Payman Langroudi: This podcast is brought to you by enlighten. Enlighten is an advanced teeth whitening system. Join [00:00:05] us for online training where I’ll take you through everything you need to know about how to [00:00:10] assess a case quickly, how to use the system, how to talk to patients. Because when [00:00:15] you know you can deliver brilliant results, it’s so much easier to talk about it. To book your course, which takes [00:00:20] only an hour, it’s completely free. Visit enlighten Online training.com. [00:00:25] Now let’s get to the pod.

[VOICE]: This [00:00:30] is Dental Leaders. The podcast where you get to [00:00:35] go one on one with emerging leaders in dentistry. Your [00:00:40] hosts Payman Langroudi and Prav Solanki. [00:00:45]

Payman Langroudi: It gives me great pleasure to welcome Bijan [00:00:50] Shukri onto the podcast. Bijan, funny spelling for your name. It’s perfect. I like it [00:00:55] because A.J. wouldn’t have done it. Yeah.

Bizhan Shokouhi: So I mean, this was a [00:01:00] big one when I was young. First of all, I love it that you can say my name properly. That’s one of the biggest things no one gets right the first time, obviously. [00:01:05] Fellow Iranian. Right? Yeah. But, uh, but yeah, Jay always looked wrong and it kind of people would say [00:01:10] Bijan, but.

Payman Langroudi: Did you decide yourself?

Bizhan Shokouhi: Uh, no, I can’t say.

Payman Langroudi: Obviously someone made a [00:01:15] decision there.

Bizhan Shokouhi: It might have been my parents. Right. But I’m glad because.

Payman Langroudi: I know loads of Bijan J’s.

Bizhan Shokouhi: Yeah, [00:01:20] sure. Yeah. Me too.

Payman Langroudi: But you’re what, z h?

Bizhan Shokouhi: Yeah, because z h you know, is so. [00:01:25]

Payman Langroudi: Oh, like in the Eastern European way, right?

Bizhan Shokouhi: Yeah. Exactly. Yeah.

Payman Langroudi: Oh I see, I see, of course. [00:01:30]

Bizhan Shokouhi: Yeah.

Payman Langroudi: That all makes a lot more sense. So Bijan is a specialist oral surgeon. [00:01:35] Um, I first heard about you through my other guest, Pavan. Yeah. Uh, [00:01:40] when I asked her what was her favourite resource book, internet, whatever. And she [00:01:45] said your Instagram page. And I thought, okay, she’s a periodontist. It must be perio [00:01:50] thing. And it turns out, you know, it’s an oral surgery page. And when [00:01:55] I started following you, suddenly I started getting interested in oral surgery. So brilliant [00:02:00] content, brilliant content, amazing content. I think for anyone who’s in dentistry [00:02:05] should be following. What’s it called? Doctor.

Bizhan Shokouhi: Doctor. Doctor.

Payman Langroudi: Yeah yeah yeah. Nice. [00:02:10] Nice complicated.

Bizhan Shokouhi: Name. Yeah.

Payman Langroudi: We’ll put it into the show notes. Um, so that’s a pleasure [00:02:15] to have you. You are working as an implantologist oral surgeon [00:02:20] in private practice and teaching on several MSc [00:02:25] courses. Which ones are.

Bizhan Shokouhi: They. So the Bristol MSc in implants. [00:02:30]

Payman Langroudi: That one.

Bizhan Shokouhi: Yeah. And then I kind of teach a mentor just privately outside as well. But that’s, that’s [00:02:35] the main kind of didactic.

Payman Langroudi: Thing.

Bizhan Shokouhi: That I do.

Payman Langroudi: Yeah. And so are you there all the time.

Bizhan Shokouhi: No, no, [00:02:40] no, I couldn’t because there’s like a three hour commute for me. I couldn’t do.

Payman Langroudi: It. So it’s all remote.

Bizhan Shokouhi: So no, no, no. It’s like on [00:02:45] average it works out about ten days a year. Okay. So um, yeah, so we have [00:02:50] like, because I do at the moment clinical supervision, which means I’ll go in and [00:02:55] these are students that are seeing patients. So we’ll take them through the whole kind of process [00:03:00] of assessment and all the way through to the end surgery and restoring. And I’m there [00:03:05] for every stage. So it works out around ten days a year. I’m there with them. Um, yeah. Spread out [00:03:10] throughout the year.

Payman Langroudi: And your day guys, what do you do then?

Bizhan Shokouhi: So there I’m just one [00:03:15] of the specialists there. So it’s not a teaching role.

Payman Langroudi: Treating patients.

Bizhan Shokouhi: Treating patients. Yeah. So clinics [00:03:20] and I have an IV list basically. Um but yeah, as part of the job, there’s a lot [00:03:25] of teaching always incorporated into it just from yeah, from the more junior staff [00:03:30] kind of asking for help and so on. And there’s a little bit of undergrads coming and shadowing as well. But [00:03:35] it’s not, I’m not a, I’m not a, um, undergrad teacher, like a, I’m employed by [00:03:40] the trust as a staff.

Payman Langroudi: So your typical work week is four days in practice, one day in [00:03:45] guy’s and then here and there you.

Bizhan Shokouhi: Do, I do, um, on average, I would say three [00:03:50] days of clinical.

Payman Langroudi: Um.

Bizhan Shokouhi: So it works out about two days of practice, one day of guys [00:03:55] and then one day is always off. That’s like family time. And then one day [00:04:00] is teaching and mentoring.

Payman Langroudi: Okay. Okay.

Bizhan Shokouhi: Yeah. So it’s very mixed. I couldn’t tell you [00:04:05] like each week would be slightly different, but the average is work out three days. [00:04:10] Clinical one day guys. And then one day teaching mentoring. Yeah. [00:04:15]

Payman Langroudi: So look I look at your work and it just screams excellence. [00:04:20] Thank you. And you know really, really detailed. I mean a lot of oral surgeons don’t don’t [00:04:25] get into emergence profiles and you know, beautiful lab work and, and [00:04:30] all of that. When did you become excellent? Were you always like, were you an excellent [00:04:35] six year old? Or like, do you do you think do you remember an inflection?

Bizhan Shokouhi: Um, [00:04:40] I mean, what you’re describing is the big difference between oral surgery and kind [00:04:45] of more perio implant side of things, right? And yeah, I see that a lot. And I think for good reason, [00:04:50] there’s this reputation that oral surgeons don’t have that aspect of it. But yeah, I’m glad [00:04:55] you see that because I hope I can show that that doesn’t have to be the case. But one of the biggest things I would say [00:05:00] is that I wasn’t always into oral surgery. So when I actually qualified, I didn’t even know I wanted to [00:05:05] be an oral surgeon.

Payman Langroudi: Oh, really?

Bizhan Shokouhi: Um, so I actually went into practice thinking I’m going to be a [00:05:10] restorative dentist.

Payman Langroudi: Okay.

Bizhan Shokouhi: And yeah, I did a lot of restorative stuff. I did courses in that. And [00:05:15] that taught me a lot of things that are applicable now into implants. Right?

Payman Langroudi: Mhm. [00:05:20]

Bizhan Shokouhi: But then there came a point. I realised I like surgery more, so I put all my eggs into that. But but [00:05:25] that’s been. So what’s so good about the journey in terms of not just being an oral surgeon? So I’ve got all the [00:05:30] other aspects of dentistry that I can put into use.

Payman Langroudi: How many years were you in general practice before [00:05:35] you specialised?

Bizhan Shokouhi: Um. So I did, and then I did, um [00:05:40] one year in practice because at that point I didn’t even know I want to do kind of any [00:05:45] hospital jobs. Yeah. But then that year taught me that I actually don’t want to [00:05:50] be full time practice. So then only then. And this is kind of a funny way to do it [00:05:55] because most people do hospital first and then they decide. So I did practice first, but then I did a max fax job. Um, [00:06:00] and then that told me that I actually don’t want to be a full time hospital.

Payman Langroudi: So [00:06:05] that was where was that?

Bizhan Shokouhi: That was Sidcup. Queen Mary’s. Yeah, yeah. And this was [00:06:10] um, before, for example, their A&E closed down. So it was full on. It was like full on max fax and yeah, [00:06:15] uh, I hated it at first, but then I loved it. It was like amazing. And I encourage everyone [00:06:20] to do max fax. I think it’s one of those.

Payman Langroudi: How long did you do it for?

Bizhan Shokouhi: Just one year. That was enough to kind of.

Payman Langroudi: Make [00:06:25] it for you. What’s that? Makes a man of you? Yeah. I was gonna say.

Bizhan Shokouhi: Character building, right? You [00:06:30] kind of just have to get on with it. And it just makes you it doesn’t, you know, you don’t get phased as much as you would do [00:06:35] otherwise. Yeah, but but yeah, at the same time, I realised that Max fax is the thing is such [00:06:40] a lifestyle choice. Right.

Payman Langroudi: And yeah. Did you even consider doing medicine [00:06:45] and.

Bizhan Shokouhi: So not medicine. I never thought about doing medicine. So um, So [00:06:50] both my parents are doctors. I’ve got two brothers. The elder one is [00:06:55] the youngest, the elder one’s a doctor, the middle one’s a dentist. So I kind of I was lucky I could see what’s involved, [00:07:00] I suppose. And and yeah, medicine didn’t really appeal to me. [00:07:05]

Payman Langroudi: No, but I mean medicine after dentistry, like.

Bizhan Shokouhi: No, no, no, I mean, I guess that goes along [00:07:10] with what I’m just saying. Just even start with I never wanted to do so again. All of that is very much [00:07:15] you really have to love the job enough that. Yeah. And one thing I knew from [00:07:20] very early on was that I don’t want my job to be my life. You [00:07:25] know, as much as I love my job now, you know, I enjoy my life more than my job. [00:07:30] So and I think some of these things, you have to kind of commit to a lot more than others. And [00:07:35] don’t get me wrong, when I look back at what I’ve done.

Payman Langroudi: Yeah, you look very committed. [00:07:40]

Bizhan Shokouhi: I was going to say there’s been a lot of hard work, but then medicine and then more.

Payman Langroudi: So [00:07:45] you mean you’re talking about you saw your parents and by the way, my brother’s doctor, [00:07:50] hospital consultant. I kind of see what you mean. It can be. It has to be sometimes all encompassing. [00:07:55] Yeah. So you saw that and early on decided that’s not for me.

Bizhan Shokouhi: Partly, [00:08:00] yeah.

Payman Langroudi: What kind of doctors are they?

Bizhan Shokouhi: So my dad’s a surgeon. My mom’s a internal [00:08:05] specialist. Yeah.

Payman Langroudi: Are they still working?

Bizhan Shokouhi: No, they’re retired now. But, um, [00:08:10] I would have loved to be a surgeon, by the way. Like something like neurosurgery. That that sounds amazing. [00:08:15] But when I saw what you have to do to get to that, and then the kind of life you have when [00:08:20] you become that. And then when I compared that to what dentistry could be, it just seemed [00:08:25] more of a balanced life, I suppose.

Payman Langroudi: And definitely.

Bizhan Shokouhi: Yeah, I think most people would say [00:08:30] that. Right?

Payman Langroudi: Definitely. Especially if you’re talking UK. I mean, other countries, maybe [00:08:35] not. Maybe maybe the benefits can outweigh some. My my cousin’s [00:08:40] a psychiatrist in Arizona. Right. And okay, she came out [00:08:45] of university with a $500,000 of debt, but the amount [00:08:50] of money she can make.

Bizhan Shokouhi: Now about.

Payman Langroudi: That. And really like, it’s not what we were [00:08:55] saying about takes over your life. She’s medical director of something and [00:09:00] she said, so how often do you get a you know, anything from me? She said, you know, two [00:09:05] emails a week come in for that. And she gets a whole salary for that. And then, you know, the doctors in [00:09:10] the US, they can have a great life if they want to. Here it’s more difficult, [00:09:15] I think, for a doctor. And on balance, I keep on saying maybe I’m doing the wrong thing here. I keep on telling [00:09:20] like, you know, friends, children when they say medicine, I said, don’t do it. Do [00:09:25] dentistry.

Bizhan Shokouhi: I agree.

Payman Langroudi: I.

Bizhan Shokouhi: Agree. Yeah.

Payman Langroudi: So, so okay, let’s get on to work life balance then. [00:09:30] Um, because to me, from the outside, it does look like you’re full on all in [00:09:35] on work. I’m wrong about that, am I?

Bizhan Shokouhi: It couldn’t be anything further from [00:09:40] the truth.

Payman Langroudi: Really?

Bizhan Shokouhi: Yeah. Really interesting. Like some weeks I feel like [00:09:45] I’m not working enough, like, but but that’s what I mean. I really consciously try [00:09:50] and balance it, right? You know, with the two young boys and I, [00:09:55] you know how I said I was very conscious, I don’t want just work taking [00:10:00] over everything. And the more you do stuff, the more you realise how it can suck you in. [00:10:05] Yeah. And once you get to a certain kind of level of doing stuff, it’s hard to kind of then back out. Yeah. [00:10:10] So I’m always very kind of kind of up and down in terms of commitments and [00:10:15] whatever I do. But um, yeah, and look, it’s not like I [00:10:20] don’t feel like that balance is there. And that’s one thing I, I think no one has quite a balance. [00:10:25] It’s, it’s, it’s always a. Struggle to get that [00:10:30] balance. Basically, you have to kind of constantly gauge where you are, how much more you want to do. Um, [00:10:35] and yeah, kind of work, work your way around it without trying to commit too much. But at the same time, [00:10:40] obviously you want to work to your full potential, right? But, but yeah, you know, I want to be there for my kids. I want to be there for [00:10:45] my family. And like, there was a funny quote. I read that by [00:10:50] the time your kids are 12, you would have spent [00:10:55] 75% of the time you ever spent with them. Have you heard this?

Payman Langroudi: Yeah, I’ve heard it and I’m living it. I’m [00:11:00] living it right now. Yeah, because you’re right. My my son’s 19 [00:11:05] and you don’t see him much. He’s at university. If you if you [00:11:10] accumulate the total number of minutes you see him in a year. Yeah. It’s not much. It’s [00:11:15] not much at all. But it’s an interesting thing because, you know, I guess [00:11:20] you’re saying you didn’t get as much exposure to your parents as you wanted. [00:11:25]

Bizhan Shokouhi: Um, I never actually thought about that. Like everything I’m saying isn’t [00:11:30] as a result of, or at least consciously anyway, of kind of what family was like when I was younger. [00:11:35] Um, yeah, my dad used to work more, I guess my mum was naturally around more, especially [00:11:40] when we came to the UK. Um.

Payman Langroudi: Yeah, So I remember, you know, [00:11:45] this whole question of should you have a nanny or not? Yeah, yeah. In Iran, it was very normal.

Bizhan Shokouhi: Yeah.

Payman Langroudi: Yeah. So I [00:11:50] had one nanny. My brother had another nanny. And and by the way, I loved that woman. Love [00:11:55] that woman, you know. But there was never any question about who was my mum [00:12:00] and I was my nanny. Yeah. So, you know, this this idea of. I want to bring up my [00:12:05] own kids. You know, it’s sometimes I’m not sure. At the same time, I’ve [00:12:10] got friends who’ve put all their kids into boarding school. Mhm. And you think, what time [00:12:15] is so short? Why would you shorten it even more by doing that? Yeah. But then they say things like, [00:12:20] um, the school takes care of all the crap, and then you end up having just [00:12:25] quality time with your kids, which is very.

Bizhan Shokouhi: Very limited time. Right.

Payman Langroudi: Yeah, yeah, yeah, yeah. No, [00:12:30] I wouldn’t do it myself. I wouldn’t do it especially I went to school where there was boarding and a lot of them had a terrible time.

Bizhan Shokouhi: But [00:12:35] you didn’t board yourself.

Payman Langroudi: I didn’t myself, I mean, maybe times were different back then, but still still. Um, [00:12:40] yeah. So that question of, you know, homework or sports [00:12:45] and all that is taken care of by the school. And then, you know, these days, boarding school is convertible. [00:12:50] It’s like you can opt not to board for three weeks if you want. Really? Yeah. Actually, [00:12:55] they actually love it, right? Because they don’t have to feed you and house you for that [00:13:00] period. Yeah, I wouldn’t, I wouldn’t do it myself.

Bizhan Shokouhi: Yeah, I don’t know. I mean, this sounds unfair [00:13:05] sometimes, but it’s just like, why have kids if you’re going to just send them to.

Payman Langroudi: Mhm.

Bizhan Shokouhi: Right. [00:13:10]

Payman Langroudi: Yeah. I mean, listen, man, there’s different ways of living.

Bizhan Shokouhi: Oh, sure. That’s what I’m saying. It’s different [00:13:15] for everyone. But I don’t know, for us, we had kids because we wanted to spend that time with them and see them grow up [00:13:20] and whatever. Um, yeah. So and that’s why I’m saying in terms of work, I didn’t [00:13:25] want to be the one that’s just five, six days a week working and.

Payman Langroudi: And so both of you are oral surgeons. Both of you [00:13:30] have the same one day off during the week. Is that right?

Bizhan Shokouhi: Yeah. Yeah. So Linda. That’s good. So [00:13:35] she’s, uh, she works slightly less than me, especially since our second child. But hopefully once he starts going to [00:13:40] school, she’s going to pick up a bit more. Um, but yeah, basically at the moment it’s fairly balanced. I [00:13:45] do a little bit more work. She does a little bit more, uh, with the kids, but it’s always one of us with [00:13:50] him at home, which works out.

Payman Langroudi: No nanny.

Bizhan Shokouhi: No nanny. Yeah, we’ve thought [00:13:55] about it, but then I don’t know one. Logistically, trying to rely [00:14:00] on someone always is difficult. You know, we’ve had so many friends that the nanny [00:14:05] will just quit tomorrow and then you’re stuck. Um, but also, again, it comes down to [00:14:10] no one’s gonna love your child as much as you do. And we just wanted to be there for them. So it just didn’t [00:14:15] for us. We’re very lucky, especially with our jobs, that we can be flexible enough that we’re just always there for them. So [00:14:20] yeah.

Payman Langroudi: Yeah, maybe one of the best things about the job that you can.

Bizhan Shokouhi: Yeah, yeah.

Payman Langroudi: You can [00:14:25] be flexible.

Bizhan Shokouhi: Particularly as a, as a specialist. I mean, we’re so blessed that we can kind of [00:14:30] pick and choose the days and times we work. So that’s yeah, that’s been amazing.

Payman Langroudi: All right. I [00:14:35] want to get into a few things. I want to get into Implantology and the way [00:14:40] your your implantology journey yourself, how you became you. I [00:14:45] also want to get into. Am I right in thinking you’ve worked in quite a lot of practices or [00:14:50] not fair few.

Bizhan Shokouhi: Yeah.

Payman Langroudi: I want to get into lessons, good and [00:14:55] bad, that you’ve learned from working in these different places. Yeah. So where should we start? [00:15:00] Should we start with Implantology?

Bizhan Shokouhi: Yeah, sure. Um.

Payman Langroudi: What was your journey? So how did you [00:15:05] get into implants and how did you get good at implants?

Bizhan Shokouhi: Yeah, I think, I don’t know if I mentioned I, [00:15:10] I didn’t, I think I said I didn’t, I didn’t know if I want to be an oral surgeon. Implants were one of those things that [00:15:15] I didn’t think I wanted to do at all. It’s crazy to think about it now. Like I remember very specifically, [00:15:20] we had an implant guy in our practice, um, and he used to go shadow him and stuff. And I used to think, oh my God, like, who [00:15:25] would ever want to do this? But obviously things changed. Um, and [00:15:30] this is one of the biggest advice I give to people at a young stage is [00:15:35] don’t going to.

Payman Langroudi: Rule Anything.

Bizhan Shokouhi: Else? Exactly. You don’t know what you’re going [00:15:40] to like and not like. So just kind of expose yourself to everything and slowly you develop [00:15:45] what you like and you can see things. And yeah, so especially [00:15:50] undergrad students, you know, fourth years and fifth years, they all tell me I want to be an orthodontist. I want to be this like, [00:15:55] there’s no way, you know, at that point, I think anyway, so, um, [00:16:00] yeah, so, you know, I was, I said I was doing a lot of restorative stuff, just [00:16:05] general practice. Um, but then I was doing oral surgery and then I was exposed to [00:16:10] implants a bit more. So then I was able to kind of place a few here and there. Uh, and [00:16:15] then yeah, as my oral surgery kind of interest developed, I realised I don’t want to just do oral surgery [00:16:20] because the reality is, especially in practice, oral surgery is a bit limited. I mean, the biggest thing is wisdom [00:16:25] teeth, right? If we’re gonna be honest about it.

Payman Langroudi: The old apicectomy.

Bizhan Shokouhi: Exactly. I mean, we do cysts in exactly, but most [00:16:30] of its teeth, right?

Payman Langroudi: Yeah.

Bizhan Shokouhi: And that just got a bit boring after a while. And. [00:16:35] Yeah, so you’re just going to look for the next thing. And then implants was the next natural thing. So [00:16:40] then I did an MSc, the same place I teach in Bristol. Yeah.

Payman Langroudi: Okay. [00:16:45]

Bizhan Shokouhi: And that was yeah, that kind of just led full time. No. So that’s part time again.

Payman Langroudi: Part time. [00:16:50] Yeah. So how long is that.

Bizhan Shokouhi: So three years. Um, yeah. Again, spread out throughout the year. [00:16:55] There’s academic days. There’s teaching days with patients. And yeah, the unique, really nice thing about that was that [00:17:00] how I’m saying I go unsupervised. So there are practical days was [00:17:05] in a dental practice in bath. It’s called the dental implant clinic. Yeah. And [00:17:10] it’s a it’s a private practice. It’s like a normal practice, but it’s joined with the Bristol course. [00:17:15] So it’s very practical. So in terms of how things are run and how to see patients and so on. So [00:17:20] that was amazing. And then when I finished that you realise that it’s only [00:17:25] the start.

Payman Langroudi: Yeah. So how many implants did you put in in that in that three years.

Bizhan Shokouhi: On [00:17:30] the course. It’s not much. So the course and this is this is a big thing people ask about. Um, [00:17:35] so on the course you do one per year or one case per year. Okay. That [00:17:40] one case may have more than one implant, but, but that’s the point. Like you can do ten [00:17:45] implants or 20 implants, 50 implants, but not know the process properly and not kind of know [00:17:50] the basics properly. Yeah. But we make sure that that one case is done properly. So [00:17:55] you know everything how to do it properly. And of course some people then need the practice. [00:18:00] So then that becomes a bit of a challenge sometimes to kind of setting them up in practice. So then there [00:18:05] are other courses that, you know, you hear about the courses, you go to Brazil or whatever, and you do kind of 15 [00:18:10] plants in a weekend. Yeah. That can’t be kind of a starting point. Maybe if you really [00:18:15] want to build your confidence, fine. But I think as a foundation course, I [00:18:20] think you just need to know the basics properly. And that’s what we try and do. And for me, that [00:18:25] was great because I had the surgical skills, but then I just want I needed [00:18:30] the, yeah, the basics, the foundation to kind of understanding of what implants are about, [00:18:35] both the surgery side and the restorative side. And that’s another big thing.

Payman Langroudi: So yeah. [00:18:40] Do you reckon your knowledge of restorative helped a lot right.

Bizhan Shokouhi: Yeah. [00:18:45] Big time. Big time even to this day. Yeah. Because one of the biggest [00:18:50] things I see my oral surgery colleagues struggle with is just [00:18:55] the fact that they don’t have as much restorative background so they can do the implant side. [00:19:00] But then when it comes to restoring it, it’s not so easy. And you got to remember that even [00:19:05] just doing the implant is prosthetically driven, right? So if you don’t have an understanding [00:19:10] of that, then it becomes trickier. Yeah. Like in the olden days, you would just put the implant [00:19:15] wherever the bone is. You know, we clearly know that’s not the case anymore. So. Yeah. Yeah for sure.

Payman Langroudi: So then what [00:19:20] you did, you did the MSC. What else did you do next?

Bizhan Shokouhi: So, um, a lot of [00:19:25] kind of cases with mentors. And that’s the biggest thing that kind of helps you kind of progress. [00:19:30]

Payman Langroudi: How did you find a mentor?

Bizhan Shokouhi: It’s difficult. I mean, I was lucky that [00:19:35] in the hospital I work, we had some amazing guys that could help us in [00:19:40] practice. But, you know, I knew them through guys. Um, and yeah, through the course, there were obviously the [00:19:45] tutors could help you mentors and stuff as well. Yeah. I mean, it was word [00:19:50] of mouth.

Payman Langroudi: So then, okay, you’ve done the three big cases. [00:19:55] You’ve got a mentor. How do you get into the sort of getting patients [00:20:00] to do more?

Bizhan Shokouhi: Yeah.

Payman Langroudi: This is how does that work?

Bizhan Shokouhi: And this is one of the most difficult [00:20:05] things. So it’s easy ish to kind [00:20:10] of know what to do. But then to put it into practice, I think is what you’re saying. Yeah. Um, and yeah, sometimes [00:20:15] you just have to kind of step out of your comfort zone and just kind of go for it. Obviously while you’re staying [00:20:20] safe. But, but yeah, that’s why I’m saying this course, for example, where you see how things are run in [00:20:25] a practice helps you put it into practice easier. Um, just [00:20:30] from kind of the assessment, what you do, you know, how [00:20:35] do you talk to the patient about it? How what things do you check? And then what do you do? Now the at the end of the appointment, [00:20:40] how do you then lead on to the next appointment? All of these little practical things, not a lot of people teach you. Mhm. [00:20:45] Um, and yeah, a lot of it you learn by yourself, but a lot of it mentors, again, they [00:20:50] kind of you see how they do it and you kind of copy them and then you tailor it to your own style. [00:20:55]

Payman Langroudi: So look, now you’re teaching that same course and [00:21:00] what are you bringing to it? I mean, you’re obviously a very, very talented communicator. [00:21:05] What do you see are the main hurdles when someone’s in an [00:21:10] MSc, when someone’s just starting out on Implantology? What what do most people not [00:21:15] understand about that journey?

Bizhan Shokouhi: Biggest one. Communication.

Payman Langroudi: Really? [00:21:20]

Bizhan Shokouhi: Yeah yeah.

Payman Langroudi: Patient communication.

Bizhan Shokouhi: Yeah. Yeah. When you hear about this in every field. Right.

Payman Langroudi: But [00:21:25] yeah, I wasn’t expecting you to say that. Yeah. No, it’s.

Bizhan Shokouhi: I think it becomes even more important [00:21:30] in big things.

Payman Langroudi: Important things you need to talk. [00:21:35]

Bizhan Shokouhi: Trying to trying to explain something big in a simple term.

Payman Langroudi: Yeah.

Bizhan Shokouhi: You know, you don’t how you [00:21:40] word things don’t make it sound scary and you don’t. And it’s not just about putting the patient off, but [00:21:45] when you can’t explain something in an easy to understand way, one, [00:21:50] they’re not gonna understand the whole process. The consent just breaks down.

Payman Langroudi: Mhm. [00:21:55]

Bizhan Shokouhi: But then yeah, it can put them off as well. Right. So you know, the words you use how you word [00:22:00] things.

Payman Langroudi: Give me examples.

Bizhan Shokouhi: I mean, the most obvious one is like just [00:22:05] describing what an implant is. You know, some people say, oh, it’s a titanium screw. You. Drill it into the bone, you know, don’t [00:22:10] talk like that. Right. It’s I mean, it’s cliche, but, you know, say [00:22:15] it in simple terms that, yeah, it’s the best replacement we’ve got for a tooth. It’s [00:22:20] a little post that goes inside. Um, you know, you, the patient doesn’t need to [00:22:25] know Detailed to that point. They want to know what what the end result [00:22:30] is, how you get there. Yeah.

Payman Langroudi: Yeah.

Bizhan Shokouhi: Um, yeah. And this is one of those things [00:22:35] that it’s hard to teach. I’ll say, especially if you’re not there with them every [00:22:40] day. Uh, but it’s so important because [00:22:45] again, you can be the most talented clinician. And I mean, I’ll say this [00:22:50] from learning this myself, but unless you’re a good [00:22:55] communicator, unless you can kind of also build rapport on things, then there’s no point because it’s [00:23:00] just especially in private practice, because you got to remember patients when they in [00:23:05] private practice, the first appointment, they’re not really there for the implant. They’re there to kind of size [00:23:10] you up. Yeah. Yeah. Um, so yeah, like communication [00:23:15] is one of the biggest things I try and always teach.

Payman Langroudi: It’s so interesting. Yeah. I think one of the mistakes [00:23:20] we make is to be an implantologist. You need a degree of an engineer’s brain, [00:23:25] right? One of the mistakes we make, particularly I see it with young dentists, is they download [00:23:30] directly what’s in their head into the patient. And this is what you’re saying that it [00:23:35] needs to be a patient filter. Yeah. You know.

Bizhan Shokouhi: You need to tell them enough, right. [00:23:40]

Payman Langroudi: Enough for consent. Exactly enough for consent. But the patient doesn’t need to know everything [00:23:45] in your head. Yeah. And the other mistake I see people making is they say, oh, these are the seven choices. [00:23:50] Yeah. And even if you’re going to give, I think seven is ridiculous. But let’s say three choices. Yeah. [00:23:55] There needs to follow on from that. And my recommendation is choice B, you know. Yeah. [00:24:00]

Bizhan Shokouhi: When you start, you start with your top choice. You don’t say yeah, yeah. You [00:24:05] know, the choice is leave a monitor denture. You start with, you know, and if this is if if [00:24:10] it’s actually true. Right. You say, look, the implant’s your best interest in this case, but [00:24:15] these are the other options. You know, then you can talk about that. But but yeah, for sure. You know, just [00:24:20] listing stuff is pointless, right? Because how’s the patient going to know what to do. Right. Yeah.

Payman Langroudi: Yeah, yeah. [00:24:25] And the other thing is, you know, you say you don’t want to put people off. I think sometimes it’s reassuring [00:24:30] from the patient perspective to point out everything [00:24:35] that could go wrong. I mean, of course, everything. But but as a young clinician, a lot of times we think [00:24:40] we’re putting the guy off. And I don’t want to scare him. But as from the patient perspective, [00:24:45] I don’t know when was the last time anyone, you know was patient, like someone you really care about was a patient when [00:24:50] when the the surgeon says this could go wrong. [00:24:55] That’s reassuring in that he knows what could go wrong. Yeah. [00:25:00]

Bizhan Shokouhi: And you’re honest enough to tell them.

Payman Langroudi: Yeah, yeah, yeah. And I’ve been in a in a consultation with my [00:25:05] dad, with a surgeon once. And the guy kind of promised the earth man, he really overdid [00:25:10] it. And I remember thinking, really, man, like, is that going to happen? He was like, you know, he couldn’t walk [00:25:15] 20m. And the guy said, yeah, after this operation, you can climb stairs. And all of that. [00:25:20] And it put me off a little bit. And that may be Maybe because I’m from the medical background, but [00:25:25] he oversold it, you know? And my dad never complained.

Bizhan Shokouhi: So everything I’m [00:25:30] saying about trying to communicate things in a nice way, I never, [00:25:35] um, overpromise and I’m very honest about [00:25:40] what implants are and what they can do and what they can’t do. So, you know, I always, always have a little chat about them. And look, implants [00:25:45] are not permanent. Don’t expect them to last your whole lifetime. And I’ll go into kind [00:25:50] of the problems with implants equally as much as the benefits as well. Because, [00:25:55] uh, yeah, like you said, they appreciate knowing that and I think they trust you more. And [00:26:00] obviously it’s the decent thing to do, you know. Um, but at the same time, you’re not [00:26:05] putting them off, you’re just being honest about it. So there’s just going to be a balance about being [00:26:10] able to communicate those things properly.

Payman Langroudi: So what else? I mean outside of communication, what else [00:26:15] do. What’s the common myths that need dispelling for someone who’s going to go into implant [00:26:20] training?

Bizhan Shokouhi: Common myths. Um, I mean, the biggest.

Bizhan Shokouhi: Other thing I [00:26:25] say is. So there’s something I always sit down and talk to people about when they say I want to do implants. [00:26:30] So I first I ask them why. What is it about implants that kind of attracts [00:26:35] you find attractive? Is it the surgery side of it? Is it the money? Um, [00:26:40] and then that leads me on to kind of talking to them about how much there is [00:26:45] to do with implants is huge. Like even to [00:26:50] this day, I’m not done learning. I don’t think I’ll ever be done learning. You know, it’s one of those fields that the more you [00:26:55] learn, the more you realise, oh my God, there’s so much more to learn. Right. It’s like undergrads, you know, fifth year you finish, you realise, [00:27:00] you know. Yeah. Same with implants. So, um, I always [00:27:05] tell them, look, are you happy to be committed to this for the rest of your career? Basically, are you going to [00:27:10] be kind of going conferences, courses, reading journals? Because if you’re not, it’s not [00:27:15] the right thing for you. All right. Um, yeah. So how much goes into [00:27:20] it, I think is important.

Payman Langroudi: It tends to be one of those all or nothing kind of areas, isn’t it?

Bizhan Shokouhi: This [00:27:25] is what I mean. And it can’t be.

Payman Langroudi: One of those.

Bizhan Shokouhi: Things that you’re doing like a case here and there [00:27:30] in between your patients, right? You’re either that guy that does the implants or [00:27:35] just don’t bother. Yeah.

Payman Langroudi: Yeah. The other thing that people don’t appreciate, I guess, is you [00:27:40] can’t have a 9:00 implant patient and the night before be [00:27:45] drinking till 1 a.m. like, you know, you can’t. Yeah. You can be that dentist. You [00:27:50] can’t. Let’s face it. Yeah. You can, you can, you can, you can. It depends what it is. Right. It’s [00:27:55] possible. Yeah. I could be out till 2 a.m. going the next day. Do a couple of exams, [00:28:00] a couple of fillings. It’s possible as an implantologist. Yeah. It is not possible. Yeah. It’s [00:28:05] impossible.

Bizhan Shokouhi: You’re not going to be a good implantologist.

Payman Langroudi: But. No. But the the situations [00:28:10] you can get yourself into. Yeah. A bit different from an Mo. Right. Yeah.

Bizhan Shokouhi: I [00:28:15] think surgery as a whole, it’s quiet. Yeah.

Payman Langroudi: And so and by the way, you could say that about some [00:28:20] pilot or something, but but, you know, things become ordinary, you know, things that start out being difficult [00:28:25] end up being ordinary to you. But it’s something to appreciate that if you are an implantologist you doing implants [00:28:30] every day, your other life, your home life is affected by [00:28:35] that in the same way as your surgeon dad, it’s whole, complete life was affected by being a surgeon. [00:28:40] Yeah, yeah. You’re a surgeon now. Yeah.

Bizhan Shokouhi: It’s different. Yeah for sure. And that’s, that’s [00:28:45] another thing kind of in terms of the work life balance, like there’s [00:28:50] definitely kind of evenings that I’m kind of more stressed and thinking about my work more than I [00:28:55] want to.

Payman Langroudi: Write.

Bizhan Shokouhi: But that just comes along with the job, you know, accept that.

Payman Langroudi: And then what about [00:29:00] when a patient comes in? You’ve never met them before. After you’ve gotten [00:29:05] the whole rapport, you’ve explained everything they leave. How much sort of thinking time do you do before [00:29:10] the actual treatment plan goes out to that patient?

Bizhan Shokouhi: Well, I mean, when I say loads, it depends on the case, [00:29:15] but it can be loads. So I mean, if it’s a very routine straightforward case. Yeah. Not much. Nothing basically. [00:29:20] But yeah, other other things other cases would need. Yeah. Lots [00:29:25] of planning. Um, and lots of lots more engagement with [00:29:30] the patient. So for big cases, you never go from one appointment from the initial appointment [00:29:35] to the surgery, right. So you’d get them back, you’d go through more stuff. You’re [00:29:40] going to show them wax up, you try things in. Uh, yeah, it can be. And that’s why you have [00:29:45] to be able to kind of plan things and kind of quote for things properly. But [00:29:50] also you don’t want to promise things too early. So [00:29:55] there are cases that I wouldn’t have decided that I’m even going to treat the patient until [00:30:00] I’ve seen them 2 or 3 times.

Payman Langroudi: Mhm. Because in what sized up [00:30:05] their commitment to it.

Bizhan Shokouhi: Yeah. Yeah. Because, you know, there are some surgeries that realistically [00:30:10] is going to take 1 or 2 years to finish if you’re going to do it properly. Yeah. And some people don’t [00:30:15] just don’t want that, Which is fair enough. And sometimes the patient doesn’t know that and you don’t know [00:30:20] that on the first appointment. So you kind of tell them the general gist of it, but then you get them back. [00:30:25] They’ve had to think about it. You go through things a bit more detail. Um, [00:30:30] yeah. Like you want to be sure that you don’t start something that either yourself or your patient [00:30:35] is going to regret later.

Payman Langroudi: And so, you know, you know, how in, in orthopaedics, [00:30:40] you cut it down into yet another sort of subspecialty of like hand [00:30:45] or wrist or whatever it is. Which implantologists are you? Like? I was talking to Andrew, [00:30:50] Andrew Dawood about this. He was saying so at the very end of it, what’s what is [00:30:55] your point on the narrative? And he said something about, um, 3D [00:31:00] thinking means that you end up keeping operations much simpler. Yeah. And, [00:31:05] and he was saying often you go, you go some implantologist will say graft [00:31:10] here and extra implants there. And, and he was saying that somehow that can be lazy [00:31:15] thinking as well, and making things a lot harder for the patient by overcomplicating things. [00:31:20] So which which implantologists are you having? If you reflect on what’s [00:31:25] your contribution to the implant narrative?

Bizhan Shokouhi: It’s a difficult question. [00:31:30] Um.

Payman Langroudi: Like what’s the bit of it that [00:31:35] you think you’ve sort of changed compared to what you were taught?

Bizhan Shokouhi: I [00:31:40] think just being from a background of surgery, [00:31:45] being able to kind of do the perio and pro side of [00:31:50] things.

Payman Langroudi: Properly.

Bizhan Shokouhi: Properly. Yeah. Particularly perio. I mean, some people I’ve [00:31:55] been honoured, people have called me an honorary periodontist when they’ve seen someone [00:32:00] work. Yeah. Which yeah. I mean, I really appreciate it because I do put a lot of effort into that.

Payman Langroudi: Are [00:32:05] you talking sort of the aesthetic side, the anterior or what are you talking about? Aesthetics.

Bizhan Shokouhi: This is [00:32:10] one of the biggest things. I guess there’s a misconception about implants as well. And we’re [00:32:15] understanding about this more and more is that soft tissues are equally as important, [00:32:20] sometimes more important than the bone.

Payman Langroudi: In terms of how long it’s going to last.

Bizhan Shokouhi: Exactly, and how well [00:32:25] the whole thing is going to look and work at the end of it. So it’s not even just about. So even a molar, if you if you don’t think [00:32:30] about the tissues too much, you’re not going to get a good result. It’s not going to last as long. So [00:32:35] being able to identify that and know what to do about it.

Payman Langroudi: So, you know, give me an example.

Bizhan Shokouhi: I [00:32:40] mean, the obvious one is just how much keratinised tissue you’ve got and how [00:32:45] the quality of it was thick or thin. Is it attached and unattached. Um, and this is stuff they don’t [00:32:50] teach you in oral surgery, right? Uh, but yeah, like even a single molar, [00:32:55] there might be tons of bone where the tissues just rubbish. So that’s.

Payman Langroudi: Interesting.

Bizhan Shokouhi: Then [00:33:00] you treat both. And yeah, this is one of the things that I’ve kind of really learned along [00:33:05] the years and I encourage everyone to really understand this point. It’s not just about bone.

Payman Langroudi: So when [00:33:10] you say you treat both what you build it, build it out more.

Bizhan Shokouhi: Like you do. Connective tissue graft of some sort. [00:33:15] Yeah. Along with the surgery. Yeah. But. And you see this where the [00:33:20] implants done. And it looks beautiful.

Payman Langroudi: On the X-ray.

Bizhan Shokouhi: Yeah. Yeah. But even in the mouth, [00:33:25] it’s in the right place. Okay. But then the tissue’s all wrong. Right. It’s really kind of depressed, [00:33:30] and the, um, it’s too thin. And then when you put the crown on the connect, [00:33:35] the keratinised tissue is not good enough around it. Mhm. That that needs addressing. [00:33:40] And we know this very, very well documented. Exactly. Yeah. Yeah.

Payman Langroudi: I [00:33:45] see.

Bizhan Shokouhi: And in other terms you’re asking about [00:33:50] kind of what things am I interested in. So grafting, bone [00:33:55] grafting stuff. But, uh, the digital side of things, that’s a big one that’s coming in now. [00:34:00] I mean, it’s been around for a while, but digital planning and then kind of [00:34:05] guided surgery as well. I think that’s, that’s, that’s huge at the moment.

Payman Langroudi: Do you [00:34:10] believe in people first learning Non-guided?

Bizhan Shokouhi: No. Absolutely [00:34:15] not.

Payman Langroudi: Go straight into guided.

Bizhan Shokouhi: No no.

Payman Langroudi: No. The opposite.

Bizhan Shokouhi: Yeah. The opposite. Yeah.

Payman Langroudi: Learn it [00:34:20] free hand.

Bizhan Shokouhi: First you have to you have to as in it’s not even an option. Yeah.

Payman Langroudi: Really really.

Bizhan Shokouhi: Really. Yeah. So if anyone [00:34:25] tells you otherwise it’s not true. Um we have a saying if you can’t do [00:34:30] it freehand, you shouldn’t be doing it guided. Oh just because. You [00:34:35] need to understand the, the basics. [00:34:40] You know, we’re always going to come back to this. You need to understand the basics first.

Payman Langroudi: Yeah.

Bizhan Shokouhi: And there’s [00:34:45] going to be some cases that you can’t use a guide properly or halfway. You realise you have to kind [00:34:50] of make some adjustments. And if you if all you know is guided, you [00:34:55] will get stuck. And I’ve seen it, it’s not the right way to go.

Payman Langroudi: It’s, it’s like, you know, you know, the plane [00:35:00] lands itself, but the pilot still knows, needs to know how to land it in a stormy, in [00:35:05] a stormy treatment. Yeah, exactly. Yeah.

Bizhan Shokouhi: It’s a tool, right. It’s a tool. That’s how I would say it. [00:35:10]

Payman Langroudi: Okay, so the technology now what’s what’s moved on? What’s the latest thing that [00:35:15] you it’s interesting you in terms of.

Bizhan Shokouhi: Yeah. So the degree of planning you can do now. [00:35:20] Preoperatively.

Payman Langroudi: So is it a software thing?

Bizhan Shokouhi: Yeah, yeah. [00:35:25] Like you can plan everything on a software to the.

Payman Langroudi: The nth degree.

Bizhan Shokouhi: Yeah. And you [00:35:30] know, even, even where not just the implant goes where the abutment goes, which abutment, [00:35:35] the height of the abutment, the angle of the abutment, how they relate to each other. Yeah. [00:35:40]

Payman Langroudi: What’s that software called?

Bizhan Shokouhi: I mean, there’s several, there’s. Yeah.

Payman Langroudi: It’s [00:35:45] quite a regular thing.

Bizhan Shokouhi: It’s. Yeah. It’s a big thing now. Yeah. Yeah. And then how AI is being kind [00:35:50] of incorporated into all of this. So there’s, you know, if we’re talking about particular softwares, [00:35:55] there’s a particular thing called smile cloud, which is a really cool AI [00:36:00] kind of cloud based database of, I [00:36:05] don’t know how many thousands of smiles and kind of anatomies of teeth they’ve got, and [00:36:10] it’ll wax up things exactly how it’s most functionally and aesthetically [00:36:15] pleasing, really. And then you base all the plan on that. You can make fine adjustments. Um, [00:36:20] it even does kind of little video simulations and stuff. So you’ll put one picture in and it kind of makes [00:36:25] a video out of it for the patient to see the potential result.

Payman Langroudi: So interesting. Yeah. [00:36:30] But what what? Surely soon treatment planning is [00:36:35] going to be not completely done by AI, but it’s happening. It’s already happening. [00:36:40]

Bizhan Shokouhi: There’s things so there’s I think most of them are still in beta versions.

Payman Langroudi: But.

Bizhan Shokouhi: There [00:36:45] are ones. It’s just one click. And the software will do all the planning.

Payman Langroudi: It will give you one idea of yeah. [00:36:50]

Bizhan Shokouhi: And the next natural thing from that which is already happened is robots placing the implants. [00:36:55] Have you seen.

Payman Langroudi: This? I’ve seen that. Yeah, I’ve seen that. How long do you think it’s going to be before a robot does it all? Uh, [00:37:00] dentistry. I mean.

Bizhan Shokouhi: I mean, the rate things are advancing, it’s always [00:37:05] surprises you, but I don’t think it’s ever going to be hands [00:37:10] off in our lifetime, really, in terms of I think we’re still going [00:37:15] to rely on a human to operate it and to kind of okay IT regulations and kind of. [00:37:20]

Payman Langroudi: Yeah. And trust to that extent. To that extent. Yeah. So, you know about the driverless cars.

Bizhan Shokouhi: Yeah. [00:37:25]

Payman Langroudi: There’s still a driver, you know, he’s driving 50, 60 cars at a time. Exactly. Once [00:37:30] the thing hits the problem, it reports back to base. But how long will it be before [00:37:35] you visit the dentist? And okay, it could be a human.

Bizhan Shokouhi: In a pod, or.

Payman Langroudi: It could be a human. They’re [00:37:40] just not a dentist. You know, like, yeah.

Bizhan Shokouhi: The, the other thing I think is more relevant [00:37:45] and is different from just driverless cars is that human connection.

Payman Langroudi: Yeah.

Bizhan Shokouhi: Um, [00:37:50] and it may not be important to every patient, but I.

Payman Langroudi: Think there could be a human there.

Bizhan Shokouhi: In [00:37:55] terms of.

Payman Langroudi: The TCO like some. [00:38:00]

Bizhan Shokouhi: Yeah. That, that then would just be you using it as a tool, right. Which we already are. But if you’re talking about [00:38:05] in terms of you just turn up somewhere and you sit somewhere and the robot just does.

Payman Langroudi: Everything.

Bizhan Shokouhi: That I’m saying, [00:38:10] I can’t see that happening anytime soon.

Payman Langroudi: I mean, like, look, there are certain things that this whole AI robotics conversation, [00:38:15] right? There are certain things that won’t ever change about being a person. Yeah, yeah. Like, [00:38:20] uh, we will have a meal together or, you know, break bread. [00:38:25] Yeah. If you want to get poetic about it. But at the same [00:38:30] time, the, you know, I’m starting to kind of think of my Gemini [00:38:35] as a bit of a buddy. It started to happen. Yeah. I don’t know how much use [00:38:40] Claude or whatever. Once you once it knows you and stuff.

Bizhan Shokouhi: No.

Payman Langroudi: Yeah, yeah. And it’s [00:38:45] a very interesting question, right. Of what is it that gives something, right. Yeah. [00:38:50] You know, is.

Bizhan Shokouhi: It what makes us human? Right.

Payman Langroudi: Yeah. And or for instance, let’s say they come up with a way of [00:38:55] downloading your brain into a robot. Yeah, yeah. And [00:39:00] then unfortunately, you pass away. Now, now we’ve got this robot who is exactly you. [00:39:05] Do you not count anymore? Now, you know, it comes down to that [00:39:10] spiritual debate.

Bizhan Shokouhi: Have you have you have you watched Westworld?

Payman Langroudi: I [00:39:15] haven’t, I have ever heard.

Bizhan Shokouhi: It’s exactly.

Payman Langroudi: What I’ve heard. Oh, really? Is that what it is?

Bizhan Shokouhi: Partly.

Payman Langroudi: Oh, shit.

Bizhan Shokouhi: Um, [00:39:20] I love all this. All this sci fi stuff, I love it. Blade runner is another one. Yeah. So [00:39:25] that’s kind of to do with this.

Payman Langroudi: Futurism is an interesting thing, isn’t it? Like trying to think where the world will be. [00:39:30] Yeah.

Bizhan Shokouhi: Um, and it’s interesting how there comes [00:39:35] times that what was once science fiction is just reality, right? And we’re kind of crossing that [00:39:40] at the moment.

Payman Langroudi: Star Trek and all that. The computer.

Bizhan Shokouhi: Yeah, yeah.

Payman Langroudi: I do remember there was a show, it was called. [00:39:45] I can’t remember the name. It was like, it was like the [00:39:50] every episode, the guy would wake up in someone’s life and his whole mission was to change [00:39:55] something. And, and he had this, this sidekick and the sidekick [00:40:00] used to have this little unit and he’d go and he’d go, yeah, she, you know, she, she had [00:40:05] a car crash. And if it wasn’t for that car crash, her mum would have done this and become the president of United States. She had [00:40:10] changed that. I remember thinking, there is no way this will ever happen. Yeah. And I thought, even if you [00:40:15] manage time travel and all that, that little device the guy’s got that knows everything, that’ll never [00:40:20] happen. There’s nothing quite like it’s happened like ten years after I saw that [00:40:25] show. It happened. Right?

Bizhan Shokouhi: But there are scary things about it as well. Right. You’ve [00:40:30] got a Neuralink, obviously, right?

Payman Langroudi: Neuralink.

Bizhan Shokouhi: Neuralink.

Payman Langroudi: Neuralink. Yeah.

Bizhan Shokouhi: Yeah. And like, how [00:40:35] do you feel about that?

Payman Langroudi: I think it’s inevitable I think.

Bizhan Shokouhi: Would you do it. Would [00:40:40] you imply.

Payman Langroudi: I’ll tell you what they will do to make everyone do it.

Bizhan Shokouhi: Yeah. Make everyone do it.

Payman Langroudi: Yeah. [00:40:45] Yeah. Because it’s a bit of a wet dream of, of, of some sort of, uh, billionaire [00:40:50] trillionaire people. Yeah. To do that. Yeah. The idea of I’ll put a chip in [00:40:55] this population. Yeah. And the population will kind of work for me. Yeah. By the way, [00:41:00] we’re already there with. I’m holding up my mobile for anyone. We’re already there. Yeah, [00:41:05] I saw my latest screen report. Scared the hell out of here. So we’re already there. The question [00:41:10] is inside you or not? Yeah, there will be. There will be some false flag. Yeah. Where everyone [00:41:15] who had the chip will live and everyone who didn’t have the chip will die. Yeah. [00:41:20] And at that point, yeah, your wife will trot your kids to the GP or actually probably the dentist [00:41:25] to have that chip inserted. Yeah. That’s how they’ll do it.

Bizhan Shokouhi: Scary thought right. [00:41:30] Yeah.

Payman Langroudi: In the same it’s a bit like, if I don’t know, 20 years ago you held up [00:41:35] a mobile and said, would you carry one of these or you cannot exist in the world without one.

Bizhan Shokouhi: It’s become such [00:41:40] a norm now, right?

Payman Langroudi: It’ll be that there might be, you know, the best.

Bizhan Shokouhi: Or would it be more like, [00:41:45] you know, how AI right now people are saying you either keep up with it or you kind of. Yeah. Yeah. Like, is [00:41:50] it going to come to a point where people that have the chips in their heads, [00:41:55] they’re going to be so much more advanced that you feel like you need it to keep up.

Payman Langroudi: Yeah, yeah, yeah. [00:42:00]

Bizhan Shokouhi: But at the same time, are you are you willing to sell your humanity for it? Yeah, yeah. Well you are.

Payman Langroudi: No, [00:42:05] I don’t do it. I don’t do it happily. Yeah, but to get me to do it. Yeah. [00:42:10] Just make me q a lot. Yeah, yeah. Once. Once I have to queue a lot for everything. Forget [00:42:15] it man. Like it’s the worst thing in the world for me to queue. Yeah, yeah. You could say my liberty is worth the queue. [00:42:20] Yeah, but it would be something like that. Many things like that.

Bizhan Shokouhi: Yeah, yeah, yeah.

Payman Langroudi: Like [00:42:25] how to live in the world will be defined by which chip. The other thing is you’re going [00:42:30] to have to start paying like we’re all paying now, right? I’m paying as a company. We’re paying three, 400 a month [00:42:35] now for, for AI. Yeah, yeah. And it’s going it’s increasing quickly. Yeah. I think [00:42:40] as households, yeah. You’ll start having to pay everything subscription. Mr. Musk [00:42:45] to defend you. Yeah, yeah. Like your AI will have to defend against other AIS [00:42:50] that are gonna attack. And it’s very scary, man.

Bizhan Shokouhi: Yeah, I.

Payman Langroudi: Can see the most scary part of it is even [00:42:55] when you see interviews with the guy from anthropic and the guy from all of them are like, yeah, yeah, [00:43:00] you know, the world could end. They’ve got like, no one’s saying everything’s going to [00:43:05] be okay.

Bizhan Shokouhi: Yeah.

Payman Langroudi: Um, the other one is people will lose their jobs. There’s no doubt [00:43:10] about that. Right. I had, I had, I had a guy, a corporate guy I was talking to, and I asked [00:43:15] him that question. So you’re having, are you having that conversation about job losses? And [00:43:20] he gave the cliche answer that people are giving now about no, no, no. The same people will do a lot [00:43:25] more work. Yeah, it’s possible, it is possible, but very possible. A lot of people are [00:43:30] going to lose their jobs, you know. And what is what is society going to be like when [00:43:35] that happens?

Bizhan Shokouhi: No one knows.

Payman Langroudi: Yeah.

Bizhan Shokouhi: No one.

Payman Langroudi: Knows. It’s the first time ever that we don’t know what the world’s going [00:43:40] to be like in three years time, you know? So on this journey that implants [00:43:45] we’ve kind of been through, now tell me about other oral surgery. Like, okay, [00:43:50] wisdom teeth. What else? What else isn’t oral surgery that you’re doing?

Bizhan Shokouhi: Yeah. So [00:43:55] typically oral surgery is done to alveolar, right. So anything to do with teeth and the bones around it. So we do um. [00:44:00]

Payman Langroudi: Are you doing, you know, like when, when there’s uh.

Bizhan Shokouhi: Like a. [00:44:05]

Payman Langroudi: Periodontist.

Bizhan Shokouhi: Only as part of my implant treatment. Mhm. Not, not just separately. Um, [00:44:10] and only, I mean, I’d say I know how to do [00:44:15] it from everything I’ve learned, but yeah, it doesn’t make sense to kind [00:44:20] of go into the perio as a thing separately. So yeah, no, I’ll just do the implant [00:44:25] plus the perio that’s involved with that. And then yeah, the oral surgery is kind of ectopic [00:44:30] teeth exposing bonds, cysts, sinus work, [00:44:35] anything to do with sinuses. Um, yeah, it tends to be that. And then obviously high risk cases to do with the nerve. [00:44:40] Yeah.

Payman Langroudi: What’s the limit of your implantology. Like do you do zygoma. [00:44:45]

Bizhan Shokouhi: No. So at the moment no. And that’s one of those things. So I don’t do a lot of full [00:44:50] arch. First of all.

Payman Langroudi: Are you doing. Why is that.

Bizhan Shokouhi: So. I just [00:44:55] don’t get the cases, to be honest. Yeah. Like where where I work. I [00:45:00] need to really market for it. So the clientele that I get, they honestly, [00:45:05] they just don’t need that level of full arch that I’d be doing a lot of them. Mhm. Um, [00:45:10] and yeah, I just don’t feel like I need to market for it. I’m happy with all the kind of work I’m doing. So, you [00:45:15] know, I’ll happily do advanced grafting and whatever else is involved with it. But, but yeah, I don’t, [00:45:20] I don’t do a lot of full articles.

Payman Langroudi: Like always when you say advanced grafting, what does that mean? [00:45:25]

Bizhan Shokouhi: So, uh, just to give you an idea, like in terms of grafting, we have [00:45:30] generally speaking, horizontal bone graft or vertical bone graft. So horizontal is [00:45:35] known to be fairly not easy, but more routine and predictable, whereas vertical is a whole different story. [00:45:40] Um, you know, you get what I mean by vertical.

Payman Langroudi: Yeah, yeah.

Bizhan Shokouhi: Of course. Uh, [00:45:45] so yeah, I’ll, I’ll do all of those cases basically. And any kind of soft [00:45:50] tissue reconstruction that goes along with that.

Payman Langroudi: Mhm. And so grafting, where [00:45:55] do you take it from?

Bizhan Shokouhi: It varies on the technique, but almost always the gold standard [00:46:00] is you use at least some or even sometimes all autogenous. So just from the [00:46:05] patient. Yeah. And then you mix it usually with something else. Sometimes it’s you would have heard of cow bone xenografts, [00:46:10] but sometimes it’s human bone. So we call that allografts. Um, there’s [00:46:15] synthetic materials as well. But yeah, it depends on the technique. So there’s no kind of one technique for everything. [00:46:20] And it’s one of the other big things. You have to understand what works for where. And you need to understand the biology to be able [00:46:25] to kind of understand that.

Payman Langroudi: So tell me what like obviously it’s a big subject, but.

Bizhan Shokouhi: Yeah, so. [00:46:30]

Payman Langroudi: How did you, how did you decide?

Bizhan Shokouhi: Yeah. So as a very kind of, I mean, [00:46:35] this is really dumbing it down.

Payman Langroudi: But that’s what I need. Yeah.

Bizhan Shokouhi: But there’s a, there’s kind [00:46:40] of a universal truth to it that let’s say. You’re [00:46:45] doing something within the bony envelope. So [00:46:50] it’s a just to explain that. So everyone has almost [00:46:55] a genetically determined limit to where your bone is.

Payman Langroudi: Mhm. [00:47:00]

Bizhan Shokouhi: You know, our mandibles are shaped a certain way. And then any bone outside of that would consider that [00:47:05] outside of the genetic envelope. So if you graphed that [00:47:10] outside bit with just your own bone, the body’s natural reaction [00:47:15] is to kind of just put it back to where it was. So then you need to think of doing something else. And that something [00:47:20] else is usually mixing it with some xenograft. So xenografts the cow bone, the animal [00:47:25] bone is much more resistant to these kind of resorptions. It basically [00:47:30] never resorbs. It always stays where it is. So then it holds its structure, but [00:47:35] then it also has downsides, potentially, because it’s not depending on how much of the [00:47:40] xenograft, the animal bone you use, it’s not as much real bone like you want as much real [00:47:45] vital bone. Yeah. Yeah. So that’s one of the biggest things sometimes happens [00:47:50] that results in failures is just using a xenograft, for example, 100% [00:47:55] of just the powder. That just doesn’t work because it’s not going to turn into real bone. And then [00:48:00] people think, oh, why did that fail? It wasn’t because of the material, it was because of how you used it. Um, [00:48:05] so yeah, that genetic envelope is a big thing. So outside you would use [00:48:10] different materials. Inside you can use just Autogenous or allografts, which is a human bone as well. Yeah. [00:48:15]

Payman Langroudi: What were you like as a dental student at London Hospital?

Bizhan Shokouhi: Yeah. [00:48:20]

Payman Langroudi: Were you into it? Uh, you could have.

Bizhan Shokouhi: I was always quite studious, I [00:48:25] guess. Yeah, yeah.

Payman Langroudi: Which years were you? What were you were you there?

Bizhan Shokouhi: What years were there? So I qualified 2008. [00:48:30] So 2003 to 2000. Yeah.

Payman Langroudi: And like when the first [00:48:35] time you saw Whitechapel, did you.

Bizhan Shokouhi: Oh.

Payman Langroudi: Was it on your interview day? It [00:48:40] must have been. Yeah. It must.

Bizhan Shokouhi: Have been.

Payman Langroudi: Yeah. So where were you, where were you growing up before at that [00:48:45] point?

Bizhan Shokouhi: Um well not that far actually, but the other side of the Hammersmith line, Edgware Road, basically. [00:48:50] Okay. Yeah.

Payman Langroudi: And so as as a place to work and study and all that. [00:48:55] Did you come to love it? Because they do. People end up starting by, by going, what the hell is this? Yeah. [00:49:00] I mean, I couldn’t.

Bizhan Shokouhi: Yeah, I wouldn’t say love.

Payman Langroudi: But, um.

Bizhan Shokouhi: It was all right. I mean, [00:49:05] you’re there to, to, to learn, right. It was. Yeah. And I think it’s changed a lot now. Right. It’s I haven’t [00:49:10] been back for.

Payman Langroudi: Yeah. It’s kind of cool now. It’s it’s got a cool edge to it.

Bizhan Shokouhi: This is before the new hospital. [00:49:15]

Payman Langroudi: Yeah. Yeah.

Bizhan Shokouhi: I distinctly remember do you remember those really old brown dental chairs and wooden [00:49:20] tops? Yeah. I mean, that’s what we had.

Payman Langroudi: I didn’t get into the London hospital. [00:49:25] I that’s where I wanted to go. Okay. I ended up in Cardiff, but it didn’t quite hit the grades. But [00:49:30] um did you not consider leaving London?

Bizhan Shokouhi: Yes. I mean, when I applied, I [00:49:35] got also into Bristol and Birmingham. I didn’t get into King’s [00:49:40] because they said I’m too young. So, so I was, yeah, [00:49:45] I was going to be 17 when I kind of was joining uni and they had they just had a rule that [00:49:50] you have to be 18, which is whatever. Um, so yeah, but um, also [00:49:55] gave me a place and yeah, like, I mean, it was, it was convenient, [00:50:00] right? It was just down the road, almost one tube and yeah. So no, I didn’t think of that going.

Payman Langroudi: So you lived at home. [00:50:05]

Bizhan Shokouhi: Yeah.

Payman Langroudi: Yeah. You didn’t do that proper uni experience then. Yeah.

Bizhan Shokouhi: No. And honestly I don’t regret [00:50:10] it. I don’t feel like I missed out.

Payman Langroudi: No you definitely did.

Bizhan Shokouhi: Did.

Payman Langroudi: I. Yeah yeah yeah yeah [00:50:15] yeah. Like because you’re a child. You’re a child at that point. And [00:50:20] then when, when you go and live somewhere where you have to buy salt and pepper and [00:50:25] vacuum your own floor and, you know, stuff like that, it makes it turns out I did.

Bizhan Shokouhi: All that later for and [00:50:30] just, but.

Payman Langroudi: Took to it like a duck to water. Yeah. There’s [00:50:35] so much to it though.

Bizhan Shokouhi: I know.

Payman Langroudi: I know your own kids. Would you tell them to stay? You know, for instance, my [00:50:40] son did engineering. My son’s doing engineering.

Bizhan Shokouhi: Yeah.

Payman Langroudi: Best school for engineering. Imperial [00:50:45] College. A good school, but it’s literally the building next door to his school. Yeah, and a [00:50:50] bunch of kids go from his school to Imperial College, and I just forbid it, I said. That [00:50:55] just can’t be. You’ve got to move a little bit. You’ve got to evolve a little bit. Right?

Bizhan Shokouhi: Yeah. No, I [00:51:00] totally get that. But, uh, yeah, maybe. Yeah, I don’t know, maybe [00:51:05] kind of my view on different things would have been different if I.

Payman Langroudi: By the way, by the way, I was that kid. Yeah. Because at [00:51:10] 17, you think you’d know it. All right. So I wanted to stay in London. Yeah, yeah. Because, you know, you’re in London, right? [00:51:15] Yeah. But it was the best thing ever. Leaving the best thing ever with with [00:51:20] my son. I really gave him that advice. And actually, he just came back after his first year. And I said [00:51:25] to him, what do you think? What do you think of the advice? And he said, yeah, you were right. I wanted [00:51:30] a year out as well. Did you did you ever consider that?

Bizhan Shokouhi: I did.

Payman Langroudi: But parents shut it [00:51:35] down.

Bizhan Shokouhi: No, honestly, my parents were very supportive of anything I wanted to do. Yeah, they would have. Oh. That’s nice. Yeah. [00:51:40] Like even just doing dentistry, it was never like between medicine or it. Was never that kind of conversation. [00:51:45] Um, yeah. Like, uh, the [00:51:50] living out thing. I’ve thought about this a lot, but I don’t know. It was again, [00:51:55] it was convenient. I saved up a lot of money and. Sure. And yeah, like one of the [00:52:00] other things is like, I’m very close to my family. So I never felt like, you know, some kids, they, they want to kind of just [00:52:05] go and explore and stuff. Yeah, yeah, yeah, yeah. But it was, I don’t know, it was fine for me.

Payman Langroudi: If your kids [00:52:10] want to be dentists, would your advice be to go for it or not?

Bizhan Shokouhi: Honestly, [00:52:15] no.

Payman Langroudi: No, really. Go on.

Bizhan Shokouhi: Yeah.

Payman Langroudi: Go on. That’s interesting.

Bizhan Shokouhi: And I’m saying [00:52:20] this from a position of being very happy as a dentist. Yeah, I love what I do, but when I think [00:52:25] about what I’ve done to get here and yeah, [00:52:30] I mean, it’s been tough, right? It’s a lot of work.

Payman Langroudi: It is.

Bizhan Shokouhi: And then [00:52:35] when you kind of think what kind of stresses you have in life and, [00:52:40] And kind of distil the kind of commitments you need to be [00:52:45] a dentist at this level. It just feels like there’s kind of maybe easier, less [00:52:50] stressful ways to make a living. Well, I don’t know. And everything’s changing so [00:52:55] much. So like in ten years, maybe there’ll be. Yeah.

Payman Langroudi: Look, the thing is, when you stop. I [00:53:00] stopped 15 years ago. When you stop, you realise what it is about it. That’s brilliant. Yeah. [00:53:05] And I’ve got friends who’ve. Who’ve actually someone coming in straight after you who was a dentist, [00:53:10] became a periodontist, became a barrister, [00:53:15] and then went back to become periodontist after that. Yeah. [00:53:20] And, and the question of, you know, let’s bring it down to like reductive. [00:53:25] Let’s talk about money. Yeah. If we’re talking just let’s talk about money. Only pound [00:53:30] per stress. Yeah. Do you know pound [00:53:35] per stress? It’s everything worthwhile is stressful.

Bizhan Shokouhi: Yeah. [00:53:40]

Payman Langroudi: It really.

Bizhan Shokouhi: Is. Yeah. Different kinds of stresses.

Payman Langroudi: Like you might think some guy sitting on a terminal [00:53:45] pushing a button to buy stock isn’t stress. He’s more stressed sometimes. Often when [00:53:50] he’s losing. Then when that implant’s going in the wrong direction. Yeah, yeah. So, [00:53:55] you know, you’re clever enough to have taken all of this into account. Yeah. And yet your conclusion [00:54:00] is.

Bizhan Shokouhi: Different kinds of stresses and different lifestyles, [00:54:05] right? So yeah, like one of the big things has become a thing [00:54:10] is working from home, right? Which we can’t.

Payman Langroudi: Do, can’t do. That’s the worst thing.

Bizhan Shokouhi: Yeah. Like when you see your friends [00:54:15] kind of just.

Payman Langroudi: That is the worst thing.

Bizhan Shokouhi: This is what I mean.

Payman Langroudi: Or working from Bali or whatever, you know? Yeah. [00:54:20] That it’s doable. I’ve got few people maybe. I hope they’re not listening. I’ve [00:54:25] got a few people who work here that they could say anything. They could say, I want to work from New Zealand.

Bizhan Shokouhi: Yeah, [00:54:30] same. I’ve got friends. Like.

Payman Langroudi: No, they could say I’m talking about my employees. They could say I want to work from New [00:54:35] Zealand. And I would find a way because they’re that important to me, I would find a way to [00:54:40] make that happen.

Bizhan Shokouhi: We have no flexibility.

Payman Langroudi: There is no way we can do that. That’s true. That’s true. Especially [00:54:45] if you have the travel bug. You know, like, you know, a lot of people do these days, right?

Bizhan Shokouhi: Yeah.

Payman Langroudi: Um, [00:54:50] let’s, let’s move on to the darker part of the pod. We [00:54:55] like to talk about errors, clinical errors. What comes to mind if I say what, what’s a clinical [00:55:00] error that you’ve made that kind of stuck with you.

Bizhan Shokouhi: Yeah. Um. I [00:55:05] mean, I, I’ll give you an actual example in a second. Uh, [00:55:10] but I’ve been lucky. I’ve never had any big disasters or anything drastic. And, um, [00:55:15] one thing I always, because I’ve heard you say this in other podcasts as well, uh, [00:55:20] why are we calling it a dark side?

Payman Langroudi: Like, okay, the [00:55:25] lighter part.

Bizhan Shokouhi: It should just be more open about it, right?

Payman Langroudi: We should, we should.

Bizhan Shokouhi: But that’s why it just gives it quite [00:55:30] a negative, scary connotation. Do you know what I mean?

Payman Langroudi: Yeah, you’re right. That’s the whole point of it is to get it out of there.

Bizhan Shokouhi: Yeah. [00:55:35] And honestly, one of the big things is we need to be talking about complications more.

Payman Langroudi: Yeah, I just, I just think. [00:55:40]

Bizhan Shokouhi: I get it. I just think it sounds cool. I totally get what you’re saying, but I hope you get what I’m saying.

Payman Langroudi: Absolutely, [00:55:45] absolutely.

Bizhan Shokouhi: Um, yeah. So I’ve made lots of small mistakes. Like any, [00:55:50] any mistake you can think of, I’ve probably made along the years and, uh, like everyone [00:55:55] tells you that those really are the biggest things that teach you regardless of what courses to teach you, right? You don’t learn [00:56:00] unless you’ve done it yourself. But anyway, um, yeah, in terms of a particular case that always [00:56:05] kind of sticks in my head. So I had this patient, a really [00:56:10] lovely lady in her 80s. I’d taken some teeth out for her and a [00:56:15] big cyst as well. But then by this point she was edentulous. So then she needed teeth. And [00:56:20] we really got on by that point. And she trusted me with everything. And she, [00:56:25] I mean, naturally she asked, can I do it for her? And I had a look and [00:56:30] it was one of those really difficult denture cases. And by the way, she couldn’t, she didn’t want and she couldn’t afford [00:56:35] having big. Grafting, fixed teeth basically. So it was going to be dentures [00:56:40] plus or minus implant over dentures. Yeah. So [00:56:45] it was one of those kind of the upper was all flabby.

Bizhan Shokouhi: The lower was just no bone, you know, it was basically [00:56:50] resorbed to the floor of the mouth type situation. And I had a look and I said, look, I can do the implants, but [00:56:55] I’m not an expert at dentures. But I know a good guy, you know, prosthodontist [00:57:00] down the road. I’ll refer you to him. Um, and yeah, so I told her about that [00:57:05] and she looked up where he is. It was only for half an hour away for, for her it was like a big commute. [00:57:10] And she said, look, I really want you to do it. Please. You know, it’s one bus [00:57:15] to come here, I trust you. Can you just do it so you can probably tell what [00:57:20] this is going right. So I did it for her. And, and yeah, so initially [00:57:25] it was, you know, and I did everything by the book. So, you know, I know how to make dentures. I’ve done them [00:57:30] before as part of my training as well. So I did a whole steps, all the steps [00:57:35] you have to do. I even used green stick.

Payman Langroudi: Blast from the past.

Bizhan Shokouhi: All [00:57:40] the things. And yeah, the top denture was actually pretty good even with the flabby [00:57:45] ridge just by itself was good. The lower upper two implants in because that’s the gold standard you know, you have [00:57:50] if you’re.

Payman Langroudi: With the bar or.

Bizhan Shokouhi: Yeah. Or attachments.

Payman Langroudi: Yeah. Attachments separate. Yeah.

Bizhan Shokouhi: And [00:57:55] the implants were fine. So that that wasn’t difficult bit. And the denture initially was fine. [00:58:00] And you know, it clicked in. But then of course she kept [00:58:05] coming back. You know, it was in function. It’s a totally different story right. It kept kind of moving [00:58:10] rubbing and you know adjustment after adjustment, she [00:58:15] somehow broke the lower. This was a chrome base. She broke the acrylic. Um, [00:58:20] so I remade it for her. And I think last time I counted it, it was something like over [00:58:25] 20, almost 20 something visits. Wow. Over about 18 months.

Payman Langroudi: Adjustments, [00:58:30] adjustments.

Bizhan Shokouhi: Remakes. And I didn’t charge her for any of this, by the way. It’s um. And [00:58:35] yeah, look, they just came to a point. I said, look, I was gonna say Mrs. Jones, that’s not her name, but I said, Mrs. [00:58:40] Jones, I’ve done everything I can. I really need to send you to the Prosthodontist. [00:58:45] And, and yeah, that’s what I had to do. I mean, as kind of a bigger [00:58:50] defeat as it makes you feel like you kind of just have to kind of say, look, this is as far as I can do. [00:58:55] And I’m not saying this to say that she made me do it. It was my [00:59:00] responsibility. Basically, I against my better judgement, you know, I made that judgement [00:59:05] that it’s a difficult case. I should refer it, but I still kind of did it.

Payman Langroudi: Often. That’s when stuff [00:59:10] goes wrong, isn’t it? Against your better judgement? Yeah. When you’re doing someone a favour.

Bizhan Shokouhi: Yeah. And you [00:59:15] feel like it honestly wasn’t the time that I had to spend. It was the time I wasted [00:59:20] for her dragging her back so many times. And, and yeah, the most painful [00:59:25] thing is at the end, she still had to go to someone else and try and sort it out. Um, yeah. [00:59:30]

Payman Langroudi: But what was she left feeling. Did she feel like she’d been let [00:59:35] down?

Bizhan Shokouhi: I mean, I could see her, bless her. She’s really she she she she wasn’t a complainer. [00:59:40] Like she was one of those. Every time she would call up to come in, she’d be like, oh, I’m so sorry. I’m coming in again. I’d be like, oh, [00:59:45] you know, so I was so lucky with that, obviously. Right. So and that’s one of the other biggest things [00:59:50] you learn is you’re really at the mercy of the type of patients you have, right? [00:59:55] So if she was a different character.

Payman Langroudi: If your relationship was different.

Bizhan Shokouhi: Yeah, it would have.

Payman Langroudi: Been [01:00:00] a whole different communication.

Bizhan Shokouhi: Yeah, yeah. And that’s the other thing. I was very kind of caring [01:00:05] throughout the whole thing. I was never dismissive and kind of just brushed. [01:00:10]

Payman Langroudi: Off what happened. Did the specialists do something different or you don’t know?

Bizhan Shokouhi: Yeah. I mean, he obviously did what? [01:00:15] I mean, first of all, he had one look, he said, what were you even thinking, trying to do this.

Payman Langroudi: Because [01:00:20] it was heroic antics.

Bizhan Shokouhi: Yeah. As in it was never going to be easy even for him to do it. So what [01:00:25] were you doing? So. But anyway, um. Yeah, I haven’t heard from her since. And that’s probably because [01:00:30] I mean, hopefully everything’s fine, but probably also because she’s just one of those [01:00:35] that’s, I don’t know, embarrassed to kind of keep coming back to me. But, um, but.

Payman Langroudi: So the learning point on that one is [01:00:40] trust your gut.

Bizhan Shokouhi: Trust your gut and, um, do, yeah, do what you think [01:00:45] is.

Payman Langroudi: Don’t be led on off the.

Bizhan Shokouhi: Path. And again, I’m not saying this to kind of blame the patient because [01:00:50] this is one of those other.

Payman Langroudi: Patients are patients. It’s like blaming the sea if you’re the captain of a boat. [01:00:55] Yeah.

Bizhan Shokouhi: Because you hear this, for example, in situations where let’s [01:01:00] say someone’s done something that maybe shouldn’t have done, but then they say, oh, but the patient consented for [01:01:05] it. They knew what they were signing up for. And you’re like, well, that’s not how it works, right?

Payman Langroudi: It’s, [01:01:10] it’s a bit of a get out.

Bizhan Shokouhi: Yeah.

Payman Langroudi: I like it, but I don’t like it enough. It’s [01:01:15] kind of a happy ending in the end.

Bizhan Shokouhi: Happy. But I’m still not happy. Yeah, I [01:01:20] know what you mean.

Payman Langroudi: I like that too. I like that, I like that that’s what’s stuck in your head. That that story is the one [01:01:25] that’s stuck in your head. Yeah. There must be another one, though. Like a better story than that one.

Bizhan Shokouhi: Genuinely [01:01:30] ought to think.

Payman Langroudi: Did you not ever plan something incorrectly or. [01:01:35] I don’t know.

Bizhan Shokouhi: I mean, there’s been little things, right? I mean, I’ve had implants fail. I’ve had grafts fail. [01:01:40]

Payman Langroudi: There’s been I don’t want to hear a nightmare story. I want to hear a story of a failure that [01:01:45] made you learn and teach something differently. You know, [01:01:50] you used to do it this way. You saw this failure you didn’t expect. And now you do it. You [01:01:55] know, that’s a learning we can all. Anyone who’s getting involved in implants can. What comes to mind if I say that, [01:02:00] uh.

Bizhan Shokouhi: Soft tissues again? Oh, really? I can’t stop talking.

Payman Langroudi: About it enough. Yeah.

Bizhan Shokouhi: Because [01:02:05] that’s one of the things that took me maybe longer than it should have to kind of understand and learn. Um, [01:02:10] maybe partly because of my surgery background, but yeah, like I would, you know, I knew [01:02:15] the importance of it, but I’ve had, you know, more than one case where the end result [01:02:20] was very obviously to me not adequate. And then trying to fix that is much harder [01:02:25] than if you just identified that at the start. And and do it again. So that’s why I kind of bang on about it so much and try [01:02:30] and teach all my students about it as well. But, uh, but yeah, I mean, fortunately, again, these [01:02:35] are not cases that makes or breaks it in a immediate way, but [01:02:40] I know for sure that they’re kind of not lined up to be ideal long term. And that kind of hurts as well, right? Because [01:02:45] when you do something, you want it to last forever. But yeah.

Payman Langroudi: I had a guy, he said [01:02:50] for him, Implantology came down to the suturing. Um, I did not [01:02:55] expect that. It’s different for different people, right? Different people think about things in different ways.

Bizhan Shokouhi: But [01:03:00] I think there’s more to it.

Payman Langroudi: Yeah. Of course. Yeah. But you know, the other thing is, you know, if I [01:03:05] could tell you 2 or 3 things that in my head would give you the whole key to my [01:03:10] company and my life, and, and you could go and do exactly what I did by knowing these 2 or 3 things. Yeah. [01:03:15] But you buy the thing is, you take it for granted. Yeah. All the other stuff, you know, you take [01:03:20] for granted. So, you know, for him, I guess he knew a bunch of stuff. But suturing had become.

Bizhan Shokouhi: The. [01:03:25]

Payman Langroudi: Thing he was he was facing.

Bizhan Shokouhi: You know, where he’s coming from.

Payman Langroudi: Really.

Bizhan Shokouhi: Because one of the [01:03:30] biggest things that makes a difference in implants is the suturing, but also the beginnings of the flap. Oh. [01:03:35] So it’s, uh, we’re again, we have a saying that the first [01:03:40] five minutes and the last ten minutes of the surgery are the most important.

Payman Langroudi: Oh.

Bizhan Shokouhi: I [01:03:45] mean, that can five, ten minutes can be a bit longer if it’s a complex case, obviously. But um [01:03:50] yeah, so as soon as you put your blade down, that’s when everything’s decided, you [01:03:55] know, it doesn’t matter if you do the most fancy suturing at the end, if you did a wrong flap or if you didn’t handle [01:04:00] tissues properly, it’s not going to give you the same result. Um, [01:04:05] and along with that, if we’re asking about what’s important as a surgeon in terms of, [01:04:10] uh, the actual surgery, so just having, doing [01:04:15] things, doing things deliberately. So, you know, when you raise a [01:04:20] flap, you cut in a certain way, you don’t just, you know, you hold your blade [01:04:25] a certain way, you place pressure in a certain way, you [01:04:30] do things gently. So one, one thing makes a big difference in the immediate [01:04:35] post doc phase is if you’re rough.

Payman Langroudi: Mhm.

Bizhan Shokouhi: And this is with extractions as well. You [01:04:40] know, if you’re gentle and just deliberate about everything you do, honestly, everything’s [01:04:45] just much, much cleaner and the results are better. And then obviously all the other stuff about kind of [01:04:50] 3D planning goes into it as well. But you know, you can put the implant in the perfect place. Yeah. But [01:04:55] you kind of you’re just really rough with the flat.

Payman Langroudi: These nuances are the key, right? This is what I mean. I think all [01:05:00] of us sort of understand the thing in the bone, but these nuances. Yeah. The difference between good and great. [01:05:05] Right? Yeah. Yeah. So the other thing I noticed on your Instagram is the piano. [01:05:10]

Bizhan Shokouhi: Oh, yeah.

Payman Langroudi: Pretty good piano. Yeah. Let’s talk about [01:05:15] Instagram. Were you did someone have to put you up to it? I saw your first ever post was [01:05:20] like, finally I’m being pushed into it. But [01:05:25] you don’t seem to me like the kind of influencer type.

Bizhan Shokouhi: Yeah, I’m really. I’m [01:05:30] really not. And yeah, I mean, it took me it took me ages to kind of, I [01:05:35] don’t know, I, I was going to say have the courage to do it, but that’s making it too big. But yeah, [01:05:40] I’m not into social media. I mean, when I say that to people, I think what with my Instagram, but yeah, I don’t I don’t use [01:05:45] Facebook, for example.

Payman Langroudi: I don’t it’s interesting that you say courage. Yeah. So we do this composite course, um, [01:05:50] MSM and we ask every time who has got a, um, [01:05:55] a Dental account. Yeah. And you’d imagine like the kind of person who comes on a composite bonding [01:06:00] course.

Bizhan Shokouhi: Yeah.

Payman Langroudi: It’s is that way inclined. Yeah. And yet [01:06:05] of the 30 delegates, normally it’s like 4 or 5. And [01:06:10] when you ask, okay, what’s the reason? A lot of them say it’s like [01:06:15] a confidence issue amongst your peers. It’s one of the big ones. And then the other one is like, [01:06:20] oh, I don’t want my auntie to people what I’m doing. So. So when you say confidence, [01:06:25] were you worried about that or are you worried about what your peers will think?

Bizhan Shokouhi: Yeah, sure. Partly, but [01:06:30] partly also.

Payman Langroudi: You don’t want to be seen as that guy. I get that.

Bizhan Shokouhi: I get that. So [01:06:35] it’s like a reputation thing, almost like.

Payman Langroudi: Yeah, yeah.

Bizhan Shokouhi: I’m sure you know that Instagram sometimes [01:06:40] doesn’t have the best reputation in terms of, oh, is that guy that puts stuff on Instagram kind of thing. But, [01:06:45] um, but but yeah, at the same time I saw that it doesn’t have to be that way. And I’ve [01:06:50] shown through my account that it doesn’t have to be that way. So, um, you know, you can do it more of a, I try [01:06:55] as best as I can every post to some degree, at least have some educational value, [01:07:00] for example.

Payman Langroudi: Um, but did you like look into it? Were you naturally [01:07:05] good at it or?

Bizhan Shokouhi: No, what you said about did someone put me up to it is true, basically. [01:07:10] So.

Payman Langroudi: But how did you know what to do? How did you know what works and what doesn’t? And I was. [01:07:15]

Bizhan Shokouhi: Looking at, yeah, when I look back at my original posts, I. Yeah, they’re [01:07:20] no way as good as kind of an engaging as what I post now. So yeah.

Payman Langroudi: But, but even like the cadence piece [01:07:25] of it, you know, you’re doing it every other day. You’re posting from the beginning. I know every [01:07:30] three days.

Bizhan Shokouhi: Yeah. I don’t do that anymore. I’ve become a lot more lax. But yeah.

Payman Langroudi: You know what I [01:07:35] mean? Just a lot of people don’t know to do.

Bizhan Shokouhi: That on Google, right? Yeah, yeah, yeah.

Payman Langroudi: Just look it up [01:07:40] and.

Bizhan Shokouhi: Research what works and what doesn’t. Yeah. And you try it right until.

Payman Langroudi: Yeah, yeah.

Bizhan Shokouhi: Um, and one [01:07:45] of the other big things is you just need time, I think. Yeah, you just got to persevere and it gets.

Payman Langroudi: Honestly, [01:07:50] thank goodness that you did it. Yeah. Because the number of people you’re helping with that, you know, if [01:07:55] you want to look.

Bizhan Shokouhi: At impact, I mean that’s what I’m doing. Hopefully. Yeah.

Payman Langroudi: If you want to look at impact, you know, you’re probably having much more impact [01:08:00] with that than you are with your other job.

Bizhan Shokouhi: Yeah, no, I do get messages like that. I [01:08:05] mean, I’ve had messages that I think they’re exaggerating here, but they say, oh, I learned more from your Instagram [01:08:10] than my whole diploma or something. I’m like.

Payman Langroudi: Oh, interesting.

Bizhan Shokouhi: It’s flattering. But yeah, you get the idea.

Payman Langroudi: No, it’s [01:08:15] brilliant though. It’s it’s a brilliant thing. Thank you. Um, I was talking to George. George the [01:08:20] dentist on Instagram.

Bizhan Shokouhi: I know of him.

Payman Langroudi: Yeah, yeah. I was talking to him about it as well. He. He does this thing where he [01:08:25] doesn’t really spend too much time. He’s a busy. He owns multiple practices and all [01:08:30] of that. But the day to day things that come up for him, he [01:08:35] just takes a lot of photos. Yeah. And people love that account.

Bizhan Shokouhi: Because when when [01:08:40] people ask me, I must take you ages to do this stuff. Yeah. Of course. It kind of takes some time to kind of put things and make [01:08:45] it look nice, but the stuff’s there, right? I’m taking pictures. I’m not taking it for [01:08:50] the Instagram like I’m.

Payman Langroudi: Where did you learn photography? Because that’s excellent to.

Bizhan Shokouhi: Um, learn [01:08:55] to. Over the years I’ve not done a course or anything, if that’s what you’re asking.

Payman Langroudi: So you’re the kind of person that if you want [01:09:00] to learn something, you just dive in yourself and find everything you can about it.

Bizhan Shokouhi: I’ve always [01:09:05] had this feeling that nothing’s out of reach. Um, [01:09:10] and Linda, my wife, we think the same and we’re going to try and instil [01:09:15] this in our kids as well. Like if it really. It’s so cliche, but it really depends [01:09:20] on how much you want something. Uh, especially in this day and age, there’s so much [01:09:25] out there, right? If you want to learn anything, it’s. Yeah, go learn it tomorrow, basically. But, um, [01:09:30] but but yeah, um, like being resourceful and kind of just getting in there [01:09:35] and doing stuff.

Payman Langroudi: But no, but some people will think when they have an issue, they’ll think what [01:09:40] is the answer to the issue? Some people will think who um, [01:09:45] by the way, both are really good. Both. I mean my, my business partner, he’s always thinking who. [01:09:50]

Bizhan Shokouhi: Who in terms of what do you mean?

Payman Langroudi: We’ve got a question we want to answer. He’ll [01:09:55] say, should we hire someone to, to give us the answer to that? Mhm. Um, [01:10:00] when we started the podcast, my partner Prav [01:10:05] first thing he said was, let’s go find the world’s best podcast coach.

Bizhan Shokouhi: Um.

Payman Langroudi: I [01:10:10] wouldn’t have even dreamt of a person like that. You know, um, there’s different [01:10:15] ways of, of learning, you know.

Bizhan Shokouhi: And.

Payman Langroudi: I there’s a guy called Mike grey. Have you come across him? He’s [01:10:20] like a restorative dentist. He’s, he does, he does this thing called poise. It’s [01:10:25] for veneers. Right. And it’s like, I don’t know what it sounds like. Path of insertion, whatever, [01:10:30] whatever the rest of it. Se yeah. And, um, he’s, he’s done this. It’s [01:10:35] a way of doing veneers where because it path of insertion is slightly different. You don’t [01:10:40] need to cut anywhere near as much, but he overlays these scans on top of each other [01:10:45] and the thing shows up. You just need to remove this much of the central that much of the lateral this. [01:10:50] And he preps six veneers and 15 minutes. Right. You know, because he’s just [01:10:55] taking a bit off here and bit off there. And then and he said he’d never been on a restorative course. [01:11:00] Yeah. But but every time he wants to learn about something, he just shuts himself off [01:11:05] for a couple of weeks, gets every book, every resource he can on can. And [01:11:10] he’d rather just learn it all than go to a course and, and, you [01:11:15] know, learn from someone. And yet he’s got a course, right? So people come to him. It’s [01:11:20] an interesting way that different people kind of learn about something.

Bizhan Shokouhi: Yeah.

Payman Langroudi: Yeah. So is [01:11:25] that are you more the second way.

Bizhan Shokouhi: I think depends on the subject. The subject. Yeah. [01:11:30] Yeah. So something like taking photography as an example. I feel like that’s enough. [01:11:35] It’s easy enough to learn from books and websites and whatever. But but [01:11:40] things like, let’s say implants, it’s such [01:11:45] a thing, that big thing that the thing about kind of you don’t know what you don’t know is [01:11:50] so relevant here. Yeah, yeah. And then I wouldn’t want to just go into it by myself. And [01:11:55] that’s one of the big things about kind of having a mentor. It kind of starts [01:12:00] everything for you and you learn from their mistakes. True.

Payman Langroudi: Um, tell me about the people, the [01:12:05] mentors along the way. Or who do you look up to in Implantology?

Bizhan Shokouhi: Um, lots [01:12:10] of people, but one of the biggest ones who I did his course is called Esteban [01:12:15] Urban. He’s a he’s from he’s Hungarian Budapest. [01:12:20] So he’s one of the, if not the biggest name in vertical [01:12:25] bone regeneration and just general grafting. And yeah, he’s honestly, [01:12:30] he’s amazing. So in terms of both as a clinician and as a person. Yeah. [01:12:35] Like if you’re asking, who do I look up to? Like when I see what kind of surgeon he [01:12:40] is and what kind of, and he’s like such a down to earth guy and like, he’s not arrogant at all.

Payman Langroudi: The course [01:12:45] over.

Bizhan Shokouhi: There. Yeah, yeah, he’s in Budapest.

Payman Langroudi: Great town as well. Great.

Bizhan Shokouhi: It’s great. I love.

Payman Langroudi: It.

Bizhan Shokouhi: Yeah yeah yeah. I’m going again this [01:12:50] year. So he runs a conference every two years. Okay. So I’m going there again.

Payman Langroudi: Yeah. And what graftings [01:12:55] the sort of or is it implantology in general.

Bizhan Shokouhi: No, no. It’s a hard and soft tissue grafting.

Payman Langroudi: That [01:13:00] conference is all about hard and soft tissue graft. Yeah, yeah. Amazing.

Bizhan Shokouhi: Yeah.

Payman Langroudi: Who else? Who else?

Bizhan Shokouhi: Um, [01:13:05] I mean, there’s lots of kind of names [01:13:10] within the implant world that kind of.

Payman Langroudi: Come along your journey. Like, which mentors [01:13:15] did you like learn the most from?

Bizhan Shokouhi: Okay. So in [01:13:20] terms of one of the first people. So the he’s retired [01:13:25] now, but the program director in Bristol, his name is Jonathan Jonathan Schofield. [01:13:30] He was yeah, he was very inspiring as well [01:13:35] in terms of both as a clinician. So he wasn’t a specialist [01:13:40] but he was. And there’s one thing I was going to try and point out to people being a specialist isn’t all that [01:13:45] it kind of indicates some degree of training and [01:13:50] expertise, but some of the.

Payman Langroudi: Best like carte blanche.

Bizhan Shokouhi: You know, like some of the best dentists as [01:13:55] a whole dentist that I know are not specialists. So, um, [01:14:00] yeah, so he was, uh, he was, you know, he was a general dentist, but [01:14:05] implants was his thing and he was the program director. And yeah, his work was so good, but also his attitude was [01:14:10] was just so kind of positive. But also he always had this kind of can do attitude. [01:14:15] And, um, and it was one of those people that you [01:14:20] just feel good about yourself after you’re with him. You know what I mean?

Payman Langroudi: Like some people have that talent.

Bizhan Shokouhi: Yeah. Like I know [01:14:25] other people that are really good technically and they’re amazing and, you know, very knowledgeable, but then they’re [01:14:30] always just a bit of a downer once you, you know, you know what I mean, right?

Payman Langroudi: Yeah, yeah, yeah, for sure.

Bizhan Shokouhi: And, and [01:14:35] yeah, well, he was the total opposite and everything kind of had a solution. And yeah, so I tried to really [01:14:40] spend as much time as I could with him and learn from him.

Payman Langroudi: Let’s move on to that other question [01:14:45] then. You’ve worked in a bunch of practices. Do you ever envisage yourself having your own?

Bizhan Shokouhi: No, [01:14:50] honestly.

Payman Langroudi: Can’t be bothered.

Bizhan Shokouhi: Yeah. And it’s just I’m [01:14:55] obviously very much a clinician and I enjoy it. And [01:15:00] I just don’t feel like there’s anything missing, if that makes sense. Yeah. I remember someone told me [01:15:05] when I was obviously I’ve thought about this a lot over the years, But someone told me, do you [01:15:10] wake up every day really wanting to practice? And I’m like, no, of course not. [01:15:15] No. So then that’s kind of my answer. So unless and this is what I’m saying, I was saying before, [01:15:20] you have to really want to have to want something. And that [01:15:25] passion is not there for.

Payman Langroudi: I mean, there’s nothing like a happy associate job. It’s a wonderful thing. [01:15:30] Yeah. It’s rare, by the way. You’re very lucky.

Bizhan Shokouhi: I I’m very aware of that.

Payman Langroudi: I mean, we [01:15:35] were talking earlier on about don’t you want to go to the West End or whatever, and the way you kind of what your face said to me is, [01:15:40] why, if it ain’t broke, don’t fix it. Yeah, sure. So I do get that. [01:15:45] Um, although the reason why people with different reasons, but one of the main reasons why [01:15:50] people start their own practices is control. Yeah, yeah, yeah. Um, [01:15:55] and it takes a boss who pisses you off to make you think, God damn it, I want [01:16:00] to do it my own way. That said, looking at your account, looking the way you like to do things you could [01:16:05] write, you could. Let’s say it was a. In events, they call it blank canvas. Let’s [01:16:10] say there was this blank canvas place. Yeah. And if you are, [01:16:15] you are the kind of person who is kind of idealistic. You want to do something excellent. [01:16:20] You could do something excellent, right? Something that, you know, now I can’t be bothered. I haven’t [01:16:25] got time to practice.

Bizhan Shokouhi: You mean to set up a practice? Yeah.

Payman Langroudi: Yeah. It’s possible. You know, like because. Because you’re that way inclined. [01:16:30] You’re excellence inclined. There is something to be said for it.

Bizhan Shokouhi: I mean, [01:16:35] without sounding arrogant, I know I could do it.

Payman Langroudi: I love that.

Bizhan Shokouhi: But [01:16:40] but yeah, it’s just I have to ask myself, why do I want to do it? Yeah, yeah, yeah. And I know [01:16:45] that, you know, I’m one of those people. If I’m going to do something, I’ll, I’ll [01:16:50] do it properly. And it’s just one of those things that I know is going to suck out so much of my [01:16:55] time and energy to do properly. And I just feel like I yeah, [01:17:00] it’s just at the moment anyway.

Payman Langroudi: Um, young kids are difficult, but you [01:17:05] know, when I ask people, people sitting here all walks of, of life, right? And I’m trying to get [01:17:10] to their motivation for doing what they’re doing. Yeah. Um, you know, [01:17:15] Anoushka Brogan from Three Children, 50 practices. Yeah. What? Why [01:17:20] does she have to go from 42 to 50? You know, there’s no there’s no logical [01:17:25] reason to do that. Right. But some people say I want [01:17:30] to live up to my potential as a as a reason for doing something. [01:17:35] Some people really do want jets and boats. You know, that’s, [01:17:40] that’s what they they term as success. You know, you could say to [01:17:45] me, success is not having to worry about paying the bills going on my three holidays a [01:17:50] year and happy children. Yeah. Amazing. Yeah. Like if, if you managed to, to, to [01:17:55] filter that down, the one thing I would say is that life does sort of change your position on [01:18:00] all of this.

Bizhan Shokouhi: I think to, to get to the The bottom [01:18:05] of this, you have to really know your own core values. Yeah, right. You have [01:18:10] to know yourself, which is easier said than done, right? You learn over the years. But [01:18:15] but this is what I’m going back to in terms of I knew very early on I didn’t want my [01:18:20] life just to be about my work. Yeah. Um, and like what you just said about, um. [01:18:25]

Payman Langroudi: Living up to your potential.

Bizhan Shokouhi: Yeah. So on that point, [01:18:30] what I would ask is, would you rather live [01:18:35] up to your full potential, would not be at peace with yourself or be [01:18:40] content? And that’s the thing not, you know, I think [01:18:45] there’s a big difference between being happy and content, right? Be content, but know [01:18:50] that you’re kind of working within your within [01:18:55] your potential, not to the fullest of your potential. Right? And for me, the [01:19:00] second is more true. It’s interesting. Like I’m not. Um. Yeah. Like one [01:19:05] of the biggest things I value in life, just like you said, is just having that inner peace. Just knowing [01:19:10] that, you know, tomorrow I don’t have to wake up [01:19:15] and worry about X, Y, and z, right? So yeah, like just going to sleep [01:19:20] with a peaceful mind and waking up with a peaceful mind. That’s, I think one of the biggest.

Payman Langroudi: And did you discuss this with your [01:19:25] partner? Is it Linda? Linda. Linda, do you guys discuss this.

Bizhan Shokouhi: About [01:19:30] having a practice?

Payman Langroudi: No. The question of like, your basic principles being about this.

Bizhan Shokouhi: Yeah, [01:19:35] yeah. Of course. Yeah. And we’re very much like minded. I would say she’s very [01:19:40] much on the same page. Yeah, yeah.

Payman Langroudi: You just don’t assume that for oral surgeon types, you know, you just [01:19:45] think the opposite. Yeah, yeah.

Bizhan Shokouhi: Yeah. I don’t know how it’s worked out, but um, yeah, [01:19:50] we’re not. Yeah. I don’t know how.

Payman Langroudi: Assumptions can be wrong. Right. [01:19:55] So what comes to mind if I say what’s the best lecture or course? Is it [01:20:00] this guy in in the course.

Bizhan Shokouhi: Yeah. Easily. Like that was the the thing that kind [01:20:05] of really propelled me, I would say, from being an okay surgeon to like, really? Yeah. [01:20:10]

Payman Langroudi: What about lecture? Like even even early on or something like a lecturer.

Bizhan Shokouhi: Yeah. So I can tell [01:20:15] you one that I still remember, um, you know. Martin Keller. Yeah. So, so yeah, [01:20:20] there was a, I think it was one of those bd a evenings.

Payman Langroudi: The daughter test kind of one [01:20:25] that.

Bizhan Shokouhi: It was along those lines. Yeah. So and it was funny. I don’t know if they, they kind [01:20:30] of did this on purpose, but it was two speakers. There was him. But then [01:20:35] before him was someone talking about veneers and.

Payman Langroudi: Oh, I think I remember this, [01:20:40] I think I remember this.

Bizhan Shokouhi: And it was just great because and you know what he’s like, [01:20:45] he just says what he thinks, right?

Payman Langroudi: Yeah, yeah yeah yeah, yeah.

Bizhan Shokouhi: And he just came up and obviously he had his talk, but the way he kind [01:20:50] of not directly but indirectly ripped into the first guy and just [01:20:55] saying, I don’t care about, you know, what people think, you know, he kind of really just laid it out there. [01:21:00] That. And you got to remember, this was ages ago, before all this minimally invasive thing became [01:21:05] the norm. Yeah, yeah, yeah. And he was one of the first people to really kind of talk about it.

Payman Langroudi: It was before Invisalign [01:21:10] properly.

Bizhan Shokouhi: Yeah.

Payman Langroudi: Got out.

Bizhan Shokouhi: There. Exactly. Like he was the guy before. Was talking about full on [01:21:15] full prep veneers I’m talking about. Um, and yeah, it was just so refreshing to see in terms of, [01:21:20] you know, talking about the things that matter, but then also not being afraid of saying [01:21:25] what needs to be said.

Payman Langroudi: It’s a funny time, right? That people are afraid of saying these days. [01:21:30] Yeah. Things.

Bizhan Shokouhi: Yeah.

Payman Langroudi: For fear of being politically incorrect, for fear of whatever [01:21:35] it is. Yeah. And, but I think it’s incumbent on that class, [01:21:40] the professorial class, to speak their mind because in a way, that’s [01:21:45] one of the reasons we’re paying them to be professors is to speak their mind. Yeah. But [01:21:50] sometimes politically they’re the most constrained. Yeah. You know, they can’t they’re not they’re they’re [01:21:55] they’re they are the system. Yeah. And I was sitting next to Ian [01:22:00] Chappell. Do you know him?

Bizhan Shokouhi: I know of him. Yeah, I don’t know.

Payman Langroudi: And. And I [01:22:05] was sitting next to him at a at a dinner. And then I’m good friends with Avi Banerjee and [01:22:10] just trying to understand. Right. If these guys want to say something, can they? Mhm. [01:22:15] Yeah. And in the end, it came down to. Yeah. They’ll say it in private.

Bizhan Shokouhi: Mhm. But on the air.

Payman Langroudi: But [01:22:20] not in public. But and Kelleher.

Bizhan Shokouhi: Was he was.

Payman Langroudi: Kieran was bucking that trend.

Bizhan Shokouhi: That’s [01:22:25] what I mean. That’s what was so nice about it. Yeah yeah yeah yeah.

Payman Langroudi: Yeah yeah for sure. It’s [01:22:30] been a massive pleasure to have you man. We come to the end of our time. I tend to end it with the same questions [01:22:35] every time. Um, fantasy dinner party. Three guests. [01:22:40] Dead or alive.

Bizhan Shokouhi: Yeah.

Payman Langroudi: Who you.

Bizhan Shokouhi: Talking to? Our friends about this. And I think it depends [01:22:45] on my mood, but. Right. Changes. Right. But [01:22:50] I’d say, um. Derren Brown. Oh, yeah. Do you know him? Yeah, yeah. Have you [01:22:55] seen his shows? Yeah.

Payman Langroudi: Well, no, I haven’t gone.

Bizhan Shokouhi: Have you not gone? Is it good? Amazing. Yeah.

Payman Langroudi: It’s [01:23:00] hypnosis.

Bizhan Shokouhi: Yeah. Mentalism.

Payman Langroudi: Yeah yeah.

Bizhan Shokouhi: Yeah yeah.

Payman Langroudi: Yeah. He’d be.

Bizhan Shokouhi: Fun. He’d [01:23:05] be very fun. Yeah. So like, his shows are much better than his TV stuff. And he’s written a [01:23:10] lot of books.

Payman Langroudi: He’s I wasn’t aware.

Bizhan Shokouhi: Yeah. So he writes a lot about, um, [01:23:15] like happiness, but also like stoicism, which I’m big into. [01:23:20] Yeah. I think he’d be fun. Um, second person, I mean, it’s a bit out [01:23:25] there, but on the topic of stoicism, Marcus Aurelius I think [01:23:30] it’s really interesting.

Payman Langroudi: It’s not the first time he’s come up.

Bizhan Shokouhi: Has he not?

Payman Langroudi: He’s come up before. Yeah.

Bizhan Shokouhi: Just [01:23:35] because. Yeah.

Payman Langroudi: Just because of how long ago he was saying the stuff he was saying. Right.

Bizhan Shokouhi: Yeah. And how it still [01:23:40] applies today.

Payman Langroudi: Still applies.

Bizhan Shokouhi: Today.

Payman Langroudi: Yeah. I mean, listen, we’re Iranians, right? You we’ve Iranians, [01:23:45] you sit around with your parents talking poetry like thousand year old poetry. That’s [01:23:50] still, still applies today. Yeah. And, you know, we were talking about this conversation of, um, AI, [01:23:55] But there are certain human truths, right? Certain human truths that will never [01:24:00] change.

Bizhan Shokouhi: But there are things he writes in his book about, um, I don’t know, like [01:24:05] comparing yourself to others, for example, like we think it’s a very modern thing on social [01:24:10] media.

Payman Langroudi: Yeah.

Bizhan Shokouhi: But you think back 2000 years ago, they were still thinking about [01:24:15] the same things. So yeah, there is some. Yeah.

Payman Langroudi: Who’s your third? What an interesting dinner [01:24:20] parties already turning out to be.

Bizhan Shokouhi: So this one I’m gonna cheat a little bit. [01:24:25] I’m going to say Muhammad Ali.

Payman Langroudi: Yeah.

Bizhan Shokouhi: But both in his prime and [01:24:30] also when he retired, there’s two different.

Payman Langroudi: Characters to see the to see it. Yeah. Yeah.

Bizhan Shokouhi: Because [01:24:35] I would just want to know because, you know, he got Parkinson’s when he was like 42, 43, something [01:24:40] like that.

Payman Langroudi: Yeah yeah yeah.

Bizhan Shokouhi: Yeah. Was it all worth it? You know, we keep talking about [01:24:45] this topic of kind of living up to your potential and.

Payman Langroudi: Yeah.

Bizhan Shokouhi: But then, you know.

Payman Langroudi: I [01:24:50] mean, you’re right. You know, apparently Gandhi’s wife hated him.

Bizhan Shokouhi: Oh, is that right?

Payman Langroudi: Yeah. [01:24:55] I don’t know. I shouldn’t. I shouldn’t throw out something. So. So general. Yeah. [01:25:00] But these. It happens. It exists. I’ve got friends, you know. Like your dad. Eminent [01:25:05] surgeon. Never home. Never home. You know that. So you know it’s a real thing. [01:25:10] Is it worth it to live up to your potential? It’s a brilliant question. Yeah. Should we. Should we? Should we [01:25:15] call that the pod? The name of the pod. We’ll leave. We’ll leave. We’ll leave it up to, uh. Is it [01:25:20] worth it? The copyright. Is it worth it? Was it worth it?

Bizhan Shokouhi: Was it worth it? Was it worth the journey?

Payman Langroudi: Yeah. No. [01:25:25] Thank you so much. I’ve really enjoyed talking. Thanks for coming.

Bizhan Shokouhi: Thank you for having me. It’s been a pleasure.

Payman Langroudi: Amazing.

Bizhan Shokouhi: Thank you so much. [01:25:30]

Prav Solanki: Thanks for listening, guys. Hope you enjoyed today’s episode. Make sure you tune in for future [01:25:35] episodes. Hit subscribe in iTunes or Google Play or whatever platform [01:25:40] it is. And you know, we really, really appreciate it. If you would, um, give.

Payman Langroudi: Us a six [01:25:45] star rating.

Prav Solanki: Six star rating. That’s what I always leave my Uber driver. [01:25:50]

Payman Langroudi: Thanks a lot, guys.

Prav Solanki: Bye.