Subscribe to Lemonada Premium for Bonus Content

Dr. Jason Giles is an addiction specialist and a helper and friend to many, including me. When the rigors of life in the ER became too much to cope with, Jason turned to the very narcotics he was trained to supply to patients as a trauma anesthesiologist. As his successful life disintegrated, he was forced to face his own doubts and delusions, and his journey through them is what made him who he is today. Now he’s working to help others understand and heal their addictions. Jason and I talk about accepting help, the power of forgiveness, and how closely the definition of insanity can resemble the act of persisting. I’m immensely grateful for Jason’s support over the years, and I’m excited that this week I get to bring his story and wisdom to you.

Fail Better is now on YouTube! Watch this episode here.

Follow me on Instagram at @davidduchovny. Find more video podcasts on our YouTube channel. Stay up to date with Lemonada on X, Facebook and Instagram at @LemonadaMedia.

Joining Lemonada Premium is a great way to support our shows and get bonus content. Subscribe today on Apple Podcasts, Spotify, or wherever you get your podcasts.

For a list of current sponsors and discount codes for this and every other Lemonada show, go to lemonadamedia.com/sponsors.

Transcripts

SPEAKERS

David Duchovny, Dr. Jason Giles

David Duchovny  00:07

I’m David Duchovny and this is “Fail Better”- a show where failure, not success, shapes who we are. Dr. Jason Giles is a specialist in addiction medicine and anesthesiology. He has devoted his life to helping people recover from their struggles with substance abuse. Jason is also a friend of mine, and while I’ve never formally been a patient of his, he’s helped me out a ton over the years. I’m thrilled to have Jason on the podcast today to listen to him tell his story so I don’t want to spoil it too much, suffice it to say he was drawn to the work he does today because of his own experiences with addiction. He’s lived an incredible life. Has a beautiful family that I know very well, and he supported so many in their recovery through the groundbreaking work he does day in and day out. So without further ado, I’ll turn it over to him to tell you all about his journey and the unique perspective he’s able to bring to his practice. Here’s my friend, Dr. Dr Jason Giles. Good morning, Jason.

 

Dr. Jason Giles  01:03

Good morning, David.

 

David Duchovny  01:06

It’s nice to see you. Haven’t seen you in a while.

 

Dr. Jason Giles  01:08

It’s nice to see you, too.

 

David Duchovny  01:09

You are my guinea pig today.

 

Dr. Jason Giles  01:11

Awesome.

 

David Duchovny  01:12

As I embrace the stupid question. Here’s my first stupid question to you, I would start with is, who are you? Tell me who you are. Tell me a little bit about your childhood, where you got at a certain point and where you are now.

 

Dr. Jason Giles  01:32

Sure. This question is actually not so stupid question. It’s a humble, simple question. As a starting point, I grew up in Southern California. I grew up in Santa Monica, raised in a rent control apartment with an alcoholic father and an awesomely co-dependent mother, and one younger sister. That balance of the family, kind of making its way, getting it through, shaped my early sense of the world – myself in it, but the world also. I went to public schools. I was one of the smart kids growing up. I could do stuff. I was in special programs for being smart, so I was rewarded for that. I think, I maybe like an athlete or somebody else with a talent. I hit the gas on that.

 

David Duchovny  02:26

A mathlete?

 

Dr. Jason Giles  02:27

A mathlete, yes – math and science. That would end up ultimately taking me to Berkeley for college and then medical school and residency. I fell in love with clinical medicine working in the Berkeley free clinic when I was a college student there. As I was going through school, I got more and more interested in the harder things, and more complicated, more involved, more complex. That’s the stuff that turned me on. So, I wound up in anesthesia, which is all patients for all surgery and with all medical problems. There’s arecurring theme, which is based on those early experiences (I think this is my understanding of it today) – is based on those early experiences. I was seeking to understand the world in an attempt to manage the world, in terms to control the chaos around. It’s very chaotic in an operating room and the anesthesiologist stands at the head of the table and is the one administering calm, not just in the form of the of the chemicals, but it’s the coxswain of the whole operating room – coordinating the nurses and when the surgeon starts, and keeping everything on track. That was a fish and water situation for me back then. Loved it. Then there were some other adventures to have along the way that revealed some deeper insights, which I have a hunch we might get into.

 

David Duchovny  04:00

I feel like we’re almost there, because I do want to talk about our relationship and how we met. I don’t think we can actually get into that until we take you further on your journey.

 

Dr. Jason Giles  04:14

That’s probably true. Otherwise it won’t make any sense. Why would a nice guy like you be talking to a guy like me this? Drive to become okay by knowing things (maybe the simplest way to say it), left me feeling flat. I did not feel okay despite acquiring an enormous amount of knowledge and competence and excellence in an area. Probably behind that feeling of emptiness, my assessment of this is kaleidoscopic, because there’s different facets, but my sense looking back at the time is that I was wanted some relief from my own thoughts of inadequacy, of incompetence, of just being wrong. Overall, generally wrong. I think most people, I bet every one of your listeners, has a deep suspicion that they’re missing something or that they’re inadequate in some way. That’s a universal feeling, where it gets into pathologic is thinking that there’s something I can do to fix it, because it doesn’t need to be fixed. That missing bit is the yearning for connection, for spirituality.

 

David Duchovny  05:33

How are you using the word pathologic at that point?

 

Dr. Jason Giles  05:36

Well, if you think there’s something wrong with you and there isn’t, then the next step you take is guaranteed to be wrong, because you’re trying to fix a problem that isn’t an actual problem.

 

David Duchovny  05:46

Okay.

 

Dr. Jason Giles  05:47

Right? It’s just a story that I had told myself and it’s a story that a lot of people tell themselves that they’re don’t fit, don’t belong, not good enough. So, let’s get to the heart of this figure out what’s actually wrong. I need help. I’m going down. It was, “Okay. I need to work harder. I need to manage my own internal chemical environment by bringing in some extra neurotransmitters from the top drawer of the anesthesia cart and then I’ll be able to keep going”. That’s pathologic, right? I think everyone would agree that the car just come off the rails. It’s well past time to ask for help when you’re considering managing your feelings with fentanyl (which is what I was doing). But again, this is my understanding of it, post hoc at the time, it seemed like a really good idea. In fact, it seemed to me, like who better to manage his feelings than the guy trained in all these chemicals? It seemed like a really smart idea at the time.

 

David Duchovny  07:04

Right?

 

Dr. Jason Giles  07:05

You and I were chatting earlier about what constitutes failure and and I think it has to do with with timing. Has to do with with the timing of our awareness, sometimes our biggest mistakes turn out to be the portals or the thresholds of our greatest success and insights – vice versa […].

 

David Duchovny  07:30

One of the things that I’ve come to realize having these discussions is, and I think it’s kind of this Chinese proverb that people have been talking about for a couple years (I don’t know it) but the punchline, the through line is, at this point we don’t know.

 

Dr. Jason Giles  07:49

Too soon to tell, yeah.

 

David Duchovny  07:50

Too soon to tell. So, that is pretty much where I’m standing today on success and failure. This is a great success. You’re a doctor. Well, it’s too soon. This is a great failure. You’re a junkie doctor, right? Well, it’s too soon to tell.

 

Dr. Jason Giles  08:09

It’s too soon to tell.

 

David Duchovny  08:10

When we first met, you gave me a self published memoir. I guess I’m calling a memoir, junkie doctor and that’s where we are at this point in your story, right? At this point, you stand to lose so much by the time it got unmanageable for you, because you managed for a while. You’re capable.

 

Dr. Jason Giles  08:33

Keep the plate spinning. Yeah, for sure.

 

David Duchovny  08:46

How long were you able to anesthetize yourself while being employed?

 

Dr. Jason Giles  08:54

There’s interesting piece of it, which is the chemical itself is actually a smaller part of the story. The part that takes up. It took up more of my mental windscreen, my thought space. Just what you said, I have so much to lose. So, the oddly reinforcing notion that there’s something wrong with you, played out in thefact that I was behaving as if there was there. In fact, I created something quite wrong with me by doing that. Now taking drugs from the hospital, the danger of self administration, all that stuff that you know. Progressive dependence as marked on a map by the distance front between when I first used, which wa my backyard of my house, which is about 10 miles away from the hospital. Then several weeks would goby because I knew that was the wrong thing to do. Sort in my mind, constructed it as anescape hatch. Okay? I have this thing in case it gets bad. Bad meaning in my feelings about myself, or the stressor the intensity. I can take a break and look, nothing happened. T Nothing happened, and hen a few weeks later, I got to do it again and again, nothing happened. Then a couple of weeks later, then a weeklater, then a couple days later, and then the next day. So, the distance away from the hospital got shorter andshorter until finally. At the end, couldn’t wait for it to be the end of the day, end of the shift, and walking out in the last award after your way out of the door, right? Even before I even got in my car.

 

David Duchovny  10:40

Instead of the break from the pressure, it becomes the thing itself.

 

Dr. Jason Giles  10:46

Because your own pressure, yes.

 

David Duchovny  10:47

And the work is becoming a break that you don’t want from the feelings that you’re doing.

 

Dr. Jason Giles  10:54

Exactly. Precisely, precisely. So, […] of mess. Yes, exactly.

 

David Duchovny  11:00

That’s terrifying. Can you take me back to the moment before it falls apart, which is actually the moment where it all comes together? Because at this point, we don’t know.

 

Dr. Jason Giles  11:11

The turning point of the story is when I’m miserable all day long at work, because I’m in withdrawal. I’m in withdrawal from the opiates, which feels like, when my patients best described it. He said, each drop of sweat has thorns – everything hurts, everything’s awful, everything’s miserable, and I’m trying to function that way. I’m not intoxicated, but I’m the opposite of that. I need to be intoxicated so I’m struggling through the day. I’ve got my plans that all I have to do is stop. All I have to do is just not do it for a couple of days, then I’ll be all right. Of course, that day I don’t make it. I get through the work. I get through the end of the day. Patient’s okay. No point was I ever intoxicated dealing with patients but, let’s be honest, I was not in my right mind while doing that. I get to the end of the day, I’ve got my fentanyl that I’ve argued with myself all day about not using, but I I use it just to get the sick off – just to feel not so bad. I’m almost back home, and I get a page from the department chair (who doesn’t usually talk to the residents, usually get a call from the boss). I call back. I say, “What’s up?” He says, “Not casting any accusations. However, a large amount of fentanyl is missing from the hospital or pharmacy. If it’s all back by six o’clock, this phone call never happened”. So, that was my invitation. That was myworst day ever, coming to light from the guy who recruited me into the specialty whose respect that I craved and enjoyed professionally. I had let him down, the profession down, and myself down, and everybody else. So, that was the worst day.

 

David Duchovny  13:09

This is the part of the movie where we go, “What’s he going to do? Is he going to go and try to replace that fentanyl? Is he going to come clean? What’s he going to do? What did you do?”.

 

Dr. Jason Giles  13:19

Yeah. Believe me, I thought about it. I thought about trying to Bonnie and Clyde the last little bit of it, and because it was all on fire behind me, metaphorically. There was nothing to go back to how it looked. He said some words to me, and this is where I think words make a huge difference. He said, “You’re an excellent doctor. We love working with you. I love you personally. I want you to get well. This is a problem we’ve dealt with before. When you’re well, I want you to come back and work here”. So, those are the words he said. That was the fig leaf, the olive branch, or the entreaty. It did not sound like that. I know those are the words, but the way it sounded to me at the time was, “We caught you. This is the end. You’re going to go through all this stuff […] case for us by going away to treatment. That’s how we’re going to be certain that this is a problem. Then you’re never coming back in here before”. That sound you’re going to hear, the bolt sliding, sneaking  shut, and you’re done as a doctor.

 

David Duchovny  14:48

In the time between you got that phone call from the head of your department or the head of the hospital. When you had the meeting with him, did you start to try to handle this in your personal life as well or were you just kind of focused on the professional aspect of it at this point? You had a short window, right?

 

Dr. Jason Giles  15:11

Yeah, I had boxed my personal life into a very tiny little space. I wasn’t telling anyone the truth. I wasn’t opened up to anyone. I was always too busy. I was always either back and forth to work or asleep, or quietly throwing up in the bathroom, or lying in bed, hoping that the night would pass quickly. There were enormous number of off ramps and opportunities that I could have spoken up. But, I was too scared and too confident that I could handle it myself. Sort of a weird. No, frozen.

 

David Duchovny  15:36

I’m frozen.

 

Dr. Jason Giles  15:39

Maybe not.

 

David Duchovny  15:45

This is our first time filming and I hate it, because now I’m catching the sun. I got into radio because, I like the idea of just being a voice out there. Now, I’m fleeing the sun coming in the windows, and I’m moving around here and I’ve completely flow of the conversation. Thank you everyone for wanting to goover to YouTube or the hell we think we’re going.

 

Dr. Jason Giles  16:21

That’s where the audience is.

 

David Duchovny  16:22

Yeah.

 

Dr. Jason Giles  16:24

They’re telling me.

 

David Duchovny  16:24

Okay.

 

Dr. Jason Giles  16:26

Anyhow, it was this weird mixture of increasing confidence that I got this. I know it looks bad, but I can write, which is my professional life. My job in the OR is to take a death situation and turn it into a survival situation. That’s my job.

 

David Duchovny  16:44

Right.

 

Dr. Jason Giles  16:44

I’m super well trained in that. But where I’m concerned, where I’m trying to save myself, it’s literally the biggest Achilles heel you can have. It’s the fatal flaw. Is to say, “Oh, I got this. I don’t got this. I did not have this”.

 

David Duchovny  17:05

Mel Brooks movie it said, I got it.

 

Dr. Jason Giles  17:07

I got it. Yeah, that’s exactly what happened. Can of corn gave me a great big black eye. For some reason, and probably this is not noble, it’s probably because I had really no better options at that point. There was no going back to the hospital. I didn’t want to die. I knew I didn’t want to die, which would have been another alternative, I suppose.

 

David Duchovny  17:30

There are quite impressive statistics about anesthesiologists who do […].

 

Dr. Jason Giles  17:35

Well, that’s the other thing. I forgot to mention he said, “We’ve been through this before with another resident. There’s a resident that was in training before me, who had passed away a couple of years before I joined the department” (they had found him dead in the call room, overdosed on fentanyl). So,that’s another one of those things where you thank God that he was tuned into that experience. Unfortunately, one of my colleagues who I never met, lost his life. But it wasn’t in vain, because that heightened the suspicion or sensitivity to the superstar resident who was dribbling off the court. So, you never know what forces come, right? Too early. It was too soon to tell. I leaped, I left at the chance to do something different, and I abandoned my plan.

 

David Duchovny  18:40

You felt a great relief.

 

Dr. Jason Giles  18:42

At some point, I felt a great relief. I said, “Can I talk to you?” And he said, “I was hoping you would say that”. He gave me his address, and I went to his house and I explained. The only way for all that fentanylto get back in the pharmacy would have been if I were standing in the pharmacy, because I used it all. He gave me a number to call, which connected me to a program. I just kept doing the thing they said. I did not think it was going to work, but I didn’t have a better plan. I didn’t have a better idea of what to do. I just kept one footing in front of the other, until.

 

David Duchovny  19:25

This program was […].

 

David Duchovny  19:27

What did that treatment consist of, aside from getting physically off of the fentanyl?

 

Dr. Jason Giles  19:27

This program was the the medical board diversion program, which is formally no longer in California. It was the first one in the nation. It’s reformed in a different guise. This was kind of the golden age of it, and I got very fortunate to be in with some of the original founding night, thought leaders in the doctor wellness space (that was an outgrowth of the 1970s and all). Great counselors, great therapist, great group. I went to treatment for 100 days, at a doctor focused treatment center.

 

Dr. Jason Giles  19:37

That was interesting […]. This is October, end of September – beginning of October of 1999. I didn’t have my plans worked out yet. I said, “Yes, but I had no money to go to treatment. I had no wherewithal to do it. I had a dark night of the soul of trying to figure out if I should even be a doctor”. During all that time, I was out of fentanyl and decided the last thing I was going to do was try and get more opiates. I knew that would make things worse. I had a prescription pad. I could probably go on the run for a few days or a week or two, but that was just been, adding crimes to the thing, and good chance of something really bad happening. I knew that was not the way.

 

David Duchovny  21:05

Had you told your partner?

 

Dr. Jason Giles  21:08

Yes, that was an exciting conversation before the poor thing. I said, there’s something I have to tell you. Still, 27 years later (25 and 26 years later), if I say those words in that order.

 

David Duchovny  21:24

I have something to tell you?

 

Dr. Jason Giles  21:25

This piece of the PTSD comes back up, yes.

 

David Duchovny  21:28

For me, it’s whenever I hear my name, I think it’s going to be bad, like “David”.

 

Dr. Jason Giles  21:34

My inflection at the end of rising, something we have to talk about. Anyhow, she knew what’s going on. I mean, even more another deeper level of disappointment and let down and so forth for being appearing one way, but being a different way. So, I detox at home. And home was at the top of a Delta flat in Sacramento with a one little wall rattler air conditioner. It was still hot at that time of the year. Lots of fentanyl and nothing. I mean, just the coldest of cold turkeys. It was me in a half filled hot water bathtub trying to get the chill off and there’s this instantaneous switch between being Arctic cold to surface of the sun hot. So, I would stand up and stand in front of the fan, try and cool off. There’s a lot of that back and forth for a while until the chills died down.

 

David Duchovny  22:46

This is one of the things that I am interested in, in terms of addiction to a drug because we try and split up the components of it between the physical addiction and the mental or spiritual addiction, at least I do. If you’re drinking every day, how many days before your body is okay? How many days of not drinking before you have that physical need? I guess it’s not really something that we can quantify. But in your case, how many days was it before you were like, “Oh, my body is actually chemically […]”?

 

Dr. Jason Giles  23:29

Yeah. Mentally, I was done. Mentally, I was finished with it. As it turns out, never went back and I think that’s a huge piece of it. Why go through that misery if you’re just going to go back and do it again? So,  think that’s super torture if you’re not finished in your head. Physically, I was basically awake for close to 10 days, 12 days (something like that) of sleeping in 10 minute stretches. Then I didn’t really sleepthroughthe night for another six months. I had sleep disturbance or another profound insomnia (a betterway to say it) for months. Thank God for video games, because I played a lot of Max Payne during that time, which is an interesting game to play during all that time. It helped take my mind off and give me something to do.

 

David Duchovny  24:19

Little problem to solve.

 

Dr. Jason Giles  24:28

Well, I was also in detox from work, right? So, I had my entire life full with work, the hospital and all thosed opamine hits and rewards, so forth. That was all gone as well. Went through a lot of withdrawal i the fall of 99. It was three months before I could get into the treatment center for a bunch of reasons, timing,the board and economics was a piece of it. Fortunately, a guy I know need a down payment to goto rehab. Otherwise, I wouldn’t have been able to go there. It seems like you checked in sober.

 

David Duchovny  25:04

You had the good luck of having some (not mentors), but friends along the way. They could have been derailed in a much more spectacular and horrible fashion. If you hadn’t had that Chairman, there’s a certain sway of luck there. I guess.

 

Dr. Jason Giles  25:05

“There’s no other grace”, is probably the better way to say it, because it’s nothing that I did. I didn’t likebuild up a bank of friendship, then I got to cash it in.

 

David Duchovny  25:39

Well, I might argue with you on that because I might say that the chairman was the way he was because he saw something in you, the way you were reacting. And your friend was the way he was, or she was because he or she saw something in you that was authentic.

 

Dr. Jason Giles  25:55

Could be. I paid off. I did all that stuff. I worked as a general doctor for a while, which is one of the best experiences that sort of early get well job (they call get well). My get well job was doc in the box, which is the guy that does your school physical and your pink eye (that kind of stuff). And there I got in touch with why I wanted to do this job in the first place? It wasn’t liver transplants, although those are fun. But this simple stitches for a cut and sprained ankle, sore throats and new baby – those kinds of things. That’s how I got attracted to medicine in the first place. It’s like that scene in the superhero movies, instead of after you’re a superhero, you’ve got to go back and not be one. You’ve got to go back and stock the shelves and chop the wood, that kind of stuff.

 

David Duchovny  26:51

What is your ego like at this point?

 

Dr. Jason Giles  26:53

Grateful.

 

David Duchovny  26:54

Already there. There was no.

 

Dr. Jason Giles  26:59

At the treatment center, I had a spiritual awakening, as they say in the in the recovery world it which the gift of being wrong. That’s what I got. I got the gift of insight into being wrong. So, we do these exercises in treatment, they’ve gotten away from it a little bit, but they’re still around where you do the steps – the steps and their rubric for getting to know oneself and understanding oneself in the world […].

 

David Duchovny  27:27

You’re not just talking about the 12 Steps.

 

Dr. Jason Giles  27:30

In this particular case, in this specific treatment center, I’m talking about the 12 Steps. But, you can get there through Celebrate Recovery or the Dharma, it’s the same path. It’s the same way of self discovery, the 10 bulls, right? The Buddhist wood blocks. It’s all the same. In this particular case, it was step two which is phrased this way. Came to believe that a power greater than us could restore us to sanity. Now, that’s like some lawyer ease right there. Came to believe that a power of ourselves could restore us to sanity. If you take that step, or if you ingest that understanding and make it your own, you have to concede you’re insane which is dramatic phrasing. But the truth is, thinking that I needed chemicals to be okay, that is insane and I was just mistaken. All I was wrong. It doesn’t mean I’m wrong, it just means I was mistaken. Once that stone came out of the wall, the whole thing fell down. Because if I’m wrong about something, that at one point, I was the most certain about anything I’ve ever been in my life. I can make it as long as I have these chemicals to deal with, something to put between me and the world. If I’m wrong about that, something that I was certain of, what else am I wrong about? Am I wrong about my traumatic childhood? Right? Am I wrong about my successes? Am I wrong about my role on Earth? I was wrong about most of it.

 

David Duchovny  29:16

Yeah.

 

Dr. Jason Giles  29:18

The gift of being wrong is, I just guessed wrong, that’s all.

 

David Duchovny  29:24

What’s missing from that – that I like is a concept of shame, which is something that I’ve dealt with when I’ve been wrong. Something that I talk a lot about on the podcast here is the attendant shame that comes with the notion of failure.

 

Dr. Jason Giles  29:44

Sure.

 

David Duchovny  29:46

Before you get to the enlightened position. At this point, we don’t know. That’s fun for us to say. That’s hard to live by.

 

Dr. Jason Giles  29:55

In fire. Not so easy. Yeah.

 

David Duchovny  30:01

How did you alleviate that? I’m going to assume that it was there. I’m going to assume that there were parts of you, or moments in your day when you were like, “Oh shit”. Now, those people are going to  that this happened. I was this high flyer, and now I fucked up. I’m ashamed of myself even though I know I’m on the right track. I know that those were all illusions of success, in a way, but it hurts. It’s hurting my ego. My ego is hurt. Ego wants a little inflation.

 

Dr. Jason Giles  30:37

It hurt. The thing where it hurt me the most with. I did doc the box, totally fun. The board says, “Actually, you know what you can, because I wanted to go back to anesthesia. I wanted to finish.

 

David Duchovny  30:50

You wanted to go back.

 

Dr. Jason Giles  30:50

Yeah, I did.

 

David Duchovny  30:50

A little strike you as the classic definition of doing the same thing.

 

Dr. Jason Giles  30:54

Of course. I mean, that’s what everybody was worried about – that it was proximity, is handling the substances, it’s the OR that got me intoxicated or gave me this. I didn’t believe any of that was true, and I was willing to bet my life on it. Many people were willing to let me do that (the chairman top of the list), but I wasn’t just betting my own life. I was possibly betting somebody else’s right, because if it all went bad and I was messed up and I was taking care of somebody else, then I could maybe hurt them or kill them.

 

David Duchovny  31:27

Sure.

 

Dr. Jason Giles  31:28

That’s where all the alarm was. Ultimately, I went back, and this is with monitoring and all kinds of accountability and safeguards. Also several years at this point, it was three years sober before I went back to the OR so, I had a lot of habit practice in living life without anything. But the part that hurt, the shame piece of it was, all the chatter there he is. He said, “That’s the guy”.

 

David Duchovny  31:56

There’s junky doctor.

 

Dr. Jason Giles  31:58

There goes junkie doctor, exactly. That was all right, because I earned that, and that was on me. The part that was the hardest is that my wife worked in the same hospital. So, she dealt with all that. She dealt with all the gossip and the back talk, that sort of water cooler stuff, including from her surgery chairman who counseled her to dump me and run away. Yes.

 

David Duchovny  32:30

There you have a different chairman. We talked about your heroic chairman. Now, we have a different chairman.

 

David Duchovny  32:35

Just as a matter of curiosity.

 

Dr. Jason Giles  32:35

I had a different chairman over there, but there was a lot of that going on. So my actions, besides scaring her and endangering somebody that she loves and cares about, which of course, we don’t think of when we’re going through all this stuff. But I certainly realized it later, I also made it tougher for her professionally, and made it worse for her at work. Because, at that point when I first went back now nobody thinks about me, I’m sure. But, I did ultimately not just finish the residency, but for many years, I came back to the department and gave the talk on what to look for so that you can spot the next Jason running around the hallways who might need help. So, I became success stories.

 

Dr. Jason Giles  33:22

Yeah, it’s all the things. It’s overworking. It’s taking extra cases. It’s the superstar studs stand out.

 

David Duchovny  33:30

So, what you’re looking for.

 

Dr. Jason Giles  33:32

Yes.

 

David Duchovny  33:32

To see the person who’s really gonna fuck up is, look at the successful people. That’s what we’re looking for.

 

Dr. Jason Giles  33:38

Where we’re hiding.

 

David Duchovny  33:39

There’s where the problem is.

 

Dr. Jason Giles  33:43

Exactly. Or the people who were and then have something’s gone wrong, right? This hygiene or tardinesswhere that wasn’t the case, or forgetfulness, starting to degrade perform. Acute performance degradation is one of the hallmarks also. Used to be sharp, but now something’s wrong.

 

David Duchovny  34:04

Sure.

 

Dr. Jason Giles  34:04

That’s getting better. It’s getting better. We don’t tolerate the abusive surgeon anymore. We don’t tolerate somebody smelling like alcohol anymore.

 

David Duchovny  34:04

It’s true. But, I think there’s still the sense of the goose that’s laying the golden eggs.

 

Dr. Jason Giles  34:04

The main thing was there’s a Myrta of Silence in medicine and maybe there isn’t Hollywood too. We found out with all the Weinstein stuff and all that. Nobody wants to be the one that snitches. Nobody wants to be the one, because if you get it wrong, maybe he’s just going through a fight with his wife or something. So, there’s this reflexive I don’t want people getting into my business, so I’m not gonna drop adime.

 

David Duchovny  34:04

Right.

 

Dr. Jason Giles  34:08

That’s definitely true.

 

David Duchovny  34:10

So, we got the superstar here. Let’s not screw this up. As long as he’s still laying those golden eggs, it’s not my business what he’s doing, or she’s doing.

 

David Duchovny  35:15

Let me just say I really appreciate your candor and it’s powerful. Your story is powerful and I appreciate your honesty. The articulation of it is stunning as well. So if you don’t mind continuing, I would love too.

 

Dr. Jason Giles  35:38

Exactly. The entourage problem, right?

 

David Duchovny  35:38

Yeah.

 

Dr. Jason Giles  35:38

Yeah, exactly. I didn’t have an entourage, but it was the whole thing, and says, “I don’t talk about it very often, but the whole thing”.

 

Dr. Jason Giles  35:38

No. So, I went back to the hospital. I did all those things and stayed sober. The story went from what this unfortunate soul fuck up. Exhibit A went to “Wow”, people can return to redemption story and again,that’s grace. I did my part which was to not drink or use I did. I did my part which was to show up continue to work on self improvement. And then as things get better, my life got better. I had a son and and later a daughter. This beautiful life materialized just from the simple act of what I had to do in order to live life on the natch as they say, right? So, without anything.

 

David Duchovny  36:40

I’ve never had that.

 

Dr. Jason Giles  36:41

On the match, natural. So, old 40s term 1940s, I’m bringing it back.

 

David Duchovny  36:45

We’ll try on the match.

 

Dr. Jason Giles  36:48

To live that way, you got to ask for help and you have to tell the truth. You have to show up and you have to be patient and not seek external validation. That turns out to be the root of the problem. Is needing to be constantly reassured that I’m okay. I’m okay because I can save lives, or I’m okay because I can go on the roof when the helicopter comes in for the trauma […]. That’s all ego. I don’t feel enough, but I need to be reassured that I’m enough.

 

David Duchovny  37:22

And you trace that this is the wound that you’re talking about.

 

Dr. Jason Giles  37:25

Yeah.

 

David Duchovny  37:26

This is the wound.

 

Dr. Jason Giles  37:27

I couldn’t fix my dad, right? I couldn’t say, “As if that were my responsibility as a five year old”.

 

David Duchovny  37:34

Is it not the human condition? Or is it certain people are wounded in this way more deeply than others?

 

Dr. Jason Giles  37:43

I think it’s a bell shaped curve. I think you’ll meet some people and they’re like, “I don’t even know you’re talking about. I have great life, always have.

 

David Duchovny  37:53

What those people do think you’re just full of shit you’re not getting it yet? Or are you just one of the lucky ones?

 

Dr. Jason Giles  38:00

I want to think that, but I think, “Well, okay. Maybe lucky, maybe not”.

 

David Duchovny  38:04

This one. We don’t know.

 

Dr. Jason Giles  38:05

We don’t know. I mean, I have been in hell. I’ve been at the lowest points of low and this morning looking at the buds on the trees and the birds jumping in them, it has I don’t know if there’s a direct correlation, but I think that having seen the dark side, I appreciate the other side so much more.

 

David Duchovny  38:57

We got to know each other when I came out of rehab for addictive behavior, sexual addiction. You were my friend at that point. We’d met before that – but we reunite, we reconnected. I would just say this, that even though that addiction specialist would be how I thought of you, that was your job. You never asked me for a penny. You were my friend who happened to be really knowledgeable in this field that I was now looking at myself. Again, I’m still ambivalent about the whole idea of compulsive addictions and things like that. I don’t know if addiction is the right word and my stupid question to you would be, what is addiction? I’m going to ask that at some point.

 

Dr. Jason Giles  40:05

Yes.

 

David Duchovny  40:06

I’m ambivalent about all that. But, what I’m not ambivalent about is that I had like you. I had a hole inside or a sense of unworthiness, or a sense of failure, let’s say. In my case, as you say, you couldn’t save your father or your mother?

 

Dr. Jason Giles  40:30

Neither.

 

David Duchovny  40:30

Well, I couldn’t save my mother, I think is probably at the root of all my evil. I had been like you, I had achieved success which made me untouchable, in a way. I was a goose. I was laying golden eggs, so don’t get in the way of his process. So, that success for me enabled me to to be an idiot and to do things that were destructive and self destructive. So, I welcomed the window at that point, because on some level, I knew that I was being inauthentic or dishonest at the very least. I hate that I’m thanking you in front of other people right now, because that’s what I hate about this world that we live in right now. I’m happy to be thanking you, but I’m mad at myself that I’m thanking you so that other people hear it, in a sense, let me get over that guilt.

 

Dr. Jason Giles  41:40

Yeah.

 

David Duchovny  41:41

In terms of brand and shit like that.

 

Dr. Jason Giles  41:43

I know, I hate that too.

 

David Duchovny  41:45

So, let me say I’m going to thank you in private as well. But, what I come back to is that fact. I mean, it’s just that fact that it was never a doctor patient relationship. It was a peer to peer relationship. There was no exchange of money, never even a discussion of that. You kind of opened me up into this world of 12 Steps and accountability, which I really appreciated. Opened me up into a realm of of knowing, or at least of admitting that you don’t know. Let’s say, a realm of unknowing.

 

Dr. Jason Giles  42:32

Right.

 

David Duchovny  42:33

That I would never have wanted to be in like you. I wanted to know things. I wanted to master things. I don’t know where I’m going with this, but I guess I wanted to say thank you.

 

Dr. Jason Giles  42:44

Yeah. And I’ll say two things. One is, you’re welcome and thank you, back at you. The reason I did that with you, you want to know the answer in the back of the book about that, because that was deliberate. That was deliberate back then. I had a feeling that was the only way to reach you. That was the only way to get in, is to take all of the economic, or all of the professional piece of it, out of it. So, I played a hunch.

 

David Duchovny  43:07

Are you saying you knew I was cheap? Is that what you’re saying?

 

Dr. Jason Giles  43:18

No, I knew that was not it. That’s not it, but I knew that it would be more speaking plainly, it would be more difficult for you to defend against things I was reflecting back to you, or things that I was saying or observations. So, I just decided that I made that decision because I didn’t want you to miss out on the joys of this awesome experience for that – for something silly, trivial like that. Then we’ve gotten to doamazing things, you know?

 

David Duchovny  43:55

Yeah.

 

Dr. Jason Giles  43:56

The friendship was not a construct in order to be able to get in. It was true and it remains.

 

David Duchovny  44:05

This struggle for me within the friendship was always, and maybe this is a struggle within friendships in general, and maybe marriages as well. But, I’m not eternally comfortable in the position of the one who knows less. Friendship is hard to maintain with an expert and a novice and that’s where we entered into our friendship, in a way. I hope we’ve been able to kind of equalize in some way. But, if you say you had a sense that money was the going to be the problem – yeah, possibly money makes it feel weird but alsothere was for me, because I have an ego. Let’s go back to the ego. I can have a friendship somebodywho has expertise in this thing that I don’t have, but it can’t stay that way. I have to be able to equalize. Ithink most friendships do in marriages as well.

 

Dr. Jason Giles  45:18

Yeah, but if you recall, you did. I had aspirations to tell stories in your field, and you mentored me in  that. So, you’re the expert in that and guided me through that. To success and scratch that itch, helped me get to that thing. So, I think we swapped, we’ll say we bartered expertise in that as far as the professional piece of it goes.

 

David Duchovny  45:45

Well, what I would want to pivot to for the last part of this is your job now. The business of addiction, let’s say. That’s a crass way to put it, but there is a big business out there, and it’s kind of a wild west at this point. But, I would like for you to talk to me a little bit about what you’re doing now, what your business is now, and how you go about merging the business side with the service side.

 

Dr. Jason Giles  46:33

Yeah, that’s tricky.

 

David Duchovny  46:35

Yes, tricky.

 

Dr. Jason Giles  46:38

It’s not the wild west of the searchers, John Ford’s the searchers. It’s more like a wild west of Unforgiven or tombstone. There’s a few buildings up now. There’s a saloon, a church and the courthouse. I’ve been doing this job for for 20 years in the addiction medicine field. It used to be way wilder and way west here.

 

David Duchovny  47:03

Yeah.

 

Dr. Jason Giles  47:03

It was only the downstream tenants and experience of the 12 step community. It was hardly any science or medications or observations. I wrote an article today on my my little fledgling sub stack account, which is about the mathematics of the timing and the intensity of interventions, right? So, we forget, we get “Okay, get sober or get your habits under control, or get away from the refrigerator and eat less”. You get your weight where you want it, whatever that is. We all have a tendency to drift back to the way we used to be, and that’s human nature. But, when you get maybe a text message reminder, or phone call or someone knocks on the door and says, “Hey, David, we’re worried”. David, right? Some of this but there’s a mathematical relationship between the intensity of an intervention and it being annoying. Sometimes they’re perceived as annoying, interesting stuff. I think the field has gotten more organized. In many states, we have gone through turmoil where there were bad actors that were selling patients or fly by night, floozy facilities that were not giving a square deal. That’s mostly gotten better.

 

David Duchovny  48:29

My experience of it being processed through that system was this is not you. That they were charging a lot of money to basically use the concepts and the precepts of Alcoholics Anonymous, which are free.

 

Dr. Jason Giles  48:31

Here’s your $30,000 big book, right? Yeah, exactly.

 

David Duchovny  48:57

Yeah.

 

Dr. Jason Giles  48:57

I think that’s what a lot of it was, and in the era when nothing works, so at least try this. I think the standards were our expectations anyway. Were so low that you might be able to get away with that. We’ve learned a lot about what works, and we know that the longer you stay engaged in a treatment program. That one that I was involved in, back in the beginning of these tales, that was a five year long program. The five year long physicians diversion. It’s addiction management program, has a 90 or 95% success rate. So, there is something that works. There is a gold standard, which is to stay connected withthe process long enough to form new habits. Addiction and habits are the same thing. It’s the same thing. You asked me about definition of addiction earlier, one of my favorite. But, one of them is activity without progress. So we do a lot, but don’t get anywhere. A lot of motion, but not coordinated. So, the business is mature the field […].

 

David Duchovny  50:11

My pushback against that would be, that sounds a little capitalist American to me. Activity without progress seems like a Buddhist principle as well, that might be seen as a koan as well. You know, like “Oh, today was great. There was a lot of activity and no progress”. Progress being this American capitalist kind of.

 

Dr. Jason Giles  50:37

There’s two ways to have no progress.

 

David Duchovny  50:40

Yes.

 

Dr. Jason Giles  50:41

So if you’re trying, let’s say you’re trying to go south. You’re on the globe and you’re trying to go South, that’s the direction you’ve identified that you want to go. The two places you can have no progress are everywhere on the Globe, if you don’t move (that’s the obvious one), and at the South Pole. The Enlightened Buddhist have reached the South Pole. There’s nowhere else to go for us, but the rest of us are probably ways off.

 

David Duchovny  51:09

One of the things that I push against in addiction speak is to call it a disease. When I say it’s not a disease, the way I understand disease, and then they’ll say, “Dis ease”. But breaking that down is instructive to me, because it’s like, “Yes, it is a disease that makes us go out and do things either catastrophically bad or catastrophically good”.

 

Dr. Jason Giles  51:39

Right.

 

David Duchovny  51:40

That’s the human condition. I’m not quite content where I’m sitting right now. I’m gonna go do something. My kind of like consternation in the face of uring that disease is, how can you cure what it is to be human?

 

Dr. Jason Giles  52:00

Precisely.

 

David Duchovny  52:02

I think saying is, “Okay, some humans are dealing with in a way that is more constructive, and some humans are dealing with more destructive. Then, most humans are a mixture of the two”.

 

Dr. Jason Giles  52:17

Yes.

 

David Duchovny  52:19

What you’re saying, you’re lending out a hand to those who are in the destructive mode, primarily.

 

Dr. Jason Giles  52:26

Yes. Sometimes you don’t realize that what you’re doing. So, everyone who comes into treatment has two problems, and I had two problems when I went in. One problem was the substances themselves, which had taken on a life of their own. They were a problem, but they were a solution at one point that thing turned against me and turned into a problem was at one point a solution for how I felt. So, if you get rid of the substances, or you get rid of the habitual behavior, you get rid of the addictive process, whatever you want to say that is. You still have the person left who needed, it was motivated to move around or do something different, or had […].

 

David Duchovny  53:04

It’s what’s underneath. As you began this interview, what’s underneath the impulse to the behavior? The other question, because I worry about the children (all the children), and the addiction to the phone. The dopamine in a reward system that is so entrapping of all our children at this point.

 

Dr. Jason Giles  53:28

Yeah.

 

David Duchovny  53:29

So difficult. I think there’s a whole new world out there of addiction to phones that is going to have to beaddressed. I just feel like we’re fucked, like, how are we going to deal with this? For kids, you talk about a five year. The best stats that you have is somebody to go away for five years or somehow be in a program for five years. Do you start at the age of 13 for five years? Or do you start at the age of 14 for five years? How are we going to get out of this? Or do we just throw up our hands and go this is the way life is going to be from now on?

 

Dr. Jason Giles  54:05

I think we need a global digital detox. I think we need to get away from. I’m interested in this thing. There’s this device that is your phone will read it, and it will unlock your phone. If you lock it from your apps, from your social media apps, or whatever habitual thing you’re doing.

 

David Duchovny  54:29

Yeah.

 

Dr. Jason Giles  54:30

You can leave this at home. The only way to get at that stuff is when you come back and put this next to the phone. So, it’s the key. There’s no code you can, “Okay, I changed my mail. Whateveryou hear on the other side of that door, don’t open it”. “Open the door, right?” So, it’s a way to modify your own behavior. The whole world of that stuff is interesting. There are guys like me so there are addiction experts at all of the social media companies that are fig and gambling companies and so forth. This sports gambling trying to figure out how to make their products even stickier. What they’re messing with is to bring it back to your field, they’re messing with our stories. So, the best stories have mystery with opportunity. That’s the best stories, right? That’s the hook. That’s because in the world, when we’re looking for food, or shelter, safety or a mate, we’re hooked by opportunity and mystery. But, mystery is also scary and dangerous. Maybe this new post will be something that’s totally awesome and I’ll get likes and validation, or maybe it’ll be something bad. But either way, I have to check and the checking is the hook, that’s how we’re built. Look, I’m not saying that somebody who had to have his heart valve replaced because of infection from heroin doesn’t have a severe case of whatever you want to call that. But, the shortcutting to relief by using substances or behaviors or the phones that we’re all susceptible toeveryone’s susceptible to it. So if it’s a disease, everyone’s got it because everyone has something that they over lean on for relief. Everyone does. So, I don’t think it’s a distinction that’s very useful to say this person has a disease and this person doesn’t, because everybody has built. We’re all wired up the same way. Listen, if you didn’t keep doing things that the same thing, expecting a different result, you would never learn to walk.

 

David Duchovny  56:56

Right.

 

Dr. Jason Giles  56:57

So, doing the things over and over again, expecting a different result is also the key to success. Maybe next time, I won’t be so scared when I go on stage, or maybe the next time I’ll be able to get the weight off the rack, or whatever it is. We keep trying. That’s how we get better. But, also that can obviously become pathologic.

 

David Duchovny  57:16

Yeah. Well, I look forward to when you figure it out.

 

Dr. Jason Giles  57:22

Yes. Well, what you’re going to see and when you figure out the source. It’s yourself, right? The good news is, it’s your fault. Your life the way it is, it’s your responsibility. My message fundamentally, is take responsibility. So, it doesn’t matter what happened, it doesn’t matter how you got here. It doesn’t matter what your shame is, or the mistakes that you made, or the ways that you failed. The way out, the way forward, is to take responsibility. I did this. This is me. I want to live a better way.

 

David Duchovny  58:03

I want accountability.

 

Dr. Jason Giles  58:05

Yeah.

 

David Duchovny  58:09

I thank you for coming on and kind of skirting around (not skirting around), but allowing me to skirt around these things that are interesting to me. But also, as I said, in the middle of this, full of candor and bravery and lack of shame, all these things that I think are exemplary. So Jason, thank you for this and also for being in my life.

 

Dr. Jason Giles  58:36

My pleasure, David. Many years to come.

 

David Duchovny  58:52

Shortly after concluding my discussion with Jason Giles, I texted him just to thank him for his candor andhis honesty and frankly bravery for coming out and telling his story. He texted back that he felt it brought us closer as friends which I thought was true, but also very interesting in terms of what I’m doingwith the podcast, because I don’t think of it as something I do for myself or to make my life better. But that is sometimes the case, especially when I’m talking to friends or people that I’ve known for a longtime. The podcast I’ve done with Maggie Wheeler or Jason Mckay, people in that case that I’ve known for 50 years. I get to know these people better or somehow share more honestly, or tackle difficult subjects more bravely. That’s the hope.

 

David Duchovny  1:00:07

Thanks so much for listening to Fail Better. If you haven’t yet, now is a great time to subscribe to Lemonada Premium. You’ll get bonus content, like my thoughts on conversations with guests including Alec Baldwin and Rob Lowe. Just hit the subscribe button on Apple podcasts, or for all other podcast apps. Head to lemonadapremium.com to subscribe. That’s lemonada premium dot com. Fail Better is production of Lemonada Media in coordination with King Baby. It is produced by Kegan Zema, Aria Bracci and Dani Matias. Our engineer is Brian Castillo. Our SVP of weekly is Steve Nelson. Our VP ofnew content is Rachel Neel. Special thanks to Carl Ackerman, Tom Kopinski and Brad Davidson. The show is executive produced by Stephanie Wittels Wachs, Jessica Cordova Kramer and me, David Duchovny. The music is also by me and my band, the lovely Colin Lee, Pat McCusker, Mitch Stewart, Davis Roland and Sebastian Modak. You can find us online at Lemonada Media, and you can find me at David Duchovny. Follow Fail Better wherever you get your podcasts or listen ad free on Amazon music with your prime membership.