2207: Living with ADHD • You can have struggles and still have success with Dr. Kalaki Clarke
We’re kicking off a series on the show we’re calling “Living with ADHD,” a set of episodes in which we talk to people about their journey ー careers, challenges, surprises, and terrific a-ha moments — and try to learn a bit about our own experiences as we look to the experiences of others. Today on the show, a valued community member shares her own story, waking up to ADHD and becoming an advocate from her position in her medical clinic.
Dr. Kalaki Clarke joins us to talk about her journey with ADHD to becoming a physician, her work as an advocate for ADHDers everywhere, and her side gig as an award-winning in-car singer!
Links & Notes
- Watch “Here to Say” — 2018 winner of the ADHD Viewers Choice Award promoting ADHD Awareness
- Life After Plans
- Follow @this_md_kalaki on Instagram
Episode Transcript
Brought to you by The ADHD Podcast Community on Patreon
Pete Wright: Hello, everybody and welcome to Taking Control, the ADHD podcast on True Story FM. I'm Pete Wright, and I'm here with Nikki Kinzer. Well, hello, Nikki Kinzer. How in the hay? Who are you? You good? You feeling strong? No, yeah, how in the hay, who are you? I may have just made it up, you're welcome. Just that's the new thing, feel free to use it. I am very excited about our conversation today and I think we need just a little bit of setup because we're entering a bit of a brief series and we're talking about just sort of living with ADHD, is that what we're calling it?
Nikki Kinzer: Living with ADHD, highlighting some stories from our listeners who are inspirational and I'm hoping will provide some motivation and hope to our other listeners on different ways that they have worked with their ADHD. And just some, I hate to say success stories because as soon as you say success stories, people think, "Oh, I don't have anything. I'm not successful. I don't have a success story." And one of the things that we are naming this show, you can have struggles and still have success. And that came from our guest, that's how brilliant she is.
Pete Wright: I think it's really important, back to your point that this is not a show about success stories and I really hope people can shake that language because success comes in all shapes and colors and you should not think that just because you don't have what looks like success to somebody else that you are not experiencing success yourself in your own way with your own systems and your own little steps forward every single day. So I'm excited about these next couple of episodes and we're starting with one that I think is just a fantastic I think example of exactly what we're talking about. Before we head into that and introduce our wonderful guests, head over to takecontroladhd.com to get to know us a little bit better. You can listen to the show right there on the website or subscribe to our mailing list and we will send you an email each time a new episode is released. Connect with us on Twitter or Facebook at Take Control ADHD, and if this show has ever touched you or helped you make a change in your life for the better, we invite you to check out our Patreon, patreon.com/theadhdpodcast. Your direct support of this podcast helps us to do what we do every single week, week after week, month after month, year after year. Season 22. We're on right now, season 20, it's bananas, 22. Bananas that we've been doing this this long, I know. But it is thanks to the direct support of everybody listening that we continue to do this. So if it's ever touched you, if you've changed your life from anything related to what we've done, any of the nonsense that I've spouted, all the brilliance that Nikki brings, we sure would appreciate it if you check out patrion.com/theadhdpodcast, learn about our tears, our goals, what we're working toward and let us know let us know what's up. Thank you everybody for your support. Nikki, do we have any news?
Nikki Kinzer: Oh boy, I didn't write it in my show notes so of course I'm like, ha.
Pete Wright: But do you have news?
Nikki Kinzer: I do have news, yeah. So we're still doing Study Hall. It's just the same news as it was last week. We're still doing Study Hall every Thursday afternoon so come join us and it's magical.
Pete Wright: It's magical. It's straight up magical.
Nikki Kinzer: Right. You have to give us a testimonial on that.
Pete Wright: Oh, huge plug. I don't do Study Hall that often because I thought, well, the stuff I have to do, usually when I'm just checking off tasks is audio related and I thought, well, if I'm there, is it going to mess up? If I'm sitting in Zoom doing stuff? It doesn't at all. And in fact, people were watching me record voiceovers, bumpers, thinkers, ads for my podcasts all day long the last time I was in Study Hall, last Thursday, it was great, magical. I got so much done, crazy. I really surprised people, they heard from me so much with all my stuff that I was getting done.
Nikki Kinzer: It was great. It is. It is magical.
Pete Wright: That was great. Although I think we need to work in more dance breaks.
Nikki Kinzer: You think?
Pete Wright: I think we need to work it, yeah. We need more, that would make Study Hall better, more dance breaks.
Nikki Kinzer: All right. I'll keep that in mind that.
Pete Wright: You can run with that.
Nikki Kinzer: Yeah, absolutely.
Pete Wright: All right.
Nikki Kinzer: And then the last real quick, and you can look at this on my website is the GPS planning pro workshop is going to be starting again. March 1st is going to be the first day. The enrollment closes the week before March 1st, whatever that day is, so you'll have to look at your calendar because I do not have it in front of me, but if you can't do these six weeks, I'm going to be offering you again and again. So as long as people want this, I'm going to be offering it so.
Pete Wright: Keep it coming. All right. Let's talk about living with ADHD. (singing) Our guests today. I worked and worked on trying to figure out how I want to introduce our guest today and I feel like I've finally come around to keep it short. Our guest is Dr. Kalaki Clarke. Kalaki has been a part of our ADHD community for some time and she is a board certified family physician who has just a fantastic story and a fantastic, I think, mood and approach and tone to her life with ADHD. Kalaki Clarke, welcome to the ADHD podcast. Thank you so much for being here.
Kalaki Clarke: Thank you for having me here. It's a pleasure, it's a pleasure. And you guys are a success. You guys are examples of successes podcast and success. I look back and you've been doing this since 2010, is that correct?
Pete Wright: Yeah.
Nikki Kinzer: Yeah, crazy.
Kalaki Clarke: That's a long time, that's a long time. So you guys are a definition of success however you want to call it.
Nikki Kinzer: Oh, thank you. Thank you for having that.
Pete Wright: Very kind.
Nikki Kinzer: That's very kind.
Pete Wright: Thank you so much.
Nikki Kinzer: Well, so I think a great place for us to start would be about this video where you actually were the 2018 winner of the Viewer's Choice Award promoting ADHD awareness and Pete, can we put this in the podcast so that people can hear it?
Pete Wright: Yeah we can do that.
Nikki Kinzer: Okay, because I think it's about two minutes long and it's awesome.
Kalaki Clarke: (singing)
Nikki Kinzer: You wrote it? Oh my gosh.
Kalaki Clarke: I did write it.
Nikki Kinzer: How long did it take you to write it?
Kalaki Clarke: It was a process. Probably over about two weeks, but not straight two weeks, of course. I had the idea and then last minute, put it all together.
Pete Wright: Has Stevie wonder heard it?
Kalaki Clarke: I don't know. I don't know. It's based off his song, I Just Called To Say I Love You, is that what it's called?
Pete Wright: Yeah.
Kalaki Clarke: Anyway, I chose him because he does have ADHD, I don't know if you were aware of that.
Nikki Kinzer: I did not do. Yeah.
Kalaki Clarke: So that was part of my inspiration and I made sure that I pointed on defining what it is talking about the struggles, but also talking about the success within it in terms of me being a physician and basically the plea or the cry is just bear with us. Bear with us, not excuses and explanations. So bear with us.
Pete Wright: So it's really, it's fun and funny and you got pipes so that makes it great. And it's quite a flex that you're doing it from your car.
Kalaki Clarke: From my car, I was still in the parking lot of a gas station.
Pete Wright: I don't know if there's anything... That just screams ADHD is the best of all ways.
Kalaki Clarke: And submit it two minutes before it was due. I mean, there's no other way to do it.
Nikki Kinzer: That's right.
Pete Wright: Yeah, no. That's it. That's the way we live.
Nikki Kinzer: Oh, that's fantastic.
Pete Wright: That is amazing.
Nikki Kinzer: You also did another video that we'll put in our show notes as well for people to take a look at, not so much the emphasis of ADHD, but a little bit more about you so they can learn a little bit more about who you are. So let's talk about ADHD. When were you diagnosed?
Kalaki Clarke: So I was diagnosed 2015. So about six years ago, I was actually 35 years old at the time. It was during my first year of residency in Family Medicine training. The way it came about was that I did a rotation in child and adolescent psychiatry and I was shadowing the psychiatrist I was with and I saw a recurrent thing on the children that had ADHD and that recurring thing was they were very smart, but they took a long time to do things. They were kind of disorganized, not so neat, messy. They were like I said, take a long time to do things. They were all over the place, so to speak there. Their family couldn't understand them, but they loved them. And I was like, "This is exactly how I am right now, really interesting." And my story is complex when it [inaudible 00:11:04] to my medical journey, but I will say I was in medical school in 2002 where we learned that ADHD is the hyperactive little boy who can't stay still, who is bad, so to speak. Or let's just say bad, just restless and hyperactive. Didn't give us any hint about the inattentive side that we were as of today. So when I had this epiphany, so to speak, about this could be me, it didn't fit the picture that I had been used to learning about in regards to what ADHD looks like. But then when I looked up the criteria, it was just reading my life was me, it was me, it was me, it was me, to the team. Yeah. And so then I again... Sorry, go ahead.
Pete Wright: No, no, no, I'm sorry. I interrupted you, finish your thought.
Kalaki Clarke: No. So then I again sought confirmation, so to speak, and I looked out to reach out to a psychologist who helped to confirm it by the testing questionnaires, getting my background and doing what's called a TOVA, which is the test of variables of attention, I believe, where it's an objective, kind of, you do not have to have this test done to have the diagnosis. However, it was interesting when I was doing that test. I was like I'm just being me. I'm doing the best I can. And when I was done in attempts of ADHD, likely. Very, very, very likely, but it wasn't like, wow. It's a thing. This is real.
Pete Wright: What does that look like? The doctor gives you the results and you're obviously somebody clearly who appreciates the value of data in terms of... I feel like it's written on the 10 if you're going to be a physician, and what sorts of holes? Can you describe the kinds of holes that understanding this about yourself fills in about how you got to that point? How does that reframe your academic experience leading up to that diagnosis?
Kalaki Clarke: Well, at the time that I received the diagnosis, it made everything make sense in terms of my behavior, things I was doing in terms of my performance and my residency training. So for example, at the time, I was taking a very long time to complete my documentation for my clinical notes. It took me a long time to be prepared, to present the patients to my attending physicians, I was late all the time, I was having difficulty with focus so I wouldn't be able to do my work when everybody was gone. So it made things make sense in terms of my life. And it also made me look back into my childhood to see how it was overlooked or not caught. So for example, with me being in attempts of in nature, it wasn't a matter of my ancillary capacity, it was just my execution. So for example, I studied a lot. My goal was to be a physician since I was five years old. So as you know, dopamine is often [inaudible 00:14:12] with ADHD brains and so my focus in the dopamine so to speak was being a doctor. Being a doctor, being a doctor, be a doctor. Had the intellect so I was able to accomplish that goal. But then when the structure was uplifted, meaning after I finished medical school and started residence training the first time which is another separate story, I was kind of unroofed. But when it was first unroofed, I didn't know it was ADHD until let's say 10 years later when all the pieces of the puzzle came together and I was like, "Wow, this is it. This is why I'm being told I'll be late to my own funeral." This is why I look into other people's cars and I'm like, "Why is it so neat?"
Nikki Kinzer: Now you know. I mean, it makes sense. And you were actually from the video that we're going to put in the show notes, you talk about your depression. Were you actually diagnosed with depression first then before ADHD?
Kalaki Clarke: Absolutely.
Nikki Kinzer: Okay.
Kalaki Clarke: Absolutely. I was diagnosed first and I think a couple of reasons, partly that the knowledge of ADHD and what we know now in [inaudible 00:15:24] criteria was not really normal back then. I mean, when I was diagnosed, it started when I first had depression as diagnosis, that was 2005, right after I finished medical school and then my depressed mood is what led me to take a break in my training and it was attributed to me not being able to function in the hospital setting, I was not able to handle all the tasks that are thrown at me. I would just lose things, I would just not be organized, and that made me depressed. So it goes to show that that diagnosis of ADHD can be missed or masked by depression because number one, depression is there. And also number two, depression can be worse than the ADHD. So if the depression is not managed, the ADHD is going to be even more heightened and more severe in regards to symptoms. It's pretty much what it was. And the way I can tell that my situation I was diagnosed in 2015 was I was different 2005 is that I wasn't depressed. I'm able to distinguish my depression from ADHD symptoms. When I'm depressed, I don't want to do anything, my mood is down, [inaudible 00:16:36] bleak, there's no hope. Whereas the ADHD was, "Goodness gracious, why am I losing things all the time? And why didn't I remember something I was just told? And why is it taking me forever to do things?" But I was not depressed it's frustration, but it wasn't depression. That's how I was able to distinguish it. And I mean, basically about a fifth to a half of people who have ADHD also have co-current or comorbid condition major depressive disorder. So it's not a surprise that the two can go hand in hand.
Nikki Kinzer: Yeah, absolutely.
Pete Wright: I'm so curious, one of the things that we've been talking about over the last several weeks is this idea of change and how ADHD is not the thing that changes, it's the world around it that changes if you're going to be successful with ADHD and I'm so curious, your experience post diagnosis, right. Once the veil is kind of lifted and now you understand, "Okay, I have words to describe my experience," how does that change your experience in the hospital? Because the hospital is not changing their systems to support you, right? You're another cog in the machine, what do you do to adapt and find a way to be successful as a physician?
Kalaki Clarke: Right. That's a wonderful question. Well, I think, first of all, me recognizing where I thrive or I don't thrive. So specifically you mentioned the hospital. During my residency training, I'm required to be in the hospital setting doing what I'm doing? However, that is a training that has a finite, it has an inpoint. So I knew from the get go, the hospital setting is not for me. So I don't set myself up for failure and work in the hospital, which means my thriving comes from keeping patients out of the hospital as a primary care physician. So I'm a family physician, which means I'm all about prevention, about treating acute illnesses, treating and managing chronic ongoing illnesses. So I don't put myself in the hospital, that's one form of-
Pete Wright: Lesson number one.
Kalaki Clarke: Exactly.
Pete Wright: Get out of the hospital, as fast as possible.
Kalaki Clarke: Exactly. However, there are a lot of emergency physicians which have ADHD and I can imagine those are the hyperactive ones. That need that stimulation, need that [crosstalk 00:18:59]. They get bored and that's not my area. That's not my comfort. So if you meet one person with ADHD, you meet one person with ADHD. Everyone's not on all the same basket, so to speak. So as a physician, I realized the hospital is not my thing. And with that being the case, I do work in a clinical setting and then once I learned more about my situation, I learned to advocate for myself and request accommodations as appropriate, or is that allowed to do my job?
Pete Wright: What does that look like? What sorts of accomodations were you able to get as a physician?
Kalaki Clarke: You talk about two different areas of that accommodation, meaning in my training. So you can be, say, accommodations for test-taking like me being board certified, and then accommodations for the workplace. So when I got diagnosed, this is after me passing the previous testing in the past, and I passed all the steps you need to get to this point, but I didn't realize I could have probably done better if I would've had accommodations. I would've not gotten by by the hair of my chinny chin chin. And barely make it if I had accommodations, and keep in mind, accommodations are not a heads up, it's leveling the playing field. So you see someone in a wheelchair, you don't say, "Well, that's not fair, they get a ramp to go up there. I don't get a ramp." Well, you have legs. You don't need a ramp for your wheelchair because you don't have a wheelchair. So it's leveling the playing field. And so that means I got extra testing time for my board exam. It just meant that instead of one day taking the test, I took it in two days. They didn't change the questions, they didn't give me the easy version, it's just more time to allow me to get the answer and I did get the answer. I did very well and I got accommodations for the bard certification. In the work setting, it's more like, okay, there's a deadline to complete your documentation so I might have, instead of having to do half of the notes in five days, half of my notes need to be done in seven days, you know what I mean? Or I have to set up my stuff on administration time before I start work. So that means if I'm a little late, that's not affecting the time that I start with my patient because I'm thinking it's my own time, which could affect me other ways, but it's not directly affecting the big picture for everyone else.
Pete Wright: Well, that was my next question is how much of that creeps into your time, which leads to increased stress, anxiety, that sort of waterfall of issues that can drive straight back into depression and... What are the triggering activities for me, breaks my brain? I shouldn't be in a hospital either. That's what I've learned from this conversation, Kalaki is, I'm not made for that so dodged a bullet.
Nikki Kinzer: Now, is the clinic that you're working in now, have you worked at other clinics or other places before that? And how did the accomodation conversation come up in those places too? Or I'm just curious.
Kalaki Clarke: Yes. All right. So when I started working, after being board certified, I first worked in a setting where I was a locum. Locum is just a contracted type of work where you're not employed by the company, you just kind of come in and out when we want to. So my accommodation with that was like not working too much, was like not having an overwhelming schedule of my own so I can kind of work when I want to, and then they will allow me maybe to do my notes, having to do the following day versus the same day because without even expressing what my situation was, they could tell that it was taking me a long time to finish all my work. So then they want me to finish so they allow me the next day. And previous appointment before where I am right now, I did disclose that at the very beginning what the diagnosis is and what my situation was in order to get those accommodations which a little similar, just more extended time for me to finish my work. And I will say me finding the diagnosis or knowing what the situation was, it was a bittersweet thing, whereas it's like, "Oh, something's wrong with me?" But, "Oh, that's what's wrong with me," at the same time. So it was like you know something's not right, but at least now you know how to put a name on it and do something to help yourself out. Because in the big picture, if I'm able to identify it, then I'm able to request the assistance that I need in order for me to function and do the job. I will say the current location I'm working it was the best place for me. I mean, I literally, from the first day in the interview, disclosed my diagnosis. And because I was accepted, because my value and what I had to bring to the table kind of walked before me, then it was a matter of, "Oh, okay, I get what you're saying. It just takes a while to do things, but you'll eventually do it." Yeah, that's it.
Pete Wright: Would then everybody found it such a clear way to describe that experience, because what I'm hearing is people who are able to hear that from you and skip the judgment step, that seems at least from what we hear in the community, that's an anomalous experience.
Kalaki Clarke: Oh my God. Yes. Yeah.
Pete Wright: Yeah.
Kalaki Clarke: And that's why I'm very grateful and I'm very happy where I'm working as well because you get upset as in jump the beginning, then it's little selling. Not selling in terms of your work, but you're accepted as you are and they're working with you. Now we'll say, I believe in order to have that confidence to express that, I have to know, as I said, what my value is or what I have to bring to the table. So for example, if I was a horrible physician and I didn't have patients following me and I didn't have people referring patients to me all the time, or if I wasn't a great doctor, I wouldn't be able to freely or readily disclose that information, right? Because it explains...
Pete Wright: [crosstalk 00:25:36] Yeah, it's authority. You bring professional authority to the discussion.
Kalaki Clarke: Exactly. So it's kind of if I was a horrible doctor and I share all this stuff and they'll be like, "Well, that's why you're a bad doctor, look at you. You can't even [inaudible 00:25:49]. Well, duh." You get what I'm saying? So with that being said, anybody who thinks about disclosing, you have to fill it in yourself, you have to know when you're ready for it. And for me, it's more of a thing of it's so strong and so severe in my situation, it's going to come up, it's going to be [inaudible 00:26:09]. So it's just let me bring it to the table and let you know about it so that we can be on the same page and figure out how to work forward with it.
Nikki Kinzer: It takes the hiding out of it, right. I mean, it feels like if you don't have to hide it and you can just be yourself, there's a great deal of freedom there, I would think.
Kalaki Clarke: Oh yeah, a lot of freedom. And where I'm currently, this is before or just after rather I put the video out that I won the award. So when I did the video in 2018, to me, that was my coming out so to speak or for ADHD, because, I mean, that's the world wide web will have to vote for me to be [inaudible 00:26:46]. So I could have easily pop the YouTube video to my future employer like this is what it is.
Pete Wright: Yeah, right.
Nikki Kinzer: What made it important for you to do that video, I'm curious, because not everybody would have done that?
Kalaki Clarke: I'm still liberated. For some reason, I felt liberated. What do I have to lose? I like singing. I'm not the greatest singer, but I like singing. When I was younger, I always changed the words to songs of commercials and made it my own in different forms. So it was a challenge that I was up for and I did it and people voted. I had people vote for me and I got it. So I just-
Nikki Kinzer: It's so cool and the words are wonderful and it's a great description of ADHD. And the very end, when you look away like you're daydreaming, it's so cute.
Pete Wright: I'm curious how you, in a professional capacity, because that video, whether you intend to or not at that point, you become sort of an ADHD advocate, right?
Kalaki Clarke: Oh, absolutely.
Pete Wright: You take on the role of being an ADHD personality and you've posted a number of things that are super inspirational about your experience. How is that reflected for you at work when you're working with patients? Does your advocacy creep into your work as a physician, or do you just outsource that to a psychologist, psychiatrists in your network?
Kalaki Clarke: No. It all works together. I mean, I say I'm the patient and the clinician as well, because I treat patients with ADHD. I rule out or I identify, I diagnose ADHD or not with patients. Also, part of my training after residency, there's a fellowship that UC Irvine, UC Davis has that allows primary care physicians to get training in primary care psychiatry. So not only do I have the personal experience for having challenges with mental health, I also have clinical textbook formal way of helping and treating those situations as well. And to me, I feel like it makes me more effective because I'm not just reading about something that's hypothetical or something I can't relate to, I'm actually from experience understanding what it's like to be all over the place, or to be smart but scattered from a real life experience and I've actually been able to use my video for the song and also my video that kind of summarizes my life to help patients and make them have hope because I'm not talking from a hypothetical standpoint or not helping from a hypothetical standpoint.
Nikki Kinzer: Yeah.
Pete Wright: I'll never forget, we took my daughter when she was just a couple of years, she was a younger teenager and she was diagnosed with non-convulsive syncope and it's terrifying until they bring in a neurologist who is able to sit down across from her, look her in the eye and say, "I have the same condition, let me tell you how I deal with it." That means so much more than sitting down and saying, "I've studied what you have for a long time." So I have to imagine that goes miles to increase the affinity that you have with your patients, that's really beautiful.
Kalaki Clarke: Oh, yeah. I mean I'm human to them. My thought process is if 5% of the population as adults, more or less in US have ADHD, why would not doctors? Why wouldn't we be a part of a 5% within that as well, right?
Pete Wright: I don't know if you've heard but apparently doctors are superhuman God people, and they don't have any conditions ever at all.
Kalaki Clarke: So false. So so so false. I mean, there are patients that asked me if I say, "Oh, I wasn't here because I went to the doctor," "You go to the doctor?"
Pete Wright: You have a doctor?
Kalaki Clarke: I have a pulse too. So they make us super human but the sad reality is, I don't know if you're aware of this statistic though, but about 300 doctors kill themselves every year.
Pete Wright: Yeah, that's so sad.
Kalaki Clarke: So where's the highest profession actually to do that. The highest at the top. And that's another thing I like to raise, that stigma of mental illness because we're human, as I said, and as long as we keep it under the cover, as long as we act like it doesn't exist, then there's no help for it. And part of my coming out is to, I don't want to say normalize it, but make it like it's neuro-diversity we're trying to appreciate. So why not? And we have a lot to offer this world.
Pete Wright: Yeah, you do.
Kalaki Clarke: Well, I want to pick you guys' brains with some things I'll do myself.
Nikki Kinzer: All right. Yes.
Kalaki Clarke: Does any one of you guys have asthma or have any kids with asthma?
Nikki Kinzer: My husband has asthma.
Kalaki Clarke: Okay. Your husband has asthma.
Pete Wright: Are we playing symptom bingo? That's amazing. No, I do not have asthma. I have all kinds of lung stuff, but not asthma.
Kalaki Clarke: Oh, okay. So the reason why I brought up is because I like to make an analogy in regards to the brains organ, just any other organ, right? So, for example, what are these symptoms your husband has of asthma, Nikki?
Nikki Kinzer: What are what?
Kalaki Clarke: What are his symptoms?
Nikki Kinzer: Oh, he'll have a hard time, like you can tell, he's having a hard time breathing so it's just like he can't take a deep breath, so yeah.
Kalaki Clarke: Right. Any wheezing coughing, maybe [inaudible 00:32:37] swell.
Nikki Kinzer: Yeah.
Kalaki Clarke: Right. So let's think of it this way. So ADHD is a chronic neuro-biological neurodevelopmental disorder of the brain and is a brain based situation. So asthma is a chronic lung disease that involves two components. One is airway construction, and the other is inflammation. So I like to make an analogy with ADHD and the brain. So ADHD is a chronic neurological neuro-biological condition in which the brain's ability to self-regulate, which includes executive functioning and our ability to basically manage ourselves is impaired, right? So some symptoms of asthma, can you give me a couple of symptoms of asthma?
Nikki Kinzer: Oh boy. I can just see him kind of gasping like he's having a hard time breathing and can't take a deep breath and there's almost a little bit of panic looking for the inhaler. Yeah.
Kalaki Clarke: Right, right. So let's put it this way. The symptoms of ADHD, which is basically, like I said, impaired executive function are going to include inattention, the challenge with time management, being disorganized, restlessness, all the above. And we have to realize that the brain is what it takes behavior. So what you see when ADHD is not managed or it's not being managed correctly are the symptoms, so to speak of ADHD. So instead of the wheezing, we have the forgetfulness or that inability to organize self. So with asthma though, too, you have different severities. Mild, moderate and severe. ADHD goes the same way. Mild, might not be that bad, maybe medication is not necessary. They might be able to just exercise a lot or meditate mindfulness, eat right moderate. It might require medication or not, or it will just require coaching or therapy. Severe, definitely medication is going to be necessary to help things flow appropriately eating right, and all the above, all the modalities used to treat ADHD will need to be there. And so the treatment for asthma, inhalers, right? Inhalers that help to open up the bronchioles and the airways, reduce inflammation, as well as not smoking, doing exercise actually helps out with asthma and avoiding triggers. With ADHD, I can mention the therapy, coaching, medication, obviously, eating right, supplements, listening to Taking Control, the ADHD podcast is one of the light regimens that helped with me managing my symptoms. So the triggers of asthma. What do you know that triggers your husband in regards to those asthma symptoms?
Nikki Kinzer: Oh gosh. When we had the fires in September, that definitely, I mean, he couldn't be out there for very long because of all of the smoke and everything, so yeah. Smoke and well, that's the one that-
Kalaki Clarke: Cold? When it's cold, does it make it worse?
Nikki Kinzer: Yeah, yeah. Probably. We're home a lot right now because of COVID so I don't see a whole lot of it but it actually is...
Pete Wright: Man, that smoke though, that is such a great example of a trigger because with ADHD, the triggers are often everywhere. It's like that smoke that ever present just sort of is everywhere.
Nikki Kinzer: Was everywhere, yeah.
Kalaki Clarke: And so our triggers could be lack of sleep, poor nutrition, lack of rest like not getting a break, doing doing doing could be a trigger that makes it get worse. Unmanaged depression can be a trigger of making the ADHD worse, stressful environments, non-supportive work environments, that relationships can all be triggers for the ADHD. So if people are listening who have no idea about ADHD or think it's fake or a joke, number one, it's not fake and it's not a joke, it's very real and being educated about it not only for yourself as a person with ADHD and a person who doesn't need to be educated about it just helps you just be accepted in this world. Everybody can't be the same. As I said, we represent 5% to 6% of the population, which is why when people are ignorant of it, I don't blame them. I kind of get it because when you have ADHD and you read of ADHD things and you listen to podcasts, it seems that's your world. But the reality is we're a small part of the world so you can't expect everybody to get it if that makes any sense.
Nikki Kinzer: Yeah. Yeah. I have a question about how you said it can be mild, moderate, or severe, is that something that can kind of move depending on where you are in your life or how loud the ADHD is? Could you have sort of a mild case be going along okay and then somehow it feels more triggered and now it's more moderate or severe? I mean, can you move up and down in that ladder?
Pete Wright: Well, you just described Monday for me.
Kalaki Clarke: Yeah. Even within, they got moments for moments. Because let's say a mild version is let's say I'm able to actually sit down and do my work, I might get distracted by something on social media and I get back to it, I'm able to get back to focus, but severe is I haven't even started. I put it off all for days, I'm not even thinking about it, I'm just avoiding it because it seems overwhelming to me. So you can kind of have within the same person, within the same day or overall. So for example, someone may not have my challenges with time management, or other things in they are not as overall severe, you know what I mean? But for me, I mean, hey, when we started, you know what happens? I just told you about how I did the video submission, how that went.
Nikki Kinzer: But it worked.
Kalaki Clarke: It worked, but it worked because I had talent for the submission. So it was good and it worked because of that. I work because I'm a good doctor, so it works because of that. It worked that I was living a little late because you guys have me as a guest and you want me as a guest. And I'm not saying those things to take advantage of anything or to abuse it, but I know you have to have something to bring to the table. And everybody with ADHD has something to bring to the table. It does not have to be the same thing. Seriously. You could be the best mechanic, you can be the best architects, you know what I mean? You could be the best lawyer you could be whatever, you know what I mean? You only stopped yourself, you stopped you, that's the big message.
Pete Wright: That's a really powerful observation too, because I think that my hunch is the degree to which you are experiencing all of those comorbid conditions are really they represent the gap between your ADHD and finding out what you're best at, right? The people who are struggling the most just may not have found that answer and if there is anything in that message, that hope, it's out there. It's out there, keep looking. Keep trying new things. Use the ADHD. If there's anything you're good at, it's moving from thing to thing, so use that and try new things because you'll land on it.
Kalaki Clarke: You'll find it, you'll find it.
Pete Wright: Yeah.
Kalaki Clarke: And you have to do what resonates with you, it can't be what someone else wants for you because they're not you. They don't know what you like, what's your dopamine. Me with patients and my patient care is my dopamine.
Nikki Kinzer: Mm-hmm (affirmative). Question for you, when we did the pre, you and I got together last week to talk about what we were going to talk about today, and you came up with this title, and it wasn't even meant to be a title, but you said it. You said, "I want people to know that they can have struggles and still have success," and I think a great title. But where did that come from because you were very passionate about that when you said that and it sure resonated the heck out of me when you said it.
Kalaki Clarke: Well, it came from something that I created for a group I'm a part of. I'm an administrator for a private group called physicians for ADHD. There're about over 400 of us and we support each other. And it came from why should you disclose? And I disclosed for four reasons, my diagnosis. To educate ignorant, to obtain accommodations, to help myself to my job, to inspire others so they can know that they can have both struggles and success and that's where [inaudible 00:41:44]. And the last reason I disclosed is to celebrate my uniqueness and help others celebrate it. So that was kind of a can ready to say to you type of thing, because it was something that I already had preplanned in terms of why would I disclose? Because I was telling my group why they could possibly disclose. That's where that came from.
Nikki Kinzer: Yeah, love it.
Pete Wright: That's really lovely. And you hear that? She's not the only, the only physician with ADHD. There are a lot of them out there, that's amazing.
Kalaki Clarke: There's a lot of us and we support each other, we get it, and it's for real, we exist. We're here to help.
Nikki Kinzer: But you had told me a while ago what is the statistic of black women being doctors? Isn't it really low?
Kalaki Clarke: We represent 2%, 2% of all physicians are black female physicians.
Nikki Kinzer: We've got to increase that.
Kalaki Clarke: 5% overall black physicians and then 2% female, 3% male.
Nikki Kinzer: Wow.
Pete Wright: Wow.
Nikki Kinzer: That's not good enough.
Pete Wright: Well, that's disappointing.
Nikki Kinzer: Yeah.
Kalaki Clarke: It is.
Pete Wright: Also, congratulations, right? Given all of the things that stand in the way of you achieving your [inaudible 00:43:02].
Kalaki Clarke: Yeah.
Pete Wright: That's amazing.
Kalaki Clarke: It's a minority within a minority.
Pete Wright: Minority in a minority in a minority. That's exactly what you are. That is unbelievably beautiful.
Kalaki Clarke: And honestly, that's why I use myself when I try to encourage others that if can do it, what is your excuse? You don't have all that going on. You're not black, you don't have ADHD, what is your [crosstalk 00:43:22]. I'm just saying. I'm creative and that's nothing. I pride myself on I always know plan B through Z. I'm so used to plan B through Z. If something doesn't go right, I already know what the backup plan is because I'm so used to having stuff happen.
Pete Wright: Yeah, right.
Nikki Kinzer: Well, and the resilience and perseverance, because you didn't go into the detail of the night. it's so hard, all of it, right? Getting through school and dealing with the depression and figuring out where are the best places for you to work. And you're a mom and you're a wife and you play all of these roles that we didn't even touch upon. You persevere. You're a go getter, you get through it. And I know it's not easy and it can be really difficult, but I think you're also a really great example of not giving up and believing in yourself and all of the, like you said, creativity, all of those great qualities as well, I'm so glad you were here today. Thank you so much.
Kalaki Clarke: I'm so glad that you guys are here too. I mean, as I said, I've been listening for a while and I appreciate, first of all, you definitely have ADHD. I mean I don't need to tell you that.
Pete Wright: I love you so much. Thank you.
Kalaki Clarke: And this is a doctor telling you, I know you didn't know but I'm just going to tell. No, I relate to stuff I can't even tell you, I can't remember the exact words, but when I hear you and Nikki talk, I can just relate to a lot of your thought processes things. I would say, or think the same thing you say what I'm thinking. And just to state the obvious, because the fact that I'm a black individual, black female, and you guys are non-black, it just shows that ADHD does not discriminate. ADHD doesn't care what color you are. So how can I relate to Pete, a white man, in regards to his situation when I'm a black woman? Because ADHD is ADHD even though we can have individual backgrounds and situations, it's still the same situation that is a frustrating thing that does not go away, it is not based on bad parenting, it is not based on what? Not enough rest or... And those things can trigger it, but it's a real biological situation that needs more attention and we still have so much value. I respect Pete. He knew nothing about me really before this interview, but he's able to ask appropriate questions and get good stuff out of me because he's talented. That's his gift. This is his gift. And I'll get all excited.
Nikki Kinzer: Yeah. Oh, look, he's like, oh.
Pete Wright: Oh, I just that means so much. It means so much. It really is.
Kalaki Clarke: And we're real too. If I didn't mean it, I wouldn't say it.
Pete Wright: Yeah, yeah, it's beautiful. That's just beautiful. Thank you so much. You're just a straight up delightful individual. I am so grateful to have not only had you on the show with Nikki and I, but to just meet you and be in your orbit. That is really lovely what you do. Thank you so much for doing this. What do you want to plug? What do you want in the show notes? Obviously we've got the videos, the videos that you've done for sure.
Kalaki Clarke: Here's the thing, I'm not a physician that's here to sell my services or... I don't.
Pete Wright: Yeah, right?
Nikki Kinzer: Yeah. She doesn't have a book that's coming out.
Kalaki Clarke: I'm going to have a book. I'm going to have a book, don't ask me what it is because I'm full of pressure, but I will, because I have so many ideas, this is ridiculous. Okay, let's put it this way, if there are any physicians out there with ADHD and they would to be a part of this is with ADHD, they can email me at kalakiclarke@gmail.com or anyone who has questions, but that's specifically if then I can vet them out [inaudible 00:47:14] their physicians, [inaudible 00:47:15] they can join us and be supported. You follow me on Instagram, but it's not. I mean, I do have one post that says I have ADHD in bold letters, but it's not an ADHD Instagram page. That is this_md_kalaki is what it is and it has a video, not the ADHD video, but it has a video that is really transparent, talks about my struggle with depression. It's five minutes and stuff, summarize my story on there. But it talks about like me getting COVID vaccination and still being alive, that's a whole separate story, but it's just me.
Pete Wright: Yeah. Well, we'll put links in the show notes and we'll see if some physicians, ADHD physicians in the community definitely reach out to Dr. Clarke.
Kalaki Clarke: Well, last thing you guys can edit how you want. I want everyone with ADHD to know that even if someone is ignorant of your diagnosis, it does not negate your experience of ADHD and how you feel, okay? So just because no one's heard of it or think it's real, it does not mean it's not real. So get your help you need and realize that you are valuable and you are empathetic and you're successful and you got what it takes.
Nikki Kinzer: What a great way to end.
Pete Wright: I can't think of a better way to end, yeah, absolutely.
Nikki Kinzer: Yes, I love it. Thank you. Thank you so much.
Pete Wright: Thank you so much, everybody, for downloading and listening to this show, we deeply appreciate your time and attention. On behalf of Dr. Kalaki Clarke and Nikki Kinzer, I'm Pete Wright. We'll catch you next week right here on Taking Control, the ADHD podcast. (singing)
