TRANSITION INTERVIEW #15. Dr. Kathryn Pate. Neurophysiologist, PhD. Trauma and Military Medical Researcher. Veteran Advocate.

Bridging the Gaps of Traditional Health Care, Psychedelic Interventions, and the Potential Dangers of "Healing" Culture.

Dr. Kate Pate is a neurophysiologist who has been conducting research for 15 years in a variety of areas, including Traumatic Brain Injury, respiratory neurobiology, mental health, combat trauma, and psychedelics.

While often recognized for her contributions to veteran mental health, her expertise reaches far beyond, benefiting many communities.

She has a deep understanding of both traditional and emerging approaches to health, making her work widely applicable and relevant.

Personally, I find her ability to connect what is physiological and what is psychological to be profoundly helpful. Furthermore, her willingness to share aspects of her own journey adds depth and authenticity to her work.

You're from Florida originally?

Yep. Vero Beach. My dad worked in home building, so we moved around around Florida a bit. He’d finish a project, get relocated.

And have you always been interested in science? Neuroscience?

I was always a big nerd and loved nature and being outside. I spent a lot of time running around in the woods with my brothers, thinking about life, and science, and animals.

I was interested in the brain at a young age. I remember being - not in high school yet, and I got one of those "For Dummies Books." You know what I'm talking about?

I had the one for neuroscience.

I initially thought I wanted to be a veterinarian because of my combined love for animals and science, then that changed to wanting to become a medical doctor. But, life happens, things change, and different opportunities arise that we feel compelled to take advantage of.

You definitely gain a different perspective as you get older.

Sure, and after high-school you go off to the University of Virginia? I actually grew up in Blacksburg, right down the road.

Yes. It's a long story. I went to a few schools.

We'd moved to Texas when I was a freshman in high school.

My brothers and I were always super close. Right before my senior year, the two who still lived at home left for college at the same time, and that was really hard. All of a sudden, the rock I relied upon so heavily was gone.

It was a difficult time for me. I wasn't in the best place mentally and I wanted to get away from the dysfunctional home and town I was in. I thought changing my environment would make everything better.

So, I applied to UVA, having worked very hard in high school. I graduated in the top few of my class and thought, this will be my ticket. I'm gonna pursue this really difficult program, and that will be my way out of this situation.

As you can imagine, running away caused many of the family issues that were bubbling up that year to become more challenging. It didn't really solve anything. Instead, I unknowingly internalized and concretized the problems that were negatively impacting me.

In my attempts to cope, I became a stressed-out wreck, mentally, physically, emotionally, spiritually. Sadly, I'd developed an eating disorder and a very poor relationship with alcohol - both would impact my life for a long time. In an attempt to fix what was going on, I again thought changing my external environment would help. So I transferred home to the University of Texas for my sophomore year.

That started this long journey for me, trying to figure out what I wanted and who I wanted to be in life.

I got back to Austin, and that wasn't working either; things got worse, actually. Not long after, my dad got transferred back to Florida for his job. So, again, I switched schools and attended the University of Florida.

Nothing wrong with that. Some similarities to my own college experience. And I know you earned a doctorate, where did you go to graduate school?

Yep, I had gotten a Zoology degree from the University of Florida, thinking at the time that veterinary medicine might still be in my future. When I graduated, one of my physiology professors encouraged me to do research, but my idea of research at the time was pipetting by myself in a lab all day. That didn’t sound like me.

But he was like, look, just explore it. Do research for a while and buy yourself some time to figure out if you really want to pursue medicine as a career.

That was good advice. I did a little research in his lab before applying to a PhD program focused on respiratory neurophysiology at UF and was thankfully accepted and offered a great scholarship. I started my doctoral work in 2006.

And was Traumatic Brain Injury (TBI) something you were interested in back in 2006?

TBI is something I've always been interested in.

Academic labs, however, are really centers of specialty. They want to be the best in the world at some particular thing. So, I had to decide, do I want to move to where the best researchers are for TBI? Even if that's somewhere I don't really want to live?

TBI was definitely on my radar, but the lab where I got my PhD wasn't focused specifically on that.

It's funny, I read your last interview with Dr. Kelly. Colorado has attracted a multitude of TBI researchers since then; Marcus Institute for Brain Health in 2017. But in 2009/2010, that didn't exist.

I ended up taking a postdoctoral position in Denver. I was working at National Jewish Health, a top-ranked respiratory hospital, doing respiratory, arthritis, and cancer and radiation biology research. I did a mini post-doc at the University of Alabama one summer, where I did spinal cord and brain injury research, and I brought the TBI research back to NJH with me where I developed a TBI program. That’s how all of this ends up coming full circle.

I see, and you eventually get into teaching and working with some health startups/non-profits?

I needed to make better money to survive in a city like Denver. Your job security and paycheck in the academic world depends upon winning grants – keeping you in this constant state of waiting and wondering when the next one will come.

So I started teaching anatomy and physiology in various nursing programs around the city, then applied to and was offered a faculty job at Rocky Vista University as an Assistant Professor of Physiology. I also became the Director of Research. One day, a colleague tells me his son-in-law needs help with a military medical project and asked if I’d be willing to meet with him and possibly offer my expertise.

Also, what I haven't mentioned is that my brother, Mike, was a medic in Army Special Operations at the time.

The question of whether to help was an easy choice for me. That company was working on creating a combat casualty care research program, and they needed someone with my background to help run it. I loved the idea because it seemed like an amazing way to serve the military community that I deeply respect. Plus, I love trauma medicine.

I also saw it as a way to reconnect with my brother. We'd grown apart at that time. He was on active duty and had a family, and I was busy with my own life and work stuff.

How cool? Full circle, I suppose. Growing up together, going separate ways, and then coming back together, professionally.

I'll tell you it was almost overnight that things started to get better when I got involved in that space. I began to see ways to apply my career skills to solve problems I thought mattered and to help people directly.

I connected with people in the military medical space very quickly. One day I realized that the overwhelming majority of my friends were now military service members on active duty, veterans, or first responders.

I listened closely to my friends and started noticing patterns that really worried me. These were people who outwardly appear very strong but internally were fighting physical, emotional, and spiritual battles. Things they're reluctant to share because they're still doing the job and stigmas are still very much a thing.

I think because people knew my research background and that I had studied TBI, they felt comfortable talking about their symptoms and explaining what they were going through. People would call and tell me, "Ever since I got blown up," or "We've been shooting these 'Carl G's, and I don't feel so good."

I'd have guys tell me, "I'm hesitant to go through normal channels because I know they're just going to put me on pills and tell me to go to talk therapy. And my friends have killed themselves after doing that."

You can imagine that this caused me to look at my work in a completely new light. I'd studied so much physiology and anatomy related to TBI but not the impact on mental health.

Wow. You must be proud of that. It seems like you found what so many are looking for?

I was still battling my own demons – trying to heal from ongoing physical and emotional injuries and fighting against the chains of enslavement of addiction.

I felt connected to these guys in the sense that here I was, seen as sort of an educator and healer, outwardly appearing driven and successful, always ready to serve and tackle the most difficult challenges, but the truth was that I was falling apart on the inside.

So many of the men and women I met from these communities told me similar stories. They carried the entire world on their shoulders and outwardly appeared to hold it together, but they were not okay. And they didn’t know what to do about it. I felt like we had that in common.

And you're still teaching at this time? These relationships you're building with vets, it's something that develops naturally out of your work in combat casualty care research?

I ended up transitioning away from teaching to work for the combat casualty care research company full-time before starting my own company that now continues that work.

Totally on the side. I was getting calls from people I didn't even know pretty regularly. They would say, "So and so gave me your number, and I don't know what to do."

Some were battling intense suicidal ideation.

It would break my heart. Calling a complete stranger.

It was a huge motivator for me. And what you realize, or at least what I realized through all of this, is that - something isn't right with the system.

The system was not capturing these people.

Can you be more specific? I agree with what you're saying. What is about our healthcare system that results in veterans so often preferring to talk to someone like you?

Several things, I think. First off, the VA is just so big. In any kind of bureaucratic behemoth like that, you can easily lose touch with what’s going on and relevant for individual patients.

Helping someone requires understanding, which in turn requires a lot of context, details, and nuance, especially in mental health. And clinicians across the board these days are overworked. They’re forced to see a set number of patients, leaving only a few minutes with someone. You don’t build trust or capture the whole picture in a 15 minute encounter.

Another problem is that clinicians are trained in the traditional medical model, which doesn’t take into account the unique health issues veterans face. And it’s not their fault – they’re using the tools they’ve been given. But if you’re working with this community, you owe it to them to educate yourself further.

A good example of this is missed cancer diagnoses. Another would be something like the overlap between symptoms of PTSD and TBI, and frequent misdiagnoses by physicians and mental health providers alike.

Beyond that, any kind of emerging or innovative intervention is likely not understood, recommended, offered, or covered. Even if you know psychedelics, hyperbaric therapy, or cold plunge might benefit someone. These are just not options yet.

Right. It sort of lacks the ability for individualism and time.

When did psychedelics become something you were interested in?

Around the same time I began working with the combat casualty care research company.

I became close with a veteran who told me about his ayahuasca experience. I had no idea what that was. I grew up in the D.A.R.E. era so psychedelic drugs being used for medicinal benefits wasn't really on my radar.

Anyway, he tells me about his experience, doing ayahuasca, and how it completely changed his life. And I could see it. I could see a real difference in this person. I started doing a lot of research and reading whatever I could find. I was blown away by the publications that were out there. I had no idea that people were investigating these things clinically and for the treatment of different mental health conditions.

Interesting. Will we see the VA and private health care embrace these non-traditional interventions anytime soon?

I think the short answer is yes. Depending on your definition of "soon."

One thing people are starting to realize, health care providers and decision makers that is - the veteran community will take things into their own hands. They're creating non-profits, raising money for research, becoming medical doctors. There's a movement amongst veterans and first responders in our country who want better health care for the next generation. Better than they received.

Either policy will change, or these communities will change it for themselves. We're already seeing significantly less reliance on traditional systems.

That's true. I've not considered it, but you're right; if someone calls me today and says they're really in pain… My advice would include a mix of standard health care measures, but more non-standard ones. If someone breaks their wrist, the opposite is true.

It sounds like you found a lot of purpose working with veterans. Did you eventually start to feel better, personally?

I did. Not overnight, but you look at any non-profit founder, and so often, it's the same story. By helping other people, you inadvertently end up helping yourself.

A big thing I got from working with the community was something that was reflected back to me in the stories I heard. The realization that I grew up in a family where emotions weren't safe to express; vulnerability was seen as a weakness. My friends and I seemed to learn that compartmentalizing everything or suppressing your emotions meant you were tough. Being tough meant survival, coming out on top.

The more I dove into the mental health literature and just experienced life on my own terms, I realized how backwards and harmful that belief really was. In working with veterans and encouraging vulnerability, I witnessed some of the most incredible examples of strength and courage I’ve ever seen. And it was like they were inadvertently holding up a mirror and lots of bright lights for me to see my own life more clearly - where I still had walls up and lacked that same strength and courage. It became an accidental but providential invitation for me to start practicing vulnerability. By them asking me for help and leaning on me, I realized I needed to do the same thing.

And have psychedelics been beneficial to you personally?

Yes. Same friend I mentioned before. I contacted the non-profit that sent him to Costa Rica for his ayahuasca journey and found they were looking to do some research. They learned about my background and asked if I wanted to help them with a new project. I eventually became their Director of Research. This also included an invitation to experience what they were doing for myself.

The project was a gut microbiome study looking at how ayahuasca changes the microbiome and potentially interacts with our physiology in a way that leads to some of these long-term changes that we see in a person over an extended period, six months to a year.

That study will be published next year actually.

So, I went down to the jungle in Peru with a bunch of veterans - the only woman in the group. I learned a ton about myself from that experience.

I told you how close I was with my brothers growing up. I remember being in the jungle with these people, and they ended up feeling like my brothers.

I never want to portray psychedelics as an easy fix because it's not. I had lots of really dark nights post psychedelics, but it starts a process.

It's not a silver bullet. For many people, life generally improves afterward. But that doesn't mean you’ve fully addressed everything. In a way, it can show you what life could be like if you put in the work. But it doesn’t magically make you into that new person. You have to come home and put in effort in day after day to become the version of yourself that you saw – the one you want to be. It does help, but you've got to go in with understanding and managing your expectations.

That's right. I've found in my own journey, we all know our physical health is something that's ongoing. It's normal to exercise every day. In mental health, I find I have a good run or a good season of life, and I'll start dropping the things I know are helpful.

Totally. There's this phenomenon now with social media – it feels like a culture of healing that exists, this idea that tells us we're sick when we're not. Like "you must constantly heal."

We've come a long way in de-stigmatizing mental health, which is great, but I think there's some danger in thinking you should never feel pain and never be sad.

To your point about physical fitness, you get up, I'm a religious person, so I pray, I have time to read, I have time to journal, I make sure I move my body, and all of that contributes to my mental health.

Is there healing going on in the background as I'm doing all of these things? Sure. But it's also just being a healthy person.

Oh man. Definitely. It's like, if your knee hurts, go to the doctor, but don't wake up and try to evaluate whether or not your knee hurts.

That's exactly right (laughter).

There's something about that, something to do with being busy, I think. When I think about the times when I was the "happiest," for lack of a better term. Most of them are times when I was really busy.

Yes. Me too. Like in mountain biking, you don't stare at the tree, or you're going to hit it the tree. Don’t stare at what you think might be a problem, or it will become a problem.

Look, I definitely don't encourage people to ignore anything or to minimize their mental health issues, but there's a balance.

Seems there are a million interventions out there right now. From SSRIs to gardening, you have ten different psychedelic options, magnets, and various types of scans. Is there a particular modality or a particular area of research that you're particularly excited about right now?

Well. There are two things, one specific to treatments, and the other is this "movement" we discussed.

On the treatment side, I'm excited about how much interest there is in inflammation. Inflammation really is at the core of so much disease and pathology, including what's going on following a TBI.

We're seeing new treatments designed to address inflammation, some of those being psychedelics and other things, like various strains of bacteria found in the soil.

All of that is really exciting to me.

Then there’s this movement where communities are starting to heal from within. Your community, the veteran community being one, but there are many more. Groups of women, native and indigenous people, men and women who experience similar trauma, all kinds of things.

You see the volume of non-profits in America today, and in some ways, that's problematic, but at the same time, it's a response to something. It's change; it's people helping people, coming up with solutions.

I've not thought of that way. You're right.

I'll ask you one more and let you go. I mentioned the panoply of treatments we're seeing today. If someone reads this and is thinking… I want to feel better, I have some work to do, but I'm overwhelmed by all the options. Where do you recommend they start?

Start small. Basic things. Things that everyone should be doing as a baseline.

Daily movement, diet, eating well. I always tell people that you don't have to do anything crazy. Things like Mediterranean diet, any anti-inflammatory diet is going to really help your brain.

Also, have an accountability partner. Someone interested in improving just like you are. Someone you can discuss sleep with, how much you're drinking.

You don't have to listen to every episode of the Huberman Lab Podcast; you just start collecting little wins – just a little bit better.

Thank you for doing this and thank you for everything you’ve done for this community.

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