Amanda: Hey guys Welcome back to the podcast. I'm Amanda.
Laura: I'm Laura
Kendra: And I'm Kendra.
Amanda: And today we are so excited because we have a special guest, Dr. Laura Fortner. She is a board certified OBGYN and a medical malpractice coach. You will remember her from our podcast number 27 on what to do when you get sued. Just as a reminder, if you have any friend who is unfortunately going through that, please listen to that because there is help and you don't need to go through it alone.
But today she joins us for something different, memory reconsolidation. We were recently at a coaching conference together and we're super bummed because our talk was at the exact same time as hers. So we missed it, but it worked out for everyone. There's always a silver lining because she promised to tell us all the things here.
So crisis averted and now we all get to learn what her presentation was about. So thank you so much, Laura, for joining us today.
Laura Fortner: Thanks for having me. I'm excited to be here. Especially with you three,
Kendra: Okay. Dr. Fortner, remind our listeners a little bit about you, your training, where you live, and don't forget about the cattle ranch part, because you know, we're. You're my sister from another mister, so
Laura Fortner: yes. Yeah. Yeah. So I live in rural, Ohio, very tiny town.
We have a, about 130 acre farm. And that's what my husband does. I am an OBGYN and I got into, I am a med mal coach. I got into that because of getting sued in the past, which is very common if you're a physician, especially in the high risk specialties. So I'm here to normalize the conversation, but also I really wanted to talk to people about how they can help themselves, because I think it's so important.
I remember Going through my case, not having anyone to turn to, being told not to talk about it, you know, all the things, and I just think that's wrong, and we need to change that culture. So that's why I'm here, and we're going to talk about memory consolidation, which is something that I found through healing while I was going through a 10 year Case, basically one case trial and dismissal and everything beyond.
So yeah, so that's why I'm here. And I have four kids. They range from 24 to 14 and it is crazy. Like everybody else I know with working full time and helping other physicians through MedMal and being a mom, but I love it and I wouldn't change it. So.
Kendra: Awesome. And I'm so glad that you said that Laura, about the fact that it was 10 years and you went to trial because, you know, when statistics are put out there, there's a very small amount of med mal cases that go to trial. So, I'm glad you said that because I think that's just not talked about either because we want to focus on all the majority of the cases getting settled or just not going to trial. But you had the unfortunate experience of going through trial, and I think that's why you're so good at what you do.
You are known for your niche in med mal coaching. What got you interested in memory reconsolidation?
Laura Fortner: Yeah, so through my journey of healing, and like you said earlier, I am unique in the fact that, first of all, my case lasted 10 years, which most cases do not. The average time is 4. 9 years. I just want to put that out there.
But I went through every single gamut of the legal process, from dismissal. To actually getting it reinstated to trial then appeal after appeal. And it did not go in my favor. And I think that that also is a really good testament of why I, I am the person to do this, because if I can come out of it and still practice, still have joy in medicine, love what I'm doing, anybody can, and I got excited about.
Memory reconsolidation when it really transformed and healed me, I went through a three week long trial was on the stand for six hours total. And during that time, it is, it is, something that none of us are prepared for, and we do have to withstand things that perhaps we don't want to withstand. Hear are things that are untrue about ourselves and that whole experience. really created a trauma pathway PTSD like. Now, I will say, it impacted my PTSD like trauma pathway in my brain, because typically these pathways get created when we get sued as physicians. And we can talk more about that, but I knew after that trial that I had to do something. different to heal because it was very traumatizing for me.
And I did love medicine. I wanted to go back, but I felt that maybe I should quit like every other physician feels and maybe I'm not cut out for it. So I went and got a form of memory consolidation. And it changed me it what it does is erase the trauma pathway and we can talk a little bit more about that exactly so you can kind of get the gist of it.
But it is something that we all as physicians need to know about and when we go get help, which I say when, because I think every physician should go get help that they're in this predicament and getting sued when you go get help. This is something that you want to know that your person can do for you.
Kendra: So, why don't you start by giving us the basics about memory reconsolidation?
Like, what in the world are you even talking about?
Laura Fortner: Yeah, so memory reconsolidation was discovered in 1981. It's a biological fact of the brain. And basically what they discovered is when human beings like ourselves witness things. That become traumatic and I, and to back up a little bit, we have to talk about the definition of trauma and I want to, what the definition of trauma I use and we all should be using is anything.
That still impacts you today. You still think about, still has a psychological effect on you today, even if it happened in the past, right? Or if you're going through it currently, it's impacting you in some way. You're thinking about it. And it, it, and you get triggered, you know, something happens and it'll instantly come up, right?
Or you'll get intrusive thoughts about it. These are things that you have built a trauma like pathway in the brain. And that pathway, what memory reconsolidation was, it's So interesting, but when they discovered it, what they realized is when human beings witness things that human beings shouldn't witness, which is what we do every day.
This is what our jobs entail us to do. Right? We're giving CPR on someone and they die. We're operating on them and something goes awry. There's a complication. You know, this. We are witnessing things as humans that most people don't witness in their lifetime, and this is not normal to the human brain.
So the human brain labels this as trauma, a trauma like pathway gets created, it activates your amygdala, and then there is a memory that gets formed. When this happens, and that memory is called an implicit memory. There's different types of memory we have in our brain, right? And the implicit memory is what is important to know in this equation because that implicit memory holds our emotion and our psychological impact of the event. It holds it there. And the discovery of memory reconsolidation is our memories can change. They're malleable. And you can actually change this memory to change the psychological impact and actually erase the trauma response that you have when you get a trigger and when you think about what happened to you.
It is. Incredibly important. And there's decades of research on this and it seems as if people really don't know about it. And I think as physicians, this is something that we should actually learn in med school. I mean, it should be part of our curriculum and we should know how to do it ourselves.
Amanda: Yeah, that's amazing, because some of the books, and you can, we'll ask you some references later on, I mean, they're published recently, like, and it was a psychiatrist, psychotherapist, writing the book, who just found out about it on accident, like, they They didn't even have training on it. So that is, I feel a little bit better myself, since people that are deep within this field also don't realize that this is available.
So what are some examples of situations when memory reconsolidation would be really helpful?
Laura Fortner: Yeah, so anything that still psychologically impacts you today or that and you know anything that represents or something that happens to you now that Represents the past and you start thinking about it a trigger of some sort.
So in medicine, we can talk about medicine, specifically events that are very common are complications that go that are unexpected of patients. Okay. Any of sorts. Somebody young comes in, you're giving CPR and they don't make it and they were expected to make it, right? Anyone that is operating or doing a procedure and that goes awry and was unexpected.
That one case that came through the ER that you thought for sure was this, but then turned out to be something else, right? Or that one patient that you hear about two weeks later that actually ends up dying after you thought was going to do well, right? Like all of those things, any of those things. And really it's bad outcomes, unexpected outcomes, things that we think we Might have been able to control, but we really couldn't control.
Right. And getting sued is a huge one for us and many of us either develop the trauma pathway with the bad outcome that happened or actually getting served papers wherever you were. So, for me. It wasn't I had a delivery back in -01 and I didn't have any traumatic event with that delivery. Like, there was nothing there that triggered anything.
But when I got served papers. 14 years later when the child was 14 and the sheriff came to my front door to deliver the papers and I had three little kids with me answering the door, that was very traumatic for me. And that, that memory, I can tell it to you in detail, right? But now I can tell it to you without crying and without the trauma response and really very neutral and at peace with it because of the work of memory reconsolidation.
Amanda: I think, I can think of some examples in the ER where, like, the level of violence that I saw like, I probably knew in that moment, like, that I, I don't, I don't know if I'm going to be okay after this. But I didn't know that there was, you know, we were just like, keep your head down, get five stars, go see the next patient, you know apologize for the wait, you know, I just wish I would have known that this happened, that this is a modality back in my day.
Laura Fortner: Yeah, and you know what? I love that you brought that up because it's not only violence with patients and things going on in that realm, but it's also within the medical culture and community. So there are lots of people that I work with that have, in residency, had an attending that impacted them. And I really like to share with people that we don't want to grade trauma.
Meaning that one trauma is not worse than another in our brains. If it psychologically impacts us, it was trauma. So somebody who thought this attending was super mean to them and the words that they said to them really impacted them, that they can't stop thinking about it is trauma to that person.
Whereas another person might not have had the same experience. And so You don't want to grade any of this. This is normal neuroscience, what I'm talking about here. So really want to emphasize there's no right or wrong or perfect or not perfect. It's, it is just what it is. And if your brain registered it as traumatizing, that's when the amygdala gets activated and a trauma response occurs.
And that implicit memory holds all that information, and that implicit memory comes up every time then you get a trigger. And so, it's important to know that that, there, in that pathway, you can actually erase Not erase the experience, right? You'll remember the experience and you'll still remember it in detail most likely, but you will erase the response that you have, the psychological and the emotional response and the physical response because we get physical symptoms, too.
Heart racing, palpitations, nausea, all that stuff. All that stuff can go away. And it's very, I mean, it's, it's crazy that we don't know about this. And like, to your point Amanda is like, The people in the therapy world don't know about this. Yeah. Right. Yeah.
Amanda: And I'm even thinking like, I mean, this clearly would apply to things outside of medicine too, getting served divorce papers, finding out that your partner's cheating on you, something, you know, a horrible diagnosis with your child or something like that.
I could see how that would be really helpful. too. Yeah. So what are some, is there just one kind of memory Reconsolidation or are there different techniques? Are there, tell me more.
Laura Fortner: So there's different techniques and there's different ways to go about it. So if you had something very recently happen to you, you can do something called EMDR, which is, I think it works extremely well for recent events.
It really helps you. So that's what I did right after my trial and it It just totally stopped the trauma response of that trial. Like that trial, even though the trial did not go my way. And I can remember vivid details of the trial of, actually my lawyer knowing what the outcome was when the judge came out.
Sort of like, Because the way things were or whatever was happening in the courtroom, and I was clueless, you know, him putting his hand on me. And like, I can remember that in detail. And the, I knew, you know, it was not going to be an outcome I wanted. And so, you know, those kind of details. You'll still remember, but like for me, I was able to take away that whole response of like, just that emotional and physical things that were going on totally went away for me.
And that's what happens with people, right? Like if something happens in the ER and it's many of you sometimes don't want to go in the same room. that it happened in, or you're walking into work and you're starting to get the symptoms, you're driving to work, you're getting the symptoms, right? Like all of these things, you can do something for them.
Amanda: Well, you just described every, back in the olden days. Every trip into work, let's start getting, Oh my God, the physical effects for sure. So EMDR, are there other ones?
Laura Fortner: Yeah. So there's also other ones that, that I I personally like the most, which I think works the most for people is to work on actually changing the emotion that's in that memory.
Because most of us, what happens with that memory, every time you think about the event, you'll bring the memory up and then that memory. Whatever emotion you've attached to it, typically, you make that emotion worse, like you compound that, because we're typically negatively thinking about it, and if, in terms of medical malpractice, we go down the path of, Oh, I should quit medicine.
I'm not cut out for this. I'm not good. I'm a bad doc. People will think I'm terrible. My reputation is going to be ruined. My income is going to go away. How am I going to support my family? I'm going to lose my license. Like these are streams of thought that happen because the memory comes up and we start experiencing those emotions and physical and emotional symptoms.
And so that. You there is a four step process that I kind of created out of all this to really work on that emotion to take that emotion away. Because most of us, when, when you know, physicians come to me to help them, we're, wanting to feel calm, peace, no matter what the outcome happens with Med Mal or the bad event, right?
Or peer review. I've got several people that come to me because they're being peer reviewed and proctored and all those things, right? So it's, it's. It's really working to get them peace no matter what happens and neutral in it so that those responses aren't occurring. And so we work on the emotion part of that.
There's also, so I do a lot of emotion and ha and how you're feeling, but I also do verbal lots of docs are very logical people and once the logic, the problem is the primitive brain overrides the logic, right? Like, but Sometimes we've got to do storytelling and logic, doing, doing in a logical way instead of the emotional way.
There's four different components of that implicit memory that can be worked on, and they all have different modalities to do it. So you're not stuck. Let's say you go and try to get EMDR and it really didn't help you. You need to just go do something else, right? Your brain wants you to do a different way in order to make that work.
Amanda: So you told us about your own experience with EMDR you know, during or right after your trial, and you said that that works really well for acute scenarios, like what, what happens in a memory reconsolidation session how you do it, or like, what's, my understanding is that it's taking that memory from being relocated and like, The amygdala and, and hippocampus and like moving it more towards the prefrontal cortex or what, or what's going on.
Laura Fortner: So implicit memory is connected to the amygdala and you know, so it, it, every time you get a trigger event, that implicit memory will come up along with the symptoms, right? It basically goes trigger event, amygdala, then implicit memory comes up. Okay. When now you unlock this memory. In different ways.
So you have to, so what happens with clients and with EMDR is we're asking them to think about it. Now, a lot of times, and just fun fact for everyone out there, you don't even have to tell us exactly what has happened. To make this work. Okay, because you have to think about it, right? Sometimes I mean, I have people verbalize it because I think it's helpful. You have to think about the prior event or trigger and you always want to go to a trigger first before you work with the real event that happened. So you have to bring that. Up to unlock this memory. Now, this memory to get it unlocked is like a combination safe. Okay. So it is like a combination and it doesn't, that's why I say, you know, sometimes you have to work on it a couple of times.
It's not always instantaneous, but when you unlock it, then it stays open. This memory. stays open for about four hours. And that's when you can do the reconsolidation of reconsolidating it to a positive. Like for, if you were talking about emotion, you're going to reconsolidate towards a positive emotion.
Now what does that emotion entail? Sometimes it's anger because If you look at the emotional scale, shame is all the way at the bottom. And a lot of us have shame around this. I, mine was shame. Okay. And in order for me to move up, anger is even better than shame. So I could actually reconsolidate that memory initially with anger. And then move up to neutral. Typically we're moving to neutral and peace. We're not moving to, Oh, I'm happy and joyful because it's not possible. I mean, right away. And so, but you have to unlock the memory, bring it up, and then you have to do a series of things. To, in order for this to work and and that series entails you feeling the symptoms initially of what it feels like, like the physical and emotional, you got to feel it. What does it make you feel like, like when you bring this memory up, right? You get a trigger. So, for instance, for me, I would see a nurse that was part of my, part of the scenario of all of this. She was a trigger for me. And so this nurse, every time I'd see her, it'd bring up my senses. I have to feel those symptoms.
And then you disconnect from that. You disconnect from that sort of. And there's a way to do that. You can, you can jump up and down, you can laugh, you can do something else, but you want to disassociate yourself from that. And then you want to, what I love to do is bring up a new memory of how they really want to feel and find a memory.
that they themselves have felt that way. So, and they don't have to do it with medicine, by the way. So, you know, when I'm working with clients, like they, you know, they'll a lot of times say, well, I don't know if I can come up with something in my office that I felt that way, you know, but I don't, I don't, it doesn't have to be that it could be like, Oh, they saw their child playing and they just felt this just massive love and peace.
And that memory can be taken into this, Implicit memory that we're trying to change. To just bring the emotion into it. Okay. And I know, I hope that doesn't sound too complicated. It's really not complicated. It's very simple process. But there are some key things that have to be done in between to make it happen.
And sometimes it, you know, human beings are human beings. Sometimes it takes a while. Sometimes I figure out, you know, the emotion part of it is not going to work for this person. Like we need to do storytelling. And then that story. We got to get to a story at the end that transcends where they are like, yes, they're in this bad place, but where are they going and, and getting them share a story of transcendence.
Laura: Okay, this is so awesome. Let me see if you can help me with something issues with teaching. I'm having to teach , my 3rd child to drive and. I don't remember me doing this with the others, but I am so reactive when he makes any kind of mistake. And I realized it's because when I was a young driver, in fact, three weeks after I got my driver's license, I rear ended somebody and had like.
Three or four other things happen over the next few years. And so I'm like, I'm like wigging out every time he even gets out of the lane a little bit, but I think maybe it's. Because of all of that. So do I go back and relive that and like pour the love of my my love I have for my child into it to try to
Laura Fortner: yeah, so no you start first first Laura What you do is you start with the trigger?
Okay, so we go back to the most recent time that you were driving with your child And when the symptoms came up and we would talk in detail about the exact things that happened and, and sort of timing when they occurred, what was going on? What did he do? What did you do? How did you feel? What were your physical and emotional symptoms?
We go into very detail. This unlocks the memory. Again, you're starting with the trigger first, and then I have you feel those physical, you, you want to feel those symptoms. Most people can feel them pretty quickly once they start talking about it and what was going on with this, you know, you're driving with your child.
I'm sure I can get you to feel those emotions right then, you know, and then we disassociate right away. And that disassociation, a lot of times. I'm telling a stupid joke. I got to get new jokes. But or like I'm getting people to laugh or I'm having them jump up and down, wave their arms, do silly stuff to just disassociate from that.
But what that does is it opens up the memory. And then we go to the next step of tell me what you really want to feel or how, how do you, how do the symptoms do you want to be able to do? And you would probably tell me what. Calm. Yeah. Peace, not reactive, you know, that kind of thing. And then I'd ask you, When's the last time you felt that?
Not with this scenario, but like any memory, anything that you could think of when you felt that way. And then we would discuss that memory in detail, so you could start feeling that. And then what I have you do is sort of close your eyes and have you take the feeling that you have with that new memory that you were telling me about and you walk back in driving with your kid.
Laura: I love that.
Laura Fortner: In your mind.
Laura: That's awesome. Is there?
Amanda: Is there any, I'm wondering, like, for particularly, are there any contraindications for this?
Laura Fortner: Yes, yes, yes. Okay, okay,
Amanda: because I'm like, I can see how, like, if it was something way off, you know, that, like, maybe I don't, maybe I need to be specifically trained or something for that.
Laura Fortner: Well, the thing is, you have to make sure that people are dysregulated and ready to do it. So sometimes the trauma experience is very that people are very activated and you have, there is a nuance. So I don't typically dive into this until about the fourth session with people, third or fourth session, because a lot of times I'm giving them tools to dysregulate themselves.
Like you want them to be. You know, a little calmer, not activated. You don't want them to be in fight or flight when they're on the phone already with you. Okay. So in sometimes in order for them to get the gist, we will do something totally different than med mal. I mean, I will go to, you know, you know, something about what happened with their husband or like something little, the dogs did something, you know, something that they can handle.
And then we'll move to that. But there is a nuance. So you do want to make sure that that people are not activated. You don't want to rush them into it. And you never want to start with. So, in Laura's case, she knows that she rear ended this person way back when you would never start with that way back when you always go to the triggers 1st.
And work your way back and I like to go from trigger to trigger to trigger back before we even get to that event because you can't, especially if it's been more than a year, even six months to a year, it's, it just doesn't, you know, it's in there, it's been in there and what we've been doing is we've been bringing up this memory and just making it more negative and more negative and more negative with our physical and emotional symptoms.
We're reconsolidating it in the opposite direction, most of us, because that's the way our brains want us to think. You know, when stuff like this happens in medicine, we label it unsafe. So our brain thinks our job's unsafe, everything's unsafe. And so now we're just reconsolidating it in the opposite direction we want it to go.
Laura: Oh my gosh. This is just. Just so amazing. And apparently I have a lot of rewiring still to do. I think this all feels like it's a lifelong process. All this undoing of what's been done, but. So if anyone wanted to try memory consolidation, what would be their next steps?
Laura Fortner: So next step is just reach out to somebody that you think would be, you know, helpful that does it, that knows about it.
I think that's, you know, a lot of physicians now are seeking coaches, which I love. I think it's fantastic, but I think these, I think us as coaches also should be trained in this. If we're dealing with. sort of types of situations like this. And it's not, , business or career, which might be a totally separate, you know, when you're talking about life coaching, everybody has had trauma. I don't care who you are, you have a human brain, you've all had it, it doesn't matter. And it will come up, it shows itself up in different ways, in different variations. And but if people reach out to someone, whether it's a coach or therapist, they want to just be sure that they know it and that they could help them if that is something they want to work on.
Especially with MedMal, bad outcomes, peer review process, anything in medicine that's like. penalizing, we feel like we're being penalized for something. I think it's, it is a trauma like pathway. So that's first and foremost, I would just say, you know, like, I think you guys just had a podcast I listened to last week, or the week before that, that they do it as well.
And I think that that's fantastic for healthcare workers. So, it's needed.
Laura: So if somebody wanted to get in touch with you, what's the best way to do that?
Laura Fortner: Yeah, so they could just go to themedmalcoach.com or they can look me up Dr. Laura Fortner on social media outlets. I'm happy to chat with anybody at any time actually or if you message me I, I'm an open book and I'll chat with you.
So I have no problem you know talking to you for 10 15 minutes and just seeing if you need something. Sometimes it's funny because That one phone call sometimes is all people need. So this is just like, I just need to tell my story in front of somebody that's been through it. And I do want to give you hope, like, med mal is not, it's a, it's an unfortunate part of our business.
It is, there is an emotional turmoil and, you know, the AMA does recognize it as the number one problem with medical malpractice is the emotional turmoil that the physician goes through. And so I do, we, we don't want to disregard it. But sometimes. Just talking to somebody that's been through it can heal someone and so reaching out It's so, it is necessary, I think, and don't be afraid to do it. Especially if you do it. You know, in my realm, I just tell people, like coaches, most of us, you can even ask them. Don't keep notes, don't keep charts on you. You know, therapists, they can subpoena them and they can take the charts. But we don't keep any of that. I don't record anything. I don't do any of that stuff.
I am launching, a a wonderful program coming soon that can be, you could walk in and be totally anonymous. And I'm doing that on purpose. I want that for you because I think it's, you don't have to tell anybody your name. They won't even know who you are, but you will be able to get the benefit of learning how to do memory reconsolidation.
You will have sessions with me that are video recorded that you could go through as if you were sitting across the room from me and you could change. Your entire well being in medicine and I've created it specifically. So you don't have to show your face if you don't want to, and you don't have to say who you are.
Laura: That is awesome. So for any of you who are wondering if she's really this safe of a person, as she seems she is, she is. She's that wonderful and authentic. So, so helpful. So. So, Laura, any last thoughts for us?
Laura Fortner: No, I just I want to really change the face of medicine in this arena. But not only, and I'm just going to put this in here because I think it's so, so needed, you know, in MedMal in general, I think that We need reform, and I'm, I'm really wanting to change the face of what we go through, to help us, and I think it can happen in the next 20 years of my life if I give the last, the last part of my career to this, and I think I think we can make some massive change.
It's just no one. I don't know of anybody been willing to go around talking about getting sued, like me.
Laura: Well, you are changing it. I have no doubt. And how much better would it be to practice medicine and not have to worry about that anymore?
Laura Fortner: Oh my God. Seriously, what an awesome question, Laura. Like, yeah, I think it's a great, how would we all feel?
That safety would be huge for us.
Laura: Yeah. Yeah. Well, thank you so much for all that you're doing.
Amanda: Okay. And I just went to your website and I see that you're holding out on us for tools to stop intrusive thoughts. Click here. So is that a freebie that you have out right now?
Laura Fortner: Freebie. And then if you get on my email list, you'll hear all the details about the launch of this program.
And I am, you know, the first. You know, a few physicians that go through my first part of my program will actually get an amazing deal too. And so hopefully by the, in January, it's going to be up and running. So, yeah.
Kendra: That's awesome. Yes. You guys heard it here first. So, everybody go to Dr. Laura Fortner at MedMalCoach. com and get signed up. And Laura, we thank you so much for coming on our podcast. You're always a gem and everything that you presented here today is. You know, not only a testimony of what you went through, but it takes a, you know, a special person with a special kind of bravery and courage.
So thank you so much for even just being the first one. Pioneering something is not always the easiest thing to do when you're stepping out in faith and just using. Everything that you went through, it, it takes a special kind of courage. And so we honor you for that. And thank you for sharing it with us.
Thank you. We appreciate it. And click the link below to join our email list. If you're not already receiving our weekly well check, visit our website, www. thewholephysician. com to get more information.
So until next time. You are whole, you are a gift to medicine, and the work you do matters.
