In This Episode Dr. Civelli sits down with Tim Pace — physician assistant, 20-plus year clinical veteran in orthopedic surgery, and doctoral candidate in lifestyle medicine graduating in 2027. What starts as a catch-up between colleagues turns into a deep, honest conversation about stress, burnout, the six pillars of lifestyle medicine, and why the people most qualified to give health advice are often the last ones following it. Topics Covered What Is Lifestyle Medicine? Lifestyle medicine is built on six pillars: adequate nutrition, avoiding risky substances, restorative sleep, physical activity, stress management, and social connectedness. Tim's two favorites — stress management and social connection — are also the two most overlooked. The field goes far deeper than it sounds, because the problem isn't that people don't know what to do. It's that they don't do it. The Lifestyle Medicine Assessment When Tim completed the long-form intake questionnaire for his own program, he discovered he scored off the charts on anxiety — something he'd never considered a diagnosis. That moment of stopping, reading, and looking inward changed how he thinks about both himself and his patients. The American College of Lifestyle Medicine holds providers to living the lifestyle themselves, which Tim calls one of the most therapeutic parts of his doctorate. Box Breathing — The One-Minute Reset Box breathing is simple: inhale for four seconds, hold for four, exhale for four, hold for four — and repeat while visualizing a box in your mind. The benefits are measurable: increased oxygen, decreased blood pressure, reduced cortisol and adrenaline, activated prefrontal cortex for clearer decision-making, and a calmed amygdala — your brain's fear center. You can do it at a red light, between patients, or the moment you feel yourself flooding with stress. Your Brain Can't Tell Real From Imagined When you run a stressful scenario in your head — even one that never happens — your body responds with the same chemical cascade as if it were real. Cortisol spikes, adrenaline surges, oxidative stress builds. The amygdala fires whether the threat is real or imagined. The good news is the reverse is also true: calm the thought, calm the chemistry. Medical Provider Burnout Tim and Dr. Civelli get candid about the reality of provider burnout — chugging Mountain Dews, smashing Red Bulls, eating Snicker bars at 3am between surgeries, going home with amniotic fluid on your neck. Medical training is entirely patient-focused, and providers are expected to just be okay. Burnout rates are skyrocketing alongside documentation demands, EMR systems, social media, and post-COVID anxiety. You cannot pour from an empty cup. Nutrition — Whole Food Plant-Based The evidence overwhelmingly points toward whole food plant-based eating. Not vegetarian, not giving up meat entirely — just making plants the foundation. Tim reversed his chronically elevated triglycerides and cholesterol by shifting away from meat at every meal. His weekly routine is simple: random vegetables from Trader Joe's, protein beef broth, bullet it, done. Lentils, soy, beans — protein is not a problem. Sleep, Distraction, and the Art of Recentering Both Tim and Dr. Civelli admit to the middle-of-the-night spiral — waking up, brain firing, anxiety about not sleeping compounding into anger. Tim's trick is listening to something without a storyline, like David Attenborough narrating animal facts. The key is redirecting focus away from the stressor before the amygdala takes over. Meditation is the cleanest solution, but it takes practice — real, ongoing practice, like any skill. Social Connection as Medicine Isolation is one of the most underestimated health threats. When people are stressed, they isolate. But social connection drives oxytocin, reduces cortisol, and is a documented protective factor against chronic disease. It doesn't require a big social life — wave at your neighbor, find a community around something you love, try Meetup or Bumble BFF. Small moves count. Reading Research Without Bias Tim and Dr. Civelli discuss the responsibility that comes with a platform — how easy it is to take a study, spin a narrative, and present it as truth. The goal for this show is always to create conversation, not confirm bias. Look it up yourself. If they're wrong, they want to know. Mentioned in This Episode The six pillars of lifestyle medicineAmerican College of Lifestyle MedicineFITT prescriptions (frequency, intensity, time, type)Stages of change / pre-contemplation modelBox breathing techniqueAmygdala and prefrontal cortexCortisol, GABA, adrenaline, noradrenalineOxytocin and pet bonding researchCalm app / bedtime storiesDavid Attenborough sleep listeningGame Changers documentaryWhole food plant-based nutritionBumble BFF / Meetup for social connectionMedical provider burnout statisticsResearch bias and media spinConnect with Tim Pace t.paceoflife Connect with Dr. Civelli 🌐 trifectamedical.org 📍 7702 Meany Ave #101, Bakersfield, CA 93308 📞 (661) 677-2623 📧 info@trifectamedical.org White Coat Black Sheep — where science gets curious and dogma gets uncomfortable.
