Rooting for the Underdog

Dr. Madan Kandula and Dr. Ethan Handler take time on this week's episode of ADVENTing to discuss ADVENT's role as an underdog in the world of healthcare.
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Published on
March 18, 2020
Updated on
February 20, 2023

On this week's episode of ADVENTing Dr. Madan Kandula and Dr. Ethan Handler talk about being an underdog in the world of healthcare and how it doesn't stop them from providing the best care possible. And now that care can be provided with the launch of our new virtual* platform, ADVENT Virtual Visits*.

*ADVENT no longer does virtual visits

Dr. Kandula:
I shot a recent video about Dave and Goliath and so why, what's up with that David and Goliath situation?Dr. Handler:
Well, let's talk. Well, what about like, just good underdog stories? You know, I saw it, I saw that you had miracle on ice was like, they're meaningful, it was very meaning for you growing up.Dr. Kandula:
You grow up, you know, you weren't even born.Dr. Handler:
I wasn't, that's why it's less meaningful for me, but certainly, um, but I've seen the movie, you know.Dr. Kandula:
It's not the same. It's not the same.Dr. Handler:
But why did it matter? Like, why do people, why do underdogs appeal to everyday folks?Dr. Kandula:
Why? I don't know, why?Dr. Kandula:
To me, like why I, I, to me personally, there's nothing better than a underdog fighting against injustice or a system or a David versus Goliath or David Goliath. You know, that whole situation is, you know, sort of everything I've ever wanted to fight for. And cause it's, I think it's how we're wired. I don't know why. I think, and I don't think I'm alone in this. I think it's just, I think it's human nature to root for, um, in those situations, root for the David's root for the underdogs, even when you're a Goliath. So even if you're in a big system, a monstrosity of monstrosities, um, those folks don't root for David. They still do. They because they're human beings who live human on human scale. And while they're part of this massive machine, they still relate here. They still relate on eye-level. We still relate to each other as people.Dr. Handler:
Right.Dr. Kandula:
And to me the best, you know, underdog stories are the, are the [inaudible] are the stories of perseverance, uh, for folks or by folks who are just like you, who are not special. We're not given anything. We're just, you know, sort of maybe even tossed aside and then they stand up and they fight for what's right and it's the fight that matters. Not every underdog wins. In fact, most underdogs lose at the end of the day. And, and Vegas makes so much money, which is also why it makes it so much more compelling. Of course, when you either have an underdog that you think has a shot or you see an underdog that actually, you know, that that wins. It takes take again in a David and Goliath analogy a day, but that actually takes on Goliath and wins. Um, there's nothing better. I don't care. I mean, to every single great movie that's, you know, sort of, you know, those, those big movies, the gladiators, a star Wars, the, those massive, they're always, always, always that Dave and Goliath story. It's the same. It's the same story you tell over and over again. It's the same story that was, that was being told back in the biblical era because it's so compelling because why? I guess this is where for me, I know, I know that. I know that. I love it. And I know that it's, um, that I'll always root for the underdog. Um, and, and, but, but there's, there's gotta be,Dr. Handler:
There's an element of human struggle, you know, and grow from that like human struggle and not that everybody can relate to. And, you know, just this weekend, like I don't watch boxing really, but like there was a big heavyweight bout on Saturday night and it was fury and Wilder, you know, and, and the underdog won and his story was such that he was at the top of his career and then got into drug addiction and alcohol lost his title and like without, for years and gained all this massive weight and like, and just came back from this struggle in life to like get back to the top right. It's still when he was an underdog and everybody was like, you know, this was their second fight and you know, I didn't watch it, but I read about it quite a bit after. And it's just, it feels good to see those people with, you know, deal with something that is, that can be shattering. And then,Dr. Kandula:
Yeah, absolutely. I mean it's, there's nothing better than that. And honestly, I'm sort of thinking about this cause we, again, we just did that video on David and Goliath and kind of talking about that concept. But, and I've said this before, but I have not really recognized it until more recently is our patients are who we fight for. And you take, I mean, again, and it may be hokey, but it's, it's how I feel as you take somebody who's compromised, you know, for us the actual care that we deliver for patients are, you know, most of what we do, nose and throat. That's, that's kind of what we're known for. Snoring, sleep apnea, you know, nasal blockage, sinus issues, all those things. You take somebody who, they're their own David in their own story and they're being held back by something, something that's out of their control. And then we can acknowledge that we are David too, and we're fighting together, uh, for, for the greater good. And we can help you. We can take something away from, you know, takes a burden away from you that can get you back and, and, and do what you, you kind of meet your potential. Um, that's what we do. And I think for me that's part of like this whole David and Goliath battle that, that we as a practice are in, is fighting for the people, fighting for the people that we are actually taken care of. Um, because we believe in them so strongly. It's that same story. To me it's like the, it's the same story that's baked into our DNA about why we do what we do to begin with. Um, it's a little bit of a different riff that, but it's the same thing. And so back to the, but, but it gets back to our humanity. It gets back to our, um, our, our flaws, like our flaws as people, our weakness. You know, I think that's where maybe another way to look at this as in just from a, from a a construct standpoint is Goliath is sort of by definition, inhumane, not human, not of us. A human up against that sort of a thing. It's like got no chance, man. Like you're a human versus a superhuman not going to happen. Um, but the human that's got willpower and Moxie and mojo and um, grit, grit can do anything and everything. And, and, and, and humanity has proven that throughout time. And then in, in now their current era, well where do we see that? We see that on the sporting field very often, every day, every night, every weekend, you know, whatever sporting event there, there is, there is the team that's supposed to win or the individual that's supposed to win. And the, uh, and the other guy and you know, um, great teams and great players. Michael Jordan being a very specific example of it, have built their entire careers on feeling like, uh, David and, and fighting that battle against, you know, against all odds. Um, cause that's the only way to get motivated if your goal, I mean, good luck, good luck if you're Goliath, try to motivate yourself into battle. You know, coming after David, it's not going to happen because you're going to say we got this. And many, many a sporting team has fallen to that same folly where they, they're like, you know, like the 27 Yankees or whatever, and they're there. They can roll over anything and the best things back to the miracle on ice, the best things in the world are you take this massive inhumane machine, which is what the Soviet union was and was as a hockey team. And you take this gritty group of college kids and you put them up against each other and you take that gritty group of kids and they, they actually take the machine down. Like there's nothing better. And it's been literally 40 years, um, you know, to the day, uh, as far as when that happens. And I was, you know, I was 10 years old when that happened. And, um, it just doesn't get better than that. Just doesn't, um, does that, I missed that. Yeah. If only you were born, been born earlier. It really, honestly, for in my life out of the things and I've been a sports man my whole life, played hockey, growing up, played all, you know, played all sorts of things growing up. But I think I was, that's the thing that left the greatest mark on my, um, my mindset is, is sort of seeing firsthand that the impossible is possible. Um, once you see that, you may never see it again, but you always know that there's a chance. Like if you guys, there's a chance, there's like, there's a, there's a chance that, that, um, that that could happen again if you've never it, like they don't show, I don't think they're probably showing too many clips of the miracle on ice. This is gonna sound like a really screwed up analogy, but I don't think they're showing those clips in North Korea right now. You know, it wouldn't, you know what I mean? I think that those sorts of places, um, you have to create a false sense of humor, who people are to make any sense of, of sort of insanity when you have systems that are broken. Um, you have to figure out a way to rationalize that to yourself in your own head. And it's just, um, it's hard to do, but, um, but yeah, I mean, so that one, you were the Miracle on Ice, you weren't around for, uh, you know.Dr. Handler:
Yeah. I was always around for some of the star Wars movies. Not a New Hope, but, you know,Dr. Kandula:
see you in the star Wars movies, you were rooting for Darth Vader. Right. Everybody's rooting for the, for the, um, for the evil empire, the evil empire.Dr. Handler:
And thinking about the evil empire. Think about what star Wars created from an evil empire standpoint. And now, you know, it's the Yankees, the Blue Devils, you know. [inaudible] yeah. And, uh, uh, who else would it be? I guess it would be, um, Patriots like painted that way, you know, who knows. I mean, there's sports analogies all over the place for that, but I Rocky, I watched the same kind of thing, right? Like it's the American fighting and the machine of the Soviet union and the behemoth.Dr. Kandula:
And there's a reason they don't make movies, uh, from, you know, Rockies. I mean there's so many different villains in those movies, but the villain's perspective in those ones in particular was always a David Goliath kind of a proposition. Cause it's, it's, um, it just cuts to the core of who we are as, as human beings. And it's, it's something that's just compelling. I'm sure. Well, as you mentioned, I went to Duke undergrad, um, and that's my team, Duke blue devils. Are they, if there is any Goliath in the world on the sports or in college basketball these days, it's the Duke blue devils. Um, and, but they're my team. I've got a root for them now. I knew them. I was there when they won their first two national championships. I was there before they became Goliath. And so for me, the story I tell myself is, yes, Duke is successful and they've become a Goliath, but they're a David at heart. And then it makes it right. That's how I, that's how I deal with this duality of, cause I hate [inaudible]. I hate Goliath as much as anybody hates Goliath. I hate, hate that. And so, um, if I didn't go to Duke and I wasn't associated with that team, I would probably not be a big fan. Now you can respect the program and how it's put together. Just like the Patriots. Like you can say what you want about Bill Belichick or the Patriots, but without that they are Goliath. Nobody's going to question their, the fact that they're a Goliath, but, um, they, they, they worked themselves into that position to, to be there. And there's a certain level of respect. Uh, that's there. I have a hard time finding David in that story. But for Duke, for me, I see David there. Cause I saw, I saw Goliath when it was David. And you know, as it's grown in my opinion, you know, being a little bit more on the inside there, there's still a heart that's beating, um, that's trying to fight together.Dr. Handler:
Well, it could be, you know, as someone like Jordan or Kobe or how some of the greatest basketball players motivate themselves is they have to put theirselves in the mindset that, you know, they have to grit it out. And they have to succeed and work hard and always be better and can always play better. And, and so, and Tom Brady, I mean, where was he drafted? So I mean he's got an his own chip on his shoulder to find motivated him throughout his entire career and maybe still next year. But like right,Dr. Kandula:
well yeah, almost it's weird thing but I mean, cause he's got these, they have six Superbowl rings, Tom Brady has five, whatever it is, four rings and fingers. But he was drafted in the sixth round I believe. Right. Um, and I honestly, this is kind of, it sounded really twisted and warped, uh, as well. But I'd say I guarantee you, I bet you he's more proud of his sixth round drafting. Like those, I don't know if it's five rings or six rigs, but they would not be as sweet if not for his big rap. Like if we went first, you know, and he, in fact, I would, I would suppose and propose that he, it's him. It wouldn't be possible for somebody to do that unless they are a Jedi master like Michael Jordan. Like you have to, you have to get your mind in that position where you're, you're always fighting a battle. You're always climbing the mountain, right? Always climbing the mountain. You're never, you could never be at the top of the mountain looking down because if you do, there's only one way to go kind of a thing. And so there's a certain mindset, same thing with Aaron Rogers and his whole graft situation is that made him who he is. If not for that, he would not be who he is. He has the same talent, same body, same everything. But it's the situation that those folks put are either put in or have to put themselves into to, to sort of thrive and even survive to to some extent. But yeah, I mean I think, I mean that whole construct is something that, um, is sort of core to who we are.Dr. Handler:
I mean, how does it relate to our story?Dr. Kandula:
So our store, I mean I think it relates to like to me, I could do this all day cause I can relate to every, everything is every single story. But for us, ADVENT is what we're an independent medical independent medical practice, right?Dr. Handler:
How many independent medical practices are there still alive and well in this area?Dr. Kandula:
Not many.Dr. Handler:
So how many ENTs?Dr. Kandula:
Not many, you know, you're talking, you know, they basically, there we are the lone David standing, um, out there and, and we're okay doing that. And in fact, not that I want that to happen, but it is what's happening. It is what's happened. And so what does B, what does being independent means? That being independent means that we get to set parameters for the care that we deliver. It's on our terms. It's how we would want to be treated. It's not on somebody else's terms. And, um, we do things, you know, in one way, which in my opinion is the right way. And so, but, but we are surrounded by little ol' is surrounded by Goliath. We're surrounded by the biggest hospital systems. Um, some of them, the biggest in the country that are surrounding us. And you know, not that they even care about us or look at us because they'd have to look so far down. They'd have to like take their magnifying glass out to find us down here. The little rule was, um, but if they did take a magnifying glass and look down and find us and see us there, it wouldn't know what, what they wouldn't know how to make sense of us because we were nonsensical in a world that's full of nonsense these days. It doesn't make sense. So you have big, big Goliath, you have little ol' and you know what, it doesn't seem like, not that we're battling them, we're not, but what we are doing is providing care for our patients and we're doing that at our patient's level. Maybe, maybe back to that sort of thought processes. If you have, you know, if you have an issue and even a medical issue that you want care from, um, we're at your level. We're on your level. We're above you. You literally, you know, um, you know, we, our entire reason too that we exist is to, is to take care of you on your level versus looking down at you or upon you or gracing you with, you know, uh, the fact that, that, um, we're going to provide care for you. So I think it, it just a different mindset, but it's, it's the right mindset. And it's almost our superpower in a way because it's something that if you have that mindset and you really understand the, how special that is, because in this day and age, this, in this day and age, the independent practice of medicine is shrinking and shrinking fast. And so if somebody doesn't break that cycle, it's possible that it goes away and it's gone. And once it's gone, it's gone for forever. And there's no way to recreate that once it's gone. Because once, once it's only Goliath in this world, uh, they will make sure that there's never a place for a David to, to survive. And they'll do everything in anything, in their power, um, to, to make it so.Dr. Handler:
And ultimately who is going to suffer from that is the patient, you know, it's going to be the care for the patient, you know? And so, yeah, it's the hospital systems. It's insurance companies. Sure. Obviously there's a lot of people with, uh, probably, uh, uh, making a concerted effort to not want independent practices to survive.Dr. Kandula:
Yeah, absolutely.Dr. Handler:
Waves and that sort of thing. And so, um, yeah, right.Dr. Kandula:
But the end of the day, I mean, it's at the end of the day when you kinda, this is where it gets kind of weird too, is you break it all down and what's happening in healthcare. It's a doctor taking care of a patient. And that's a, that's a David and a David situation. That's a, it's a human to human interaction. Um, that's is raw and special as you can possibly get it to be. And that's the thing, that's, that's what's precious and that that's what needs to be preserved. And, um, we're about all about preserving that. We're all about doing that. And so whatever happens with the healthcare system that we exist in, I mean it's obviously evolving. It's changing, but that can never, that's always going to be a part of it. That's always going to be the core of it. And, um, that, that's I think why we are, that's why it is so important for us to do what we continue to do is that that deserves to be fought for. It deserves that sanctity of that situation is something that, um, that, that that's how you, if you're going to build, if you let me go this way, if you're going to break everything down and build up, build it up again, you would, you have to have that as a starting point and then you build up from there. So, and that's fine. But what you wouldn't do is build some massive conglomerated, you know, system and then try to figure out a way to get that down and uh, get on the front lines of three people. Cause you're never gonna but by the time you're there, you'll never get there, I guess is what I would say. And so what we are and what we have been and what we're trying to be is the one thing that makes sense in this world, which is take care of somebody, do it in the best manner that you know how possible, and then figure out a way to build a system around that, that allows you to continue to do that in the best manner possible. Like, yeah, that sounds okay to me. Like that's how I would want it done, and that's what we're trying to do. So, you know, we'll kind of keep, keep fighting the fight, but, uh, it's worth fighting for.

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First published by ADVENT on
March 18, 2020
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Rooting for the Underdog