#211: Sandra Musial - Leaving a Medical Practice to Go All-In on Food as Medicine
Contact Dr. Musial and her team at plantdocspvd.com
In 2021, Dr. Sandra Musial gave up a private practice and teaching career to go ALL-IN with what she loves most - helping people transition to a whole foods, plant-based lifestyle.
She and other plant-based physicians started Plant Docs Providence to provide classes, education, and consultations to the public and medical professionals about how whole food, plant-based nutrition can prevent, improve, and reverse chronic diseases such as type 2 diabetes, obesity, heart disease, and certain cancers.
Today, she and Rip discuss:
Her Ukrainian roots and why she wanted to pursue medicine
Why she become a pediatrician and work with children
What or who inspired Sandy to pursue plant-based nutrition
The rewards and challenges of working with children and their parents
Starting an obesity clinic and a food garden at Hasbro Children’s Hospital
When she knew it was time to go all-in on plant-based nutrition education
How Plant Docs found a home at Plant City in Providence
Upcoming programs at Plant-City
This career transition hasn’t come without risk, but when you pursue what you believe, the risk also comes with high-reward when you KNOW you’re making a difference in the lives of motivated people.
Sandra Musial, MD is a physician specializing in food as medicine who is dedicated to preserving health and reversing lifestyle-related chronic disease through whole, plant-based nutrition. Sandy earned a BS degree in Nutritional Sciences from the University of New Hampshire, and an MD degree from the University of Massachusetts Medical School. She has worked in a private pediatric practice and at Hasbro Children's Hospital teaching the pediatric residents and medical students from the Warren Alpert Medical School of Brown University. She is a Culinary Coach from Harvard’s CHEF Coaching program, has a certificate in Plant Based Nutrition from eCornell, and a Health Coaching certificate from the Institute for Integrative Nutrition®. Sandy is board certified in Pediatrics and Obesity Medicine and started an obesity clinic and the first vegetable garden at Hasbro. Though she has witnessed the healing power of conventional medicine, she has also seen its limitations, especially with regard to disease prevention through healthy nutrition. Sandy started the nonprofit Plant Docs as an avenue for people to learn about the power of plant-based nutrition to improve health.
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Full Transcription via AI Transcription Source
Rip Esselstyn [00:00:01]:
I'm ip Esselstyn. And welcome to the PLANTSTRONG. Podcast. The mission at PLANTSTRONG is to further the advancement of all things within the plant based movement. We advocate for the scientifically proven benefits of plant based living and envision a world that universally understands, promotes and prescribes plants as a solution to empowering your health, health enhancing your performance, restoring the environment, and becoming better guardians to the animals we share this planet with. We welcome you wherever you are on your PLANTSTRONG journey, and I hope that you enjoy the show. This week's episode of The PLANTSTRONG Podcast is about going all in on your passions. Dr. Sandra Musial is board certified in pediatrics and obesity medicine and was in private practice for over 13 years in lovely Providence, Rhode Island. She also taught at Brown University for eleven years until 2021, when she decided to give up private practice, break out of her comfort zone, and go all in with what she loves most, which is helping people transition to a whole food, plant based lifestyle. She and two other plant based physicians started Plant Docs Providence to provide classes, education and consultations to the public and medical professionals about how whole food, plant based nutrition can prevent, improve, and reverse chronic diseases such as type two diabetes, obesity, heart disease, and certain cancers. This career transition has not come without risk, but when you pursue what you believe, the risk also comes with high reward when you know you're making a difference in the lives of many, many people. Please welcome to the PLANTSTRONG podcast. Dr. Sandy Musial. Hey, everybody. Welcome to the PLANTSTRONG. Podcast. We have got Dr. Sandy and Dr. Sandy. Help me. What is your last name?
Dr. Sandra Musial [00:02:17]:
Musial.
Rip Esselstyn [00:02:18]:
Okay, and where does that originate from?
Dr. Sandra Musial [00:02:21]:
Oh, good question. Ukraine, actually. My father and his two brothers came over, immigrated from Ukraine, and their name was Musialowski.
Rip Esselstyn [00:02:34]:
Wow.
Dr. Sandra Musial [00:02:35]:
And that wasn't cool. Back in the early 19 hundreds. So they chopped off the Owski and they were left with Musial.
Rip Esselstyn [00:02:42]:
Do you still have relatives over in the Ukraine? I do.
Dr. Sandra Musial [00:02:45]:
All my second cousins are over there.
Rip Esselstyn [00:02:47]:
And how are they holding up, do you know?
Dr. Sandra Musial [00:02:50]:
They're doing okay. They're all in western Ukraine, fortunately, where there's less aggression from so, but it's not fun. I think there's trouble with electricity and jobs and money and food.
Rip Esselstyn [00:03:08]:
Yeah, I can't even imagine. Have you ever been over to the Ukraine?
Dr. Sandra Musial [00:03:12]:
I have. In 2009, my sister and I went to find our family and meet everybody and we stayed with them. It was awesome.
Rip Esselstyn [00:03:22]:
Wow. Is it a big family or small?
Dr. Sandra Musial [00:03:25]:
Yeah, well, it was just my mother's mother's family that we visited and we found the house where my grandmother was born and her mother's grave. It was very powerful, way more than either of us expected. We often just felt tearful for no reason and we just felt this incredible connection to our roots. And along the plant strong line. Everyone grows food there for sustenance farming because they have to. Even before the war, they didn't have a lot of money. Even my cousin, who's a surgeon over there in a small public community hospital, they're not paid very much at all because they're government paid jobs. So they have grapevines in the front yard and all kinds of vegetables and fruit trees throughout their yard. And my sister and I are both just born farmers. We love to grow organic vegetables and fruit. And when we went there, we were just like, it all makes sense now.
Rip Esselstyn [00:04:31]:
That's really bravo to you that you went over there to do all that. So your immediate family, so your mother and father, where did you guys grow up?
Dr. Sandra Musial [00:04:48]:
Around the Boston area. All four of my grandparents were born in Ukraine and came over, and somehow they all ended up in the Boston area. And there's a Ukrainian church there, which was often the focus of community and gathering. So it's the St. Andrew's ukrainian Church of Boston. And so that they all met each other and married other Ukrainians. So that's how I ended up being 100% Ukrainian.
Rip Esselstyn [00:05:15]:
How many brothers and sisters do you have, Sandy?
Dr. Sandra Musial [00:05:18]:
I have two brothers and one sister.
Rip Esselstyn [00:05:21]:
And are you the only one that went into medicine?
Dr. Sandra Musial [00:05:25]:
Yeah, later in life, my sister became a respiratory therapist, and so she's in the medical field as well now.
Rip Esselstyn [00:05:33]:
Got you.
Dr. Sandra Musial [00:05:33]:
But yeah, no other doctors except the generation below me. There's some emerging doctors.
Rip Esselstyn [00:05:41]:
Very cool. And what was it that initially drew you to medicine?
Dr. Sandra Musial [00:05:49]:
I think it layered up, but it started with I would say my father was a very big influence to me. He's very analytical. We're very similar in that way. And his brother died of a sudden heart attack at a very young age, and it was an older brother, but I think my father knew enough to put the pieces together, like, what are the risks for heart attack? And I don't want that to happen to and so he started subscribing to Prevention magazine and talking about it a lot with the family and making changes at home. So we stopped eating red meat and stopped told my mother to get rid of the fryolator and stopped making fried chicken and some things that maybe weren't great, like, oh, let's eat more margarine. We just didn't know. But I think his interest in that really piqued my interest in how the food that you eat is related to health and health outcomes. So that's what led me to study nutritional sciences in college. And I thought originally I wanted to become a dietitian or a nutritionist, which is funny because it's kind of what I am now, full circle.
Rip Esselstyn [00:07:13]:
So you ended up going into medicine. You went to medical school where? At the University of Massachusetts, is that correct?
Dr. Sandra Musial [00:07:21]:
Yeah.
Rip Esselstyn [00:07:23]:
And then from there, what did you get your residency or internship.
Dr. Sandra Musial [00:07:31]:
Yeah. Well, I was kind of torn between family medicine and pediatrics. I wanted to do prevention. That's something that always just was a philosophical thread throughout my life. That was very important. And originally I thought, I can just do nutrition and influence people with nutrition. But then when I got out of college and I went to look at what jobs were actually available, I was really disappointed that you don't really have much control, especially as a new graduate. I was going to be working in the kitchen of a hospital or at some weight loss clinic. That seemed ridiculous to me. So I ended up taking a job in research and realizing if I become a doctor, I'll have a little bit more a lot more influence over kind of diet and health. So that's what led me into medical school. I fell in love with the pediatric population, and from there I became a pediatrician. And I spent the first 13 years of my career in private practice taking care of kids with five other pediatricians in the southern part of Rhode Island. But I was kind of feeling like I'm just influencing people one at a time, and I'd like to have more of an influence by maybe being a teacher of rising doctors and medical students. So I left my private practice to work at Brown University's teaching hospital hasbro children's hospital in Providence and I was.
Rip Esselstyn [00:09:06]:
Teaching the what year was that?
Dr. Sandra Musial [00:09:09]:
That was 2010.
Rip Esselstyn [00:09:13]:
Okay, I'm trying to get this wrapped around my brain here. So how long were you in pediatric medicine before you went to Brown?
Dr. Sandra Musial [00:09:25]:
I was four years in training and then 13 years as a private pediatrician, and then at Brown, eleven years doing the teaching.
Rip Esselstyn [00:09:36]:
Wow. And you said that you loved pediatrics. What is it that you love about pediatrics?
Dr. Sandra Musial [00:09:43]:
I love the innocence of the little children, and I love babies and I love the parents. I was very compassionate toward the parents. I'm a parent myself. Those are my boys. I could just understand the concern and the pain and what parents are going through, and I loved holding their hands and helping them navigate parenthood and even the little challenges of mild illnesses in children. I never got tired of talking about discipline and potty training and breastfeeding. So I loved all that and I really missed leaving it, but I just wanted another chapter in my life professionally.
Rip Esselstyn [00:10:37]:
Yeah. So in those first couple decade or so, was there one thing that you saw more than any other as a pediatric practitioner?
Dr. Sandra Musial [00:10:51]:
I mean, I think, well, childcare is kind of the bread and butter of pediatrics, seeing kids for their well visits, and you see babies more than older kids because older kids come in once a year and babies come in all the time. So I loved that. But as far as pathology, it was the ear infections, asthma were probably the most common pathological conditions that we?
Rip Esselstyn [00:11:19]:
Yeah. And looking back on it, is it fair to say that a lot of these ear infections may have been contributed to by dairy?
Dr. Sandra Musial [00:11:30]:
Yeah, it's possible. It's hard to know. It was a really fascinating time. I was kind of struggling, like, at the same time that I was doing this and know, it starts to get a little know when you're seeing the same thing over and over again, but at the same time. One of the moms, who was a very educated she was a pediatric intensive care unit nurse and had two children that she was bringing to me. And she asked me if I had read The China Study and that her doctor had told her to read it and that she should stop giving her children milk. And that's what kind of started me down, this pathway of plant based nutrition, but at the same time feeling this conflict with my career, with the American Academy of Pediatrics, teaching us that milk is good and milk is important, and you have to tell everyone to have it three times a day for strong. So, like, I had that ground into my brain, and then I'm reading this new information and feeling like, well, why are they separate? And it still eludes me now. And this was years and years ago now, when The China Study came out what is it, like, 15 years ago or more?
Rip Esselstyn [00:12:50]:
China Study came out in 2005.
Dr. Sandra Musial [00:12:53]:
Yeah. That started me down this path of I already had this interest in nutrition, and I had studied it as an undergraduate, so I just started seeing the movies and watching and reading the books kind of like anyone else, doctor or not doctor. That's where I was getting this new information and the studies that were coming out, and I just felt like, I really want to do this. This is very interesting. And I gave the book, the China study to my brother. I'm still working along as a pediatrician, but I'm starting to educate the adults around me about this. And my brother's eight years older than me, and he had high blood pressure and high cholesterol, was about 50 pounds overweight, living in Colorado, kind of meat and potatoes, tough guy. And he read it on a trip to Florida. He opened the book, and he said by the time he know, of course, he was only a little bit into the book, he was convinced he had read enough. And he called me from Florida and was know, my neighbor just died of a heart attack, and I knew I had to do something. I didn't know what it was, but this is it. And it changed his life. He's been doing it ever since I gave him that book. He lost 50 pounds within the first year. He dropped his cholesterol and blood pressure, never needed to take the meds. And last summer, he hiked the Colorado Trail. He's just become very healthy guy. So I feel like he was the kind of person in my life that, as a result of me educating him and the influence I had over him, was pivotal in me wanting to help more people that were my age and to not have a heart attack and to not have to go on blood pressure meds or statins.
Rip Esselstyn [00:14:49]:
Well, I think that says a lot about your relationship with your brother, too, that you could say, hey, you should check out this book. And he reads it, and he makes these lifestyle changes, and it's sticking to this day. That's pretty powerful stuff.
Dr. Sandra Musial [00:15:02]:
Yeah, it was very powerful.
Rip Esselstyn [00:15:04]:
And then for you to be able to see firsthand the results of somebody that close to you and what can happen when you embrace this lifestyle. Wow.
Dr. Sandra Musial [00:15:14]:
Yeah. And then shortly after that, you'll like this story. Your dad, Essie and Colin Campbell and your mom that's funny to refer to them like that. Did a weekend at Krapalo, which is, like, this yoga retreat in Western Mass. And I brought my sister, my niece, and my father in law, and they were all interested, but not, like, completely all in or on board. But after that weekend, all four of us, it was just so energizing to see the three of them with all this amazing data and influence, and to me, they were like, it's not just a fad or some book. This was, like, medical data that they were sharing. And I felt like this is well credentialed and valid. And my father in law has been doing all of us have been eating really healthy ever since. But my father in law has reversed aged since that weekend. He's turning 80 next year, and he just looks no, I'm sorry. He's turning 90 next year, and he looks like 70 something. It's incredible. And he's a big fan.
Rip Esselstyn [00:16:32]:
Well, yeah, it's nice when you can reverse the aging process. That's something that we all would. This is super exciting. The China study. And so did you read that, like, the year it came out, or was it introduced to you a couple of years later?
Dr. Sandra Musial [00:16:51]:
I think it was a couple of years later when that patient told me about was because I thought she was talking about some kind of research paper, which I didn't realize it was a book. And then when I finally figured it all out and it was coming at me from different directions, I kept hearing about it. I'm like, I got to read this book. And, yeah, that was the pivotal book for.
Rip Esselstyn [00:17:15]:
It. So many people. The China Study was kind of the gateway book into the lifestyle. For sure.
Dr. Sandra Musial [00:17:25]:
Yeah.
Rip Esselstyn [00:17:28]:
You're at Brown doing something there. Tell me. And you were there until what, 2020, 2021? 21. 21. And was it there that you started a kind of obesity clinic?
Dr. Sandra Musial [00:17:45]:
Yeah, so being there, I wanted to do more with nutrition, so I did a lot of nutrition education and making materials for the residents and the medical students. And obviously, pediatric obesity has been becoming a big epidemic, and I just felt like we weren't doing enough to address it. But not just kids who have obesity, but all the children in our clinic. They're the inner city, very poor kids eating horrifically nutrient deficient diets, and most of them are getting too much weight overweight obese, maybe 40% of the kids in our clinic. So with another colleague of mine, Dr. Corcoran, we both got board certified in obesity medicine and started this obesity clinic for children called Health Clinic healthy Eating Active Living Through Hasbro. It's a little acronym.
Rip Esselstyn [00:18:49]:
And what's hasbro?
Dr. Sandra Musial [00:18:51]:
Hasbro is the name of the children's hospital because the Hasbro toy company is from Rhode Island and they funded a lot of the hospital.
Rip Esselstyn [00:18:59]:
So it's named after well, that's a very clever and catchy acronym. Health.
Dr. Sandra Musial [00:19:05]:
Yes. Right, because we wanted the focus to be on health and wellness, not like your weight, it's about getting healthy. But that training in obesity medicine was mostly an adult specialty in medicine. So I felt like it was giving me because I was trying to think, how am I going to start treating adults? How can I do this more with adults when I'm a pediatrician? I felt like I picked the wrong profession, and I really wanted to help more people like my brother and other people that I had helped that were adults, friends and family. So it was after that training that I realized I can work with adults now because I have this board certification in obesity medicine. And it's not like I'm doing hospital medicine, I'm doing nutrition education.
Rip Esselstyn [00:19:57]:
Yeah. So I want to get to where you are today. But before we do, I still want to dig in a little bit with this obesity medicine that you started. So did you say that almost, what, 40% of the children that were coming in were kind of overweight or obese? Right. So almost 50%. And what is your definition of somebody that's a child that you were seeing as a pediatric practitioner? What's the age range?
Dr. Sandra Musial [00:20:31]:
Well, the kids in the whole clinic are birthed to 18, but in the obesity clinic, we would start seeing them at three. Three to 18.
Rip Esselstyn [00:20:44]:
A three year old comes to you and you can just and they're overweight at three.
Dr. Sandra Musial [00:20:51]:
Right. So in all of pediatrics, we track weights, heights, and head circumferences, and we do it as percentiles. The BMI is we define obesity and overweight as a percentile of kind of what a healthy weight is. So anything from the 85th to the 95th percentile is considered overweight in children, and anything over the 95th percentile is considered obesity. It's a medical definition.
Rip Esselstyn [00:21:19]:
Yeah. And so if somebody was to come to you because you started this obesity clinic, you're just seeing basically obese pediatric patients all day long, rough. Is that accurate?
Dr. Sandra Musial [00:21:35]:
Well, I wore several hats. So I worked in an urgent care with sick children, and the residents would see the sick patients, and then they would come we call it precept. They would come to us and we would precept them, like hear the case, double check the exam, help them learn which antibiotics or what the appropriate treatment is, what the education is, or I also worked in the Well Child Clinic, and this is where the residents practice to be pediatricians. So they have their own panel of patients that they follow for three years, and we oversee them in that role as well. So as their interns, the first year residents, they need a lot of overseeing and double checking, but by the time they're third years, they're working very independently and ready to go off on their own. And so in addition, I had another day where I was doing the obesity medicine, and it would be the children from these other clinics that would get referred by the residents to work to be seen in the obesity clinic.
Rip Esselstyn [00:22:39]:
Got it. And were you able to have success? Because I would imagine that the parents would be there, or the mother or the father or both with the child. And then are you trying to say, listen, it's just really as simple as eating these foods? Could you get any traction or buy in?
Dr. Sandra Musial [00:23:01]:
It was variable. So there were some people that were unaware that their children were an unhealthy weight and hadn't paid it much attention. And when you bring it to their attention and you kind of go over what a healthy diet is like, is your child getting five fruits and vegetables every day? And you go through their diet and realize they're getting zero to one a day? Or how many whole grains is your child getting compared to processed foods? And then it didn't take a lot for some parents to just steer them in the right direction and educate them. Some people didn't realize, like, how much sugar is in apple juice, for example. It says no sugar added on the bottle, and well meaning parents think it's healthy. It's also provided by WIC, the program that provides food for low income families. So if the government's telling them they should be giving their child this every day, isn't it good for them? I think there was a lot of education. We made these bottles, like with apple juice and soda, ginger ale, Gatorade, and then put the sugar in the bottle. And then when parents would hold those bottles and see the sugar, they would be like, oh, my God, I had no idea. So we did a lot of concrete.
Rip Esselstyn [00:24:27]:
That was really smart. So they can actually see it.
Dr. Sandra Musial [00:24:31]:
Yeah, it's powerful. And so for some families, that's the kind of education we did. It was kind of activity based. Another example is we would show them how to read labels, like how much fat is in a McDonald's French fry or chicken nugget. And then you calculate what that looks like as far as tablespoons. And then we would make these fat sandwiches with kids with graham crackers and spread the fat on know they don't eat them. It's just to like, would you want to eat this lard using.
Rip Esselstyn [00:25:05]:
Me? Give me an example of like, for example, I don't know, a Burger King. Whopper do you know how many teaspoons or tablespoons of lard you would be putting on a cracker? Can you remember?
Dr. Sandra Musial [00:25:17]:
I can't remember. I would say it's probably three to for that big one. Probably three to five tablespoons.
Rip Esselstyn [00:25:25]:
Tablespoon, yeah.
Dr. Sandra Musial [00:25:27]:
I can't remember for sure because we were doing more like the chicken nuggets and small French fry. What a younger child would eat was probably close to three. Yeah, it's a lot, and when you realize it helps them give meaning. So then if they're looking at a label and it says it has 12 grams of fat, they could see how that translates into a visual cue. I think when someone like when a three to I don't know where the cut off is eight to ten year old comes in, the onus is on the parents to take ownership of what their child's eating, what they're buying at the market, what they're feeding them. There were some families that didn't really get that and would take a step back. They'd be on their phone saying, tell my kid to stop eating potato chips. And it doesn't work like that. It's a family affair. So sometimes there were families like that, but the children were older, like teenagers, and the parents were hands off. Maybe they're working all day, they have issues and problems of their own. It gets really complicated. Right. But some of those kids would come in on their own, like take a bus and come to the clinic and really want to know, how can I get healthier? And I would see them regularly.
Rip Esselstyn [00:26:58]:
Yeah. I have a friend that practices pediatric medicine in Boston, and it's to a lower socioeconomic group of demographics. And he said it's just so absolutely heart wrenching, the level of the obesity that he sees. And he told me the other day he saw 14 and twelve year old brothers. The twelve year old was already over 250 pounds, and the 14 year old was in the was interested in having breast reduction surgery because so many of the kids at school were making fun.
Dr. Sandra Musial [00:27:37]:
Of making fun of them.
Rip Esselstyn [00:27:38]:
Yeah. I'm just like, oh, that is just so painful.
Dr. Sandra Musial [00:27:43]:
Yeah. And then there's the children that have fatty liver disease, type two diabetes, high cholesterol. This should be adult diseases. They shouldn't even be anyone's diseases. Right. But I think that sometimes was a motivating factor for families when they realized their child that was a big motivator. When they realized that there's these comorbidities that go along with having excess weight, and it's reversible like, get me on board. Let's try to fix this.
Rip Esselstyn [00:28:15]:
You mentioned the non alcoholic fatty liver disease. Can you speak for a second about that, just for our listeners that want to know? Kind of, because that's seriously on the rise here. A lot of us know about cirrhosis from alcohol, but from non alcohol. Can you explain that?
Dr. Sandra Musial [00:28:38]:
Yeah. So alcohol used to be the number one cause of liver disease, and now it's obesity. So it's a comorbidity, which means they happen together. So when you see a rise in obesity, you also see a rise in these other conditions that are comorbidities the type two diabetes, the fatty liver disease. So fatty liver is literally an accumulation of fat in the liver, and it leads to inflammation, and then that leads to scarring. And before the scarring phase, it's reversible. So if you have early fatty liver disease or steata, hepatitis is a fancy name for it, where you have a lot of inflammation, those conditions are reversible.
Rip Esselstyn [00:29:25]:
Can you see this or how do you diagnose it?
Dr. Sandra Musial [00:29:29]:
The first thing you can see is on a laboratory test, you'll see elevated liver enzymes. They're called AST and Alt. And when those are elevated above a certain amount, the doctor will order an ultrasound, and it will test for the elasticity of the liver to see how much inflammation and cirrhosis is in the liver, and then they can do biopsies. But the great thing about changing to a healthy diet is the ability to reverse this condition.
Rip Esselstyn [00:30:00]:
Yeah, no, it's incredible to me how resilient our bodies are, how much assault and pounding that it can take. But as you said, up to a certain point, and then you cannot actually reverse. You can still make some great, I think, efforts. But tell me this, in what you were able to see, typically, what's, like, the youngest age that you saw scarring in somebody's liver, and it happened as early as 15.
Dr. Sandra Musial [00:30:37]:
I never saw scarring in the pediatric population. Yeah, kids are super resilient, so when they're having fatty liver disease, it's early. So I don't know if it's possible to have that kind of scarring just from a poor diet.
Rip Esselstyn [00:30:56]:
Right.
Dr. Sandra Musial [00:30:57]:
I did not see that.
Rip Esselstyn [00:30:58]:
Right. Good and plenty and burgers and shakes. You started the first vegetable garden at Hasbro. Do you know if that's still there and what inspired you to start it?
Dr. Sandra Musial [00:31:11]:
I just love gardening, and I just thought it would be really fantastic to show kids where vegetables come from and how they could grow a garden, too, if they were so inspired in their urban backyards. It took five years to get the administration at the hospital to agree, but what I did was we did six different beds. Each one was a different color of the rainbow, so we called it the Hasbro Rainbow Garden. So there was, know, purple, blue, green, orange, yellow, red. So we had red tomatoes and orange pumpkins and yellow squash. And then we had a teepee in each bed with ribbons of the colors of the rainbow and annuals to help with pollination that were all in the colors of the rainbow. So it was very colorful and educational, and we definitely integrated it into the clinic. It was right outside the clinic doors and the health clinic.
Rip Esselstyn [00:32:11]:
That's really cool. I can't believe it took you five years.
Dr. Sandra Musial [00:32:16]:
There were some people that were concerned in the administration.
Rip Esselstyn [00:32:22]:
It's funny, I saw a quote this morning, and it's hard to beat a person who never gives up. And that's Babe Ruth, so way to go on never giving up. It kind of reminds me of one of my favorite movies is The Shawshank Redemption, where he keeps sending a letter to the warden because he wants to put a library in the prison and finally he grants him permission. Yeah. Reminds me of your garden. You mentioned you love gardening. You also love yoga. How long have you been doing yoga?
Dr. Sandra Musial [00:33:02]:
Forever. I feel like I probably started doing it formally in residency, so 25, 30 years ago.
Rip Esselstyn [00:33:12]:
Nice. I just got back from a retreat where I did it every morning for six days in a row, and nice. Just it's a reminder to me how much I love yoga in the did it three times a week for probably, I don't know, five years in the middle of the my body just so needs it, especially as I'm getting older.
Dr. Sandra Musial [00:33:35]:
It's great. There's a fun little yoga game with a spinner, and you spin it, and then there's these cards that show kids how to do different yoga poses. And I got that for the obesity clinic. And we would play it. I would always have we'd have, like, an education piece and then like, an exercise piece. So that was one of the fun things we did, was play the yoga game.
Rip Esselstyn [00:33:57]:
Yeah. I also see that you're into sweater alchemy. I have no idea what that is.
Dr. Sandra Musial [00:34:05]:
Well, it's my name. I made it up.
Rip Esselstyn [00:34:08]:
Okay, good.
Dr. Sandra Musial [00:34:09]:
So don't feel bad, but I have this passion for the whole trash to treasure concept. I think it's being brought up by parents of the depression where you don't throw anything out. And I collect sweaters that someone might throw out because they have mothholes in them, but they're like good fibers. Wool, cashmere, alpaca. And then I shrink them. I wash and dry them so they don't come unraveled, and then I cut them up and make other things out of them, like mittens or blankets.
Rip Esselstyn [00:34:45]:
Very cool. So you mentioned trash to treasure. I was just listening to something yesterday. It was talking about fecal transplants and how one person's trash is another person's treasure relating to that. But have you heard much about fecal transplants lately? And as far as what it can do for ulcerative colitis and autoimmune diseases.
Dr. Sandra Musial [00:35:12]:
And things of that nature, one of my favorite topics is the gut. Biome. I just think it is so fascinating, and I think we're just the tip of the iceberg in understanding the power of the gut biome. I think it has a huge role in metabolism, autoimmune diseases, obesity. And I don't know the answer to your question, but I would be fascinated to read about it. I think fecal transplants is just fascinating, how it can fix. I think what's most famous and best known in the literature is when you have C. Diff, it's like an overgrowth of this bad kind of bacteria in your gut, and you have to use these super powerful antibiotics, which is why it happens to begin with. Right. You go on antibiotics, it kills your good bacteria. The C diff overgrows, out of control. Then you have to use a more powerful antibiotic, and it's developing all this resistance. So people die of this because they can't kill off the bad bacteria. So then they end up getting a fecal transplant with someone's good bacteria, and it just fixes it overnight. It's fascinating.
Rip Esselstyn [00:36:28]:
It's remarkable because I'm ignorant with this topic, and I don't want to go too deep into it, but how do you do a fecal transplant? Is it oral? Is it erectile? Do you have any idea?
Dr. Sandra Musial [00:36:43]:
I think it's oral, but I think they're like capsules that don't open until they're in the gut. But I really don't know. Yeah, I don't think that's how they used to do it. I think it used to be more, I don't know, up the butt, but I don't right. I think it's gotten more sophisticated.
Rip Esselstyn [00:37:02]:
Well, if they're looking for somebody that's got a healthy microbiome and healthy stools, I think we need to sign up somewhere for people that need our trash, which will be their treasure.
Dr. Sandra Musial [00:37:20]:
Well, one thing I do like to teach our participants is you can change your gut bacteria. It shifts as you change your diet. So what you eat feeds your bacteria. So if you're eating a bunch of stuff with preservatives and ultra processed foods, it makes sense that that's going to kill off a lot of the good bacteria, and only a few strains of this more unhealthy bacteria will grow. But if you feed yourself all kinds of diverse fruits and vegetables and fermented foods, then you're giving your gut, like, a lot of different kinds of bacteria, and you're feeding the good ones that will grow more and be favorable to your health. It's fascinating.
Rip Esselstyn [00:38:06]:
It is. And I've had Dr. Will Bolshowitz on the podcast. I've had Dr. Robin shutkan. So both gastroenterologists that 15 years ago didn't even really weren't talking about this. And as you said, we literally are, I think, just scratching the surface when it comes to the microbiome and the trillions and trillions and trillions of bacteria that we can cultivate there that can really help raise our health. I want to transition right now. I'm going to start with this quote that's actually on your Plant Docs website. The food that you eat can either be the safest, most powerful form of medicine or the slowest form of poison. That's Anne Wigmore. So you during the pandemic, was it 2021, you decided you were going to unhinge yourself from kind of traditional medicine and start your own Plant Docs Providence with yourself and two other physicians? Tell me about that and what's going on with it.
Dr. Sandra Musial [00:39:15]:
Yeah, I love that quote. We start every program with that quote and it literally defines what I do now. But in 2019, I met up with Kim Anderson, who's the owner of and co founder and creator of Plant City, which is a whole food plant based food hall in Providence, Rhode Island. And she had this idea to start. They have like Plant City sellers, so there's all kinds of programs in the cellar space. They have documentary showings and cooking classes. And she suggested I could do some kind of a jump start where we took a group of people, taught them how to eat whole food, plant based no oil, grab labs before and after to really show people the impact that it can have. And I love the idea. So I kind of got together this business called Plant Docs, and this was in 2019 when Plant City opened. And so we were all doing it as like a side thing, but all of us, we were all like, this is the most rewarding thing we've ever done in our career. In one short month, we're changing these people's lives. And we're not prescribing drugs or surgery. We're just showing them how to eat healthy and seeing these kind of miraculous turnarounds in health. And some of them are like the type two diabetes and prediabetes that stuff. It's amazing how the cells just start working. When you stop giving animal fat and animal protein and all the oils and you start eating all these nourishing foods, the cells start working, the insulin receptors start working and within like a week, people need to adjust their insulin dosages. So, yeah, we were like, this is great. But then COVID started we had like a big hiatus of 14 months because we were cooking and eating together and it just didn't seem it wasn't okay to do that. So when we started up again, we created a hybrid program based on social spacing and mask wearing. And we had the in person part was we would wear masks and just have the education for two of the classes and the other two would be fully remote. And we had people cook in their own kitchen. I would send out the ingredients and we would cook with them and show them how to cook and we would make a breakfast, lunch and a dinner together. And the feedback we got was that they liked that better. People were empowered to they had to go out and buy these ingredients. They weren't just watching us do it and then eating it. So we ended up keeping that model. It was in 2021 that I decided, I just want to do this. This is really where my heart lies. And I gave my notice and left my job halfway through 21, kind of when the residents switch in June. So I finished off one class, and then I just dove right into this. I did this harvard has this great culinary coaching class, chef coaching. So I thought, okay, I'm going to learn a little more professional how to teach I'm not a chef, but how to teach culinary nutrition and cooking. And I've just been running with it ever since.
Rip Esselstyn [00:42:57]:
Is that course that you did with Harvard, is it plant centric or animal centric?
Dr. Sandra Musial [00:43:05]:
It's Mediterranean centric. So it was mostly, I think most actually, most of the recipes were plant based. They weren't oil free. I don't think there was any chicken or fish. Actually, it was mostly beans, legumes, fennel, lemon soup. It was very good.
Rip Esselstyn [00:43:26]:
Yeah. Good.
Dr. Sandra Musial [00:43:28]:
Yeah.
Rip Esselstyn [00:43:29]:
And so Plant Docs is so is it affiliated with Plant City or is it nearby or you just kind of use the seller to do jump starts and stuff, is that right?
Dr. Sandra Musial [00:43:42]:
We started by using the seller, and Kim gave us an office there in the basement. And it's a real synergistic relationship because we're teaching people the power of eating a whole food plant based diet to heal and as a lifestyle. And she's providing this restaurant with four different restaurants in a marketplace. So after the pandemic, I think she loves having us there, and we love being there. So I still have an office there, and I run the in person programs there. But we offer all of our programs are now with the option to be fully remote because we have people from all over the country participating in our jump starts. So every time that we have a jump start, 20 spaces are remote, fully remote. And 20 spaces are for people who want to come into Plant City.
Rip Esselstyn [00:44:38]:
Why do you limit the remote to 20?
Dr. Sandra Musial [00:44:42]:
Because we're ordering labs before and after, and I thought it might be too overwhelming to follow everything. It's very concierge. So people email me and call me whenever they want to during the program. They'll send me texts from the supermarket, like, what do you think of this product? And that's what I want everyone to be successful. And if I have too many people, I worry that it's going to lose that kind of attention.
Rip Esselstyn [00:45:14]:
That's remarkable. That's really high touch, lots of attention. You get great results with that. Way to be with that. And the other two docs that are part of Plant Docs, what are their backgrounds? Were they interested?
Dr. Sandra Musial [00:45:31]:
They're both family physicians, and they both went to a lifestyle medicine conference that's a number of years ago. That's how they got introduced to the power of kind of whole food, plant based eating. And so they joined me in the very beginning. We all co founded it together, and their role now is primarily with the Jumpstart Your Health programs, the one month programs. They teach it with me, and we have different personalities, so there's a nice balance between some of us who are more strict and some that are more funny. So I think we have a good thing going. But I'm primarily in the plant docs business. I'm doing all the consultations, and I started a monthly cooking class last year in 22 using Dr. Gregor's How Not to Die cookbook because I wanted to use recipes that were all no oil and teach people. And it was kind of meant to be like a support group for our Jumpstart graduates so they could sign on for these cooking classes. But this year we're doing these plant based global health cooking, and I'm having a lot of guest chefs from different countries. I have, like, a co, a colleague of mine who's Indian, and she did an Indian cuisine one in February. So we're having a lot of fun with it.
Rip Esselstyn [00:46:58]:
Don't you have one coming up, if I'm not mistaken, that's based on was it Okinawa?
Dr. Sandra Musial [00:47:05]:
Yeah, that was last weekend. We're visiting all the Blue Zones of the world, and I do a little education each country. We do a little education about kind of the food from that country and then how to make something fun and tasty from that region.
Rip Esselstyn [00:47:25]:
Yeah. And in seeing Dan Buettner's lecture, he came to one of our plant stocks a couple of years ago. The one overlapping thing with all of the blue zones are the legumes, which is pretty darn cool, and of course, very plant centric and all that good jazz.
Dr. Sandra Musial [00:47:51]:
Yeah, it's fascinating. I loved reading about the Blue Zone, so I really wanted to incorporate it. Just positive, healthy longevity. It's incredible.
Rip Esselstyn [00:48:02]:
Yeah. I'm going to ask you a question. You can tell me to jump off a cliff if you want, but I'm just wondering, based upon what you were doing with traditional medicine and probably, I would imagine, the salary that you were making, are you able to make a living as a plant based doctor?
Dr. Sandra Musial [00:48:22]:
Not yet.
Rip Esselstyn [00:48:23]:
Yeah, not at all.
Dr. Sandra Musial [00:48:26]:
When we first started it, it was like a side gig. So we were just kind of running a couple of jump starts here and there. Then there was COVID. So then I've been doing it now for almost two years and I haven't figured out how to make a living. In the fall of last year, we have something in Providence called the Social Enterprise Greenhouse, and they help businesses with social agendas to get off the ground. So I did that for a semester. So that took a lot of my time, but was very valuable and helped connect me to a lot of people in the community and learn how to grow a business and connect me with lawyers and other people that I didn't have connections with. And so during that time, I switched it from an LLC to a nonprofit because I feel like the mission of Plant Docs is more nonprofit oriented. I want to educate everyone. I don't want to make money. So, I mean, I would like to get paid for what I do. I'm working on that. But I think we're going to have to rely on grants and funding to supplement what people can pay because I don't want to charge. If I charged what the actual cost of the class was, it would be too much for people to afford. So I want to keep it affordable.
Rip Esselstyn [00:49:52]:
No, it's incredible to me. I saw, like, you do your jump starts and for the month, and I'm imagining it's including labs. It's like $250.
Dr. Sandra Musial [00:50:03]:
Yeah, no, the labs are paid for by their insurance company, but it includes like, a doctor consultation and all the cooking classes and in person classes. And we also have one coming up in June that's going to be a Providence Community Health Center, which is an inner city population, and they're not going to pay anything. So I'm hoping this will all fall into place, but I'm hoping to get some grant money to cover that. And then they all have issues with food insecurity, too, so they're all going to leave each day with a bag of food, and that's going to be fully in person. So that's the beauty of it being nonprofit, is to try to access these communities that need this information, but there's nobody teaching it. And it's also going to be bilingual. That course in Spanish and in English.
Rip Esselstyn [00:50:53]:
Do you speak Spanish?
Dr. Sandra Musial [00:50:55]:
I don't, but I've met another doctor who's bilingual who's going to teach it with me. And we have a Latino medical student from Brown medical student who's going to translate all my slides into Spanish and English, and she's going to help teach it too.
Rip Esselstyn [00:51:11]:
Right? Yeah. The thing to me that's just so it's unfortunate is that you decide to leave traditional medicine because it has so many limitations and go into this basically lifestyle medicine. And right now, the way the whole model is set up, you cannot make a legitimate living doing that, and yet it's the one way that you are getting to the root causation and really helping people. It's just so unfortunate.
Dr. Sandra Musial [00:51:45]:
Yes, I agree. I could open a lifestyle medicine practice and take insurance, but then you have to follow this traditional model of billing and time slots. And that's what I really wanted to get away from. I didn't want anyone telling me how to do what I'm doing. I want to spend the amount of time I need to spend to get people to be successful to reverse their disease. I don't want to be told, you only have 15 minutes and you have to build a 99213, and yes, you're going to get paid a whole lot more money, but I'm not going to be successful at my goal, which is helping patients to reverse their disease.
Rip Esselstyn [00:52:29]:
Can you and your other docs that are part of plant docs do nutritional consults with anyone across the United States, or is it limited to where you practice medicine?
Dr. Sandra Musial [00:52:41]:
I can do them with anyone.
Rip Esselstyn [00:52:43]:
Wow, that's wonderful.
Dr. Sandra Musial [00:52:44]:
Yeah.
Rip Esselstyn [00:52:45]:
And so what's the best way that for somebody that's listening that wants to do a consult with you, where should they go?
Dr. Sandra Musial [00:52:52]:
My website is plantdocs. PVD. PVD. I shouldn't have kept this. It's a little confusing to people who don't live in providence, but anyone who lives in Providence knows that p V as in victor, d as in dog, stands for providence. But I wasn't aware that no one else knows that. But so anyway, my website is plantdocspvd.com. And on there is all our information about our programs that are upcoming, the cooking classes, the consultations. And the other thing that I've kind of took a dive into over the last year is the world of cancer. I was asked to do a cancer class for breast cancer survivors by a local breast cancer resource organization called the Gloria Gemma foundation. And after doing that, I realized, like, oh, my goodness, there's so much important information out here for cancer survivors or people at high risk for cancer. So I'm running a program a couple of times a year that's fully remote. It's information about the most powerful anti cancer foods out there and how to make a healthy dinner with them.
Rip Esselstyn [00:53:59]:
Wow. Can you tease me and tell me, what would you say are the top three or four anti cancer foods?
Dr. Sandra Musial [00:54:08]:
Yeah, I mean, mushrooms always just jumps to my head. All different kinds of mushrooms. The whole allium family. Onions and garlic are super powerful. Broccoli sprouts are probably one of the most powerful anticancer foods. They're way more concentrated than broccoli. The sulforaphane that's in them is a super powerful anticancer molecule. And then the berries, those would be my top four picks.
Rip Esselstyn [00:54:43]:
I'm just thinking here, I haven't had a mushroom in a couple days, so I need to get mushrooms. I have a problem with the texture of most mushrooms. And then broccoli sprouts. I had Doug Evans on my show. I don't know if you know who Doug is. He wrote the sprout book, and he talked all about sulforaphane and all these other things that are there, like broccoli sprouts and why sprouting. Everybody should do it and how easy it is. And I still haven't done it, so it's a nice reminder for me.
Dr. Sandra Musial [00:55:19]:
You can add them to salads or even to a smoothie. And Sproutman.com has this new powder. It's for people who don't like the taste of sprouts. That's 100% food that you can add to smoothies. And while we're on that topic, mushroom powder, if you hate mushrooms, you can buy, like, real food mushroom powder. I actually have it every morning in my coffee. I know a lot of people think it's weird, but it's called mud water.
Rip Esselstyn [00:55:48]:
Mud. Great.
Dr. Sandra Musial [00:55:50]:
And I just love it. I put it in my coffee with my frothed oat milk and my turmeric powder.
Rip Esselstyn [00:55:58]:
Do you know what kind of mushrooms this mushroom powder comes from?
Dr. Sandra Musial [00:56:03]:
Yeah, there's like four or five. There's rishi mushrooms, cordyceps, lion mane. They have a whole bunch in there.
Rip Esselstyn [00:56:09]:
Oh, now you're talking my language. Rishi's and lions. Mans. Holy Toledo. During the day, do you snack? And if so, what do you like to snack on?
Dr. Sandra Musial [00:56:22]:
Fruit. I love using the Dr. Greger's Daily Dozen app. And when I check myself to see how good or bad am I eating, I'm usually deficient in fruit. Which is funny because I love fruit. So when I snack, I usually have some fruit and a handful of nuts.
Rip Esselstyn [00:56:42]:
Yeah. Well, just so you know, I've already had a cup of berries. It's a frozen blend that I have. It's relatively cheap. I had a banana on my cereal. The berries. I also had sliced strawberries and a mango. And I'm going to have this mango, this champagne mango. Oh, yeah. And it's so perfectly ripe. I'm going to have these are the Sumo orange, which just easily I'm going to have these two little squatty bananas that I'm going to have as well. During the afternoon. And on your website, I saw you guys talking about the mango and how there's like 500 to 1000 different varieties of mangoes.
Dr. Sandra Musial [00:57:24]:
I know, me too. So what kind of cereal did you have?
Rip Esselstyn [00:57:28]:
Was it?
Dr. Sandra Musial [00:57:29]:
Big bowl.
Rip Esselstyn [00:57:30]:
Yeah, thank you for asking that question. It is my commercialized ripped Big Bowl cereal. And it was the berry almond this morning. And I just love it. I have it six mornings a week. Yeah. So one of the things I noticed in Perusing through your website is you've got the plant docs. And then separating plant and docs, you have this great asparagus that's going up. And then around the asparagus is the snake. Right? Is that the medical yeah, it's like a medical icon. Yeah. And then you also talk about how and I just found it to be fascinating because I find asparagus to be such a fascinating vegetable is how it's a perennial, so it comes out every year. And you can have a plot of asparagus that can last for 15 to 20 years. That just blew my mind.
Dr. Sandra Musial [00:58:26]:
Yeah. So every time I move, the first thing I do is plant asparagus.
Rip Esselstyn [00:58:32]:
Yeah. And I know this is a very personal question, but does asparagus make your urine.
Dr. Sandra Musial [00:58:39]:
Know? Probably.
Rip Esselstyn [00:58:43]:
That means that to me means no, because you would know. It is so potent. I think it's another Babe Ruth thing, is something about asparagus and urine. But anyway, I can't remember it. Sandy, this has been an absolute blast. I am so impressed with your commitment and what you've done there with plant docs and all things related to lifestyle medicine. Huge congrats. And again, anybody that's interested, their Jumpstart programs look incredible. Go to Plant Docs Spvd.com and check out all the great resources they but and the reason I found out about you, Sandy, just before we close this out is because my sister Jane was there at Plant City with you, and she, I think, gave a lecture. She was signing books with be a woman Warrior. I actually talked to her this morning, and she know how fantastic you are, and she wanted me to tell you hello, as well.
Dr. Sandra Musial [00:59:58]:
Oh, thank you. Yeah, we loved having her, and we look forward to your visit as good. I can convince yeah.
Rip Esselstyn [01:00:06]:
Yeah. Well, Sandy, have a great rest of your day. Thanks so much for joining me on the PLANTSTRONG podcast.
Dr. Sandra Musial [01:00:15]:
Thank you for having me.
Rip Esselstyn [01:00:17]:
Yeah, my pleasure. Anything you want to say as we close out our conversation today?
Dr. Sandra Musial [01:00:25]:
My one thing I always want to just reiterate is I want people to know that some of these conditions are reversible. These chronic conditions are reversible by changing your diet. And I think a lot of people think, like, once they're on medication, that that's it, and they're going to be on it for life. But it's possible to get off these statins and high blood pressure meds by changing your diet and working with your doctor to kind of move in that direction away from meds.
Rip Esselstyn [01:00:54]:
Yeah. All right, Sandy, can you hit me with a fist bump here? Keep it plant strong. Yes, indeed, Sandy is available for consultations, and she is launching a whole new Jumpstart Your Health four week program in September that can be done remotely. As Sandy likes to say, you have a choice to have a daily rebirth of sorts, and it's never too late to build a whole new you. The good news chi and all of us here at Planstrong are here to help. We'll be sure to link to Sandy's website in the show notes of this episode. Thanks so much for listening and sharing the PLANTSTRONG podcast. Thank you for listening to the PLANTSTRONG podcast. You can support the show by taking a quick minute to follow us wherever you listen to your favorite podcasts. Leaving us a positive review and sharing the show with your network is another great way to help us reach as many people as possible with the exciting news about Plant. Thank you in advance for your support. It means everything. The Plants Drawn podcast team includes Carrie Barrett, Laurie Kortowich, Ami Mackey, Patrick Gavin and Wade Clark. This season is dedicated to all of those courageous truth seekers who weren't afraid to look through the lens with clear vision and hold firm to a higher truth, most notably my parents, Dr. Caldwell B. Esselstyn, Jr. And Anne Crile Esselstyn. Thanks for listening.
