bright side of things, we could (and should) have more influence online, and you will see more and more of these relationships develop online.
Besides nurturing the doctor-patient relationship, what else can be done to positively influence the public?
Education from trusted and credible sources with expertise.
How does one know who a trusted and credible source with expertise?
Who is the source? What are their credentials? Is it some random person who is getting paid to write content on the internet? It’s rarely a board certified physician as the source.
You also have to consider their motives, because its almost always about the money. Most of the health websites (yes, the most famous ones that you can think of), get paid through advertisements. They hire non-physicians, sometimes not even people in the health care sector, to write/create health content to keep traffic coming to their website. They will post attention-grabbing headlines with “New study shows…” based on a weak study that prematurely gets people’s hopes up. Physicians know what is going on here, but most of the public does not.
There are some not for profit public health education websites, like NIH, CDC, etc.
In an ideal world, you would get your education from a trusted, board certified physician with expertise in their respective field(s). Better yet, one who actually knows you. You know? Kind of how it used to be.
And is that why you do patient education videos?
Exactly. It’s not as good as having an individual conversation with a patient, but it is pretty darn close. Knowledge is power, including knowing how to find that knowledge.
You also enjoy educating medical students, residents, and fellows as well?
Yes, I love teaching. After all, the word doctor is _____ for teacher. ……. I have learned a lot from outstanding doctors. “If you’ve done well, it’s your obligation to spend a good portion of your time sending the elevator back down, to lift someone else up.”
At the beginning of my fellowship a group of Cornell residents were discussing a medical case while eating at a table, and when I walked by, they asked me if I could help them, as they had this patient with an acid base disturbance they couldn’t figure out after two days, they just couldn’t wrap their head around it. I showed them my acid-base technique, and it worked for them instantaneously, they were just floored, because it was so simple, and yet it wasn’t something they could learn in any other book or review course. And because residents tend to gossip with each other like in high school, before I knew it, I was getting bombarded with questions, or wanting me to help them prepare for their boards. Eventually someone asked ‘how come you don’t just create videos so that you aren’t doing this 24/7, and have your unique teaching online.’ And so that’s what I did, teaching thousands of students and residents ever since.
Who was your mentor?
There have been several physicians that have inspired me to keep getting better and better. This goes back to me being a medical student, a resident, a fellow, and still today as an attending. I always try to pick people’s brains and learn great things from great clinicians. As a virtual mentor, there is William Osler, basically the Godfather of medicine. The learning never stops, and I like it that way.
In June 2017, you participated in a “Best Buddies” fundraiser. What is that about?
I teamed up with Tom Brady (aka the G.O.A.T. of football) as part of “Team Tom Brady.” Our team is competed in a biking challenge to raise money for “Best Buddies.” (To learn more, click here).