Feeling Lost When Plans Fall Apart? Here's What to Do | Checkpoint 10

When plans fail, you adapt. In this off-script episode, Fred reflects on the first 9 episodes and reveals what's ahead; deeper, harder, more human topics.

There's an old military saying: "No plan survives first contact with the enemy." Today, that became reality when the scheduled guest couldn't make it. But in healthcare, we don't stop when plans break, we adapt.

In this raw, unscripted Checkpoint episode, Fred Nazario-Alvarado goes off script for the first time. He reflects on where MAP has been, shares more of his personal journey from Navy corpsman to medical assistant instructor, and reveals the direction the podcast is heading, toward the harder, emotional topics healthcare professionals rarely discuss.

In this episode, you'll learn:

• Why the first 9 episodes were designed as "boot camp" for your healthcare career
• The importance of knowing your "why" (and why Episode 1 remains the most critical)
• Fred's personal story: from military service to civilian struggle to finding his way back to medicine
• Why tactics get you hired, but emotional armor keeps you from burning out
• What's coming next: grief, burnout, resilience, and the conversations healthcare truly needs
• The "Identity Check" challenge to reconnect with who you are beyond the scrubs

This episode is for anyone who's ever felt lost when things didn't go as planned, and needs a reminder that adapting is what we do.

My Recommended Stethoscope
I still use my Littmann from 2011 because it lasts. This is the modern version of the one I carry.

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Transcript

Fred: 0:01

There's an old saying in the military, one that every corpsman knows by heart. No plan survives first contact with the enemy. You can have the perfect strategy, the perfect gear, even the perfect timing. But the moment you step onto the field, shit happens. And today, that happened to this podcast. I had a plan. I had a guest. I had a perfect interview ready to go. And then, life got in the way. Now, I could have canceled. I could have waited for the perfect conditions next week. But that teaches you nothing. Because in healthcare, we don't stop when the plans break. We adapt. you for a success. For those who don't know, I'm Fred Nazario Alvarado, and today, we're going off script. No guest, no safety net, just an honest after action report. We're going to be talking about where we've been, what we've done, and exactly where we are going next. You know, in land navigation, if you never stop to look at the map, you're just guessing. Sometimes you have to pause, check your bearings, and make sure you haven't drifted off course. So, I thought that's exactly what we should do every 10 episodes. Welcome to Checkpoint 10. So let's begin with talking about the first nine episodes. I have to acknowledge those first nine episodes were heavy on tactics and survival. I mean, look at episode three. It was talking about what you needed to know for your certification exams. Or look at episode two. You were talking about understanding medical career pathways. I created those episodes because I wanted to make sure that everybody entering this field had something readily available to them. Because when you're entering this field, there's just a lot of things that nobody tells you about. For example, take study guides. They're great. Don't get me wrong. I love them. But if you're just studying from a study guide and memorizing what's on there, but you don't actually understand what's going on, when you take your national exam and they give you a scenario and they ask you to figure out what you need to do, That memorization isn't going to help you. Active recall and understanding is what's going to actually make things click. And that's the whole reason for episode three. And take for example episode two, when I talked about the medical pathways, people could come in to all these different types of areas in the field. They can do administration, they can be clinical, they can be leadership. But who actually tells them that there's all these different fields that they can go into? So I wanted to make it available for everybody to just have it there ready for them whenever they needed it. That study episode is great. When you're in your career too and you're looking to accelerate it by getting a new certification or going up to become an RN or who knows, maybe you decide to go PA or become an actual doctor. Having that kind of stuff in your pocket whenever you need it. That's the reason for these first few episodes. I created them so you could all benefit from them. Right away. I mean, look back at episode 5, where I talked about imposter syndrome. That's something I deal with even here now with the podcast. I never saw myself being a leader or a mentor. So I face imposter syndrome when I do this podcast because it's just not what I expected to do. But I've learned that it's something that's really needed. And it needs, there's things that just need to be heard. And I know from experience that imposter syndrome is something you're gonna face when you're in the field. I knew there were some of you out there that needed to do an externship. And that's why I created episode six, even though I never personally had to have one. Believe me, I did a lot of research for that because I knew you guys needed it. And then episode seven, soft skills that set you apart. Because it's not just about knowing the information, but being able to show that professionalism. And then there's probably the most important episode of the entire series, which is episode one. The reason why it's the most important is not because it introduces what this podcast is about or introduces me. It's important because that very first map moment... That was the time I had you guys really figure out your why. Why are you doing what you're doing? Why are you coming into medicine? Why? If you don't know why you're doing something, getting through it and finishing becomes so much harder. If you don't know why you're still working where you're working, getting up in the morning feels like a chore. If you don't know why, then what is there? That is why I feel the first episode is the most important. You need to know your why. m And then there's the other thing I do near the end of the episodes. I ask you all to like, follow, and share these episodes with people on their healthcare path. And I'm not doing it because I want the follows and the likes, although I do appreciate those. Don't get me wrong. But I'm doing it because I really want to do everything I can to help you become better and stronger healthcare professionals. I know there's a lot of people out there struggling. I read it on Reddit all the time. People struggling with how to figure out how to care for their loved ones while in school and working two jobs. There's people out there that are trying to figure out why they aren't doing well in their current jobs when they just started after coming out of a course. This is why I front-loaded these episodes. There were so many people out there needing ammo with nobody to give it to them. And so I just created the ammo. And now it's readily available whenever you need it. These first 10 episodes were like my personal boot camp, just helping you grow and become stronger. But we're going to be moving forward now into more deeper and emotional topics. that are hardly ever discussed out in medicine. Episode 8 was a sneak peek of just how deep these episodes are going to be. I talked about the whole human and their identity. That patient I failed because I stayed silent. I wasn't the only one. There are so many people out there that are constantly remaining silent because they're afraid of speaking out. They're afraid because they fear for their jobs, for their own personal identity. They don't want to be classified as the person who speaks out. against somebody higher up in the chain. But that's the kind of ideals we need to start changing. And it starts at the very beginning. because it starts with you. And so I gave you guys a peek at the kind of discussions I'll be having. My very next episode, which I'll discuss further at near the end of this one, is going to be very deep and emotional. But it's something that needs to be discussed because it's something that leads to burnout, depression, and in some circumstances, possibly even suicide. So we need to move forward. And we're going to be doing that on this podcast. But before we start discussing what the future of this podcast is going to look like, we need to discuss the host. I never made this podcast to be about me. I want it to be about you. Everybody out there. It was never my intention to make this solely about myself. Because that's the thing in medicine. We aren't doing this on our own. Medicine is a constant battle that requires all of us to fight in it. In the military, we had a saying, one team, one fight. And we need to start taking that mentality in medicine. And that's why I decided to go with this podcast to be more about you. But now I understand that in order for you to trust what I have to say, you need to know more about me. So who exactly is Fred Nazario Alvarado? The green ogre once said, onions have layers. So why don't we peel back the layer? A little bit about me. I joined the Navy in 2008. I was a hospital corpsman right after boot camp. And I got stationed in Pensacola, Florida for my first duty station. thing is, I was actually trying to get away from Florida. I actually enlisted in Florida and I joined the Navy to get away and see things. And I got stationed there, funny how that worked. But I will admit it was a great for a studio station. I started working in labor and delivery. That was definitely something different. Caught babies. Saw some stuff there. Then transitioned to anesthesia, as you guys have heard in my third episode when I was talking about mastering what you're bad at. And that time in anesthesia actually taught me quite a lot. I mean, first I realized I loved Anesthesia. The cool thing about the Navy was if you were willing to learn and your providers trusted you, they would teach you anything. While I was there in anesthesia, I was able to intubate patients. I learned how to do nerve blocks, even how to do spinals. Let me tell you, doing your first spinal, that gets your adrenaline going. And it's also interesting because sometimes you can have the best providers in the room and they can still be struggling with something. But then there'd be that one time the corpsman comes in and they'd be like, hey, why don't you give it a shot? And then it's the corpsman that actually gets it. So it's cool that in the military, the hierarchies, while they were there because we had ranks, it isn't like I've seen out in the civilian world. We all worked together and it was just this well-oiled machine. And that's really what I learned a lot about when I was stationed at Pensacola. Just how well we all work together. After my time in Pensacola, I was sent over to field medical training battalion, which is prepping corpsmen to go with the Marines. So it was like almost like a second bootcamp for us. It had some pretty extensive trainings while also getting us ready on the medical end for doing emergency medicine out in the field. But it was definitely a lot of fun. And then so from there, when I was getting ready to finish FMTB as we called it, I was given my first orders and that was to 1st Battalion 6 Marines. The thing about that was we were deploying within I it was a two month window. I graduated in May. And we were graduating. We were deploying in July. So, literally right after I graduated from FMTB, literally a week later, we were in California doing a training out in the Mojave Desert. After that training, I got back and I only had two weeks for leave. And what I didn't say was before I even left for FMTB, my first child was born. And it was definitely difficult because I had to leave literally a month after he was born. Once I had finished my training from FMTB, there was no time for a break. Literally had to go to another training for a month. And then when I get back, all I'd had was two weeks to spend with my family. I know it's not a lot of time, but that's the military. And I missed quite a lot of my child's first year. Because immediately after those two weeks, I came back and we were deployed out right away. So I did my seven months in Afghanistan and I literally came back to the States on my child's first birthday. So yeah, deployment can be heavy. uh Lots of stuff happened there. discuss in an upcoming episode, I'll discuss some of that more in detail. So if you want to hear a little bit about that, it really goes well with what we're talking about here and what happens in medicine and things that we just keep in and don't really discuss. And so after my deployment. I was asked if I wanted to remain with one six to go on a mute with them. Mew stands for Marine Expeditionary Unit. It's pretty much a. Cruise on Navy ships for training. And I decided to decline on that one. I'm actually pretty happy I did because from what I heard from some of my corpsman buddies that had gone on it. It was absolutely boring. The Mew was still about a year out, so in that time we did sick call. And the interesting about sick calls was we were trained just like doctors are. Marines would come in, they'd tell us what was going on. We would take them into the room. We would do their vitals, their height, weights, all the basic stuff. But then we'd go into the assessment ourselves. We would ask what was going on. We'd get the history. We would do the physical assessment on the Marines. And then we would bring our findings back to the provider. We would discuss the signs, the symptoms, what we found during our assessment. He would ask us what we think is going on and how we would treat it. Then he would come with us into the room. We would discuss it with the Marines. If he had any more input or if he disagreed with our diagnosis, he would give us that information too. And then we'd prescribe the medications that the Marine would need and send them on their way. Now we didn't physically prescribe with actual prescriptions. We actually had some medication on hand in our battalion aid station. So if we had anything the Marine needed at that time, we would give them that. If it required an actual prescription, then the provider would put it in through our EHR system and they would go to the pharmacy to get it. So that was pretty interesting. It was definitely a learning curve, but it definitely made me a better provider because it made me think a lot more differently than if I was just a regular medical assistant, just getting vital signs and the basic initial history. And so once the mu got closer, I was sent over to division psychiatry instead, since I wasn't going. And I got to learn quite a bit about the human mind and psychiatry with some really interesting stories behind that. I might just discuss in a future episode if you guys are really wanting to hear about it. And after my time with the Marines was up, I was sent over to the hospital there on Camp Lejeune, Naval Hospital Camp Lejeune, where I worked in the post anesthesia care unit. Yeah, I went from anesthesia to post-anesthesia care unit. Interesting how that worked. It just happened to work that way. And I loved my time there in post-anesthesia care. Again, in the military, your nurses, if they trust you and you're willing to learn, they will let you do and they will teach you. And so that's where my naval career ended was at Naval Hospital Camp Lejeune. I separated from the Navy in 2016. From there I was quite a bumpy road, not sure what I wanted to do or really what was going on in life. mean, the military had been my life the entire time and the civilian side was completely different. So I ended up working at a Chick-fil-A. I was there for about a year and a half. I got into an argument with one of my coaches and ended up walking out that day and going to a medical assisting school and signed right up to get back into medicine and finally do something that I knew I enjoyed. And the reason I signed up for those classes was because I wasn't aware that with my history, I could have just challenged and taken the exam. I just figured I had to start from the beginning again, because every time I tried to do anything with college, it all had to be from the beginning again. They didn't accept any of my sciences because they didn't have lab hours. So I figured it was the same with my medical assisting. And so I went, signed up. took the course, and then I started my medical career. I worked at a hospital, a large one here in Jersey. I ended up leaving due to a back injury I had sustained in the military. I had gotten worse while I was there at the hospital, and it was just hindering my work. And so then I took up teaching, and I really enjoyed teaching. was just exhilarating seeing how people were getting into this field and how I was the one guiding them through it. So I taught for a while. After that, I went back to the hospital, working in the outpatient side of things, dealing more with the social determinants of health side. So these were patients that were really in need as far as housing or financials. That was very different. It was very disheartening. It got to my mental health pretty bad. And I ended up quitting just because my mental health got to an extreme point. but Even though I quit because of my mental health and I took a bit of a hiatus in between just to clear my head and get myself bright again. It's literally what led me to creating this podcast in the end. It made me realize that there's just so many things out there that we as healthcare providers and professionals hold inside and never really discuss. Or when we do discuss it, it's just acknowledged and then pushed to the side. And I felt that something like this needed to be created. so that others out there had more of an understanding of what's going on and what they could do to make it better. So that's me, my history, and hopefully it gets you a little bit more of an insight as to who I am, why I'm doing this, and why I care so much about it. But with that, let's start discussing where this podcast is gonna be going moving forward and what the mission is ahead. So where are we going from here? I mean, I look back at the first nine episodes and I realize they were all focused on the brain of this profession. I mean, we covered how to study, how to pass tests, and how to think like a clinician. And you need that brain to get hired. But the truth is, the brain gets you the job. But it's the heart that keeps you from quitting. We covered tactics. So now we need to cover the resilience. Because knowing how to draw blood won't save you from burnout. And knowing medical terminology, it won't help you from processing grief. So starting next week, we're going to be discussing some tough topics, including a very heartfelt and deep episode on grief and just how much it can actually impact you in this career. Grief is something that's not discussed quite often. We all tend to keep it quiet. But it's something that really needs to come out more. Because there's so many providers and healthcare professionals out there that are holding all this in. Thinking that they're weak because they are feeling these emotions. And this is not true. And that's why I felt that starting off with grief would be a great way to get started with this. And to do it, I'll be taking you into my past and giving you a little bit more history of just who I am and what I have had to deal with. Other topics we'll be discussing will be things like burnout. I mean, imagine if your heart is under constant pressure, eventually it's going to fail. And that's the same thing with burnout. If you're constantly pushing or more things keep getting added to you, more pressure, more grief, you're going to burn out too. So that's definitely something we need to discuss and how we can avoid it and get past it if you're already at that point. I also feel that we should talk about leadership because the things about leaders is that you don't have to be a leader to lead. You can still lead when you're starting out. Because leadership isn't a rank you wait for. It's a decision you make. You lead by setting the standards, even if you're the newest person in the room. And that's something we really need to understand. So what I want to do moving forward is help you build your armor that you're going to need to survive the emotional side of healthcare. Because right now, if you walk into a clinic with just your textbook knowledge or your certs, You are essentially walking onto a battlefield naked. You might know how to fight. I mean, you might know the procedures. You know the anatomy. But you have zero protection. And the first time reality hits you, the first time a patient screams at you or a doctor belittles you or you lose a patient you cared about, it's going to be a catastrophic injury. The kind of hit that takes people out of the profession forever. But if we build this armor, if we talk about grief and burnout and boundaries, now, It changes the outcome. When you wear the armor, you still feel the impact. You're still going to feel the weight of the job. But instead of mortal wounds that end your career, you're going to walk away with just cuts and bruises. You're going to heal. You're going to recover. And you're going to stay in the fight. And so that's the direction I want to go. That's the direction we all need to go. We're all in this fight together. One team, one fight. We need to have each other's back. And that's why I'm here. To have your back. To be there for you when you need assistance. And that's why I'm doing these episodes. So with that, it's time for your map moment. uh It's time for your little push to keep you going stay focused keep strong your pathway to success is on Since today is about pausing to check our bearings, your challenge this week is something I call the Identity Check. Here is the problem I see with so many students. We obsess over what we are becoming. The title, the certification, the scrubs. And we forget who we are. The human underneath. So this week, I want you to do three things to reconnect with that human. Step one, the civilian check. I want you to find a photo of yourself before this medical journey started. Before the stress, before the exams, and look at that person. Remind yourself, you haven't replaced that person. You are upgrading them. Don't lose them in the process. Step two, define your why. No jargon allowed. I want you to write down why you are doing this, but here's the big rule. No medical buzzwords. If you write to provide quality patient care, tear it up. That's a brochure, not a purpose. I want the real reason. It could be something as simple as, I'm doing this to make people feel safe when they are scared. or I'm doing this to prove to my kids that hard work pays off. Or better yet, here's my example. I'm doing this podcast to help you find your path, your confidence, and your purpose in medicine and making sure you succeed. Find the human reason. That is the fuel that doesn't burn out. And then step three, the badge reset. The next time you clip your ID badge or put on your scrubs, take three seconds. Read the name, not the title. Remind yourself that the name is who connects with the patient. The title is just the tool you use to do it. Because here's the truth. Competence gets you hired. Knowing who you are keeps you from burning out. So that's the pivot. Plans changed, we adapted, and we moved forward. If you're listening to this right now, and you are struggling with your own change of plans this week, maybe a test went sideways, maybe your schedule fell apart, or maybe you just feel stuck. Don't stop. Adjust your gear, check your map, and keep moving. And that bearing check has led me to create an episode that will now become a reoccurrence to make sure we're all on the right track. Now I want to hear from you. This episode was different. No script, no polish, just real talk. If you like this style, if you want more of the honest, behind-the-scenes reality of this field, let me know. Send me an email at madpobcast at outlook.com. Or better yet, share this episode with a classmate who looks like they're feeling a little lost in the grind today. Sometimes, just knowing they aren't the only ones whose plans fell apart is enough to get them back in the fight. Before I let you go, I need to tell you what's coming up in our next episode. These last few episodes, like I said earlier, we discussed the hows. And next week, we're going to be talking about something hard. the cost. I'm going to be taking you back to August 11th, 2011. Camp Bastion, Afghanistan. the day I walked into a morgue to verify a casualty. I thought I was prepared. I wasn't. Because the face I saw wasn't a stranger. It was a friend. And the hardest part? The mission didn't stop. The war didn't pause for my grief. So I had to learn to keep moving. while part of me was broken. Next week, we're going to be discussing how we were trained to save lives. not how to grieve them. It is the most important conversation you have ever had on this show. So don't miss it. Until next time, keep learning, keep growing, and keep following your map, your medical pathway for success.