EPISODE 13 - Recording Podcast (Eric Levi) with Sharee Johnson
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Sharee Johnson: [00:01:00] [00:02:00] It's, pure joy today to welcome Dr. Eric Levi to Recalibrating with Sharee Johnson. Eric is an otolaryngologist, head and neck surgeon, with subspecialty interests in complex airways diseases, head and neck tumors, sleep, and saliva gland surgery. He trained in Melbourne, Canada, Brisbane, and Auckland, New Zealand.
He is an academic and consultant surgeon at The Royal Children's Hospital, Melbourne, the University of Melbourne, Eastern Health, and Melbourne ENT Airway Clinic. Eric has completed a science degree in psychology and master's degrees in public health, tropical medicine, and health administration. He has published over 30 papers and presented over 150 lectures internationally, including talks on health and wellbeing in surgeons.[00:03:00]
It's my absolute joy today to welcome Dr. Eric Levi to the podcast. Eric is an otol... Uh. Eric is an otolaryngologist. No, I'm still not saying it right. Well done. Did I get it right? Close enough. Close enough. Otolaryngologist. Yes. Eric, Eric is an otolingar- ling... Ugh. The more I try, the more I'm gonna stuff it up.
Eric is a otolaryngologist, head and neck surgeon, with subspecialty interests in complex airway diseases, head and neck tumor, head and neck tumors, sleep, and saliva gland surgery. He trained in Melbourne, Canada, Brisbane, and Auckland, New Zealand. He is an academic consultant surgeon at The Royal Children's Hospital in Melbourne, at Melbourne University, Eastern Health, and Melbourne ENT Airway Clinic.
He has completed a science degree in psychology and master's degrees in public health, tropical medicine, and health administration. Eric has published over 30 papers and presented over [00:04:00] 150 lectures internationally, including talks on health and wellbeing in surgeons. Welcome to Recalibrating with Sharee Johnson, Eric.
Dr Eric Levi: Thank you so much, Sharee. It's, I sound really smart, but I'm not really.
Sharee Johnson: Oh, well, that's debatable, and maybe we'll find out today, right? It's really is a joy to be having some time to talk with you. I always feel very appreciative of, of people's time. So you've got three fellowships, Eric. You, gained them in Australia, New Zealand, and Canada, so you traveled as well to do that study.
I wonder if you can paint the picture for us. What's a typical month look like, for you at work at this stage of your career?
Dr Eric Levi: Thanks Sharee for having me here. I've always, watched you from afar, and we've crossed path multiple times. Thank you so much for all the wonderful that work that you do, both for doctors and the community in general. Uh, love your book as well.
Now, um, what do I do? So, uh, as an ENT surgeon, I, I divide my time between the public hospitals, uh, you know, Royal Children's Hospital, Eastern Health, uh, University of Melbourne, but also in the private as [00:05:00] well, about a third in each, um, quadrant, so to say, a third in each quarter.
Um, and, and yeah, I mean, on a typical week, basically it's a 7:00 to 7:00 job. Uh, and with lots of after-hours meetings, on-calls one to two nights a week, and one weekend in every three or four. Uh, you know, juggling the busy life. Um, I think all of us are busy. Uh, we all have our different, uh, kind of puzzle pieces that we put together.
Uh, for me, where I am right now, about, 11, 12 years since becoming a surgeon, that's how I juggle it. Two days at The Royal Children's Hospital, a day at Eastern Health, and a couple of days in the private. And on top of that, just a bit of educational teaching, uh, committee work here and there, after hours.
Sharee Johnson: And Eric, for people who aren't surgeons or haven't been around the theater for a long time 'cause they did their internship a long time ago, or who are nurses or occupational therapists, other people- Yeah ... can you talk a little bit about what you do when you're in your office? 'Cause doctors say that, "I'm in clinic."
What does that actually mean?
Dr Eric Levi: Yeah, [00:06:00] yeah. So typically, we would say, for example, uh, uh, uh, like this week, on Monday, I spent, all day in the hospital, consulting. And then basically starting my clinic at about 8:00, 8:30 in the morning, and then finishing the clinic at 5:00 or 6:00 in the afternoon.
Typically, there is a lunchtime meeting. Every Monday there is a Monday morning 7:30 AM Zoom meeting with the, the rest of the team. And often there's an educational meeting at 5:30 to 6:00 in the evening. So that's kind of a, a, a day of consulting. And then the following day on Tuesday was a, a day of operating.
Basically, operation starts at 8:30. All the sessions start at 8:30. This morning in the private, my operating session starts at 8:00, so you gotta be there from about 7:30. Uh, see all the patients, go through the process again, and do the operations,. So life in the surgical world is basically, um, sessions of clinic, sessions of operating being put together in all sorts of various different ways.
Probably on average about 50/50. Half of it is consulting, the other half is operating. And then everything else is [00:07:00] outside those sessions. Meaning the emergency cases, seeing patient in the emergency, visiting a, a patient on, uh, in the hospital for a ward round. Uh, tomorrow morning I have to see my private patients I, that I've operated on today.
Gotta see them in the morning, so drive up to one hospital, and then I'll have to drive to another hospital to do a clinic. Uh, we have a complex drooling clinic in, in another hospital. And then after that, uh, I'll be driving to my private practice for an afternoon of, uh, consulting. So week to week it's slightly different, but essentially blocks of consulting or operating with emergencies outside those hours.
Sharee Johnson: And with all that juggling, you're still smiling.
Dr Eric Levi: I guess it's, w- we've been doing this for a long time now. We get used to it. Yeah. And we actually love it, you know. I, maybe, maybe there's a part of us that just can't sit still. Um, you know, my wife is an infectious diseases physician, and her days look very different.
Uh, she does, two to three hour long ward rounds. She has two to three hour [00:08:00] long meetings, case studies. Uh, she has clinics. When she's on call she's on the phone a lot. So a lot of things, uh, do happen around, around the place.
Sharee Johnson: And let's go back a little bit, Eric. Can you tell us about, uh, when you first came, when you left school and you came to university, you came from overseas, so you had some recalibrating to do then, and we're very interested in that on this podcast. Uh, and, and just walk us through a little bit from when you went to med school or you, you actually didn't go to med school first.
You went to a science degree, studied psychology. Yeah. A man of my own heart. And then you, um, went on to medicine. Can you walk us through from, you know, that whole journey until now?
Dr Eric Levi: Yeah, yeah, yeah. So, uh, very interesting. Um, I mean, I was born in a non-English speaking country, in a developing country. I grew up, um, non-English speaking.
Uh, I came to Australia when I was 17, so I picked up English only in high school when I was about 14. So I came to Australia at the age of 17. Uh, my mom is an educational psychologist, and that's probably where I fell in love with the, the, the idea of doing [00:09:00] psychology. Uh, so I came to Australia wanting to do psychology, basically just to finish my degree in psychology.
Uh, uh, detours in life, I met a, I met a young, beautiful lady, uh, who was doing medicine at that time, and the rest is history. So I went into medicine, uh, you know, to, to get a wife maybe, if I can put it that way. Um, her father was, uh, very traditional, who, who said that, uh, she comes from a family of doctors.
Her two older brothers and her parents are all doctors, so basically they said, uh, "You, you can't go out with our little sister, uh, with our daughter, unless you're a medical student," so I did medicine for that. We're still married. We're still married for 23 years now. Um, so yeah, so that's how I got on from psychology to medicine, was basically, um, you know, uh, obviously it's, it's a service, industry still, uh, helping people industry.
So, uh, that transition to medicine was, um, was, was, a detour, but a detour that I look [00:10:00] back and said, "Yeah, well, I, I kinda ... I love being where I am right now." Interestingly, when I did medicine, of course, everyone thought, "Oh, you've done psychology degree. You're obviously gonna be a psychiatrist," because that's kind of the natural inclination, right? You've done psychology. Why don't you do psychiatry? Um, but I guess I was one of those who kind of loved- a lot of things. And when I was doing obstetrics and gynae, I loved it. When I was doing, anesthetic, I loved it. When I was doing emergency, I loved it. So it was all really, really, really in- interesting and exciting.
Uh, but surgery was the thing that I finally fell in love with, really. Just, you know, uh, just wanted to do surgery. Um, although I wasn't quite sure of what kind of surgery I wanted to do. Uh, I had a general inclination towards general surgery, ENT, plastic surgery. And I kind of fell in love with ENT after doing a few rotations of terms in ENT.
Sharee Johnson: Some, some young doctors have said to me it depends a lot on the, um, the consultant that they're working with that helps them decide which specialty they went into. Was that-
Dr Eric Levi: That is true ...
Sharee Johnson: play a [00:11:00] role in terms of-
Dr Eric Levi: Yes ... mentorship or the, the- Yes ... regarding? A- absolutely. Uh, I think meeting, uh, the people that, um, that you groove well with.
So when we were rotations, doing different rotations, you kind of got a feel of the different units, different departments. Uh, not just the job itself- Mm ... uh, but actually the community. And I think it was ENT that, really where, where, where I kind of gelled really well with.
What's also interesting is, uh, and I think maybe this is a circle of life thing, my, youngest sister was born deaf. So we grew up in speaking American Sign Language, a bit of, uh, Australian Sign Language. She's now in London, living in London, and, and we s- uh, you know, do a bit of British Sign Language.
But, you know, it's almost like, when thinking about surgery, well, she had cochlear implants. She was born deaf. You know, wouldn't therefore do ear surgery be one of the things that you might wanna do? And it turns out that, you know, I end up doing something else just slightly [00:12:00] different to that.
You know, in head and neck surgery, I don't do cochlear implants. My colleagues do. Uh, but that was almost one of the other things that came up as well. So yeah, maybe early exposure to all those things.
Sharee Johnson: Yeah. Maybe the psychologists in us both are kind of curious about what was happening unconsciously there.
Dr Eric Levi: E- exactly right. Exactly right. Yeah. You know, I always thought about that sometimes.
Sharee Johnson: Yeah. And Eric, after you, you know, you made those decisions, and thank goodness you were able to integrate into the doctor family, your in-laws. Yeah, that's right. And then, uh, you've done, you know, multiple other fellowships.
You've been on this journey of studying, you know, other things. Yeah. Is it, just this innate curiosity? Tell us about- I, uh ... these deci- these decisions.
Dr Eric Levi: I think so. I think, I mean, my wife says, uh, "You will... I don't think you'll ever be fully satisfied with where you are right now.
You're always wanting to do a little bit more, wanting to study a bit more." I mean, I did pa- uh, public health and tropical medicine. I did health administration as part of my master's, and I think that was really driven by the fact that, n- you know, I, I kind of like systems thinking as well, [00:13:00] kind of like to look at the big picture.
Um, public health and tropical medicine was something that I was interested in. Uh, but Master of Health Administration as well. I mean, we often talk about the challenges that we doctors or clinicians face in a hospital. We often talk about how, oh, it's always the hospital admin, hospital admin, hospital admin.
I figured, look, if I wanted to find a solution to the problems, I probably should speak their language too, and I think that was one of the big drives for me to think about, uh, health administration, Master's of Health Administration, because I really wanted to- understand the language, understand the system, and figure out where we could potentially make a difference in that sense.
Sharee Johnson: Yeah. You find any answers in the sense of this- Were there surprises? Were there things that you, you know, didn't know and didn't understand before you did- Yeah ... these, these studies?
Dr Eric Levi: Uh, I mean, yes and no. Some of my, my, my, um, uh, not fear, but my suspicions were, were founded. Of course you learn a lot of new things, you know, like having to learn [00:14:00] the, uh, statistics, having to learn the, uh, accounting of health services, having to understand, um, how difficult decision-making at a systems level would be. That's always something that I appreciate. But on the flip side as well, again and again, it just shows that, uh, sometimes in a place like the hospital, there are multiple different ways of thinking about a problem, and sometimes the languages between specialties don't really align with each other.
The priorities of a health administrator, the priorities of a surgeon, the priorities of the charge nurse, uh, are, can all be very different. Um, finding common grounds there I think is the important part. Uh- Mm ... you know, so, so in a sense, I learn a lot. Um, and hopefully that will help me in, um, making changes both at the micro level in our department, but also higher up, uh, towards the systems.
Mm. Um, no, I'm not planning to be a CEO of a hospital. I love operating too much to, to be doing meetings all days, you know, or, or doing all of [00:15:00] that, and I think there are people who are better qualified than me, uh, to do those things. But at the same time, I think understanding the language of the economies of a hospital, the business of the hospital, does help, you know?
And at the end of the day, you know, we're all advocating for our patients. Uh- Mm ... whether I advocate from a systems point of view or clinical point of view or, you know, all that, it's important anyway. Yeah.
Sharee Johnson: There's not as many clinical leaders in management of hospitals now as there used to be.
Dr Eric Levi: Yes.
Sharee Johnson: And there are a lot of, uh, doctors who are, finding their voice around having- Yes ... clinicians at the table. Yes. I think it's a really important point that you're making. Yeah. And, you know, set of actions that you've taken, that you're saying- Yeah ... "Well, if I do ever want to have a seat at the table, if I do- Yeah
want to bring the clinician's voice, or if I do want to help the clinicians I work with understand the administrative position- Yeah, yeah ... I, I need some more knowledge." And, it, it strikes me in the work that I do coaching doctors that very- Yeah ... often, there's a lot of years and years of work going into- Yeah clinical technical expertise. Yep. And a sort [00:16:00] of assumed- Yes ... idea that I'll be able to- Yes ... do the leadership stuff- Yes ... or the people management stuff or the money management stuff.
Dr Eric Levi: That's right.
Sharee Johnson: It doesn't really make any logical sense, does it?
Dr Eric Levi: Yeah. Yep. You're absolutely right. There is, uh, multiple different skills, uh, that are involved, and I think the pendulum is swinging, isn't it?
So a long, long time ago, hospitals were probably very simple, uh, uh, uh, institutions. Now we've piled on so many things onto this particular institution, and so the complexity of it means that the doctors probably shouldn't be running it, or the nurses shouldn't be running it, and we give away the power to, uh, administrators.
And then you realize that it's all then been swung to one direction. Uh, there was just a recent paper that suggested that even from a hospital business point of view, uh, involving e- expensive consultancy or, managerial things don't necessarily equate to better patient outcome or even profit-making.
So, uh, we still, I don't think, have found the, the, the, the, the gold or the key or the answer to this. But I think somewhere in [00:17:00] between those two worlds, sort of the corporate world and the medical world, there has to be an answer to how we can make hospitals safe places for, you know, not just patients, but for the clinicians themselves.
I mean, you're the one who has been on this field, right? You know that doctors, nurses, allied health, and clinicians in general, um, are, are living in a space where there's so much demands placed upon them from the system on the outside and from them on the inside as well.
Sharee Johnson: Mm. Yeah, it's really, the pressure's coming from all directions. I think that is something I didn't anticipate I didn't- Yeah ... think I would build a set of knowledge about people who work under pressure. But I definitely- Yeah ... am- Yeah ... bu- building that understanding of what it's- Yeah ... like to work under pressure.
Yeah. Um, and that's all kinds of clinicians really at all stages of their- Yeah ... career. Yeah. The, sheer number of population and the sheer kind of pouring in of patients that's constant, you don't really have to- Yeah ... look for your customers, do you, most of the time. Yes. Yeah. That by itself is a pressure.
Yeah. Um, so, so just to go back [00:18:00] to when you first came to Melbourne, and then these- Yeah ... you know, these multiple stacked-on recalibrations. You know, you, you changed course, studies or you, you- developed beyond where you started. Yeah. Um, you had family that were overseas and, and- Yes ... now you were building your own family here in Australia.
Yes. Uh, you, you were on rotation like all junior doctors are- Yeah ... exploring and- Yeah ... testing other things. Yeah. What, what were you doing? How did you keep yourself recalibrated? H- what were you doing? What were the skills or the supports or the resources that you needed- Yeah ... so that you could kind of just keep going with the flow and, and-
managing the changes and the transitions?
Dr Eric Levi: Yeah. Uh, that's a, that's a challenging question to answer, isn't it, Sharee? Like, I don't know who I am 25 years ago and who I am right now. Would I have made decisions differently knowing what I know now? You know, like, you know, what would I say to my 25-year-old self, 25 plus years ago?
Um, yeah, we all think, "Okay, I have to get through bachelor of science to get through [00:19:00] medical school. I have to get through medical school so I can get internship. I've got to get through internship so I can get onto my surgical training program. Got to go through selection."
Once you go through selection, uh, you have to pass your exams, then you have to get yourself a, a job or fellowships, you know, and all of that. So at every single point, there's always, um, I guess recalibration. You're always changing the direction, always changing plan. Um, I'm particularly, um, kind of aware that there's a lot of, you know, kind of the, the challenges of a junior doctor and the challenges of the mid-career doctor, uh, you know, the challenges of the consultant can all be very different.
Um, I feel for my, a lot of my junior doctors who, like, they, they want to get onto ENT or plastics or neurosurgery or psychiatry or emergency, and they have to keep changing plans because sometimes the jobs are locked up or there are no opportunities. It's a real challenge in that [00:20:00] sense, and I, I actually had that kind of times as well when I was thinking, "Okay, um, if I don't get into surgery, what's my plan B?
If I don't get into general surgery, what's my plan B? Or if I don't get into plastics, ENT, what's my plan B?" Um, and you just kept working hard and trying and trying and trying. So I don't know that I have a very specific answer other than to say I just kept trying, and I knew that, that if I work hard enough or work tried hard enough or be as sincere as I can or do a, a good job as I can, um, the worst-case scenario is I'll still be a doctor, maybe not in that one specialty that I want to do, but I'll still be a clinician somewhere, you know?
I've always felt that there was that safety net. Once you pass medical school, uh, you know, you do a good job and, uh, be a good clinician, there will be a job for you somewhere. Uh, but- Yeah, living in that space, living in that tension between wanting to be a [00:21:00] particular specialty versus being ready to, to be open to do whatever, um, whatever I end up doing, you know?
Yeah.
Sharee Johnson: My experience of you, Eric, is that you do have a general optimism. Your, your, part of your personality is that you're optimistic or hopeful or- Yeah ... you know, you have a positive approach to things. Yeah. What do you say to junior doctors who are struggling to maintain that, who are feeling- Yeah
dejected or just in despair or- Yeah ... you know, there's a, there's a sort of a learned hopelessness sometimes. Yes, yes, yes. The young doctors, they're so low in the hierarchy and they do- Yes ... feel like they don't- Yes ... have enough power to kind of- Yeah ... make things happen. Yeah. And it is competitive. There are- Yeah bottlenecks in training programs- Yeah ... and places like that.
How do you encourage them or help them to keep going? What's, what's your wise words of advice?
Dr Eric Levi: Look, it is hard, and I just often want to sit in that rubble, you know, to say, um, look, it is hard. Um, and it's, it's not because we make it hard, it's just a numbers game unfortunately.
You know, there are only an X number of positions in [00:22:00] training for this particular area, in this particular city, and sometimes, you know, sometimes this particular specialty becomes more, uh, uh, popular than others for whatever reason. There are all of those seasons and, and, you know, um, and sometimes I just have to say, look, you, you have gotten through medical school training and you're an intern or a first year, second year, third year resident.
You're trying to be a good doctor, and you're trying to look at the future as well. I sometimes just remind them again to pull back and just say, listen, you know, um, you go to work every single day, even if it is just... And I still remember this when I was in my second year as a resident. Even if all I did that day was do some paperwork, put in some IV lines, insert some indwelling catheters, and chart a few things, I'm still seeing patients, and I'm still interacting with people who are there not for their own choice, but because they had to be [00:23:00] there.
You know, in a sense there is that kind of human side of us, right? I need to remind myself firstly that- even the littlest thing I do for patient actually do matter for them. You know? Even the IV line that I put in, the chart that I write up, or the medication that I write up still matters for them. So, so to me, I often start with that baseline.
And then I'd say, "Look, at the end of the day, um, you have goals, you have wishes, you have hopes. And unfortunately, life sometimes throws different hard balls at you. Um, and you know, you keep trying, you keep trying, you keep trying. But you always have to have a, your plan B or plan C as well, you know, kind of keeping your options open is another important thing as well, you know?"
Yeah.
Sharee Johnson: I'm not a drawer or a painter- Yeah ... but I wished I was because I have this vision of you sitting in the rubble with, you know- Yeah ... a, a much younger doctor. And what a- Yeah ... powerful image that is, to have a senior person who's willing to sit with you even for a few minutes and just lament the- Yeah.
Yeah ... the struggle, because there is a struggle. And, [00:24:00] and you're also reminding me of a, a young doctor I worked with very, very early in my coaching doctor's time, and she was... I can't remember if she's in her first or, you know, intern year or her second year, but she said, "I feel like a glorified secretary, and I didn't know that I'd done all this hard- Yeah
study just to be- Yeah ... a secretary." Yeah. And I said to her, uh, "What, what, what are you doing?" She described the charting and the things that you've just described, and chasing results and so on. And then I said, "So what would happen for that patient if you weren't doing those things?" Mm-hmm. Mm. Mm. That was really a watershed moment I think for her- Yeah
and for me- Yes ... in my learning about a, a junior doctor's life. Yeah. Yes. And she told me later on that she was now able to go through her days and leave work feeling like she'd really contributed and she'd been really useful, where before- Yeah ... that she was really very dejected and like- Yeah
"What's, what's the point of all that hard work I did?" Yeah. Yeah. I, I'm pleased you're, you're recognizing that too. Yeah.
Do, do you think that when you got to be a consultant maybe, let's move forward a little bit, um, was it how you thought it was gonna be? Like, by then had you been in medicine long enough to have a kind of- Yeah
[00:25:00] realistic view of what it was really gonna be like? Did you know you were gonna work these really long days, and that you were gonna interact with so many people, and fix and, and solve so many problems in a, in a week, every week, you know?
Dr Eric Levi: Oh. I wish, Sharee. I wish I could, I could have said that, "Oh, yeah, I knew this was what I was gonna walk into." Still, still not. Even till today, even till th- this weekend or last night, I still think, "Oh, my goodness. What am I doing with my life? I just want to be home a lot more." Um, and I think that's the challenge, isn't it? So, um, I still remember very clearly wr- writing a tweet when Twitter was, was famous back then.
I wrote down a tweet, "I'm finally a surgeon now. I have control over my life." You know, just LOL, LOL, LOL, LOL. And then people knew that because, you know, people think that as, as a consultant now I have, you know, I have control. Yes, there is a little bit more control. Yes, I, as compared to [00:26:00] my days as a second year, third year, fourth year resident- Mm
where I was a slave to the pager, um, now I can control things a bit, but it's not that different either. You know, I thought I was gonna have a lot more control, but as it turns out, not that really. I mean, it comes down to the fact that the, the moment you choose the path of being a clinician or a surgeon or a, or a physician or, or critical care physician or a nurse or anything, it's a life of service and, you know, y- whether you like it or not, it is a life of service.
And so I still have to turn up even, you know, those days when I'm, you know, not really, feeling like it, I still have to turn up because I've got five patients booked for an operation this morning. Um- Yeah ... you know? Uh, and so, so there is a certain sense of duty that continues to drive that daily, activity.
Um, yes, you do get a bit more control, but not as much as what everyone thinks there is. I think I remember reading, was it Barack Obama's, memoir or [00:27:00] somewhere he said, you know, you think that the life of a president of the USA, that you have all control. Not really. You go from meeting to meeting, you're taken from places to places.
You are, you, you have duties and commitments and responsibilities that you have to do, and that's just part of the job, you know? Um, and so that's, that's, to a certain degree, that's, that's how I feel. Um, you know, touching back again about, about, you know, just I feel like I'm a glorified, uh, chart person. At the same time, I saw there's also that particular phase in life where, yes, understanding the importance of giving orders, receiving orders, doing the right orders is important.
All those things really were character building or skills building towards the long run, you know? Um, I still write medication, you know, as a surgeon, you know, as a consultant. I still have to check bloods, and I still have to know all of that and, but those be- that's a, that has become a natural, easy thing to do, but because those skills were built over many, many years.
You know? Uh, I graduated in [00:28:00] 2005, so I've been a doctor now for, yeah, ele- 21 years, and 10 of it as a surgeon. I still have to read, charts and write charts and all those things, so nothing is ever wasted.
Sharee Johnson: Yeah, they're the foundation skills in many ways- Yep ... aren't they?
Dr Eric Levi: Yeah, that's right.
Sharee Johnson: And we know that, practice is what makes those skills
Dr Eric Levi: Yes
Sharee Johnson: That's mastery.
Dr Eric Levi: Yes, yes. That's right.
Sharee Johnson: Yeah. So I wonder, um, on this journey from, school and deciding to do psychology and then medicine and then all the consultants and the fellowships and now coming to this place where you have your own, you are choosing at some level the balance between how much public, private and, in your own clinic work- Yeah ... you do. And yes, your values are very alive in terms of service. , If you- Yeah ... feel that level of service, that, that's values alignment, and so you- Yeah ... want to keep showing up even on the days that you're tired. Yeah.
Have there been any dilemmas or crossroads? I'm wondering for instance, when you had ... You've got some kids.
Dr Eric Levi: Yes. You know, and- Yes, that's right. Yeah
Sharee Johnson: And they were small babies, and also I'm thinking about the two of you are both doctors with on-call- Yeah ... um, responsibilities [00:29:00] and, and these, these obligations o- of service. Mm. How, how do you manage all of that home life stuff?
Dr Eric Levi: Uh, terribly I think. I don't think I'll be where I am if it wasn't because of all the sacrifices that, that my wife has, has made as well. Uh, so yeah, we've got three kids now. Uh, one is in year 12, uh, year eight and grade six. My year 12 boy wants to do medicine as well, and, uh, I, um ... Regrets in life.
So one of my biggest regrets ... So, so like I started the journey towards surgery when he was born. So, you know, so like I said, I've been, I've been a doctor for 21 years now, so I started my surgical training basically when, when he was born. And I always have at the back of my mind, I just need to get through surgical training so I can spend more time with him. And then I just need to get through the exams so I can have more time with him. So I need to get through my fellowship so I can have more time with him. I need to set up my private practice and get established in Melbourne so that my life is safe and [00:30:00] secure so I can have more time with him, and the next thing you know, he's in year 12, and next year he probably doesn't even want to be with me anymore.
He's probably gonna do medicine somewhere in another state. I don't know. But that, that, that was a real, um, regret. I, I had breakfast with him just a few months ago and, and I, I openly said, "I am sorry. I, as a father, that's one of my biggest regrets is not having enough time to spend with you because you, you know, uh, you're, you're
You know, I started surgical training when you were zero, when you were one. Um- And, and that, that, that, that has been the kind of, um, always at the back of my mind, could I have done things differently? Could I have done things better? Uh, have I spent, um, you know, too much time in surgery? Because there is a minimum duty requirement in, you know, it's, you know, I can't just operate on a patient and just say, "No, I'm not gonna be on call [00:31:00] for you."
Um, yeah, so that, that's a real balance as well. And the other thing as well, unfortunately, I've chosen the life to do quite a lot of public work. Um, some of my colleagues probably spend 80% of their time maybe in the private, um, and only 20% in the public. I'm almost the reverse. I'm spending 75% of my time in the public with the commitments of being part of leadership, teaching, education, and all those things.
These are the things that I do enjoy, um, and that's why I love, I love the teaching, I love the, the operating, I love the engagement with trainees. But at the same time, it is costly, uh, from a time and emotional and cognitive point of view as well. So, so, you know, I, I don't know that I have the, the, the, the, the easy answer.
Maybe I should be your the example of what not to do, Sharee You know?
Sharee Johnson: Well, I, I'm not sure about that, Eric, what I'm really noticing is the, the reality of this. That we're not- Yeah ... trying to paint a here's the perfect picture or here's the- Yeah ... recipe, 'cause there isn't one. Yeah.
The benefits, you know, we can [00:32:00] make arguments for any of the sides we want, can't we? You know- Yeah ... the benefit of you doing work that's fulfilling and- Yeah ... challenging and that you enjoy- Yeah ... means that you come home in a certain state- Yeah ... to, to if you were doing something you didn't like.
What I do hope the listeners are listening to is that there is a choice in this, and that we are responsible for our choices. Whether we regret them or not- Yeah ... there is a element of being responsible for our choices.
A lot of, uh, early consultants come to coaching saying, you know, that they don't know what to do 'cause they're not on the, they're not on the prescribed track anymore, you know?
Dr Eric Levi: Yes, yes. Exactly.
Sharee Johnson: So I think this time of trying to work out, well, will we have children, won't we have children, will we move interstate, won't we move interstate, um, you know, how much of a commute can I tolerate, 'cause that's- Yeah ... more time away from my family. All of these things- Yeah ... are real, you know, day-to-day- Yes- dilemmas that people are grappling with.
And, and for any audience that's listening that's not a healthcare worker, and particularly not a doctor, I think there's so much unseen work that doctors do- Yeah ... that we don't appreciate. We just as members of the community think, oh, well- Yeah ... when the [00:33:00] doctor's not with the patient, they must be at home with their family, and of course- Yeah
that's not the reality. That's true. Yeah. Yeah. The, the other thing that you're pointing to is the variety in your work. Mm. That going to the public, being part of the public institution- Mm ... gives you more variety in terms of leadership and, and teaching and so on. And, and I think that's something that is of value as well.
Dr Eric Levi: Yes, yes. Uh, you, I think you beautifully kind of summarized that. Um, when, when I told my son "Are you sure? You know, haven't you seen how Mommy and Daddy work? You know, I do 60-hour weeks. My weekends, you know, are, you know, c- caught up operating once in every three weekends. We don't do too many, uh, weekend or evening things, you know, uh, and stuff like that because I've got meetings in, you know, two out of three, two out of five evenings on a weekday," and all those thing.
And he just said, "But you seem to love what you do, and your job seems really, really interesting and exciting." Um, and that was what drew [00:34:00] him to, to medicine or surgery in particular. But you're right. I mean, the, the, the various different varieties, you, you've nicely put it all together by saying that these are the little passions that I like or that I enjoy that at least gives me a sense of purpose or give me a sense of pleasure.
There's always that, that question about, you know, joy in work, seeking the joy in work. I find that, for me anyway, speaking personally, joy is the secondary side effects of purpose. You know, what I mean by that is what I'm looking for is not I don't necessarily come to work wanting to be happy. I want to be useful.
And when I feel that I'm being useful, that's when I get the joy, you know, as a secondary aftereffect of knowing that my work matters and that is purposeful and impactful, you know?
Yeah.
Sharee Johnson: So beautiful, Eric. We wish that for everybody, right? Yeah. That they can have something purposeful to do in their day.
Yes. And that out of that comes, uh, these other things like joy.
Dr Eric Levi: Yes. Yes. That's [00:35:00] right.
Sharee Johnson: You post on social media, and I wanna talk to you about that in a little bit. But, uh, one of the things you sometimes post about is getting the coffee for the team. Yeah. And so I, I wonder if you'd just say a little bit about your ideas about leadership or about teamwork.
Yeah. Wh- whatever angle you wanna come in there. Yeah. It seems, it is a part of this joy element, I think. Yeah.
Dr Eric Levi: Uh, it's the love language, is, isn't it? You know, like I come to work ... And it's very interesting because every single day I would be working in potentially different locations with different teams in the operating theater.
Um, and you know, a lot of studies, you're a psychologist so you know the studies that, that the culture of the team matters, you know? And, and to me, the simplest way that I can influence culture is just by, uh, being kind. And so that kindness in medicine and surgery is really coffee, chats, conversations.
Um, the intensity of the work, that isn't reduced. You know, we still [00:36:00] look after really sick patients. Um, but when you have built that little, uh- coffee conversations, uh, you know, kind of little jokes here and there, you know, things that break the ice. Then during those times when high-intensity work needs to happen rapidly, then you've already created culture that creates the foundational thing, or the relationship.
So, so to me that, um, uh, that ... I don't know, that comes naturally to me because I always think about that maybe. Um, but it seems to me that it doesn't always happen everywhere. Um, I, I tell some of my students, "You're always welcome in every operating theater. But before you go in, just peek into the room and just have a look at the expressions of the team members.
If you see a lot of really stressed out nurses in a corner, that's probably not a good learning experience for you because that's a, a potentially an unsafe working environment in that there's a lot of tension, uh, there's a lot of communication issues [00:37:00] maybe. If you want to step into, uh, an operating theater, see if you can find one where there's a little bit more relaxed body language."
Mm. "And that's probably where you'll probably learn the most." Uh, you know, so I kind of give this little warning. But I'm sure if you're an observer for teams, that's something that you might see as well. Teams with very strong hierarchical structures might be more rigid and intense. Teams that are perhaps more psychologically safe probably have a lot more natural body language that are a bit more comfortable.
Do you have anything to say about that yourself, Sharee?
Sharee Johnson: Oh, yeah. I think you're pointing to a couple of really important things, Eric. One is that we know that we learn when we're relaxed. Yeah. When we're stressed out, we're worried about survival and staying safe. We can't actually take in and remember things- Yes
very satisfactorily in that condition. So- Yeah ... absolutely I support that. The other thing that you're, uh, pointing to I think is that, um, the research around trust says that- Yeah ... uh, it's really about competence first and relationship second. So- Mm-hmm ... wh- when you meet somebody new, but in- Mm-hmm ... in the theater if you're working- Mm
with somebody you haven't worked with before- Mm ... [00:38:00] you want to know something about their level of competence. Mm. You want to know how much support they need or how many instructions you need to give them- so once you have an assessment of their level of competence- Yeah ... it really comes to relationship.
And if you think- Yes ... of people you know well, who you've had long relationships with, you give them the benefit of the doubt. If something goes wrong- Yeah ... you give them the benefit of the doubt. Yeah. Because you've got established trust through relationship. Yeah. Yeah. But at the beginning of a, a interaction where you don't know the person, it's more about competence because- Yes, true
you know. And so, um, what you're describing is these building of relationships- Mm ... that allows, uh, trust to build. Mm-hmm. Mm-hmm. And, uh, so, so you still need competence- Yeah ... but because you've known their name or because you've- Yeah ... um, because people feel- Yeah ... because people feel - Yeah. That's right ... uh, seen and heard- Yeah And this act of saying, "What kind of coffee do you want?"
Or, "I brought you a coffee." Yeah. Or, "Does anybody else- Yeah ... want a coffee?" Yeah. That's an act of I see you. Yeah. I want to know about you, or I want to do [00:39:00] something to- Yeah ... connect with you. Yeah. The, the Gottmans would say that's an act of looking for connection.
Dr Eric Levi: Yes. Yes.
Sharee Johnson: These are really important things in trust, and they- Yes and the other thing you're pointing to is that it takes ... It's momentary. It- Yes ... can sometimes take just a few seconds. Yes. But the value of the person feeling seen and heard means that now they trust you. They think- Yeah ... oh, he saw me. Yeah. They want to trust you. Yeah. And they just need to know you're competent, but they're already ready to give you- Yes
benefit of the doubt because they've- Mm ... connected and, and built some sort of fledgling- Yeah ... relationship with you. Yeah, yeah, yeah. Yeah. It's powerful stuff.
I have a favorite thing of saying that the art of medicine enables the science, and I think that's the territory- True ... that we're in, that, that- That's true
you can have all the magic of, of modern medicine- Yeah ... um, but if we can't get the other person, our team member's attention, or if they won't speak to us- Yeah ... you know- Yeah. Yeah ... then we may not be able to deliver the magic that the technology allows.
Dr Eric Levi: Yep, yep. No, that's, that's very true indeed. I mean, I've seen that again and again in teams. And, and maybe this is just because all through my [00:40:00] training as well I've chosen role models that actually embodies that as well. I've seen enough, uh, I know enough, uh, people with long titles over their names- Mm-hmm ... that probably are a very different person in clinic or in the operating theater.
Mm-hmm. And I've, I've seen others who are effective leaders with no fancy titles, but really is a master at getting the team together and getting good results for their patients. So, you know, the academic titles versus the day-to-day practice, you know, they're two very different things sometimes. And I guess, um, I've always wanted to model myself, following the model of those people who really empower their, their team.
And just nice to work with. You know, nice to work with. Yeah. Uh, you know, brings a lot of, uh, comfort to, to, to me even as a junior in their team.
Sharee Johnson: Yeah. You, you used the word power earlier, and now you're talking about empowerment, and even just to notice these things and name them has an impact. When people, if people have an idea that their colleague is interested in empowering [00:41:00] other people- Yeah ... then they respond differently. And we lose our voice. We had Victoria Lister on the podcast a few sessions ago. She studies, how people have their voice or, or- Mm-hmm become silent at work. Mm-hmm. And, you know, the numbers are pretty frightening. It doesn't take- Yeah ... very many times for people to stop saying something about patient safety- Mm-hmm ... or about, um, uh, the bullying that's happening or the other- Yeah ... things that might be happening between colleagues. So having people around who will name things, like, you know, um, I want you to feel empowered enough to speak up- Yeah, yeah ... if you see something. Yeah. That, that has a big impact.
Dr Eric Levi: Yes. Yes.
Sharee Johnson: We've talked a lot about your identity. We've talked a little bit about your identity as a dad. We've talked about you- Yeah as a surgeon and as a student and, and so on. You have this social media profile that sometimes you're quite active on and sometimes you, you go quiet for a while. Yes. I think I've learned things like you used to have a rabbit at home, and we have a rabbit here. Right. So I noticed that and, and- Yeah and your coffee. Yeah. And you posted a couple of things recently. You've posted about the hours and the years of [00:42:00] study- Yeah ... that you've done. But you posted a very graphic image recently, um, a couple of things, one with blood all over your face. I think that was at Christmas last time when you- Mm-hmm.
Mm-hmm ... had been in surgery. And another one where there was some reconstructive surgery. I can't remember what the case was. Mm. You showed the number of people in the room. Mm. That the, the, the pre-team and the post-team, if you like. Yeah. Um, what, what's your hope or intention when you're showing those real-life images of, of- Mm your work? Mm. Mm. What do you hope people learn when they see those?
Dr Eric Levi: I guess the humanity of it all. Uh, what I mean by that is, um, you know, people might think that the surgeon always leave unscathed, you know? We, we actually carry our battle scars. Um, uh, what a lot of people don't realize is, people say, oh, you know, that, that doctors change lives and things like that.
Well, the reverse also happens. You know, patients actually change lives. Um, patients change our lives, or patients affect us, or we carry a lot of our patients. And are both the good and the, the [00:43:00] not so good. What I mean by that is, uh, when you see one of my youngest patients who had cancer is a, you know, five kilogram, three-month-old.
Um, and that patient will stay with me for a very long time. Uh, he's alive. He's well. You know, this was about seven years ago. Um, uh, but to walk with a new parent, talking about their child having cancer and being treated for that, you know, it's a massive thing. That's on one hand.
On the other hand, you know, when, when I've got the 80, 90-year-olds with malignancies of the tongue or the face, that's another different discussion as well in that, in, in their different context. Uh, but what I really wanted to show was just the humanity of it all, that we, we do carry our patients home.
We do feel for our patients. They are more than just- cases or tasks or jobs to be done. Mm. Um, and it does affect us as well, and I think maybe a lot of people don't [00:44:00] realize how much a lot of surgeons actually do think about their patients and carry them home, you know? And maybe that's just, that's all.
Maybe this is also an expression because, um, I happen to be on social media, and I happen to be quite honest with my sharing of the busy life, the, the, the sacrifices. Um, and that's not to, to, to get a pity from people, but it's actually just to show the reality of it all. That the work, you know, takes a lot from us.
Sharee Johnson: Mm. Mm. Yes, it does. I, I wanna come back there again too, but, uh, before we do that, I, there's a bit of a push right now for, more doctors to be on social media to counter these, non-doctors, non-clinicians who- Mm ... let's say, propagate s- a lot of misinformation. Let's say it like that.
Mm. Mm. Mm. Yeah. Yeah. Um, what, what, what's your advice to other doctors who might- ... contemplating, you know, maybe I could be on social media- Yes ... but who feel very wary about the, you know, the regulation, the [00:45:00] regulatory rules around it- Yeah. Yeah ... those kinds of things. Yeah. Yeah. What, what have you learned? What advice might you offer in that-
Dr Eric Levi: Yeah, interesting. I've been on social media since I started my, my surgical training. I was under anonymous because I wanted to try and explore different things, first of all. Um, I think social media is a, a medium. It, it really is just a medium. Uh, you know, you can use it for good, you can use it for bad. Mm. Uh, I think there was a recent, uh, quote that says, "Why are doctors now becoming influencers?"
Sharee Johnson: Yes, I saw that.
Dr Eric Levi: Well, because in- and because influencers are becoming doctors now, you know? So in a sense, all that we're doing is putting on social media what we repeatedly do on a day-to-day basis, and for me, that's just education. Mm. You know, I don't put social... I don't put stuff on social media so that people can see me in my private clinic.
Uh, in fact, most of my followers and other things are probably not even in Australia. I put social media really as an educational platform to share, you know, basic, simple, ENT, uh, ear, nose, and throat related, stuff, uh, life of a [00:46:00] surgeon, and also just being a human being, being a dad, uh, with, with a life outside of the operating theater.
And my encouragement for anyone, any clinicians, doctors, nurses, allied health, is to say, well, you're a professional, at work. You can be the same professional on social media. Mm. You can tweet about or share about what you do. Now, you don't talk about patients, but you can talk about- conditions.
Uh, so that's kind of my simple line. Don't talk about patients, talk about conditions. You can talk about what you do. You don't have to say that you're the best at doing this. You just share what you do. Um, and that's not to draw attention to you, but that's again, to really just put some neutral information that is helpful for the public to engage with.
There are some clear guidelines in Australia. Um, but basically you can say what you do. You just cannot say that you're the best at doing it. You cannot promote unnecessary services, meaning you can't say, "If I take your right tonsil, I'll s- [00:47:00] do your left tonsil for free." You can't do any of that.
Uh, you can't put any patient, uh, testimonials. You know, those are some general rules. Um, so my guideline is basically simple. Talk about conditions, talk about what you do, educate, educate, educate. And, and stay professional. , You know, being a professional at work, being a professional at social media will be helpful for a lot of people, I think.
Sharee Johnson: I, I, I really appreciate seeing you there. I think you've, uh, well, you obviously doing, have been doing it for a long time. Yeah. And I think there's a handful of doctors in Australia really showing us very beautifully how you can educate- Yeah ... in the way you've just described. Yeah. But, um, before, before we went there, we were t- you were also talking about the impact of being a surgeon, how that affects you.
And you've done some talking in the world about, uh, about that, about the wellbeing of surgeons. Yeah. Can you share with us some of, the key messages are, what you think people, other surgeons in particular, might benefit from that?
Dr Eric Levi: Yeah. Yeah. Um, you, you mentioned very briefly in the past, d- during recalibration. So I had my burnout [00:48:00] period, I really, really burnt out, actually not through training. Mm. But after training. So after I finished my fellowship, I got really burnt out. Um, and that I think is partly because during training, I always had something to look forward to. I had to finish my exams, to finish my fellowship, finish this, this, this, this, this and that.
And then after you finished everything, you're kind of like, "Okay, so what's next?" And, uh, I think that point of recalibration also was a point of, okay, I was really, really burnt out at that time. And I still remember very vividly one, news where, um, I'm sorry about this, this is a trigger warning, but there was , a gastroenterologist in Brisbane who completed suicide.
And, and his wife actually wrote a very, um, a, a powerful moving letter about how, um, you know, work really affected him. Uh, some patient complications and other things really, really affected him. And I know, um, a couple of other clinicians who, [00:49:00] who have passed away as well in the context of, of work related kind of stresses.
So I, I, I came to that season of life realizing that I could be the best trained surgeon in the world, but if I don't kind of look after my own soul and heart and humanity, I may not be alive in, you know, in a few years, you know? So I had to, to face my own mortality I guess. And, and I think that's when I started talking about what are the things that we have lost as a surgeon?
We've lost our sense of autonomy sometimes. Mm. You know, our work-life balance is taken away from us because we are a slave to our pager sometimes. Uh, we've lost a sense of community, you know? The life of, of a clinician, Again, I can only speak for myself. Uh, the life of a surgeon can get pretty lonely, uh, because even though I'm surrounded by registrars, trainees, and other things, at the end of the day, the patient is [00:50:00] still mine, and every complication that happens or every poor outcome that happens, I do take it on to a certain degree personally, you know?
So, so those were some of the dark moments, the autonomy, the lack of community as well, uh, a- and the repetition of routine that gets taken away from us. And, and so some of the things that I, I encourage my colleagues to do is to return to some of that, you know? Get some autonomy over your, your life or your career.
If there are sections of your work where you find the least, , uh, where you're le- least autonomous or you're unable to make decisions, maybe those are the things that are eating away at your soul. Are you able to find other parts of your career or your life where you can feel more autonomous, you know, have a bit more autonomy?
The other thing is forming communities, you know? Uh, have a group of colleagues, and they don't have to be medical colleagues, they don't have to be another surgeon or another clinician. They can be people from your faith communities, [00:51:00] from your so- you know, your, your sport communities and, and all of those things.
Just building, uh, around that. Uh, those are probably some of the simple things, and it, it probably is so common sense, uh, to you and to many people, but I guess it's just something that just needs to be mentioned again and again, , um, that the pressure of clinical work, the pressure of, um, patient expectations, uh, weighs heavy on us, and so we need to find a way to, to resolve that balance with autonomy, joy, meaning, purpose, community.
Sharee Johnson: Yeah, beautiful. I'm, I'm noticing that you're using the word soul, which we had a psychiatrist, Ashok Bhattacharya from, Canada on about, a month or two ago. And he was talking about soul and spirit as well, and I think- Yeah, these are very non-medical words, Eric, I think. Um, I, I, I love that we might be entering this space where- Yeah people can use this language, uh- Yes ... beside the medical language. It's not either or, it's that, you know, [00:52:00] these are ways that humans for millennia have described- Yes ... something about their experience of being human. Yes. And surgeons are first and foremost humans before they're anything else. Yes, yes. Yeah.
So I, I really welcome that, that, um, apparent, progression that we're ... Yes, yes ... we're, or, or you used, talked about pendulums before. Perhaps the pendulum- Yes, yes ... coming back a bit. Yeah. What, what's important to you about having these conversations? You've done some writing over the years as well on social media, and you're talking at the conferences.
What's important about, um, talking about these issues, not just talking about your ENT, specialty and your, administration skills and so on but this human stuff. Why is it important- Yeah ... for you personally to keep talking about that in a public way?
Dr Eric Levi: Mm. I think for me, it's, it's, it's that, that, a collision between, um, your work and who you are, you know?
It's very hard. You know, people talk about how you're, we are human beings, not human doings, but at the same time, what you do [00:53:00] really does matter, and I think as you've said, you just can't split them. One impacts the other. You know, you need your human doing, uh, to support your human being, and you need who you are as a human being to, to, um, to support what you do.
. The quest, I think particularly for clinicians, is, um, we derive joy from... I guess the deepest joy that I have in work is seeing my patients, you know, get discharged well. You know, when they can return to their daily activities being better, sleeping better, breathing better, hearing better, eating better.
ENT is about, you know, senses- Yeah ... right? You know, so, so if they hear better, see better, sleep better, breathe better, uh, and they are better, that's kind of the deepest joy. It's not, you know, the status or the financial, you know, kind of all of that, remuneration and all of that. It's always that kind of human meaning, and that's the thing that is long-lasting in my mind.
Mm. And I think this is also the antidote [00:54:00] to, um... I, I still don't know how, maybe you can give me the answer. Maybe you have the equation, but the equation in my mind is, a lot of clinicians are burnt out, and we're trying to find, uh, individual solutions like, you know, mindfulness, yoga, all of that stuff. The system is causing, not causing, but have some association with that.
But at the same time, the antidote- is actually, um, altruism. You know, seeing a patient get better is one of the biggest kicks that we get. So in that triad, you know, the system, the clinician, and the patient outcome, um, I wonder whether, you know, the, the patient outcome is the antidote to the burnout. You know, the, you know, changing the system is the antidote.
I, I don't know. I, I don't have an, uh, an answer to that, Sharee. Maybe you have, but, for me, I think the reason why I still love talking about the human side of surgery... is because that's the thing that will get us going [00:55:00] in the long run, you know? Surgical skill, surgical knowledge will keep changing, but it's the human behind the knife that I really care about as well, uh, in my colleagues, in my registrars, in my trainees
I still want to be a voice in that space because that's probably the long-term antidote to the, the burnout and the, the, the mental health, effects or, or negative mental health effects of, on our work on us. Mm. I don't know. Maybe can you, can you, can you uh, piece it all together what's confused in my mind, Sharee?
Sharee Johnson: Uh, uh, uh, well, um, we could do this for, we could be here for hours, Eric, the system, people, clinicians in systems, whether they're in any country in the world, I think, I've got a lot to learn about China and some of those countries I have less contact with. But certainly in the UK, in Europe, in America, in Australia, New Zealand, South Africa, you know, a lot of these countries, Singapore- Yeah
um, the, the systems are different in a lot of ways, and the problems are still the [00:56:00] same. Yes. For clinicians. So, it's way too simple to say it's the system's fault because- Yeah ... even with the variations in the system, we still end up with some of the same problems.
Dr Eric Levi: Agreed. Yeah.
Sharee Johnson: Um, and we know that not everybody burns out. Yes. So it's not, even though the numbers are very high, way, way higher than we want them to be, you know, it's like saying it's not like every child of a person who abuses alcohol also becomes a person who abuses alcohol, right? Yep. Absolutely. Yeah, yeah. So we, we can't just say it's the system that's causing burnout, and you, you checked yourself about that association.
Mm-hmm. Mm-hmm. And we know that practices like mindfulness and- being, staying present and- Mm ... doing, uh, work in the team where we're feeling seen and heard, feeling psychologically safe, we know that those things are helpful for individuals, but they're not enough either by themselves.
Yeah. So, you know, it's a combination, as you're rightly- Yeah ... you're pointing to, of all of these things. The research from Mayo Clinic and places like that certainly says that it's unit-specific. Mm-hmm. That we can't apply a recipe from one unit to the other and assume- Yeah ... it will work. [00:57:00] It needs to be localized.
Yes. And we know, I'm sure that you're aware of the, the leadership, um, research. You know, your one-up boss is- Mm, the biggest ... 70% responsible- Yes. That's right ... for your level of happiness at work. Yes. But I think you pointed to something much,, earlier that was very important, which is this sense of purpose.
You know, our- Mm ... the story that we're telling ourself, the meaning- Mm ... making- Yeah ... that we're doing of our work is, is- Yeah ... critical in our l- our sense of, um, wellbeing. Yes. And the, and the other thing I'd point to is that outcome focus is incredible. Like seeing- Yeah ... your patient work or walk away- Yeah
more well than they were- Yes ... have some of their issues resolved- Yeah ... or their life extended or, you know, that's a- Yeah ... very powerful motivator. But it's still extrinsic to us. Yeah. Yeah. So, and so that outcome base isn't enough. Yes. There has to be some intrinsic motivation. Yeah. Something, you know, your sense of, you said before, I want to be useful.
Yeah. So this sense of feeling useful in the process, even if the outcome is not the desired [00:58:00] outcome- Mm. Mm. Yes ... is also important in our wellbeing. Yeah. This sense of- Yeah ... um, I've, uh, done everything that I could do, that I had- Yeah ... the capacity to do, that the resources allowed us to do. Yes. Um, you know, I, I met the actual person. I was present to them. Yeah. Opposed to being a robot. Um- Yeah ... I was compassionate to that extent. Those things all help us be well. Yeah. So, you know, I think you're definitely onto something with the, all the- Yeah ... all the moving parts. Yeah. Um, I don't think either of us can claim to resolve- Yeah all of that right now, but- Yeah ... but this conversation, it's a very important conversation that, that people are having now on a day-to-day. Mm. And I think that's- Mm ... going to serve us well.
Dr Eric Levi: Mm. Mm. Mm. That is true. That is true. Yeah.
Sharee Johnson: Let's kind of bring our, our conversation to a close, Eric. Mm. Mm. I feel like I really took over then for a minute.
Dr Eric Levi: It's, it's lovely. It's lovely to hear because, uh, this, these things do matter, and I think people forget that because, I, oh, do see that the solutions [00:59:00] don't often, , answer the, the underlying issues. And understanding there's various parts there is quite important, you know?
Sharee Johnson: We haven't talked a lot about teams, but I wonder if I can just ask you about the, you know, there is a hierarchy that operates- Mm ... in hospitals particularly. Yep. And, consultants are further up the hierarchy than lots- Yeah ... of the other people, the techs in the theater space- Yeah
the nurses, the- Yes ... what's your reflection on how people can do well in a hierarchy? Mm. I can't imagine that in the short or medium term the hierarchy is dramatically going to change. Mm. Mm. Mm. So what are the things that can help people from any of the different positions- Yeah ... to, to work- Yeah
really well in a team from your- Yeah ... point of view?
Dr Eric Levi: Yeah. Yeah. I mean, from what I've learned is, I mean, um, hierarchy in itself is not evil. It just provides structure to a team. It's the abuse or the misuse of that hierarchy where the negative effects on a person is. And, you know, when you are in a, in a trauma resuscitation, there's clear hierarchy [01:00:00] because we do need clear communication guidelines in such critical times like that.
Uh, but I think where people mistake it is, is thinking that this is a hierarchy of value, like that the, the theater tech is less valuable than the surgeon or that the registrar is less valuable than the, than the anesthetist or I, I don't know. Interestingly, in Australia, uh, if there is no theater tech, the whole thing gets canceled, sometimes.
So it's not a hierarchy of value. It's a, it's, it's a role definition, uh, uh, you know, in terms of that. So, um, I know too that if we were having this conversation in, like you mentioned, countries like in Singapore or in China or in other places, those hierarchical structures are probably gonna be even more strong and based perhaps either on age or gender or other things like that, where the cultural context really influence the hierarchy in the hospital.
Now, all I can say is here, here, at least in [01:01:00] our conversation here in Australia in 2026, um, there's a better understanding that the, the structure of the team or the roles of the teams are important, and clear communication is important, and of course, there's a lot of research on that. And I think we started earlier on by talking about coffee and how that matters.
You know, like forming or creating that, um, that, that trusted working relationship for the sake of the patient is quite important. Um, for me, at least, as a, , as a surgeon, I often... It's interesting as well. When good things happen, everyone's the boss. When bad things happen, suddenly I'm the boss.
You are in charge of everything. Um, there is, there's an interesting, uh, you know, kind of play there as well. I mean, all I can say is that when I walk into the clinic or the operating theater and I work with different people, um, understanding that I'm just here to provide support, counsel, general guidance, um, is, where I feel my role is, and [01:02:00] that each person, obviously in the team, has got a very specific role to play, that is important as well, you know?
Sharee Johnson: I love that distinguishing that you're talking about. It's not a hierarchy of value. Yeah. That's a very beautifully, beautifully expressed. Thank you.
Anything that you've noticed in our conversation today while we've been talking, anything that's come up for you that you feel like you'd like to put a pin in or point back to in terms of reflection?
Dr Eric Levi: Um, you mentioned stories and meaning. I think that's something that, that, I would love for all of us as just human beings to tap into it a little bit more, you know? It's just an understanding of the bigger narrative or the bigger story of our lives, you know?
Um, and, and sure, um, we have to respect the fact that there will be people, clinicians who are driven purely by status, uh, titles, uh, financial benefits, remuneration, all of those things. And yeah, I know some of them, I work with some of them, you know? And particularly, unfortunately in the surgical world, there is a [01:03:00] lot of, of clinicians that are probably driven in that.
Now, I have to respect that that's their primary drive. But for the rest of us, for most of us, I think understanding the bigger stories of, you know, um, the purpose of why we do what we do, actually really matters, and I, I, I keep falling back to that as one of the reasons why I feel, okay, when I'm really busy and I'm waking up at 4:00 in the morning, uh, you know, being called back into the hospital for the 10th time in the same week, I gotta say, "All right, this is hopefully a phase of this life. It's just this season." Um, but you know, I've got a bigger thing to live for. You know, I've got a bigger purpose, I've got a bigger story. And for the resident who've just finished their night shift and trying to get onto a, you know, anesthetic training program or, you know, for the consultant whose, you know, books are empty and they just started practice, uh, understanding that context or story I think is, [01:04:00] is important in placing that as well.
I think, um, the cold, sterile world of medicine and surgery don't often allow room for that to happen. There's a lot more understanding now, and people like you are pushing that understanding, which is really, really good for, for us. Um, but yeah, I hope that we get a bit more megaphone towards that space of the humanity in surgery or humanity in medicine in particular.
Sharee Johnson: I didn't think of it before, but I'm just remembering about the, respect program that the, that RACS, Royal Australian College of Surgery, have mandated for all surgeons. Yes. It, I think maybe it's been going for about 10 years now. Yes. Which seems ridiculous that it's gone so fast.
Yeah. Yeah. Um, do you think that that's made a difference? Has that helped these conversations now that there's this mandatory requirement?
Dr Eric Levi: It definitely has moved the needle. What I mean by that is that, um, it was interesting that it started with a problem. Mm-hmm. Uh, there was bullying, harassment, uh, and particularly sexual harassment around that time.
I still remember this- uh, quite [01:05:00] clearly. Um, and out of that problem came a big cultural shakeup. Mm-hmm. And the leadership really just took ownership of it and then ran all this program, Operating with Respect. Putting language, putting concepts, Yeah, putting language into a problem, into a communication challenge, into even more, more basic, uh, into a human relationship think., you know uh, that respecting the people that you work with- Mm-hmm ... is how we as surgeons operate, and that's mandated across all. So that's definitely moved the needle. Of course, is it 100% perfect? Of course not, but it, it gives language, it gives thought. Mm-hmm. It gives, um, uh, time to, to think about those things.
And I think it, it does matter now. You know, among all of my, you know, a lot of my trainees and a lot of the anesthetists that I work with often does say that, that, that, yeah, things are changing now. Um, seeing the difficult to work with surgeon is becoming an exception now, not the rule. In the past, [01:06:00] um, there's a lot of, uh, more challenging personalities.
Now I think, um, we're a bit more aware that having those personalities don't necessarily mean a good outcome for the patient or the team. So I think that's, that's, it's, it's important. So there's value there in understanding a problem, creating a solution, mandating that solution through a leadership and systemic change, you know- Mm-hmm
which moves the needle. Yeah.
Sharee Johnson: How encouraging. Great. Yeah. Any last words you want to offer? Any mantra that you use on a regular basis to keep- ... yourself going when you need it? When you, when, when you feel a recalibration required, something's happening that you think, "Oh, I really need- Uh ... to get recalibrated here."
Dr Eric Levi: We as clinicians, it's almost like we have this, we fall into this space between- Um, our patients expect us to have, you know, work is everything, because after all, if you're going to be operating on my child- Mm-hmm ... you need to have, you know, l- you know, like, work is everything that you think about.
You do, you do [01:07:00] your best. Yeah. And on the other side is that spectrum of work is work, you know? At 5:00 PM, I sign out, and I don't think about patients anymore. Um, on one hand, being completely fully devoted to work will burn you out much faster. Mm-hmm. On the other hand, just thinking of patient just as a job, it just takes away the humanity and the no- no
I don't know whether nobility is the word for it, but the noble calling of being a doctor or being a clinician, you know? Um, somehow the answer is in between those things, isn't it? Like, work is not everything, but patient is also not nothing, you know? Uh, and so finding that, that space in the middle is, is important.
When I meet with a struggling, um, kind of r- you know, resident doctor or junior doctor, or maybe even colleague who are consultants as well- Mm-hmm ... sometimes the thing that we go back to is, you know, at the end of the day, we're human beings. We [01:08:00] have our limitations. We've gotta be aware and be insightful of those limitations.
Mm-hmm. We will have some good days, we will have some bad days, and knowing that that flow of the, the valleys and the mountain highs and the mountaintop and the valleys is just part of being human, isn't it? Um, a few other things that I say to some- Some of my colleagues is, you know, sometimes the detours in life is exactly where you need to be.
Uh, you know, and I need to say that to myself as well because there are times when I feel, "Why am I here? Why, you know, I wish I can spend more time with my family." I have, oh, so many regrets, but at the same time as well, looking back, I think at every season in life, you've just tried to give, you know, your best to your patients, your family.
And the other thing is as well always thinking about, you know, um, the bigger picture. We mentioned it earlier, we touched on it, on that, that soul, that spirit, that story making. Uh, I mean, there's the faith part of [01:09:00] me that, that kind of perhaps sometimes overrule, not overrule, but has a huge part of what, uh, what I take meaning with, uh, what provides me my work meaning.
And that's something that I think, you know, for people, whether it's art, music, uh, faith communities, , your cultural group, your family groups, you know, I think meaning doesn't only come from the work in front of us, but from something, uh, around us or beyond us. Um, you know, uh, I think that's, that's one big thing.
I would be, uh, I would be dishonest if I didn't share that, you know, faith is a big part that informs what I do. Um, uh, but at the same time as well, I think for a lot of people, um, you know, even art, humanities, meaning from social cultural groups and families, uh, is the big part that informs what they do.
Sharee Johnson: Let's bring our conversation to a close. That's a lovely place to finish. Thank you for your generosity and your, [01:10:00] optimism and all the things that you shared today, Eric. I've really enjoyed talking with you.
Dr Eric Levi: Thank you so much, Sharee, and thank you for all the wonderful work that you do in this space.
You are making a huge difference. Thank you.
Sharee Johnson: You're welcome. Thank you.
I hope you enjoyed that conversation with Dr. Eric Levi. He is a joy in his optimism and his enthusiasm for what he does. I think he gives us a really beautiful example of when we know what our purpose is, when we have a connection, an intrinsic connection to the work that we do, then even when it's difficult and it's challenging, uh, there's a reason to keep showing up, and there's a way to hold our balance, if you like.
Not that Eric used that word in particular. He said some very interesting comments towards the end of our conversation about soul and connection to something bigger, and I want to really point to that to help us remember that as clinicians, yes, we have a very useful, purposeful job to do, uh, as doctors, nurses, allied health.[01:11:00]
There's a clear role for us. There's something that we're offering the community in our work and, we can't do that at the loss of ourself. We need to have a sense of who our self is while we're in those roles, because we're stepping in and out of the role. We belong to a bigger story than just our clinical role.
And I think it's really beautiful to hear from a surgeon talking about the realities of his work. Eric, uh, has a lot of parts of his work. He's teaching. He's, uh, clinically very engaged, doing a lot of hours clinically every week. He is a, a beautiful writer, although we didn't talk about that today.
He's been active on social media for a number of years, and I think he was very generous in sharing with us the ways that he thinks about that without being too kind of philosophical or theoretical. It's just he has a clear sense of why he's on social media, for instance. It's to educate, educate, educate.
And so I know that the people I work with who [01:12:00] have a clear sense of their why, what it is that they're trying to achieve, what their purpose is, the reason that they're involved in something, then it's much easier. There's an anchor when things become difficult or tricky, or even just when they're tired.
So, uh, I hope you've enjoyed the conversation with Eric. If you have enjoyed and are enjoying the podcast, please share it with the other people that you know, and it really would help if we had some reviews on our show. So if you are listening and, um, going along with us on Recalibrating with Sharee Johnson, please tap the review button and help, other people who are working in healthcare find out about the storytelling that's going on here on this podcast.
Until next time, may you be well.
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