Fast-Track Surgeon

• The relationship between Surgery and High Performance Driving
• “Details are important, but even moreso it is the decisions about what to do with those details that constitutes excellence”
• “You’re either on the brakes or modulating the throttle, not coasting. Coasting leads to an unstable platform”
• Smooth is Fast: “The most efficient path is the one with the least amount of “noise” – Smooth transitions facilitate precision and minimize wasted movement”
• “The ability to perform well under challenging conditions is not acquired accidentally, nor is it a natural “gift” but rather the result of years of dedicated study and perfection of technique. It takes 10k hours of deliberate practice to attain mastery”
• “‘Driving’ the camera requires a trained eye, experience, and steady hands that can also be quick.”
• What it’s like being a female surgeon as well as a woman in Motorsports
• What’s her biggest OOPS moment?
• Advice for folks starting out in HPDE … along with some fun questions and more!

and much, much more!

Crew Chief Brad: [00:00:00] Break fix podcast is all about capturing the living history of people from all over the auto sphere, from wrench turners and racers to artists, authors, designers, and everything in between. Our goal is to inspire a new generation of petrol heads that wonder. How did they get that job or become that person?

The road to success is paved by all of us because everyone has a story.

Some of you may know her as Dr. Laura Melman, a fellowship trained board certified and DaVinci robot specialist offering patients the latest in cutting edge surgical techniques. But we know her as, at Fast Track Surgeon, one of our heroes under the helmet.

Crew Chief Eric: If you’ve followed her online, you know she’s got a flair for bringing surgical lessons from the racetrack.

A series of musings on the intersection of safety, precision, and skill, explained as a crossover between the art of surgery and the science of high performance driving. And with us tonight to explain how that [00:01:00] all works is Dr. Melman.

Crew Chief Brad: And as always, I’m your host Brad. And I’m Eric. So let’s roll.

Crew Chief Eric: Welcome to the show.

Crew Chief Brad: Thanks for having me.

Crew Chief Eric: Great to be here. So, Dr. Melman, before we jump right into motor sports, it’s important for people to understand what you do as a doctor and how it relates to motor sports. So let’s spend a moment describing your specialty.

Dr. Lora Melman: Yeah, thanks. I think it’s really important to take a little bit of time here to describe the things that I do because what I do as a surgeon affects many people.

I treat obesity, I treat hernia disease, and I treat reflux disease. Chances are you know somebody that has one or all three of these things. So, being that these are very common, I want to dispel some myths about obesity in general, so let’s start off with that. Obesity is a disease, and it’s actually the disease of the body’s inability to regulate the body weight.

So, basically what we have is everybody’s body weight is set up at a certain set point. Just like your body temperature remains at a [00:02:00] relatively stable set point, that’s your normal body temperature. That’s a parameter that’s regulated by your body. Your body weight is also regulated by your body as well, by various factors that are so numerous and complex that we don’t have a simple way of understanding.

The people that suffer from obesity have an inability to maintain a normal body weight. So they’re actually stuck at the weight that they’re at because of this disease. And there’s a lot of stigma attached to obesity and shaming and blaming. And I think we really need to start to move beyond that and see this as the disease that it really is.

We don’t blame people for having hypertension or diabetes or cancer or anything like that. So we really need to start seeing obesity as a treatable disease. Obesity happens to be a surgical disease, which means that there are surgical options to help people rein in that body weight regulation factor so that they can regulate a more normal body weight.

The surgeries that we offer are just [00:03:00] tools to help people be successful with their weight loss. There is no operation or any magic surgery or anything like that that just makes weight loss happen. Obesity is also a lifestyle modification disease similar to other diseases like vascular disease and hypertension and diabetes.

Eating right and exercising are important to be successful in treating those other diseases as well as obesity, but it’s not the only factors. And when we help patients by GI tract, It helps them to achieve their success with weight loss. So it’s important for people to understand that these operations are not cheating.

They’re not the easy way out. It’s not a crutch. It’s none of those things. They are treatment options. to help people be successful.

Crew Chief Eric: So Dr. Melman, we’ve come to find out that your Instagram handle is a bit of a play on words where fast track is actually related to the type of surgery you perform. So how about we unpack that a little bit?

Dr. Lora Melman: You know, actually, if you don’t [00:04:00] mind, I’d like to describe Reflux surgery and hernia surgery, because these are very important areas of surgery and they’re very common. I think there are also maybe some misconceptions about those, those with surgery. People come in with sort of preconceived notions.

There’s always the sort of, you know, don’t confuse your Google search with my medical degree. That’s kind of a meme between, you know, surgeons and doctors and such. But people often come in with sort of a preconceived notion of what they want or what they don’t want based on what they’ve read on Google, which is not always a good source of information.

So with that, reflux surgery. is a very effective way to help treat reflux disease. Reflux is very common. A lot of people have it and a lot of people are on acid blockers. But if you think about it, the stomach is supposed to have hydrochloric acid in there. It’s part of your immune system. You think about if you eat like a piece of dirt or something like that, it gets into your system and it gets sterilized in this bath of acid in the stomach and helps protect you against pathogens and such that are out there in the [00:05:00] environment.

If you’re on acid blocking medications, there’s potential that you could become sick by things that get into your system that aren’t adequately killed off by the stomach acid. So antacid medications aren’t always the answer and they’re not always the long term answer in terms of what’s best for patients.

Oftentimes reflux disease is a structural problem. So the anti reflux barrier or what keeps acid in the stomach where it belongs and out of the esophagus where it doesn’t belong is so called lower esophageal sphincter and the diaphragm. So the diaphragm has two pillars of muscles that are on the outside, sort of between where the stomach and the esophagus connect.

And when those are not lined up properly, you have a disruption of the antireflux barrier and you get acid reflux, which means acid is going up into the esophagus. It’s burning the esophagus, and you get the so called heartburn. It also causes cellular changes to happen over long periods of [00:06:00] time, where the lining of the esophagus, if overexposed to acid, can become cancerous.

So that’s the origin of esophageal cancer, is many, many years of exposure to acid, where it’s not supposed to be. So treating this disease. is a surgical correction in many cases. It’s not just a chemical correction with medications, but they need that sphincter restored to its natural anatomic position.

The gap in the diaphragm has become a little too large, allowing the sphincter to go up too high. And that’s called a parasophageal or a hiatal hernia. So to restore that anatomy and repair the hernia and ensure that the valve stays in its proper place is a surgical fix. And a lot of people don’t understand.

That aspect of treating reflux disease. So I think that’s very important to understand that. Similarly with hernias, hernias are very common. They can happen in various parts of the body through the belly button. In the groins, they can happen at the diaphragm. That’s the hidal hernia that we just talked about.

But in terms of fixing hernias, [00:07:00] people often think that, oh, it’s just a hernia. It’s just something simple, and sometimes it is. but sometimes it’s not. So we get a range of patients that come to our practice with very simple, straightforward, first time occurrence hernias. that can be fixed in a simple manner, but we also get people that have had multiple failed repairs.

So that goes back to the pre optimization and success with surgery, especially with hernia surgery. Optimizing that patient for their particular hernia surgery will prevent them, or hopefully prevent them to the least amount possible from having a recurrence or reoccurrence of the hernia in the future.

Anytime a hernia occurs or recurs again, it’s more complicated to fix. So we want to get the best chance at a best repair the first time around. Patients that have undergone different types of repairs with various materials that are mismatched with the abdominal wall or not enough overlap or different material, you know, could have been chosen that would have matched them better, that would have gotten them a better result.[00:08:00]

We see the results of these over time where hernias have occurred or reoccurred or perhaps the patient didn’t know that they needed to stop their nicotine use and they have failed the hernia repair and the hernia has come back again just from the matter of fact that they’re a smoker. Um, so these are all things that need to be made aware of and the patient needs to be aware of and they need to optimize, you know, on the preoperative side of things in order to help them get the best repair possible.

There’s a lot of, I would say, bad press out there now about hernia meshes. And this goes back to the crossover between technology and materials, just like cars have been developed over time and they’re safer now than they were 25 years ago because of all these safety devices and better technology that we have in current models.

hernia meshes have gone through a similar evolution. So modern hernia materials, the meshes that we have are much better than we had 15, 20 years ago. So sort of the older generation materials, some of have undergone [00:09:00] recalls and various problems because of various construction issues been pulled off the market.

Those are sort of pervasive in the general public’s sort of opinion of what mesh is or what mesh should be. So, it’s a little bit outdated, and that’s another sort of misconception about hernia surgery and how to best achieve a hernia repair. Oftentimes, it does require a mesh to be placed. The best success with hernia repair is choosing the correct material.

putting in, in the correct plane in the anatomy and then matching it with that area of the anatomy so that the physio mechanical properties of that area of the anatomy match with the device that, or the material that’s put in. So that is sort of the art and science of of hernia repair.

Crew Chief Eric: Now you have me thinking that if I ever needed surgery like that, that I would at least like my mesh to be made out of carbon fiber.

Dr. Lora Melman: Fast track surgery is actually a concept in modern medicine. It’s actually one of the latest innovations in surgical care. It started with [00:10:00] the colorectal realm. And what we found is that when we got people back to eating normally and up and walking around as soon as possible, back to all their baseline functions as soon as possible.

They actually recovered from surgery faster and there were less complications. This has now been translated to all areas of surgery. It is still pretty cutting edge in that not every surgeon group or practice does this routinely, but in order to best help our patients to get better after surgery and return to work with minimal downtime, less pain, less complications, and minimize all the things that nobody wants.

Basically, we’ve developed a specific protocol to help people get better after surgery. One of the terms for it is actually fast track surgery. The other term for it is enhanced recovery after surgery, or so called ERAS or ERAS. So the two are basically the same thing, but it revolves around sort of three phases of surgical care.

The first is the pre operative phase, and this is called pre optimization or [00:11:00] pre habilitation. Everyone’s heard of rehabilitation, that happens after the fact. This is pre habilitation, so it gets you ready for surgery. For the event, which is surgery, things that we do to prehabilitate patients, we help them get into an exercise routine, fitness routine to get themselves strong and ready for surgery, nutritionally optimize them.

That’s a large part of the bariatric surgery program. Stop smoking, smoking impairs the ability to heal after surgery. One cigarette will decrease the oxygen delivery to the tissues by about 40 percent by just one cigarette. So in helping people to attain and maintain nicotine cessation, we are therefore increasing their success with surgery and decreasing their risk of complications with wound healing failure.

Weight loss is also part of some surgeries prehabilitation. This is where the bariatric surgery program and the hernia surgery program sort of cross over, in that in patients that have hernias and certain complex hernias, it’s an imperative to [00:12:00] help them get their body weight down in order to then undergo a successful hernia surgery.

Obesity and overweight is one of the greatest risk factors for a hernia repair to fail. So that’s also part of the prehabilitation for the hernia surgery program. There are other things like controlling other diseases, like making sure that blood sugar and diabetics is relatively well controlled.

That’s another thing that impairs the body’s ability to heal after surgery and puts somebody at risk for infections after surgery. So all of these things in terms of getting people ready for surgery are very important. Then we have the day of the surgery, and that’s sort of thought of as the perioperative period.

So they come in for their surgery, they get prepped, they get ready for their surgery, they undergo the surgery, they’re under various types of anesthesia, medications are administered. So optimizing that part of the process is also very important, and optimizing the efficiency which that operation gets done is also very important in helping that patient recovery.

Minimizing time under anesthesia is also important in [00:13:00] helping somebody recover. from the surgery. So if you can do a very smooth, efficient operation, it’s going to be much better than unneeded time under anesthesia. Postoperatively, we get people up and walking right away. We start them on a normal diet or as close to normal diet as possible.

There are variations with that, of course, with bariatric surgery and changing the GI tract that require different changes to the diet postoperatively, but getting people back to their baseline function, normal activities, walking around. Going up and down stairs right away, the day of surgery is very important in helping people recover from the surgery.

I tell my patients all the time, recovery is a proactive process. It’s not a passive process. And in fact, if you are recovering from surgery and just laying around on the couch all day or just sleeping all day, you’re actually going to take a lot longer. To recover from that operation. Whereas if you get yourself ready for the operation, you choose a practice that does a very efficient, streamlined, um, operation for you.

And then you get up and walk [00:14:00] around right away, get yourself rehydrated orally, get yourself back on nutrition and everything that you’re used to right away. Your recovery will be shortened. Most patients in our practice take extra strength Tylenol, they do some ice packs, and that’s it. So the other benefit of fast track surgery is narcotic reduction.

And there’s been a recent epidemic of narcotic addiction and all the downsides that come with that, including early death. So reducing the number of people that are exposed to narcotics and therefore then can become addicted to narcotics is also very important in general, in terms of global health. For more information visit www.

FEMA. gov We’ve managed to decrease our narcotic use for patients to the point where they hardly get any narcotics in the hospital at all. And they really don’t take any narcotics to recover after surgery. There are also bad side effects of narcotics, including constipation and rashes, vomiting, and that sort of thing.

Not something you want to be dealing with right after you’ve had an abdominal surgery. So these are all [00:15:00] benefits of fast track surgery. And we’ve managed to incorporate that into all the surgeries that we do. for weight loss surgery, for reflux surgery, and for hernia surgery.

Crew Chief Eric: You keep mentioning pre operative, and I wonder if that translates to, let’s call it pre track day or pre weekend.

Is there some sort of steps that you go through to get ready for a track weekend?

Dr. Lora Melman: That’s a really good question. Yeah. And in matter of fact, I have my little maps and my notes that I’ve made from prior track days at the same time. You know, location. So I review that. I make sure that the car obviously is ready and the tires and the brake pads are okay.

And the brake fluid is currently flushed and, um, you know, ready for a track day. And then I go through my mental visualization. If you, if you call it that of, you know, what do I remember from the last time I was there? And what was I thinking about at each part of the track? Like I’m thinking I’m doing this here and then I’m going to do that there.

And then I set my goals. What am I going to try to do this time? Am I going to try to [00:16:00] carry more, you know, mid corner speed here? Am I going to try to, you know, break harder and then accelerate harder here? You know, so what am I trying to, Achieve that’s kind of where my thoughts for the series come out of in terms of, you know, things like the little things that I learned, you know, at the track days, but I do go through a process of sort of getting sort of like the physical ready, like the car and myself and packing my hydration and packing my snacks and sort of prioritizing, you know, what I’m wearing that day and making sure I have everything appropriately handled before I even leave the house to go to the racetrack.

Crew Chief Eric: But I do want to lead us down more into your path and into your background of motorsports. I think this was really good, super informative. But let’s talk a little bit more about how you got started in motorsports.

Dr. Lora Melman: Okay. So I got into motorsports basically through autocross. And this goes back to when I was in my surgical residency, where I trained at Wash U in St.

Louis. Typically, the residents will do one or two clinical years. And then you go into the lab and you [00:17:00] do some research here, it’s like two or three years of publishing papers and doing, you know, lots of important research work. And during the quote unquote lab years residents typically have a little more time to do some things.

So I was at lunch, right, so surgical residents never eat lunch, for one thing. So as a lab resident, we were out to lunch, I was out to lunch with one of my co lab residents. He had a book on autocross, and I said, what’s autocross? So that’s how I got started. We went out. I had a 1997 Nissan Sentra at the time that I took to the autocross and we just had a blast.

My husband was there and this is, you know, a car like weighed a ton and it had like 110 horsepower or whatever it had. And I was like flat out going 40 miles an hour trying to navigate these turns. I had no idea what I was doing and we just had the best time. And so did a little bit more and that car actually broke down in the middle of the street on my way to one of my rotations where I had to be there at like 530 in the morning.

And here I am without a car. And so I just kind of let it roll back into a [00:18:00] parking lot that was near my house, ran home, woke up my husband, I said, honey, you got, you got to take me to work. I have to get to work. My car just broke down. So I need a new car. My husband at the time had a Mini Cooper S Clubman, thick shift, manual, right?

So he said, okay, well, you know, why don’t we think about getting you a Mini? And he convinced me to get a standard transmission car. That was my first manual car. And I remember going out just a few, you know, lessons in the parking lot, okay, here’s the clutch and here’s the, you know, how you shift. And I thought, okay, I’m, I’m good.

I think I can figure this out. I tried to drive my new Mini Cooper S hardtop. Home from the dealership. And I got onto this hill that I’d driven up in my other Nissan Sentra millions of times. It’s about maybe 20 degree incline. It’s, it’s, it’s a little bit of a hill and I got stuck. I did not have the skillset to overcome this hill.

To be honest with you, the first several months that I had that car. I was terrified. Every time I got in the car, I’d stall out in the middle of the intersection at stoplights. It just was [00:19:00] horrible. And every time I drove that car to work, it was like a cardiac stress test. By the time I got to work, I was, I was so stressed just by driving the car that I thought I got to do something.

I have to, I have to get better. I have to learn. Some way of just being a better driver in general. And it wasn’t until I finished residency and got into fellowship that I found a book called Fast Girl. And I was looking up ways to help my, you know, residents that I was teaching as a fellow get better, faster, smoother, more efficient with laparoscopically.

And I came across this book by Ingrid Stephenson, and she had a red and white mini Cooper and learned to drive high performance driving on the racetrack. And it’s, it’s a fascinating book. I recommend it to everyone, but it really kind of details her journey through going into and participating and being part of HPDE and the things that she learned and sort of the lessons she took away from the racetrack.

And I thought, okay, well, I have a car that just looks [00:20:00] exactly like that. I think I’m going to try this. And so we bought helmets and we went out to Hallett. Racing circuit in Oklahoma. I was doing my fellowship in Kansas city, Missouri, and we just had the best time ever shared the car, you know, alternated different sessions, et cetera.

And we thought, okay, this is it. This is our new thing. Um, and so, as you know, I drove that car on the racetrack for, for many years. That was the car that I came up in. And so that was sort of my foray into motor sports. And that’s how I got started.

Crew Chief Eric: So it’s funny you mentioned autocross it’s touted as one of the more precise disciplines, but also one of the most Because you only have three or four attempts to get it right, much like surgery, right?

Well, you really got only one attempt to get it right. You can see the draw there. It makes a lot of sense, especially when you dive into the technical side of autocross. I mean, doing laps at the track. You blow a lap, you got another lap to figure it out, right? You’re really running against time at that point.

So, okay. [00:21:00] So we kind of understand what got you, what drew you into it. We heard some of the challenges, especially starting out with your first manual transmission car, but have you run up against any other challenges coming up through motorsport, even maybe with the education system? I mean, did it, did it work for you?

Dr. Lora Melman: Um, it worked pretty well for me. I found that, you know, for the most part, everyone was there to learn and to improve and to get better. So I liked that aspect of it. That was very refreshing, you know, honestly, you know, as a surgeon, I have so much information, you know, coming at me all the time. That the stress or whatever you want to call it, it being on track was actually pretty relaxing.

I’m used to a lot of information, a lot of input and, you know, sort of sorting out and prioritizing bits of information, but that was just a completely different thing away from the OR away from anything. Medical surgical, you know, that I had to deal with. Um, and you can sort of get into this mindset or zone if you want to call it where that’s all you’re thinking about, that’s all you’re doing.

And [00:22:00] so that was sort of my release.

Crew Chief Eric: So do you find yourself as a doctor, maybe overanalyzing the track a little bit? Does it seem to get in your way and take away from where sometimes it’s not an exact science, or do you kind of give and take, and it’s a bit of compromise When you put your helmet on, you’re just having fun, and you let it all let loose, as you kind of alluded to.

Dr. Lora Melman: I think it’s a little bit of both. You know, sometimes I get too much into, you know, did I do that turn as best as I could, or, you know, should I have had a little bit more steering angle, or should I have carried more speed, or should I have You know, done a harder breaking on this point, or, I mean, you, you can get sort of crazy with overanalyzing, you know, your laps or your session, but then you have to kind of remember, what are you there for?

Are you really there to make yourself nuts? Are you there to have a good time? But then are you also there just to have a good time and not learn anything? It’s not that either. Um, so I think there’s sort of a good mix and I try not to get too over analytical or, you know, too down on myself and [00:23:00] try to remember to have a good time.

But you know, this, I think there’s sort of a mix of both.

Crew Chief Eric: So do you rely on data to help either confirm what you know about the lap or to maybe calm your nerves a little bit? Cause I find running data, I try not to over focus on it when I’m driving, but it’s like, Oh, that felt like a good lap. And you look over and you’re like.

Yeah, it was a good lap and you keep going or you download and you look at it afterwards. I mean, telemetry is really important because saying to yourself, did I, did I mess up that corner? Could I have done that corner better without any sort of data there to back it up? How do you make that decision?

Dr. Lora Melman: That’s a really good question. I actually have not worked with data. I have not worked with telemetry on the racetrack. So everything that I’ve learned, which is sort of like how I remember that felt. So I would like to work with data that would, that would really help me, I think maybe have somebody. that knows more than me in that area to help me look at the data.

Surgery is a very data driven field. And medicine is as well. And we always look at the data, you know, what does the data show about doing this, this way, or, you know, [00:24:00] why should we do it this way versus that way, or what mesh should we use in this hernia and why, you know, what, what is the, what is the support, what is the data for that?

So I feel like that is something that I would like to get into, and I think I would learn a lot from it.

Crew Chief Eric: Let’s talk about how fast track surgery is linked to motorsport and how you came up with the surgical lessons from the racetrack series, what inspired you? And why?

Dr. Lora Melman: Well, I’ve been doing high performance driving for five, going on six years now.

And every time I would go out and do a track day, I’d be out there, you know, doing the session and afterwards I would kind of reflect on, you know, what happened? What did I do? What could I do better? You know, what were the conditions on this lap that, you know, made me feel good or, or not so good and how could I improve?

And I started to see that there were so many overlaps between what I do and what As a hobby and what I do as a profession. And when I started back in the OR and doing cases, I thought, you know, this is sort of like, you know, seeing the line in the, on the [00:25:00] racetrack or seeing the wet line or seeing the dry line.

And this is kind of related to how we’re doing this surgery. And so there are similar things that came up in both disciplines that were so similar that I had to write about it. And so I started to, you know, capture images in the OR and on the racetrack Start to come up with little summary statements and try to match all of those images up with the thoughts that I have.

And that’s how the series was formed.

Crew Chief Eric: So I picked up on a couple of things during your description of, of your practice and, and getting to this point in the conversation. There was a couple of key words that I picked up on smooth recovery, efficient, deliberate hydration, nutrition. These are all things that we use repetitively in the motor sport world and are different.

Circumstances in a different context, those words are right there. They’re prevalent. They’re right up front. And I think we’re going to unpack some of that and we’ve chosen some of, let’s call it the top SLFTR quotes from your Instagram, as we went back through, cause this goes over several seasons [00:26:00] and let’s unpack why some of these are your favorites as well as some of the ones that we chose.

So one of the ones first up is The details are important, but even more so, it is the decisions about what you do with those details that constitutes excellence.

Dr. Lora Melman: Yeah. So I think of this as the difference between being a trivia genius versus being an expert in something. Details are everywhere, right?

Information is everywhere and you can get. You know, overloaded with information. So in order to help yourself in whatever discipline that you are trying to do or learning to do, you have to filter that information and with each piece, figure out what is the priority? Is this important? Is it not important?

Am I going to use it to help myself get better at something? So as you go along and as you get better at things, you start to pick up on little details, and then you start to chunk those details together in larger pieces. sleeve surgery, for example. It’s one of the most common surgeries that [00:27:00] we do. There are a bunch of details going on.

There’s a bunch of things going on in the room, but with each load of the stapler that you’re loading and firing, I personally pay attention to exactly how the tissue is responding to the stapler, to the load, to the dissection, and to how I’m retracting on the tissue. In order to get the best result possible.

So bunch of little details that have gone into that result, just like a bunch of little details. If you’re on a circuit, certain circuit or certain track that day, you have to kind of know what you’re doing and where you’re going, but then also you’re taking in a bunch of new details and a bunch of new markers or reference points on the racetrack or things that you’re learning on that day or on that specific session that you’re using to help.

yourself get better.

Crew Chief Eric: So another one from the list, quote, you’re either on the brakes or modulating the throttle, not coasting, coasting leads to an unstable platform

Crew Chief Brad: because they, before she jumps in, [00:28:00] I believe this is also part of the Sir Jackie Stewart quote as well. It’s either you’re on the brakes or the throttle.

There’s no in between.

Dr. Lora Melman: Right. I thought this one was kind of interesting because I was always taught, and you probably, uh, hopefully agree with this, that you’re never just lifting totally off the power, because actually, physically, that’s pretty unstable in terms of your goal as somebody driving on the racetrack is to keep the platform of the car as stable as possible with your inputs.

So if you’re just, It’s totally not underpowered, not under braking, just kind of floating there. If you think about the physical forces at play there, so, you know, you don’t have to be flat out all the time. Obviously you can’t do that. You don’t have to be under, you know, threshold braking all the time either, but just a little bit of in between.

And that’s where that sort of gray area, and that’s where the fun is right of driving. But also with regards to building a practice and being, you know, an expert in certain areas, especially in surgery. Surgery is a very, very competitive field in general, especially in this [00:29:00] area of the country. If you’re not getting better and showing that you’re better and your patients aren’t happy with their results and, you know, talking to their friends about it, somebody else will take over and take your business.

So it’s worth it to us to really look at how we’re doing every piece of every surgery every day and how we can continually get better. So I liken that to be sort of just on the sort of like maintenance throttle all the time. And sometimes you’ve got to speed up and really kind of push ahead and push through.

And sometimes you have to, You know, really slow down and take a look at things and what you’re doing, or just take a break altogether. But there is that sort of range of power versus breaking that you have to do in everyday life. And if you just start to just coast, completely take your foot off the power, then forces outside of yourself are going to start to take over.

Crew Chief Eric: So one of my favorite words in motorsport is the word smooth. And. There’s different schools of thought when it comes to smooth, but we’re going to go with your quote [00:30:00] and smooth is fast. The most efficient path is the one with the least amount of noise. Smooth transitions facilitate precision and minimize wasted movement.

Dr. Lora Melman: Right. So this is my favorite movie line of all time. It’s from the movie shooter. I don’t know if you saw that movie. The main character is trying to teach someone, I believe in the scene how to load a gun and how to do so smoothly and efficiently. And he says, Slow is smooth. Smooth is fast. You can’t just be fast, right?

So nobody is just fast out of the box. It’s a process by which you build that speed. And how do you build speed? You take away the excess noise. Nobody can be fast going in multiple different directions at any one time. So you have to figure out what is the smoothest path to where you’re going and how do you take away all the excess noise?

Unnecessary movements. I call it noise. Um, so that you can attain that smoothest trajectory, but this translates to surgery as well. If you’re doing a [00:31:00] lot of perky jerky movements, you’re, you’re actually just wasting time and that’s keeping your patient under anesthesia for longer than they need to be.

And therefore they’re going to have a longer recovery after surgery. So it behooves you as a surgeon to be very smooth and deliberate and have no transitions that are not beneficial to the patient. This translates directly, you know, to the surgical world. All my teachers have told me, just, Practice it slow, because you can’t practice something fast and expect to be smooth.

If you practice something slow to begin with, it then becomes fast, and that actually goes back to the biologic basis of learning. I don’t know if you guys have read The Talent Code by Daniel Coyle. This is a fascinating book, and it actually goes through how expertise is created. It’s not just born into existence, it actually is facilitated along the way.

What happens when somebody learns a new task, a new technique, a new sport, plug in your word there, is that [00:32:00] there are pathways between the brain and the muscles that are becoming myelinated. So nerves have myelin, some nerves do, and nerves that control motor movements have various degrees of myelination.

As somebody is learning a new technique, Or a new skill, there’s a circuit that’s built in the brain and in the skeletal muscle. And as that person becomes better at that skill over time, those pathways in the brain and in the nerves of the muscles become better myelinated. That myelination process takes about six to eight weeks.

So you can’t just have that to begin with. You can’t just make that happen instantly. It has to build and you have to build it over time. Some might say that bad habits are hard to break. Well, bad habits or any habit is actually impossible to break. You just have to build a new habit. You can’t actually break a circuit that’s already built in your brain.

You have to just kind of pave over that with the new circuit. To that end, if you’re trying to learn something new, [00:33:00] actually the best, most efficient way to learn that is by going as slow as possible at first, then as those pathways become more myelinated. You will be able to do that task more efficiently and more smoothly because you’ve myelinated that connection.

Crew Chief Eric: So that’s a really interesting parallel and I want to stay on this topic for a moment. And the reason I brought up smooth is a bit of a trigger word, at least in motorsports, mostly for coaches, because I think there’s a couple different schools of thought in how you approach smooth. I came up with an understanding that realistically all motor sports students pretty much start at the same point, you know, zero, zero on the X, Y axis.

And we all ramp up and we all have a learning curve, but there comes a point where that arc, and I’m sorry, we don’t have any graphs where, you know, this is audio only that it diverges. What I’m trying to explain here is that we all start kind of rough and tumble, and we have to learn these new habits and replacing maybe former ways of driving.

And so a lot of coaches will stress. that they want to [00:34:00] feel this concept of smooth and it really revolves around the vehicle and the vehicle dynamics and how smooth the vehicle is going around a corner. But you hit a point though where you can only go so fast by being smooth. And so what I’ve found though is As you mature as a driver, it’s a transition from you making erratic motions behind the wheel to getting the car to be complacent and to be neutral, but to go fast, the car actually becomes extremely erratic.

And then you are in this position of like full Zen, and you are completely calm when the car is. out of sorts, sideways, what would seem by the outsider, completely out of control. And so that’s where I say that the arc, the learning curve diverges from what is being said to what happens in reality. And so I wonder if that plays in to surgery and to medicine as well.

Dr. Lora Melman: That’s really fascinating. So I think it all has to do with skill sets [00:35:00] and learning skills and your performance of doing those skills actually requires you to have a higher set of skill beyond that in order to cope with something that can happen sort of suddenly and suddenly you’re out of control. So definitely translates to surgery.

We train in all kinds of situations, traumas. And during my residency, I dealt with somebody that was shot with a bullet through the aorta. And that’s a serious injury. And, you know, you have to know how to deal with that people that come in with these, you know, horrific injuries, you have to know how to gain control when things are completely out of control without being out of control yourself.

Exactly. That’s the skill set. Is it, can you maintain your calm? And can you maintain in control while everything else is out of control? And so that requires a skillset beyond just the basics. And that may be where the divergence happens is that are some people able to achieve that next set of higher skills so that they can [00:36:00] not freak out if they suddenly are sideways.

They already have that programming or they’ve developed that programming somehow to then regain control.

Crew Chief Eric: Exactly. And that’s where I’ve always stressed that there’s two forms of smooth and motorsport. There’s the vehicle being smooth and the driver being smooth. And I think we all need to get to the stage where we as a driver are smooth and we can make that car do anything we want.

And that does lead us into a conversation about driving by feel and things like that, which is completely out of the realm of. What we’re really driving towards here, pun intended, but I just wanted to bring that up as, as a notion there that a lot of people don’t kind of split the two, you know, smooth is smooth, but in the context of motorsport, there’s, it’s really multifaceted, but you did allude to the next quote that we pulled out, which is the ability to perform well under challenging conditions is not acquired accidentally, nor is it a natural gift, but rather the result of years of dedicated study.

And perfection of technique. It takes 10, 000 [00:37:00] hours of deliberate practice to attain mastery.

Dr. Lora Melman: Right. So this comes out of that book, the talent code also studying experts around the world. Musicians. Professional athletes, et cetera, in terms of how do they learn and how do they become the best in their field?

It does take about 10, 000 hours. That’s what it’s been studied to be in terms of dedicated practice, which means that somebody is deliberately practicing the sort of micro skills that are required to then have that skill set. So multiple different skills and a certain, you know, discipline, obviously there are just, you know, infinite number of, of things we could talk about here.

But how does someone become concert violinists? You know, how, how does that happen? It happens over a long period of time. There are circuits that become myelinated over time and they have to be practiced in the right way in order to then. allow that person to have the next level of skill, and then they can attain the [00:38:00] next level of skill.

So similarly in surgery, we start out as trainees, just sort of observing and watching the surgery, seeing how everything is sort of coordinated within the room, and then maybe doing a very small part of the surgery under supervision of our attending surgeons. And once we perform adequately on that level, Then we’re allowed to do more and more of the case.

And as you graduate and you become a fully trained practicing surgeon, then you are the one doing the whole surgery and then training other surgeons. So that’s how it comes 360. Of course, there are skills labs and training and such that everyone does that everyone should do. Even surgeons after, you know, they’re done with their formal training because surgery and medicine in general are such a rapidly changing fields.

There’s new technologies, there’s new devices, there’s new materials coming out all the time. We have to be able to incorporate that in the best way possible in the safest way possible for our patients in order to help them the best way we know how. [00:39:00] So that ongoing skills acquisition never stops, which is why it’s kind of fun, but it does take a long time to develop that basic skill set.

The 10, 000 hours is deemed to be your achievement of expertise. It does take a long time. It’s not something that really anyone is Born with, or it can just do instantly, it’s a process that’s built over time.

Crew Chief Eric: I often joke, I have that amount of time on a Shenandoah circuit. So it feels like 10, 000 hours, but what a lot of people don’t realize about motorsport, especially the discipline of high performance driver’s education is that it is a structured system.

There is always room for improvement. There’s obviously room to practice, but it’s a continuing education program. When you jump in, you’re not going to be Michael Schumacher or Ayrton Senna. You start as a beginner and you work your way up through the system. And every rank that you move up gets more difficult and more challenging, more techniques get brought on.

And a lot of people think that the coaches. Just know it all because they wear the title [00:40:00] of coach. And I hate to tell you guys, we’re not infallible and we do continuing education too. There’s plenty of coaching summits out there. There’s plenty of documents and books and, you know, webinars by like Ross Bentley, his speed secret series.

There’s safety programs that we’re involved in. We’re always researching the latest nannies. We have to stay up to date on the latest cars that are coming out because you never know if you’re going to be in the right seat of them. C9 Corvette, which hasn’t come out yet, but as an exaggeration, you get the point.

We need to know what we’re stepping into. And I had one of those moments recently with a Tesla on track, which is a very rare vehicle to have on track. I wrote an article about it. You guys can check it out on our website, gtmotorsports. org. But again, it was a learning moment and there’s tons of those in motorsport where you can continue to grow.

You shouldn’t feel like you’ve hit a plateau. And I think this is a really important point that mastery and motorsports. Is difficult to attain because there’s so many different disciplines to motorsport. We talk a lot on this show about how they carry over in certain techniques, like learning [00:41:00] a track very quickly.

And to negate corners that comes from autocross racecraft comes from carting, the ability to handle very odd situations could be carried over from maybe rally corners. So trying different disciplines, exposing yourself to different parts of motorsport will eventually get you to that true master petrol head level that I think people would like to get to, but there’s nothing wrong with mastering your particular discipline.

If what you like is just club racing or, or rally or whatever it might be. So all good, but I do like this next one, which is driving. The camera requires a trained eye experience and steady hands that can also be quick.

Dr. Lora Melman: That goes to laparoscopy. So when we’re doing a laparoscopic case, we’re using small incisions and through one of the small incisions is a scope camera.

And at the end of that is a beveled angle so that we can sort of look around corners. So we call it driving the camera. Typically, the surgeon will be operating with two [00:42:00] hands and then the assistant will be Assisting with one hand, providing retraction, and then driving the camera with the other hand.

And so the right angle or the certain angle that you need to actually see what you need to see is provided by your, your wing person, your wingman, so to speak. As a surgeon, you’re actually not providing the view, it’s actually your assistant. In order to have the best, most efficient surgery, the assistant needs to understand what the surgeon needs to see.

So that’s called driving the camera. So you have to know what the surgeon is looking for, what exact angle they need to be looking at the tissue at, and what they’re trying to accomplish. And ideally, the assistant is going to drive the camera in a way that is completely transparent. They don’t even have to think about it.

They don’t even have to tell you, you know, move in, move out, you know, go to this angle, go to that angle. The assistant should be able to achieve a seamless interaction with the surgeon so that they’re showing them exactly what they need [00:43:00] to see, exactly at the time that they need to see it, so that that surgeon can complete the surgery in the most efficient manner.

There’s a little bit of trained vision that you need to have in order to drive a laparoscopic camera. Also experience on both sides of the table, so to speak. So you have to be able to drive the camera, but you also have to have some experience doing the surgery in order to sort of know the other side of the coin.

There, it’s just sort of a, it’s a learned skill. And like, I go back to the, the idea that first you learn sort of the basic skills and then you learn a little bit more advanced skills and then you sort of chunk those all together and then you have your skill set and I started learning to drive the camera.

I actually couldn’t see. The different directions that the lens was pointing. It took me a long time for my brain to incorporate that and see that the angle was actually different. It’s actually pretty subtle if you ever look at a laparoscopic angled camera. It’s not really that obvious, but once you get used to it.

You can anticipate which angle the lens needs to be at to [00:44:00] provide the most perfect view for the surgeon. It’s not something that’s actually that intuitive. You have to kind of learn it. I sort of just was thrown into it and I just kind of learned along the way, but there’s a lot of things because we’re working with straight stick instruments in laparoscopy.

If the angle of the eye of the camera is looking down parallel to the shaft of the instrument, it’s actually very hard to see what you need to see. So it has to be sort of at a. angle that’s a little bit more away from sort of looking at what the instruments are operating on, not looking down the length of the instrument.

Crew Chief Eric: It sounds a lot like the relationship between a coach and their student. So do you turn to your assistant and say early and late when they apex the camera the wrong way?

Dr. Lora Melman: Not really. It’s, it’s not, it’s not like that kind of.

Crew Chief Brad: Uh, well, there’s one that I want to touch on this one. One of my personal favorites that I’d like to hear you talk about.

It’s don’t blame the mirror if you don’t like what you see.

Dr. Lora Melman: Okay, good. Yeah, that’s a good one that I was just sort of more thinking of more like a personal reflection [00:45:00] mirror doesn’t lie. And so if you’re looking in the mirror and it’s you and you don’t like it. It’s not the mirror, but it also goes to, you know, paying attention to your mirrors and kind of knowing what’s going on all around you having that 360 degree awareness.

And if you have put yourself in a spot in the group that you don’t like, and you should have pitted instead and just let everybody go by or give yourself more room and whose, whose fault is that sort of in a way. So multiple things can be sort of taken away from that. My first thought with making that little episode was if you’re just upset with everything going on in the world.

Some of that is actually you.

Crew Chief Eric: So motorsport, we’ve said many times on this show, is unfortunately a male dominated sport. And I’m not saying that it’s totally devoid of women, because it’s not, but they are fewer and far between when you walk around the paddock and you look at all the other drivers that are there at an event.

So I wonder, how did you find yourself? at these HPD events as a woman? Was it inviting? Did you [00:46:00] find it to be a good experience? Were there some challenges there? Do you mind unpacking that for our listeners?

Dr. Lora Melman: Good question. It’s really not that different from surgery. If you take a look at how many surgeons are women versus men, that basically goes back to implicit bias within the training system that did not allow women to have the opportunity to train to be surgeons.

So that’s the reason why there aren’t many women surgeons. But can women be excellent surgeons? Of course they can. There’s a study in the British Journal of Surgery showing that all other factors combined, women are actually better surgeons and their patients do better than, than male surgeons. So there’s that, but you know, going into the motorsports world and going to the paddock and being like the only girl in the group or like the only, you know, one or two girls in the, in the whole entire event that day, you know, I have to admit, it didn’t really bother me because I’m kind of used to it already being, you know, from Surgical background.

I also have done Aikido, which is a martial art, mainly dominated by men. Um, not very many women in Aikido as a martial art in [00:47:00] general. So I’m kind of used to it. So it didn’t really bother me. Did I perceive that people underestimated me or didn’t want me to be there? I don’t know. I don’t really care. You know, I just try to do my best.

And if I’m, you know, somebody that’s slowing down the whole group or something like that, then I don’t belong there. I need to be in a different group and I’m, I’m fine with that. I don’t have an ego with regards to showing that I’m better than anyone else. I’m just trying to be the best person and best driver and develop my driving skills as best as I can.

I’m not competing with anyone or under the pretense that I’m, you know, racing people into corners or anything like that. And so I think that the HPDE community. Since that’s not what it’s about, what’s a good place for me to grow. And so I found a good place there. And I found some groups that are very welcoming to female drivers and very encouraging.

All my coaches have always been very, very encouraging and very helpful to me. You know, the breakout sessions in terms of just [00:48:00] drivers talking to each other. I always find that very helpful. I think that the role of mentorship and teachers. is very important in general. In surgery, we wouldn’t be surgeons without our mentors and teachers that taught us how to do surgery.

So in the driving world, you wouldn’t be where you are if you didn’t have your teachers before you, and if they didn’t have their teachers before them. So there’s a tradition passing on that, that skill set and passing on the information, even in little bits, you learn something new and something valuable from every teacher that you have.

Crew Chief Eric: Yeah. And one of our senior members always says that you are the byproduct of all of your coaches because the driving skills that you have today, you took something the best, or maybe even you learned from the worst of all those different coaches. And now that has become your driving style. So it’s interesting.

You bring that up, but I also wanted to ask if maybe let’s just say you were a queen for the day and you could change some things about HPDE to make it more inviting, maybe break down some barriers and bring in more women. What. Changes would [00:49:00] you make to kind of revolutionize the sport?

Dr. Lora Melman: That’s a really good question.

I think that just sort of raising awareness of the sport would be a place to start And representing it in a way that this is a sport that men and women do and men and women are good at So to have that representation, I think it would start with that a lot of times Maybe the images that we’re seeing, um, in advertisements and such are, um, you know, buy this for your, you know, boyfriend, buy this for your husband, buy a track day or so that just sort of potentially very male oriented advertising.

So maybe to sort of open that up. And be, you know, a Mother’s Day gift or something like that, just to kind of broaden the interest of various people that might get into the sport.

Crew Chief Eric: With every learning experience, there are trials, there are errors, there are achievements, and there are failures. So what would you say is your biggest oops moment?

In motorsport. We won’t talk about surgery.[00:50:00]

Dr. Lora Melman: Biggest oops moment. That would go back to when I had my first BRZ. I run my cars pretty much completely stock. So I had the original tires on there. And, um, I was at the North course of Pocono. So if you know the North course, turn one kind of turns off of the infield and then goes back onto the Tri Oval.

And it was getting dark and getting a little cool, track temperatures dropping a bit. And I just didn’t think about things, obviously, before they happened too fast for me to control. Going in turn one, got a little into the marbles, got a little bit off, couldn’t control the car, could not turn in. Boom, hit the wall about 60 miles an hour.

Pulled the car and airbags went off and stuff. I was a little bruised. I was okay. I didn’t lose consciousness or anything like that. But that by far was my biggest oops moment. I think it’s important to take away from that when you have a moment like that, or even just little [00:51:00] other, you know, non damaging, you know, to your car moments.

Is it, what do you learn from that? My thing in life is that we make mistakes, everybody makes mistakes, but you should always try to make new mistakes. If you make the same mistakes over and over again, you’re actually not getting better, you’re not learning. So, there’s something to be learned there. So, mistakes are going to happen if they happen and when they happen.

Figure out why it happened and what you can do next time to avoid that. What I learned from that experience is to prioritize areas of the track where I was going to push myself and where I was going to not. And that is an area of the track where you don’t push yourself, or at least I know, because that can happen.

After that happened, and I came back to the paddock and, you know, the car was, you know, put on a flatbed and taken off the track and everything. A lot of people came up to me and said, yeah, I’ve seen that happen before at that turn. You know, obviously it happens or has happened at that point on the track before.

And so on certain circuits, there are [00:52:00] places where there is no room for error. And you have to be aware of that before you get in too deep. Just like in certain parts of a surgery, there are certain areas where there’s no room for error. You don’t want to be slightly off or too close to one vessel or the other, or because you can just wreak havoc.

So you have to be aware of that. So that’s what I learned is to. Think about the racetrack beforehand and where is it okay if I go off and not a big deal and where is it not okay and where I really want to just hone it down and really make sure I’m totally in control and if I get a little out of control, can I save it on those areas?

Crew Chief Eric: So what would you say is probably the best tool when learning a new track for you?

Dr. Lora Melman: I’ve sort of gone back and forth with making little notes on a sort of like a hand drawn map or pre printed map versus the role of simulation. I don’t have a Sim racing, you know, set up or anything like that. I’ve looked into that and I’m still thinking of getting one, but I [00:53:00] think there probably is a good role for simulation, helping you learn the visual cues, learn what the racetrack looks like from on the racetrack.

Cause it obviously is different if you look at a video of somebody else’s in car video versus if you’re the one sort of controlling, you know, sort of the inputs and the outputs. So I think that there’s a great benefit to be had and you can shorten your learning curve. By sort of practicing a track in a completely safe environment of simulated computer environment, I think you can start to learn some basics.

Of course, you don’t have the physical feedback, you know, the seat feel, so to speak, if you have on a real racetrack. But I think that is a valuable tool that people can take advantage of. And I think it actually can help you be safer on the racetrack.

Crew Chief Eric: So do you have a favorite racetrack of all the ones you’ve been to?

Dr. Lora Melman: That’s a really good question. Um, I do like Lime Rock. That’s kind of my first, you know, home track, because I used to live in Connecticut, and I had a Mini Cooper, and it was very good on [00:54:00] Lime Rock, and so I like Lime Rock a lot. I like the, uh, the Pocono infield tracks, different configurations, etc. I like, uh, Lightning.

Crew Chief Eric: All the short ones, huh?

Dr. Lora Melman: I tend to have lower powered cars, so I went from a Mini Cooper to a BRZ. And then I have an M2, which is, you know, relatively speaking to other cars, like the Ferraris and McLarens that are out there now on the racetracks, pretty low powered car still. So I tend to gravitate towards the faster tracks.

Crew Chief Eric: So is there a bucket list track?

Dr. Lora Melman: VIR.

Crew Chief Eric: It’s a good one to pick. It’s a, that’s an IMSA track. It’s a big one. It’s a lot of fun. We were just there not too long ago, wrapping up our season. So I highly recommend it if you haven’t done it. I know you’ve been to the Glen and a lot of other places, but what advice would you give someone starting out in high performance driving?

Dr. Lora Melman: Starting out, I think that it’s important to understand hydration. This is something I address to my patients all the time because after bariatric surgery, it’s actually very hard to stay hydrated. But as a performance athlete, your [00:55:00] performance is going to decrease if your hydration is not as best as it can be.

A lot of people don’t understand what early dehydration feels like. You start to lose focus, you might get a little bit of a headache, feel tired. Those are all symptoms of dehydration. And so, what do you hydrate with is the other thing. Plain water is okay. I would say the sports drinks are a little bit overloaded with sugar.

So if you dilute them a little bit, it’ll actually be absorbed better into your system. Recently, there are some products that have come out that are hydration supplements, either in powder form and you reconstitute them in water. The classic example is actually Pedialyte. Pedialyte is marketed for babies because babies have a very narrow window where if they get dehydrated, you can still save them with oral hydration.

Okay. And so it’s marketed for the, for the small humans. Um, it actually works for, for any human being. If you are dehydrated, one of the best things to do, go to the pharmacy, grab a bottle of Pedialyte, open it up and drink it. It’s actually proven that a [00:56:00] little bit of natural sugar and electrolytes in the right amount in water.

It’s going to absorb and be absorbed by your system about three times more than plain water. So that’s the way to best get yourself rehydrated. This knowledge and technology and development came out of the cholera epidemic when people were infected with the cholera bacteria and had diarrheal illness and were getting dehydrated and were dying from dehydration.

What happened then, an invention was invented, and this was called oral rehydration solution. It’s a powder packet of glucose, and sodium, potassium, magnesium, calcium, some of the electrolytes, that when reconstituted in water, absorbs more readily through the gut epithelium, and helps people rehydrate better.

They couldn’t go around and put IV fluids into these millions of people, but millions of people were saved by oral rehydration solution. So it’s a, it’s a real thing. Sports drinks are a little bit overloaded on sugar because athletes need that extra sugar so they don’t deplete their glycogen stores during a game.

So that’s why there’s more [00:57:00] sugar in those sports drinks. Zero calorie sweeteners do not do the same function as real sugar. So all of the zero, you know, this, you know, non sugar, that, that is not actually hydration solution. That’s marketing. Understanding hydration and how to best help yourself with hydration will in turn help you perform your best.

So that’s really important because you’re learning, putting yourself sort of maybe a little bit outside your comfort zone. You’re trying to, you know, learn new things, new, new sets of, of things, trying to put things together. If you’re dehydrated, you’re just not going to be able to do that as well.

Crew Chief Eric: That’s sage advice.

And we do talk about nutrition and hydration at the track often. And there’s a phenomenon we call the track hangover. And it’s directly as a result of being dehydrated. And two of our members, one is a personal trainer as well as a nutritionist. And the other gentleman is also a weightlifter and former military.

And so they bring different aspects. But to the same conclusion that you brought us to, [00:58:00] which is make sure you drink, drink, drink when you’re at the track, probably more important than eating when you’re at the track is to stay hydrated or any motor sport, really. Because let’s face it, there isn’t a whole lot of shade unless you’ve rented a garage.

That’s also another mitigating factor. There isn’t the fact that you’re out in the sun being beat on all day long. So staying hydrated is super important. Let’s look at some lighter hearted questions. We have some fun ones that we usually ask our guests as we kind of wrap up our segment. We ask questions like a million dollar lady in this case, or, you know, what’s in your free car garage and things like that.

So let’s start with what are your top three favorite cars of all time? And these don’t have to be ones you own. These are just ever been built from, you know, the model T to today.

Dr. Lora Melman: I’m going to say my top three favorites. These are the Ferrari 458 Italia, the naturally aspirated engine, because I think it just sounds beautiful.

I don’t think anything sounds as good as that. That’s just my favorite engine of all time. And I happened to drive [00:59:00] one, uh, maybe a year ago now, um, my husband bought me a birthday gift and it was a driving experience. So I got to drive the 458 Italia, they were all convertibles, the Alfa Romeo 4C, the Bentley Continental.

That was also great. And that’s actually one of my other favorites because I thought it was going to be sort of a stodgy stuffy. Car. And it was like a spaceship. It was awesome. So that’d be my second one. Third favorite car of all time. I’m going to say is the Mazda Miata. I think dollar per pound. That is the funnest car I’ve ever driven.

Like it just does whatever it’s happy to go. It’s got enough power for the street and it’s totally fun. It can be going 20 miles an hour. And having a blast

Crew Chief Eric: switching to the million dollar lady question. If you could spend any amount of money, right. On a car and let’s say that’s the car you would have forevermore.

What would it be?

Dr. Lora Melman: Wow. That’s a really good question. Probably the 458 Italia.

Crew Chief Eric: If you had to buy a new car, a [01:00:00] 2021 model, is there anything that gets your attention that’s coming out this year, next year?

Dr. Lora Melman: Yeah, not really. I’d probably buy another Miata. A

Crew Chief Eric: 2021 Miata?

Dr. Lora Melman: Okay, I can do that.

Crew Chief Brad: I’ve got a question for you.

You keep going. I just popped in my head that how, how do you feel about the electric revolution? And if you had to buy an electric car right now, what would it be?

Dr. Lora Melman: Question. I think it’s very interesting in terms of the technology and battery technology. So I only think that’s going to get better with time.

Um, I had the fortunate experience to drive the take on. So that was really cool. It was a little understeery. It’s just that immediate power. That was awesome. So, uh, if I had to buy an electric vehicle, it’d probably be the Taycan.

Crew Chief Eric: In your opinion, the most attractive car ever penned?

Dr. Lora Melman: Mm hmm. Most

Crew Chief Eric: attractive.

Usually we say sexiest car of all time, but I wanted it [01:01:00] to sound more professional than that. You could have said beautiful. Yeah, that’s true.

Dr. Lora Melman: I think the most beautiful car ever built. Is the F12 Berlinetta by Ferrari. The lines I just think are perfect. The proportions. The way that the air goes sort of through and around the car and helps with the downforce.

I just think that’s just, it’s a work of art.

Crew Chief Eric: So if we turn that on its head, the ugliest car of all time,

Dr. Lora Melman: ugliest car of all time, the Nissan Juke.

Crew Chief Brad: You are not alone.

Crew Chief Eric: You could sit down and have a glass of, Oh, I don’t know, wine or whiskey or maybe a beer. With Clarkson, Hammond, or May, who would it be?

Dr. Lora Melman: Richard Hammond.

Crew Chief Eric: Really? Why?

Dr. Lora Melman: I just like his sort of quirky personality. He’s a little twitchy. I think that’s fun and entertaining and funny. He’d be a hoot to have a beer with.

Crew Chief Eric: I was planning on asking you what your favorite car color was, but we followed you on Instagram long enough. The answer is obviously white.

Dr. Lora Melman: That’s a little bit of an inside [01:02:00] joke, actually, the white paint thing. So when I got the M2, I got it in 2017. So I got it new. It’s a 2018 model year. And I was planning to get the white cause it’s basic white and I was going to wrap it in yellow. And so when I got it. I thought, man, it’s actually kind of nice.

You know, I don’t mind the white. And then I learned about self healing, pain protection film. Right. And as a surgeon, I just thought that was so cool that the, you can get these little nicks and scratches and they heal. So I had to get that. And then I decided, okay, I don’t want to wrap it and put the paint.

So I’m just going to do the paint though. So I just ended up with a white car. Then my husband wanted to get a different car. And so we looked at an Audi TT. He was doing long road trips at the time and, you know, sleet and snow, and he wanted the Quattro all wheel drive. And the place that we go to is a specialist dealer in S and RS cars.

And they had a white TT. So we ended up with two white cars. So that was kind of funny to us. And then after that, he wanted to sort of upgrade and get the [01:03:00] TT RS. So we’re looking around and looking at that same dealer and they had a white TTRS. So he got a white TTRS. So then after that, we decided to get a Mazda Miata and we said, okay, what color are we going to get?

So we just, we stayed with the white. And then it’s just kind of funny between me and my husband and everything that we have. And if we trade paint with the cars, it doesn’t matter cause it’s all white. So that’s just our little joke.

Crew Chief Eric: So room, desk or car, which do you clean first?

That’s awesome.

Dr. Lora Melman: I haven’t cleaned my desk for like eight months and it’s messy. I have just enough room to do my work and that’s fine. I don’t care. But if my car is messy or if there’s like dirt on the floor mat or dust somewhere that I can see on my, my smear on the windshield, I can’t stand it. I have to clean it.

Crew Chief Eric: Well, Dr. Mellman, I cannot thank you enough for coming on the show. This has been a really interesting juxtaposition between surgery, the world of medicine, and motorsport.

Crew Chief Brad: I love [01:04:00] hearing about, uh, just all the, the surgical lessons and everything like that. Uh, I’ve been following you on Instagram for a long time.

So yeah, it’s, it’s, it’s good to, to, you know, to, to put a voice in everything to the stories and get a little more detail and background.

Crew Chief Eric: As we look back over the plethora of quotes from SLFTR, I wonder, I guess you don’t have a plan for where it’s going to go. They’re all reflections upon all your weekends at the track and things like that.

So we don’t know what to expect for next season, but I am looking forward to what you’re going to say next. I think you’ve really helped to clarify. The overlap between the precision and the surgery, the precision and motorsport, really tying things together in such a way that I don’t think many of our listeners really took a moment to think about before we had this conversation.

And I just find it fascinating. And I hope that most of our listeners did too. So with that being said, if you want to learn more about Dr. Melman and her practice.

Dr. Lora Melman: So anybody that wants to learn more can go to our website. If you type in bariatric surgery, New [01:05:00] Jersey as all full words, altogether. com, that’s our website.

We are advanced surgical and bariatrics of New Jersey. We’re a six surgeon practice, very high volume with regards to bariatric surgery, reflux surgery. and hernia surgery. And we’re one of the expertise centers in the area,

Crew Chief Eric: but also be sure to follow her on Instagram at fast track surgeon, as she continues to update her surgical lessons from the racetrack.

So again, Dr. Melman, thank you so much for coming on the show. We’ve really, really appreciate it.

Dr. Lora Melman: Thank you so

Crew Chief Brad: much. If you like what you’ve heard and want to learn more about GTM, be sure to check us out on www. gtmotorsports. org. You can also find us on Instagram at grandtorymotorsports. Also, if you want to get involved or have suggestions for future shows, You can call or text us at 202 630 1770, or send us an email [01:06:00] gtmotorsports.

org. We’d love to hear from you.

Crew Chief Eric: Hey listeners, Crew Chief Eric here. Do you like what you’ve seen, heard, and read from GTM? Great! So do we, and we have a lot of fun doing it. But please remember, we’re fueled by volunteers and remain a no annual fee organization. But we still need help to keep the momentum going.

So that we can continue to record, write, edit, and broadcast all of your favorite content. So be sure to visit www. patreon. com forward slash gtmotorsports or visit our website and click in the top right corner on the support and donate to learn how you can help.

Skip ahead if you must… Here’s the highlights from this episode you might be most interested in and their corresponding time stamps.

• 00:00 Introduction to Break/Fix Podcast
• 00:27 Meet Dr. Lora Melman: The Fast Track Surgeon
• 01:20 Understanding Obesity and Its Surgical Treatments
• 03:58 Reflux and Hernia Surgeries Explained
• 09:51 The Concept of Fast Track Surgery
• 10:55 Preoperative Preparation and Recovery
• 16:32 Dr. Melman’s Motorsport Journey Begins
• 21:02 Challenges and Learning in Motorsports
• 24:11 Connecting Surgery and Motorsports
• 36:12 The Importance of Smooth Driving
• 36:58 Mastery Through Deliberate Practice
• 38:01 Surgical Training and Continuous Learning
• 39:25 The Structured System of Motorsport Education
• 41:33 Driving the Camera in Laparoscopic Surgery
• 45:35 Women in Motorsport and Overcoming Bias
• 49:56 Learning from Mistakes in Motorsport
• 54:46 Hydration and Performance in Motorsport
• 58:35 Favorite Cars and Dream Vehicles
• 01:03:53 Conclusion and Final Thoughts

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