S8E17: Growth Through Challenge

Sanila: Hi, everyone, and welcome back, Bundles, to the final episode of Season 8 of "Bundle of Hers." Today, we'll be talking about lessons from medical school and residency, and everything that we've learned so far, and where we hope to take things in the future.

Hạ: Season finale's always fun. Perfect moment for reflections.

Laurel: I guess it's about springtime, which is where growth and reflection becomes, I think, a positive thing.

Sanila: I just can't believe it's been four years. I don't where the time has gone, and I'm like, "Okay, did the last four years actually happen, or did I just take a really long nap and suddenly I am nearing the finish line?" as they say.

Laurel: I think you probably got really good at lucid dreaming, is what happened. So it was just a very long nap.

Sanila: I think I mastered the art of dissociation maybe.

Hạ: It's really funny because I think all three of us are at the end of an era, you could say. I am finishing up residency, and then, Sanila, you're finishing up medical school and going into residency. Laurel, they're defending.

Sanila: You're defending? You're finishing?

Laurel: Yay. It means I finally get to become a med student again for realsies instead of just an ancient memory since, Hạ, you're finishing residency and we're from the same med school class, which is something I try not to think about too much.

But here we are, so we are. We're at all these inflection points. And I'm curious if y'all have looked over your med school personal statements recently.

Sanila: Oh, gosh. I feel like I wrote it, I submitted it, and then I never looked at it ever again. Actually, I went to dinner with a few of my friends maybe . . . I want to say it was the beginning of second year, or maybe halfway through our first year of medical school. I can't remember. But we thought it would be a good idea to go to dinner and read each other our personal statements to reflect on what we wrote about and where we want it to take us. But that was probably the very last time I've ever looked at it.

I think I just wrote it to apply, and then every time I think about it, I'm like, "Oh my gosh." I was so cringey in the way I wrote about things, and it just felt like I was trying to sell myself in a way. So, personally, I have tried not to reflect back on my personal statement.

Laurel: Dark times.

Hạ: Sometimes I like to reread back about things, because I've been in the "trying to figure out what job I want to do and where I want to take my career." So I reread my pediatric residency personal statement, and then I also reread my med school personal statement again a couple of times recently.

And one of the things that I noticed a lot with . . . So for context, my whole medical school personal statement was about how I used to really like to tell stories and do reporting, which I still really like to do. What I love about medicine is the ability to blend all of the things together that make up medicine. You can ultimately empower patients, and that I really want to create spaces where people can feel heard and can feel seen.

In a way, it was helpful to go back to the core of why I went into medicine. But also, at the same time, it was definitely written in this idealistic perspective.

I felt like now as a resident, I read through it and at my core, I do still care a lot about empowerment, but I recognize that there are a lot more complexities that contribute to how you're able to empower patients, and that there are other things that contend against you that sometimes make it a lot more difficult than simply meeting someone where they are.

And that's medical misinformation. That is state of the political landscape and laws and policies that prevent you from being able to give the care that you want fully. And so I was just reflecting a lot about that.

Laurel: That makes sense. It's funny, when you talked about synthesizing different things . . . I read my statement recently since I'm going back to med school and I'm trying to remember what I was like, I guess, in 2018 when I applied. That's jarring.

And I similarly wrote, I think, about trying to bring things that were not medical into my medical world and practice. And specifically, I wrote about originally viewing clinical work and my LGBT advocacy as two separate things, and how I realized that those were actually intertwined. And being a patient advocate and advocating for all individuals who I'm trying to take care of and to serve, that involves the lessons I've learned in a more kind of policy, queer, grassroots space that I was in beforehand.

But like you said, it turns out stuff is complicated in practice, and a lot of that integration has been in the research side the past few years. But it turns out it's still tough to bridge the gap between how I want things to be and then perhaps how they currently are.

Sanila: Y'all have inspired me. I am going to pull up my personal statement and review it so that I have something meaningful to contribute.

But really, in skimming over my personal statement, I think in mine there are a lot of themes about the emotional side of medicine and how that was appealing to me when I was first applying as a pre-med student, and then also the emotional complexity of what healing looks like for a lot of different people and how that changes over time. And I actually think that that still rings pretty true to what I value today in medicine.

And then also, it played a big role in why I chose to go into OB-GYN, because I think there is a really big emotional side of this field where patients are trying to navigate complex feelings, life histories, and decisions in a sea of emotions, both good and bad. And that sort of thing is really important for me to remember to center those when I'm helping take care of people or working with a team.

So I feel like maybe the skeleton of my personal statement is still pretty accurate for today. I think the way it was written maybe is a little flowery. I'm like, "Please accept me into your medical school," when I was first applying.

But now, having written also a residency personal statement, like you, Hạ, and I was reading over that as well, I think it really just narrows in on this emotional side that I talked about in my medical school personal statement, but just definitely dives deeper into why that is important to me as a person and how that has shaped my future career aspirations.

Laurel: I was going to ask you . . . because you matched where you matched. I suppose we are about to be at different institutions, and we speak for ourselves only. Disclaimer, disclaimer. But I guess you might be at the same institution. I don't know. I wish you much peace in this next week.

Sanila: Thank you. As they say, surprises are better on a Friday. It's so exciting.

Yeah, I've had people ask me where I've matched, and I've had to tell them that I just know I have matched. I just don't know where yet. And I have no idea what the ins and outs of my future job are going to look like, and I probably won't know until Friday.

So stay tuned to our listeners. It will be out on our social media platforms. Please pray for me that I end up somewhere that I can be happy.

Hạ: Yeah, I feel like the match process is so peculiar. It's so prolonged, and on Friday, too. It's also a lot of mixed emotions as you're opening up the envelopes. It's a strange week, but we are all rooting for you.

Sanila: Thank you.

Hạ: But all of this is to say thinking about hearing you all share about personal statements and what's at the core of what brought you into medicine and what still inspires you to continue forth with medicine, it makes me think a lot about our journeys, and I think it aligns a lot with the theme of this entire season, which is growth through challenge. That is the theme of this entire season, right? Yeah, growth through challenge.

The theme of this entire season is growth through challenge. And I think a lot about how when we're applying to medical school, which seems as that really big first hurdle, they really ask us to think about who we want to become, as we were talking about. But then through our own experiences and the challenges and the things that we face, how closely does that vision really match our reality?

I think throughout this whole season and through a lot of different "Bundles" episodes, we've alluded to a lot of this quite a bit. I'm really excited to have this conversation with y'all because we're all in that fun transition phase about reflection.

One of the things I really do think a lot about is how training changes . . . Each step of training does really change our perspective of things and how we think about approaching medicine.

Like I had alluded to a bit earlier when talking about my personal statement, I still very much care about patient empowerment and about thinking about how we can use medical research, medical knowledge, and all the different advocacy and all the different components to be able to center our patients and empower their voices.

But as I've been going through pediatrics, I realized that there's a lot of complexity to it in actual practice, because it's also this tension between centering the best interest of the pediatric patient, and then also centering the interests of the family and the community. And sometimes it can feel conflicting with everything that goes on and navigating those conversations.

I think that in a way, sometimes I want to land on the, "Oh, based off of this, I feel burnt out. I feel like I'm losing parts of myself," which is something I have struggled with throughout residency, but also trying to move forward and transform it into something productive, if you catch my drift.

Sanila: Yeah, totally. It's interesting that you bring up how . . . at least for me, four years ago now, when I was first applying to medical school, I had to think about the physician I wanted to become and then be able to convey that in a compelling way.

And having gone through the four years now and rotated throughout the hospital, worked with a variety of attendings, and lots of different types of patients, I feel like four years ago I didn't really have an idea of what kind of physician I wanted to become, other than just wanting to become someone who is nice and knows how to help people, to say the least.

I feel like having done the four years now, it's definitely expanded to be more specific of, "Oh, I don't just want to be a competent healthcare physician who knows what they're doing. This is the language that I want to use when I'm talking to patients about death, or when I'm helping them navigate vulnerable situations. This is how I want to cultivate hope. This is something that I've noticed a different attending do with their patients, and that's something that I want to embody as a future physician. As a resident, this is how I want to treat medical students when they work with me."

I think a lot of my ideas of the physician I wanted to be four years ago have just solidified themselves more. And it's been this conglomeration of a lot of different qualities that I've noticed in other attendings I've worked with.

And it's interesting because . . . I'm going to try and say this in a way that is coherent. So tell me if it doesn't make sense. But four years ago, the idea of the physician I wanted to be entirely revolved around myself and what I thought meant being a good physician was.

Now, I feel like I've become a puzzle piece of all the people I've worked with. They've shared their stories with me, and their histories have been imprinted in my brain. And so now, the idea of a great physician to me is a lot of these great physician qualities I've seen in other people.

I think that's, to your point, Hạ, how training works. When you work with other people and work in a team, they become a part of you, and then you become a part of them, and that shapes your idea of what it means to be a good doctor.

Laurel: Totally. For me, it's interesting where you said that . . . I really liked your idea of being a good physician was being nice. I think that's similar to mine, but my perspective was perhaps a lot more pessimistic, where a lot of my goals for medicine were shaped around all of the negative healthcare encounters that I had.

Basically, I want to be a physician, and I want to be a physician who is not like these physicians who have not been great, which I think is unfortunately a common experience for a lot of people, whether you're trans or not.

It really wasn't until I was exposed to actual attendings, and really, I guess people of all training levels, who were just wonderful and were able to show concrete aspects of healthcare that I could go, "Oh, okay. So it's not just that I don't want to be these things. It's that I want to advocate for my patients against insurance nonsense like this. And I want to make my patients feel the way this person seems to make their patient . . ."

And so I feel exactly like you said. We sort of become a mosaic of the people that we have encountered in our training journey. And probably, there are still some negative examples of what not to do.

Sanila: Definitely.

Laurel: But I think, hopefully, we all get to collect some good stories, too.

Sanila: Yeah, there have definitely been people I've worked with where I'm like, "Oh, maybe I won't do that, or maybe I won't word things this way."

Laurel: Totally.

Hạ: To all of your points about us becoming mosaics or a complete puzzle built of all the people that we've interacted with, I think that's what is so beautiful about medicine, because it is a very human experience.

And I think when you come into medicine, it's very easy in a way . . . I'm a very idealistic person. It's very easy to put things into ideals or concepts or really beautifully wrapped up packages. But the truth is because medicine is so human, it is so complex and so nuanced.

That's what I love about it, but that's also what can be really frustrating about it, because everyone has their different approaches and every situation with a patient or a family can also . . . even if it seems like the exact same situation, there's so much nuance to it that makes it require a different approach. And it's all part in trying to shape who you are and what physician you are. You have to have that flexibility.

It's something that I am constantly trying to work on and trying to figure out because it requires you to always be on your toes. And I'm a girly who kind of works slow. I feel like I love the sloth because the sloth can just take things a little bit at a time.

Laurel: Remind me, what was the Vietnamese word for sloth?

Hạ: It was . . . What was it?

Laurel: It's literally like "lazy animal."

Hạ: I'm pulling it up right now. Don't you worry.

Laurel: Good.

Hạ: Oh, con lười. That means "lazy animal."

But that non sequitur aside, yeah, it requires you to always be changing, always being on your toes. And it's not something that you quite expect is going to be the case when you go into medicine. I feel like for a lot of things, you always go, "I stay this exact same person," and maybe there's a little bit more nuance. But really, medicine forces you to always just be adaptable so much, which is cool.

Sanila: Yeah. I honestly think that maybe two of the hardest things for me, or two of many of the hardest things for me when I was doing my rotations and such in medical school, one of them was needing to adopt that flexibility and having the person or team that you work with every day or every week change. And therefore, the way in which you practice medicine, or the way in which you learn how to practice medicine changes depending on who you're working with.

And as a student, you are forced to adopt whoever supervises you. You adopt their traditions, their language, things like that. And so there were a lot of times where I thought to myself, "Oh, this probably isn't how I would word this," or, "If I were talking with this patient about this, maybe I would say something different," which was hard also given my limited knowledge.

But having to acknowledge that and then still having to do it the way that was expected of me was a little bit challenging sometimes.

And then one of the other hard things was honestly, just with the limited knowledge, not knowing what to do in a lot of cases. If I picked up a patient case that was a little bit complex and there was a difficult decision to be made, I had nothing to go off of, really, as a medical student who was still learning.

I think that was the hardest part of sometimes not knowing how to word things or not knowing how to have difficult conversations, not knowing the best way to help someone navigate a really vulnerable moment in medicine.

Those were all challenges that I think shaped my identity and my idea of what it means to be a good physician in terms of just wanting to know how to navigate those sorts of things in the future.

Laurel: I don't think it ends. I'm finishing up my final manuscript for my Ph.D., and I went to a talk from a visiting lecturer who specializes in the field, the clinical field of basically microbiomes impacting colorectal cancer development, which I guess maybe sounds niche, but kind of isn't because you know how common colorectal cancer is, etc.

One of the things that really struck me at this meeting was we were talking about the theories that have really developed in the last, honestly, couple of years in this field, and seeing all of the GI docs across decades of practice who are excited about finally having answers to questions that they've had for their entire clinical practice.

And so it's something where maybe this is me trying to comfort myself as I go into clinical practice for the first full time, but I feel like that attitude of learning is something that I think maybe can be lost as your actual technical knowledge level increases.

My hope is that I won't be so excited to jump into knowing things, which will hopefully happen with time, that I lose the flexibility and adaptability that Hạ talked about. The physicians who really inspire me, I think, are the ones who take an active role in their lifelong learning.

Hạ: And something like lifelong learning . . . It's so funny. In med school, it felt like a big joke. Whenever any attending goes to you, "You're a lifelong learner," I thought it was hilarious. I don't know. But part of me, I was thinking, "You can't be serious." But now that I'm thinking about, "Oh, I'm about to be an attending, and I won't have really oversight over me," I do realize it is lifelong learning.

And to your point, Sanila, one of the things that I was thinking about is recently I had a patient encounter with a very complex and difficult . . . it was tense. There were hard conversations to be had. And me and my preceptor, we walked out of it, and I was like, "Oh, this was not a good time."

And the next day, they were a complex care patient. So then they were assigned to follow up later in the week with one of our primary care complex care attendings.

I ran into her, and I was like, "Can I do a debrief with you about this patient?" And as I was talking with her about it, she's like, "I am still learning these situations. I'm still learning how to put boundaries in certain cases, or how to respond to families in these complex situations."

And in a way, it's scary to realize that there's never going to be a point where I'm going to reach peak Pokémon evolution, and that I'm just going to have to keep leveling up every single year. Also, a part of it is I go, "Well, this was really what I was excited about. So guess we're just going to have to keep going forth with it."

Sanila: I love the idea of being a lifelong learner. I don't know why, but it feels so whimsical to me. I'm like, "Oh my gosh, there's so much to know," which is also really stressful.

I would almost argue that medicine requires a commitment to lifelong learning and unlearning, because not only is the amount of stuff that you could possibly know just so vast and chasmic, but medicine advances so quickly all the time.

And so things that you thought you had learned and probably did learn and they were accurate at one point, you might need to unlearn them so that you can still be following new, up-and-coming evidence-based guidelines, or being up to date on language, and things like that.

So I think it's both being able to commit to the learning and then also to recognize when maybe something that you had learned is now obsolete, or there's a better way to do it. Maybe it's just this endless infinity sign where you're always going in loops, learning and unlearning. When does it end? Probably never.

Laurel: Yeah. I guess it ends when you stop, which is retirement or death, depending on how you want to look at it. But I was curious, when you mentioned both the lifelong learning and unlearning, if, as my clinical elders, there's something that you feel like you both have had to unlearn since you started your medical journey.

Sanila: Oh, there are lots of little things I feel like I've had to unlearn about using the incentive spirometers for patients who are inpatient to help their lung function while they're bedridden and can't really walk around to help lung function. I actually suggested that to my team in the ICU for this patient who was not on a ventilator, but I think had pneumonia or something like that and needed a little bit of extra support.

And they were like, "Oh, this patient's got a little bit of fluid around their lungs, but they're not really ambulating that much either." And I was like, "Oh, let's do an incentive spirometer because we did that all the time on inpatient wards for IM."

My attending shot that down immediately and was like, "They actually probably do more harm than they do good. And there's lots of research that says that they're not that helpful for people." And I was like, "Oh."

But little things like that, whether it's just about the right amount of fluids to give someone or managing, for example, placenta accreta with OB has recently had lots of new advancements. In the past, the only way to really treat it was with a hysterectomy or something drastic, and now people are leaving uteruses and placentas in, and the majority of people do pretty well.

And so what we thought we knew about higher infection rates with the placenta left in the uterus and things like that is being challenged with these new treatment options and conservative treatment measures as well.

So I think it's a lot of just keeping up with the times.

Laurel: Totally.

Hạ: I agree. There are so many always developing new guidelines for big management things, but it's always moving. Even now, neonatal resuscitation, we used to . . . So sometimes the babies get born, they come out a little bit floppy, and they don't really know how to breathe. You have to teach them to breathe, "You've got to go breathe, baby, breathe," with a little mask, and you give them the breaths. And now, they've even changed recommendations about how you do that resuscitation of that neonate.

The other thing of a lot of unlearning, too, is . . . and it comes back into what I was talking a little bit about with patient empowerment. I think one of the things that I always thought is that the more information you give is better. I was like, "The more that you give, the more that you explain, it can be really empowering." And I think for many people, that's true. But one of the things I also had to unlearn was that sometimes that isn't the best mode of action.

Sometimes for some families, they want to communicate, or in that moment, they need to be communicated with less is more, or they need communication to be done in a different way, and then you can always loop back and continue to give more info.

A lot of times earlier on in my training, I was always kind of like, "Let me just info dump you everything right now, and I'm just going to give this information dump."

Often confused, too, is that there's also power in trying to being able to understand your patients, which I always did. But all withstanding more information is wonderful, I've also had to learn a lot about the nuances and unlearn this very black-and-white vision of what it means to be a good communicator.

Laurel: Totally.

Sanila: I think what you said about communication rings so true, especially for me too, Hạ. I think one of the most relevant examples I can think of is when I was on my pediatric neurology rotation, I had this kiddo that I was helping take care of. I remember reading the chaplain note for that patient, and in it, they basically said that the family preferred not to have language that was like, "This patient is unlikely to regain full baseline function again," but instead, they preferred language that was like, "This is the level of function that is expected, and we hope that there will be more."

So not really talking in the, "This is not what's going to happen," but being realistic about, "This is what we expect," or, "This is what you can expect." It's nuanced, so I don't know if I'm explaining it all that well, but I do think . . .

Laurel: Yeah, totally.

Sanila: . . . there's a slight difference in the way that you word things and the tone it conveys and the hope that it can theoretically cultivate as well.

So I do think that's something that I also had to learn. Maybe speaking in the first way is probably more scientific or medical and maybe sometimes just straight to the point, but maybe the second way is a little bit better received or just feels more humanistic when you're talking to people.

Of course, I do think it's preference and knowing your patients and how they like to be spoken to and just asking them. And that's also something that you learn with time and when interacting with people that you take care of, too.

Laurel: It reminds me . . . I've been reading a lot of health theory literature, and by that, I mean philosophy of health, the "how do we distinguish what is health and what is disease."

One of the articles that I really enjoyed going through was actually basically about the complexity . . . sort of Schrödinger's dual state of parents with children with really severe cardiovascular conditions, because it's simultaneously a very severe and intense medical situation, and also it's their everyday life.

And so it was really interesting to go through this article and the discussion basically about how parents ended up viewing their kid and their child's health. The physician often led kind of disease first, whereas the parents can't necessarily do that every single day with their child who they're taking care of.

And so it was just really interesting, and what you were saying reminded me of the complexity of, "It depends on the person, it depends on the condition, it depends on the day and how new the circumstances are to both us as the provider and to the patient and to their family."

Again, it's really dynamic, and I think requires us to be not only flexible, but also probably to be comfortable being wrong or getting it wrong sometimes. I think you either do your best and try and get it wrong sometimes, or you don't try, and then you're always going to be slightly off the mark.

Sanila: I don't know if I can plug in other episodes, but a couple weeks ago, my friend and classmate did an episode with an attending, and we talked about making mistakes in medicine. So if any of the Bundles are curious and haven't listened to it yet, this is my plug for that.

Hạ: It's a very good episode.

Sanila: Thank you.

Hạ: I really liked it. I listened to it, and I was like, "Ah, this is very helpful," as I've been thinking about my likely future medical mistakes as an attending.

Sanila: Yeah, I think it's hard because I think making mistakes, and honestly maybe just not knowing better, is part of the learning process. It's hard to learn and have room for that when you are expected to always know everything or just always know better, never make mistakes, and then the repercussions for making mistakes are pretty high. So it feels hard to be able to fully commit to being a learner when you're so scared of not having the space to learn things.

Laurel: Totally. I think maintaining the trust of patients while also . . . Again, we don't and we can't know everything. Y'all pointed out some really great examples of people did the best that they could with the clinical information they had. And then the times, they are a-changing.

I guess it's lucky for me, as an intended physician scientist, that we continue to research and learn and develop new clinical gold standards. That also means that if you learn more, you do better, but you can't change what you were doing before. You can only move forward.

Sanila: Wow, time has flown by. Sorry. Let's just rewind a little bit.

Laurel: It turns out you don't only move forward. You can also rewind.

Sanila: You can also rewind. But in the spirit of moving forward, I do think sometimes the only way out is through. And speaking of moving forward and going through things, my next phase of life right now is residency.

It's hard to think about it when I don't really know where I'm going to end up. And I think depending on if I end up at very different programs, my life could look very different. But maybe that's part of the excitement and the beauty. As I said earlier, surprises are better on a Friday.

But I am excited about really doing a deep dive into OB, which is what I wanted to do, and learn how to take care of people in that setting. And also just revisit committing to being a lifelong learner, as we've talked about.

I feel like for the last couple months, my mind has been so blank, and I really have not been learning anything. I've been learning a lot of niche things, like best puzzling strategies and whatnot, but nothing really relevant to medicine. So I probably should get back into that.

Hạ: I feel that in a different way. I don't know what job I'm about to do quite yet. And so I have no clue my practice setting or what things are going to look like. But I am excited to be done with residency, because in residency you're always floating around various different practices and you get good at, or you hope that you get good at everything, but you don't really feel really situated in one location or one setting. And so I'm excited to grow my clinical strengths in that way.

I'm excited to also redefine what I'll be like as an attending when I'm able to guide the conversations and things in the way that I would like to. And I am excited to have a little bit of space from working so many hours in a week to hopefully be able to reflect and think about who I am as a person a bit more and continue reclaiming myself, and read a lot of good books and watch a lot of good TV. I think those are things that I'm really stoked about.

Sanila: And don't forget to eat a lot of good food, too.

Hạ: Yes, also good food.

Laurel: Hạ, I'm currently listening to one of the books in our book club.

Hạ: Oh, yes.

Laurel: And we can just keep book clubbing more maybe, except for maybe not, depending on what my schedule looks like. I am, I guess, excited to work an unknown amount of hours, in unknown locations, in unknown ways. I don't have my clinical schedule yet, and everyone keeps asking me what I'm going to start on in June, and I'm like, "Well, it'll probably be something either really intense or really chill, or somewhere in the middle."

So my hope is that I will remember I have gotten through everything I've gotten through so far, and I have friends and colleagues like y'all who have gotten through everything you have gotten through so far.

I hope to face the unknowns of the future with more curiosity than anxiety, which I think is something that has taken a lot of time and energy to cultivate, but I'm really hoping that it doesn't shatter the first day I go back to clinic, fingers crossed.

Sanila: Yeah. I think those are great values. I, for one, love curiosity, because I think it just reminds us to always ask questions and that there's more to learn and things that we don't know, and that's okay.

I also have been thinking about what I want to take with me into my future career, especially when I'm interacting with patients. Curiosity being one of them, but also, just walking into interactions with a community builder mindset. That is really important to me, and I want to be able to foster a feeling of safety and comfort and support for people.

All in all, Laurel, I'm really looking forward to you taking that next step in your journey. I think it's a very tumultuous time, sometimes really bittersweet, so many emotions, but also a really exciting time, too, especially when there's so much to yet be discovered of what kind of lives we're going to lead and what impacts we're going to have.

And I do feel like medical training often feels like a series of finish lines, which we also did an episode on, for our "Bundles" listeners. Crossing the finish line just means we have reached the next milestone. It doesn't necessarily mean that that inherently helps us grow.

I do think it's the moments in between of getting to the finish line that probably have the most significant growth. Crossing the finish line means that those moments have shaped us in some way that has allowed us to get to that point. And I think those moments that challenge us, reshape us, and remind us why we started are very important and also great things to reflect on.

Hạ: Love that so much. And I guess for our listeners, questions to then think about are what challenge this year shaped you the most, and how did that experience help you grow?

Laurel: And if you have some really great thoughts thinking about these questions, you can talk to us on Instagram, @bundleofhers.

You can share this episode to have a discussion with your friends and peers and people who you share podcasts with, I suppose.

And you can listen to the rest of the season and the other seasons. Sanila's already pointed out some great other episodes to start with, so this finale doesn't have to be the end.