Episode 20 -Recalibrating with Sharee
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Speaker 10: [00:00:00] Hello. A little celebration today as we launch episode number 20 of Recalibrating with Sharee Johnson. It's been, such an exciting, joyful, meaningful ride this year in 2026 to launch our podcast. I'm deeply grateful, feel quite celebratory about the first, 18 guests in the first 20 episodes, uh, so far. You've heard from really esteemed doctors who have made a big difference in their particular specialties in their area of medicine.
Speaker 10: You've also heard from a couple of patient advocates who I'm especially grateful for their time, uh, Sue Robins from Canada and Cherie Dear from Melbourne. The work that they do on behalf of [00:01:00] patients and, uh, in helping all of us as clinicians remain aware of the patient journey is profound, and I really am deeply privileged to have been able to talk with them, to know them, and to share some of their story on the podcast.
Speaker 10: I also want to acknowledge Rebecca Clark, the first nurse that we've had on the podcast. I'm definitely looking for more allied health and nursing people to come talk with me here on Recalibrating with Sharee Johnson, if anybody would like to share, uh, somebody's amazing work or, or examples of recalibrating.
Speaker 10: And I want to, particularly acknowledge the researchers as well. We've heard from Dr. Victoria Lister, one of the most popular episodes in the first block, uh, talking about the silencing of junior doctors. We've heard from Brian Lee talking about the impact of, the work that people do in healthcare, the frontline work, and also the impact on their families.
Speaker 10: Which I think also is really important research for us to follow and understand. And, uh, Duncan Brown [00:02:00] investigating how organizations help, , the frontline workers feel fulfilled or satisfied or the opposite, wanting to be, um, not helpful because of the frustration that the system causes. I hope that you find this little recap of some of our, guests useful.
Speaker 10: Perhaps it will help you want to go and look at some of-- listen to some of the other episodes in full. We have tried to create a bit of a story here for you to listen to how the ideas are progressing through our conversations. But most of all, I want to remind you of why we have this podcast called Recalibrating.
Speaker 10: That everybody can recalibrate their lives, that we are in fact all doing it all of the time. And that with the right skills and the right community, we have the opportunity to keep recalibrating in ways that make life feel fulfilling, interesting, useful, and that we can extend that as well to the health system, to bigger organizations.
Speaker 10: What is it that we need to [00:03:00] adjust and adapt a little bit? What are the skills that we need to help us collectively get back in balance so that we can deliver the best work to each other, we can support each other the most effectively, and that we can remain and build communities that, uh, are life-enhancing and empowering, that help us imagine and feel, joyful about these, short lives that we have in the world together.
Speaker 10: So here's episode twenty. Thank you so much to all the listeners for your support so far, and we really look forward to bringing you the next twenty guests in the back end of twenty twenty-six.
Speaker 10: May you be well
Dr Anei Ochan-Thou: I remember the first time I got an email, the acceptance email, I just felt this passing of electricity from top of my head all the way down to my toes. It was just so surreal and it was just sort of this, this fulfillment, this acceptance of, okay, you made it to the next step now, and yeah, I'm gonna be moving to Sydney and studying medicine.
Dr Anei Ochan-Thou: So yeah, it was a very, [00:04:00] very huge achievement for me at the time.
Sharee Johnson: And so do you bring that lesson from Lamar with you still, that idea that, don't limit myself before I even try?
Dr Anei Ochan-Thou: Yeah. Yeah, definitely. It reminds me of Cars, the movie?
Sharee Johnson: Yeah.
Dr Anei Ochan-Thou: Lightning McQueen Yeah, yeah, yeah. Yeah. There's a part of it where, um, they said to him, "Oh, you know, like, how did you know that you could do it?" And then he just said, "I don't know. I just, I just didn't think that I couldn't." You know? Like, that was the sort of mindset that I think was very similar to what Lamar was trying to imbue at the time, and something that I've carried since.
Dr Anei Ochan-Thou: Yeah, for sure. Um, when, when I was in my third year of medical school, I did found Sudo-AustralianAustralian Australian MD. That came because in so many spaces throughout high school, undergrad, post-grad, I felt like I was invisible, but at the same time I was very, very visible as an African Australian person in these spaces.
Dr Anei Ochan-Thou: Well, it's medicine through the eyes of being an African Australian [00:05:00] medical professional is because we oftentimes don't even get the opportunity to tell our stories.
Dr Anei Ochan-Thou: And if we don't tell our stories, then who's gonna tell it in a way that we actually approve of it? Right. So we have to be the ones to tell our stories and to tell that narrative, and that's what the podcast was, was all about. Everyone was so tuned in, everyone was so focused and was approving of what people were saying, because they could relate to that.
Dr Anei Ochan-Thou: They could see themselves in the stories and experiences that people were talking about. We had more than 20 African Australian medical professionals who were doctors in the room itself, and I've never seen that many African Australian doctors, like let alone two, in the same room. So it was very, very historic,
Dr Brian Lee: recognizing that workplace culture plays a very, very strong role.
Dr Brian Lee: And like you said, one of it is just that aspect of, you know, that guilt for, for, for staff as well. But there's other aspect that plays into the workplace culture in healthcare is that guilt for patients, [00:06:00] right? 'Cause it, it's not just you letting your, your teammates down or your team down, but a gap in staffing would mean also drop in quality of care for patients, you know?
Dr Brian Lee: So that affects that. So, that there's a lot of that guilt there as well. And how do we help, uh, change that workplace culture? And a lot of it comes down to, staffing, and if we got proper staffing, that would he- help, But the older and the more senior healthcare workers I've talked to who've managed to kind of manage or kind of address these concerns, they realize that, can't- hold this burden you know?
Dr Brian Lee: There will always be sick people. There will always be someone who needs help. The emergency room will never be not filled. Mm. Right? Um, but that's not your, that's not your job. Your job is [00:07:00] just to provide the care, and that's it. not here to heal the world, but just to kind of help one at a time.
Dr Brian Lee: Um, so I think that process of... I, I'm learning that myself. The work will never go away, you know. Mm. People will always need your help. being able to accept that, take the time for yourself sometimes, and it's okay, you know? I think- Yeah, that's- ... the healthcare system will still work, and they will benefit from a, you know, a healthier and I think a more regulated s- healthcare worker rather than a overworked healthcare worker who f- who might leave and, you know, and then- Mm
Dr Brian Lee: leave a gap there as well, you know.
Dr Sabine Fonderson: And when we met around, uh, COVID, that's what I was really struggling with. I was really struggling with how do I stay being a doctor, be a mom, but also do [00:08:00] things that I really like and enjoy? Because exactly what you said in the introduction, doctors seem to think that this is all I have. I, I'm a doctor and that's all I do for life.
Dr Sabine Fonderson: I'm here to treat people and care for people and, uh, that's it. And I, I was thinking about something else. I'm like, "But I have other interests. I like other things." I, I'm pretty ambitious, and I tend to say yes to
Dr Sabine Fonderson: a lot of things, finding this balance where you're thinking to yourself, "But what about me? What do I want?" And this is where I come back to the system. The system does not, unfortunately, allow people in, uh, many healthcare professions to explore those desires, those skills, those ambitions, and I think it's a wasted opportunity.
Dr Sabine Fonderson: Um, because you might be at the stage now, or for me, where I'm thinking, "Well, I have my practice. Within my practice, I wanna be more innovative." And I'll give you an example. About four months ago, , I reached a point where I was like, "I [00:09:00] understand these signals." My body was giving me signals, and I'm like, "Okay, I recognize these signals as burnout." And I wasn't sleeping very well. I was extremely frustrated about a lot of things. And I took two weeks off, and I, I just told my manager, "I have to take these weeks off. I, I can't do this anymore." So I went one week by myself away, and then the second week, it was around Christmas, where I took my daughter and went, uh, to, to, to Portugal.
Dr Sabine Fonderson: And I remember coming back and I said, "Okay, Sabine, something has to change."
Dr Sabine Fonderson: Well, I want to take a moment to thank you, uh, Sharee, because when I reached out to you back then, I was really struggling, um, with where my path and my career was going. And I remember reading your book, and I remember thinking to myself, "It's okay to find, to seek help." Mm. Um, and I want to reiterate the fact that just because we're doctors, we are humans and we [00:10:00] suffer, and a lot of doctors suffer in silence. And I think this is one of the things that, again, the system has done completely wrong by not allowing a space for vulnerability, by not allowing an open space for talking about vulnerability, mistakes, um, anxiety, uh, frustrations, anger, 'cause we deal with so many emotions from other people, and they expect us to just take it all in, okay? We're the filter, right? I have to take your emotion today because you're just angry because you had to wait 25 minutes before you got to talk to me. I have to take your emotion because you're angry because I didn't, prescribe a medication. There's a lot going on. And the system has to change.
Dr Sabine Fonderson: But sometimes the system isn't ready for that change because it likes the status quo, right? But I want to reiterate that as doctors, please remember that you are humans first, and your body is telling you every [00:11:00] day what's wrong and what's right. And your coaching, what you're doing, that recalibration, is helping us understand how to connect with those internal signals.
Dr Sabine Fonderson: And sometimes external signals are also being, uh, brought up by people around you. I've had my father say to me, "Sabine, are you okay?" You know, "When I talk to you, you sound really exhausted, make sure you, you rest." Your partners are telling you things. Your children. My kid told me, remember, "Mom, you're really negative about work nowadays.
Dr Sabine Fonderson: Maybe you should think about your mental health." Those signals are real. So what you're doing is amazing, so I really wanna highlight that doctors, people, health professionals, please, you are human, vulnerable. And I say to my team, I always say to them, "I want you to take, put yourself first before a patient."
Dr Sabine Fonderson: And I do this on purpose. I say because if you're not good, you cannot treat a patient.
Dr Lynn Scoles: I think it's that [00:12:00] we're really good at sacrificing ourselves for the benefit of others, um, and not stepping back because we can push on. Often we can keep pushing, keep pushing, keep pushing.
Sharee Johnson: Mm-hmm.
Dr Lynn Scoles: Um, and that's where the self-care part comes into it. Be- being able to step back and appreciate what we do and how we do it and what we have done, um, and the achievements that we have made.
Dr Lynn Scoles: And again, I, I reflect back on what I said earlier about, you know, you feel very average amongst all the brilliance that is in medicine. It's not often that you step back and acknowledge your own successes, and we're very good at seeing our failures. We're very good at seeing the things that we miss. And so one of the, one of the things that I do is help people to step back and see what they are doing that's valuable, um, and start to appreciate themselves and what they bring to the situation.
Sharee Johnson: Mm-hmm.
Dr Lynn Scoles: So that's one of the themes, is that sacrifice, for the benefit of others. [00:13:00] And I'd go back to my earlier statement around not at our expense.
Dr Lynn Scoles: I've got lots of coaching colleagues now that I value very much. Mm-hmm. And they're all into helping each other to develop, to grow, to notice what's working, what's not working, and to ask those powerful questions that get us thinking. Um, that's what coaching really is all about.
Dr Lynn Scoles: Mm-hmm. And I've had people around me who've been able to ask those challenging questions and,
Dr Lynn Scoles: There's a quote from the book, The Power of Full Engagement, that I think sums everything up. It says, "Is the life you're living worth what you're giving up to have, to have it?" So, is the life you're living worth what you're giving up to have it?
Sharee Johnson: Mm.
Dr Lynn Scoles: And I think it is all about prioritization.
Dr Lynn Scoles: Mm. And I think it's also connecting into ultimately what we feel our purpose is, making sure we're clear on our values and what supports that purpose.
Sharee Johnson: Mm.
Dr Lynn Scoles: And then prioritizing accordingly.
Sharee Johnson: What's [00:14:00] important about, 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 that, collision between, um, your work and who you are, you know?
Dr Eric Levi: It's very hard. People talk about how you're, we are human beings, not human doings, but at the same time, what you do 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.
Dr Eric Levi: . 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, [00:15:00] sleeping better, breathing better, hearing better, eating better.
Dr Eric Levi: 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.
Dr Eric Levi: Mm. And I think this is also the antidote 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.
Dr Eric Levi: 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 [00:16:00] 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.
Dr Eric Levi: 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 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
Dr Eric Levi: 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 [00:17:00] confused in my mind, Sharee?
Sharee Johnson: 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
Sharee Johnson: um, the, the systems are different in a lot of ways, and the problems are still the 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.
Victoria Lister: So when we're talking elite professions, it's medicine, law, divinity. In the first instance that was in the Middle Ages when those three, uh, came to prominence over the years, that's expanded. Divinity has dropped off. Um, so we now have, uh, architecture, accounting, uh, laws obviously still a part of that and other professions that have emerged more [00:18:00] recently.
Victoria Lister: But the elite professions in particular behave in certain ways that secure their, their status. That set the tone, if you like, for what that profession is. Carve out spaces, their social spaces, first and foremost. So they carve out spaces amidst the, the broader social environment and declare certain things about themselves and that they do certain things and that they have certain knowledge, which is then transferred typically through university education.
Victoria Lister: They also behave in quite aggressive ways. So this, this sort of boundary setting or carving out of territory can lead to quite interesting stoushes between different professions. Uh, each claiming their space, sometimes trying [00:19:00] to intrude into the other's space. We see this a lot in the medical profession with the ongoing debates around cosmetic surgery versus plastic surgery.
Sharee Johnson: Are you finding things that we can work towards to help our junior doctors, given the deep hierarchy and the things you are describing about competitiveness and so on in the medical, world?
Sharee Johnson: What, can we do? What, what are the things that can help our junior doctors have more voice?
Victoria Lister: Yeah. The, the main thing I believe needs to happen is that senior doctors need to, lead on these issues. Because they, at this point, particularly if you go into specialist training, other, other doctors who control outcomes for careers, for the profession itself, the people at the, in the upper echelons of hospitals, of medical [00:20:00] colleges, et cetera, often of regulators, universities, the whole bit. There are pockets of what I call pockets of enlightened leadership.
Victoria Lister: That, that kind of came to light on a couple of occasions in my research
Victoria Lister: But they're far and few between. They're hard to sustain because they're not happening at the level of the organization. Mostly they're happening at the level of a department or a unit or a hospital.
Victoria Lister: But where they do occur, they're wonderful. And what I believe is happening, um, in those more enlightened environments is that those senior doctors have recognized, at least to some extent, what I call the medical professional game that is being played. So a feature of the game. Um, and I I drew on the [00:21:00] work of a sociologist called Bourdieu for this notion, he devised the term, the game, but it describes the, the rules that are in place or the game that is played.
Victoria Lister: Um, in occupations or in any social space in which there's jockeying for power and position, which is pretty much all of them. And a feature of the game is that you don't realize you're playing it or perhaps you willfully misrecognize, and that was his term, misrecognize, that you are immersed in a game and that you are in fact playing it.
Victoria Lister: And there are reasons why that occurs, but I suspect that those doctors who recognize what is going on, recognize that as detrimental, are those [00:22:00] who can actually do something about it and create environments in which people feel psychologically safe to speak up, which is a term that gets bandied around a fair bit and is a little bit misused, but it refers to the psychological safety to speak up at work, as opposed to, other ways of thinking about that.
Victoria Lister: And it's not to say that junior doctors or early career doctors is another term, can't get involved in that kind of activity, but they're often not in a position where they can, because of the control that's exercised over their working lives, over their careers, over their job choices, over their training placements, over their exams, by the people who are in fact, the same vehicles for silencing them.
Victoria Lister: Because there's a lot of, as many would know [00:23:00] what I call workplace abuses that occur. In the junior doctor space that in tandem with the implicit messages they're receiving from university onwards, if not high school, as you mentioned, onwards, about how to behave and be as a doctor. There are a lot of compelling reasons why they don't speak up, because they can't, which effectively eliminates the notion of choice in silence.
Victoria Lister: I don't know that they're choosing it. between. They're hard to sustain because they're not happening at the level of the organization. Mostly they're happening at the level of a department or a unit or a hospital.
Victoria Lister: But where they do occur, they're wonderful. And what I believe is happening, um, in those more enlightened environments is that those senior [00:24:00] doctors have recognized, at least to some extent, what I call the medical professional game that is being played. So a feature of the game. Um, and I I drew on the work of a sociologist called Bourdieu for this notion, he devised the term, the game, but it describes the, the rules that are in place or the game that is played.
Victoria Lister: Um, in occupations or in any social space in which there's jockeying for power and position, which is pretty much all of them. And a feature of the game is that you don't realize you're playing it or perhaps you willfully misrecognize, and that was his term, misrecognize, that you are immersed in a game and that you are in fact playing it.
Victoria Lister: And there are reasons why that occurs, [00:25:00] but I suspect that those doctors who recognize what is going on, recognize that as detrimental, are those who can actually do something about it and create environments in which people feel psychologically safe to speak up, which is a term that gets bandied around a fair bit and is a little bit misused, but it refers to the psychological safety to speak up at work, as opposed to, other ways of thinking about that.
Victoria Lister: And it's not to say that junior doctors or early career doctors is another term, can't get involved in that kind of activity, but they're often not in a position where they can, because of the control that's exercised over their working [00:26:00] lives, over their careers, over their job choices, over their training placements, over their exams, by the people who are in fact, the same vehicles for silencing them.
Victoria Lister: Because there's a lot of, as many would know what I call workplace abuses that occur. In the junior doctor space that in tandem with the implicit messages they're receiving from university onwards, if not high school, as you mentioned, onwards, about how to behave and be as a doctor. There are a lot of compelling reasons why they don't speak up, because they can't, which effectively eliminates the notion of choice in silence.
Victoria Lister: I don't know that they're choosing it.
Victoria Lister: A cost benefit analysis that is conducted by every junior doctor and senior doctors as to whether.
Victoria Lister: Whether it's going to speak up or not, whether it's worth taking the risk. Mm-hmm. [00:27:00] So there's, there's a lot of fear. So there's, there's fear-based violence, which is fear of the relational risk, the reputational risk, the career risk, the risk to yourself if you speak up because speaking up comes with its own set of challenges.
Victoria Lister: You then get potentially, if you make a formal complaint, thrust into the world of having to deal with that and who wants to deal with that on top of all the challenges of being a junior doctor, there's risk to others, there's, a sense that collective forms of voice, say union activity are not necessarily embraced either because there's a fear that this is gonna impact the patients.
Victoria Lister: Because it's often associated with striking, which isn't always the only option available. But I can't do that because I'm gonna affect my patients. There's also a lot of futility. [00:28:00] So hopelessness, um, you know, I've seen people speak up. Nothing changes. Um, there's uncertainty. Uh, I dunno how to speak up. I don't know the mechanisms for speaking up.
Victoria Lister: I'm not good at speaking up. There's unfortunately, self-sacrifice was another theme. Violence is a strong belief in medicine, that violence is evidence of commitment to calling. So if I can soldier on, um, prove I'm not a troublemaker, I can cop it on the chin, it's, it's can unfortunately, a badge of honor. analysis that is conducted by every junior doctor and senior doctors as to whether.
Victoria Lister: Whether it's going to speak up or not, whether it's worth taking the risk. Mm-hmm. So there's, there's a lot of fear. So there's, there's fear-based violence, which is fear of the relational risk, the reputational risk, the [00:29:00] career risk, the risk to yourself if you speak up because speaking up comes with its own set of challenges.
Victoria Lister: You then get potentially, if you make a formal complaint, thrust into the world of having to deal with that and who wants to deal with that on top of all the challenges of being a junior doctor, there's risk to others, there's, a sense that collective forms of voice, say union activity are not necessarily embraced either because there's a fear that this is gonna impact the patients.
Victoria Lister: Because it's often associated with striking, which isn't always the only option available. But I can't do that because I'm gonna affect my patients. There's also a lot of futility. So hopelessness, um, you know, I've seen people speak up. Nothing changes. Um, there's uncertainty. Uh, [00:30:00] I dunno how to speak up. I don't know the mechanisms for speaking up.
Victoria Lister: I'm not good at speaking up. There's unfortunately, self-sacrifice was another theme. Violence is a strong belief in medicine, that violence is evidence of commitment to calling. So if I can soldier on, um, prove I'm not a troublemaker, I can cop it on the chin, it's, it's can unfortunately, a badge of honor.
Dr Liz Wearne: It's the way the work is structured to allow me to have tho- those relationships. I, I mean, I've had the experience of working in a practice where I was working very fast and seeing a lot of patients each hour, and yeah, I felt great and I felt really like I was, you know, meeting a need and, and servicing a lot of people.
Dr Liz Wearne: But I was like a kid running down a hill and I couldn't, I couldn't stop. I, I, I sort of felt there was a point at which that felt really unsafe. Whereas now [00:31:00] working in this, in the Aboriginal health sector, um, the model of care is different. There's longer appointments, there's, there's time and space for reflection on what you're doing.
Dr Liz Wearne: There's a lot more collaboration with the people around you in the building day to day, so a lot more conversation. I know that as the, the white lady doctor, I can't do a lot for some people. I need the help of, of, of an Aboriginal health worker or a driver or a social and emotional wellbeing worker.
Dr Liz Wearne: Like I ha- it's so interdependent with other people and that, that model of care suits me because my values are about that in life too, are about working together with people and, and, and living in a world where we're all interdependent on each other and we have to ... we have a responsibility in that system.
Dr Liz Wearne: I found it incredibly lonely and, um- And not, and not because I was working with people that didn't [00:32:00] care about that. I think just the pace of the work meant that everybody was just trying to stay alive really Mm-hmm. And, um, trying to meet an unmeetable need- Mm ... um, and, and, and working faster and faster and faster and faster.
Dr Liz Wearne: And, and I think unfortunately, you know, currently in Australia to make ends meet, a lot of GPs have to work that way. Mm-hmm. Um, and it's a real shame because I think it, it takes away on not, not just from, um, the quality of care we can provide, but the quality of life we can have as doctors- Mm ... um, where we're actually thinking about what we're doing and we're taking time to, you know, really celebrate when amazing things happen, as they frequently do, or to give time and space to the things we need to honor in our work.
Dr Liz Wearne: It's a very sacred job in a lot of ways. Mm-hmm. And we need space to, to do it well, I think. I was lucky in that at different points, not only did I have oppo- opportunities [00:33:00] presented, but I had people that I loved and respected say, "Come on, you know, I'll help you. I'll, I'll, I'll open this door for you." Um, you know, I'm thinking back to when I was a, a medical educator and James Brown, who, you know, is quite a senior figure in general practice training in this country, and had been my boss for a long time.
Dr Liz Wearne: I had a lot of love and respect. But he said, "Come and join us and do some qual- um, some qualitative research. And, you know, I think you'd be really suited to it, and we'll help you, and we'll teach you everything you need to know." And at the time it was like, wow, he was spot on. This is really loading my boat.
Dr Liz Wearne: So, um, having... It's more than just the opportunity. It's the, it's the people that tap you on the shoulder and, and, and tell you that they're gonna give you a hand. And about the idea about trusting your instincts. And I, and again, I, you know, I, I don't want to harp on, on gendered stuff too much, but I think a lot of women are taught to suppress their [00:34:00] instincts about a lot of things and, and probably men too, in terms of just how, how you're, how you're supposed to be in the world.
Speaker 3: Mm.
Speaker 2: Um, and certainly medical culture has a lot of very strong hidden messages and hidden curriculum and things that we don't even realize is happening. But, um, I think if I, if I could talk to my younger self or, or my colleague, you know, I think encouraging people to trust their instincts. If your body's feeling something's not right or if you find yourself repeating the same harmful patterns over and over again, or there's a problem in your life you can't get past, you know- There's, there's something going on.
Speaker 2: You need to pay attention. Being able to be present and pay attention is the big core skill, isn't it? Mm. Um, if we don't stop and take stock, um, we, we're not, we're never gonna be able to put our attention in a particular place. Um, you know, mindfulness [00:35:00] practice changed my life. Um, again, something I kinda just fell into, but it's, it's the f- the foundation skill for everything else in my life.
Speaker 2: Mm. I can't make a decision if I'm not aware, paying attention, listening. Mm-hmm. How do I know what my instincts are if I'm not listening?
Dr Ashok Bhattacharya: I was also really interested in empathy. Uh, not that word necessarily 'cause it hadn't really crossed my mind, but I was interested in the experience of that. And I saw a lot of, not to criticize, but appalling situations in, in healthcare as a medical student. So you go into the room, there's this terrified person in a bed.
Dr Ashok Bhattacharya: There's is a great big steel chart. They pick it up, there's 15 white coats in the room. And the patient's, the patient's looking around for kind eyes. And I used to lock eyes with those, those patients. And I said, sorry, I'm sorry. 'cause it was heartless. It wasn't very humane. And, and so I got through that now.
Dr Ashok Bhattacharya: I said, where's the [00:36:00] empathy?
Dr Ashok Bhattacharya: Well, I know because of my movement history, I believe in, in, in flexibility and agility.
Sharee Johnson: Mm-hmm.
Dr Ashok Bhattacharya: Like in my body, uh, the, the way I, I move it and the way I think about it, balance is important.
Dr Ashok Bhattacharya: Strength is important, but I really emphasize flexibility and agility. And if you think about it being a, being a doctor. There's a certain inflexibility to that and a certain lack of agility, unless you're on the inventive curve of coming up with new treatments and, and surgeries and that kind of stuff.
Dr Ashok Bhattacharya: I think peers are very, are, are essential if they can help you get out of the space that you're stuck in.
Sharee Johnson: Hmm.
Dr Ashok Bhattacharya: If they just jump in with you. So if two people are stuck in quicksand, they're not gonna help you.
Sharee Johnson: Mm-hmm.
Dr Ashok Bhattacharya: You know, I think, uh, so you want someone who's not in the quicksand to help, help get you out, or if, if you're not in to help get them out if you're both in it. I think that's a problem. I've always picked my peers who see me as a total person.[00:37:00]
Dr Ashok Bhattacharya: And I think for me, that's always been really, really important because if I can't be my whole self and anyway, another negotiable, non-negotiable, um, I'm gonna be squeezed and, and, and imprisoned into somebody's else's expectations of me.
Dr Ashok Bhattacharya: it's a recipe for cracking. So if we can get the shame a little bit out of this in breathing space and say that it's okay to make a mistake, it's okay. Find support. If you don't understand something, find support. Let's make it not, let's, let's applaud people who ask for help instead of shaming them, uh, for not asking for, uh, for, for asking for help and making it an easy space for people to have connections that are purely for peer support
Dr Ashok Bhattacharya: it's very important to, to make sure I look after my energy. So when I'm interacting with people, I can portray it to them. And whether that comes out as music or writing or doing a therapy session with a client, or just sharing a moment, like laughing at the same [00:38:00] things, crying at the same things.
Dr Ashok Bhattacharya: Human beings absolutely require connective energy. The essence of our being on this planet to connect with each other and have our communities and have each other. So I kind of just max out on that idea that energy is, it's here, there's no question. And that there's air and you can feel it, important to, to make sure I look after my energy. So when I'm interacting with people, I can portray it to them. And whether that comes out as music or writing or doing a therapy session with a client, or just sharing a moment, like laughing at the same things, crying at the same things.
Dr Ashok Bhattacharya: Human beings absolutely require connective energy. The essence of our being on this planet to connect with each other and have our communities and have each other. So I kind of just max out on that idea that energy is, it's here, there's no question. And that there's air and you can feel it,
Dr Ashok Bhattacharya: I said, well, I'm a doctor. I live in, you know, Canada. And I, [00:39:00] no, no, no. Who are you? It blew my mind. 'cause I didn't know. And that's when I realized when, if I don't know who I am, how can I be optimally, uh, myself in as a, in my career? In my relationships, uh, with my children, if that was gonna happen. And it did luckily and grandchildren as well.
Dr Ashok Bhattacharya: Who am I? I think what happens when you get into medicine, it's such a comprehensive experience. It can become your identity. And if it, if medicine is essentially your identity, um, you need to find some other ways to identify yourself. And that could be a hobby. It could be a a, a new relationship could be taking vacation somewhere that you'd never been before. I'm a doctor. I live in, you know, Canada. And I, no, no, no. Who are you? It blew my mind. 'cause I didn't know. And that's when I realized when, if I don't know who I [00:40:00] am, how can I be optimally, uh, myself in as a, in my career? In my relationships, uh, with my children, if that was gonna happen. And it did luckily and grandchildren as well.
Dr Ashok Bhattacharya: Who am I? I think what happens when you get into medicine, it's such a comprehensive experience. It can become your identity. And if it, if medicine is essentially your identity, um, you need to find some other ways to identify yourself. And that could be a hobby. It could be a a, a new relationship could be taking vacation somewhere that you'd never been before.
Dr Ashok Bhattacharya: So being self-aware, having self empathy, answering that question, who, who am I, what is my life about? And I think this is the, the value of taking a vacation outside of your life. 'cause you can see yourself outside of it instead of being in it. And often people come back from that space and say, oh, I, I can make some changes here.
Dr Ashok Bhattacharya: Physicians [00:41:00] have to learn how to be okay with being vulnerable.
Dr Jeremy Grummet: a decade ago I reckon, uh, so I would've been mid-40s, I decided to start seeing a, a psychologist.
Dr Jeremy Grummet: And interestingly, there was, I didn't think there was anything wrong. Mm. So I wasn't fixing a problem. It was more that I'd got into my head that, you know, we put our car in for a service every, you know, whatever it is, year or two. We see the GP every year or two. We get our teeth checked every year or two.
Dr Jeremy Grummet: And yet the most important, uh, organ of our body, we just, we just fly by the seat of our pants. We just, we don't even bother to, um, get that checked, or a tuneup or are we, you know, is it going okay? So I just thought for sort of proactive preventative type health reasons, I would see a psychologist and I found that extremely useful.
Dr Jeremy Grummet: Uh, again, there was no [00:42:00] particular issue at the time. As it happened, that turned out to be, and we can talk about this later on, it turned out to be, a master stroke, because then stuff did happen, and we can come back to that. But my psychologist, because I'd been proactive, had a baseline on my normal sort of self and function, which I think was probably very useful.
Dr Jeremy Grummet: finding the balance is key. When I did, tell this story, uh, state meeting in urology, yeah, people came up to me, uh, and it's a bit like men with prostate cancer. You know, once they get a diagnosis, suddenly all their mates, they realize they've had prostate cancer and they can start talking about it.
Dr Jeremy Grummet: , I see that all the time. And similarly, you know, uh, other surgeons came up to me after the talk and said, "Oh, yeah. You know, same, same. Yep, me too, me too." That sort of stuff. So- I know from that, And, and also you don't have to be, uh, a genius. Uh, I mean, you just look at the statistics.
Dr Jeremy Grummet: We know that there's high rates of anxiety, depression, substance abuse, um, and all the other, uh, negative things that goes on, not [00:43:00] just in surgery but amongst doctors generally. It's, it's a demanding job.
Sharee Johnson: It's a very demanding job. I think I have so much more compassion for doctors now than I had 13 years ago when I began this journey.
Sharee Johnson: You said something I think very important, Jeremy, that at some point during this process when you had anxiety you said to yourself, "I, it's time for me to have some care now."
Dr Jeremy Grummet: Empathy is really the greatest human strength. It's how you use it is what's important. Like any quality or asset or trait that's positive, there could be a dark side to it as well, a shadow side.
Dr Jeremy Grummet: Uh, and if we over-index in one way or another, we're probably gonna get it wrong. So it's about finding that balance. Um, we talked a bit before about emotional empathy versus cognitive empathy. For me, that's something that makes sense. As a practitioner, I think, empathy is absolutely critical, but you gotta figure out what's gonna work for you in terms of [00:44:00] maintaining your humanness as a practitioner, but also your energy and sustainability.
Dr Jeremy Grummet: Cognitive empathy is something that seems to work for me that's something I want to mention. Also, that, and this might sound a bit Orwellian, but vulnerability is strength. It's not weakness to demonstrate your vulnerability and, again, within context, in a trusted environment with the right people, is where it's gonna be useful.
Dr Jeremy Grummet: Not as a woe is me, I'm a victim mentality at all, in a manner of sharing, yeah, I'm human, uh, and sometimes I struggle, and sometimes I need help. Mm. And as a helper or a carer, as we are in medicine, that's okay too.
Dr Kieran Allen: When you're heavily stressed, you, you revert to a survival mode. And it's impossible, in a lot of those settings to use a lot of those skills, when you are so distressed. And even at that like baseline of [00:45:00] distress, it's hard to do. You're just pushing through and surviving with that little voice going, you're gonna get unwell again, this is not going well. You know, that, that might happen. And it's just constantly telling you that.
Dr Kieran Allen: And there's this shame sink, within people, who do fall into that and who do sort of fail to adhere to a preferred narrative. And I, I experienced that myself. You know, getting back early on was very difficult, at the very start of my, uh, you know, in my intern year in particular, and starting to do work around advocating for the mental health of doctors.
Dr Kieran Allen: Um, you know, I, I was lauded for that and, and, you know, given, you know, registrar of the Year . And then when, the shit hits the fan, so to speak, you really see who's supportive and who's not. I mean, it's easy to support someone when they're well and to say, you [00:46:00] know, we're, we're championing supporting mental illness and we're not stigmatizing, there's no discrimination, all of that until the challenge comes. Because once you become difficult, that's when the actual discrimination comes out. Um, and, and that is particularly bad, I think, for people who don't stick to that hero's journey or that ideal of it anyway.
Sharee Johnson : Mm-hmm. Or even perhaps people who take too long to get through the hero's journey.
Dr Kieran Allen: Absolutely.
Sharee Johnson : There's too much complexity for too long. If you, if you have, you know, one incident and you get it together and you get the skills and you come back better. You know, we like that as humans. Yeah. We like that simple. It's kind of straightforward.
Dr Kieran Allen: Yeah. It's neat.
Sharee Johnson : I, I wanna go back a little bit to you talking about the connection with your clinical team all the time, not just when things, when the shit's hitting the fan, but just all the time, generally speaking. I, I just wanna kind of amplify that for a minute and , remind us both and anyone who's listening probably, that I think there's such power [00:47:00] in this and when you look at workplace wellbeing, um, traditionally organizations, not just in health, have had, EAP and sort of crisis response management.
Sharee Johnson : And that's been the focus. I think now we have evolved a little bit to thinking about psychosocial wellbeing at work all of the time. I think we still a lot of work to do, but at least we are talking about that language now and we are talking about, you know, good work is good for wellbeing. People who have work that helps them feel like they're contributing. It gives meaning to their life. It helps them feel like they're valued, is really great for our mental health, as a general statement. You know, long-term unemployment is better for us for our mental health than a toxic work environment or an unsupported work environment.
Sharee Johnson : So, um, you know, I think the research is really clear about that, but we seem to be very slow about activating it. And, uh, I think I mentioned to you before that I like the phrase of having some redundancy in the system. So
Sharee Johnson : Yes,
Sharee Johnson : you know, I'm thinking about, uh, we, we want the capacity to have heroes journeys [00:48:00] individually some of the time, if it's about skill building and, increasing our competence, we also need this systemic response. And, and it's much more complex just 'cause there's more moving parts. Where's your thinking at just now about things that systems can do or things that you've seen, leaders do that have made a difference in our systems?
Dr Kieran Allen: Yeah, that's a good question. I think it ties into what you said before about, um, one of the key problems, uh, is when people take too long to get better. Mm-hmm. Um, because it, it interrupts those systems.
Sharee Johnson : Mm-hmm.
Dr Kieran Allen: You know, we're, we're caught between so many moving parts in, in medicine, particularly in the training pipeline, where, we've got more doctors graduating than ever, and importantly, we don't have enough doctors, but we haven't seen the same rise in training places.
Dr Kieran Allen: Uh, so they've got nowhere to go. And even those who are in training get stuck, um, [00:49:00] without the problems of taking time off due to their mental ill health, trying to find places for rotations we have to do, things like that, makes it really tricky. This is massively compounded in the rural setting where the access to those positions is just often not there.
Dr Kieran Allen: Or if it is, it's very hard to put people in who then need to take time off. Mm-hmm. Um, it delays everybody. Um, and that's not the fault of the individual, but it often is framed as such. And so when, when a system is so rigid that it can't tolerate, it can't tolerate someone taking time off, and it doesn't even have to be mental illness.
Dr Kieran Allen: People get, you know, pregnant with kids. People wanna take long service leave, like to, to force people into that rigidity and say, no, we can't do this. We can't fit those things in. It's a massive structural problem. So when we talk about redundancy, I think part of that is, you know, saying let's get more doctors and get, [00:50:00] get the capacity for people to fill holes when they come up.
Dr Kieran Allen: But it's also a responsibility of the colleges, I think, because when they have rigid training requirements, they, they are important. You know, it's important for me, for example, to do, to be doing child and adolescent psychiatry. That's a critical thing to understand, I think. But to have so few positions to be able to do it, and so few, supervisors to be able to supervise it, it really makes, any of those flexibilities, difficult.
Dr Kieran Allen: And it's not just saying, oh, well, we'll change the structure of the training program. Like, okay, but we still need that experience, even if you make it a bit more flexible. So how do we get the supervisors? Well, you need more consultants. How do we get more consultants? We have to train them.
Dr Kieran Allen: You're stuck in this loop where there's no easy solution to it. Um, and I think trying to break that open and see how do we, how do we adjust it? How do we fix it? I don't have the [00:51:00] answer to, because I think I, and I worry that no one does. It's, and when, when that happens, all we do is we go into crisis mode when we're trying to support someone.
Dr Kieran Allen: There's this, there's this phenomena I think where, um, I think people in sort of middle management who are often the ones making the decisions around how to support doctors when they do become unwell, um, get stuck in this adherence to policy and practice, and this is how we do it.
Dr Kieran Allen: I think what I learned when I was really, and multiple times, in the, the depths of suicidality was the thought that this will pass. It's a time thing, I'll be okay. Mm-hmm. It's not saying it fixes it, but it gives me space to press pause and let things just be okay for a moment.
Sharee Johnson : Mm-hmm.
Dr Kieran Allen: When you are in that bad a space where you wanna act on it, time can be [00:52:00] critical.
Duncan Brown: that culture and that protection for others is beyond patient advocacy. It made me realize that we are not going to improve the quality of patient care until we improve the work environment or the quality of those that are giving the care. And expecting people just to be better and smile and be compassionate and I mean, there are some patients that are, you know, fair to say there's some not nice people and, and yet you have to, but the work environments are, are unreasonable, related to the expectations or the outcomes that, that are being expected.
Duncan Brown: And so I realized that the only way that will improve the quality of care is, is really helping those that are giving the care and making it better and easier. And so that's when I picked up that research and I went, right, I'm gonna, I'm gonna run with this now. [00:53:00] Because the role of the care environment, it's not the individual that needs to be better and go on more leadership. The environment plays a significant role.
Sharee Johnson: Mm. I think, um, we, we share something here in, in our experience and it's what struck me the first time I heard you speak about Kuan's death, that we might start from a place of patient advocacy or, what it's like to be a carer or family of a patient.
Sharee Johnson: But we've both ended up with this more systemic view.
Sharee Johnson: These are conscious choices. We make a conscious choice. And your role modeling that unbelievably well, Duncan, you, you made a conscious choice very early on to not name individuals, to not name organizations, to say how can we be useful? How can we add something? How can we help this be better?
Sharee Johnson: I just think that's a very powerful example of active intentional choice and, and it's really demonstrating [00:54:00] the pro-social ideas, These are conscious choices. We make a conscious choice. And your role modeling that unbelievably well, Duncan, you, you made a conscious choice very early on to not name individuals, to not name organizations, to say how can we be useful? How can we add something? How can we help this be better?
Sharee Johnson: I just think that's a very powerful example of active intentional choice and, and it's really demonstrating the pro-social ideas,
Duncan Brown: And so that you can see in healthcare, each person is doing what they need to do to survive, to persevere, and the problem is that the system absorbs those individual changes. And so you see it so often in leadership programs and other team and cultural [00:55:00] development, you come back and go, oh gee, well Sharee's been on a course clearly, and, and within two weeks you've reverted to what you were doing before.
Duncan Brown: The hype and the excitement of the, of the team building exercise, we went on a week later, because the change is at the individual level, you are expected to change. And we're doing with healthcare, we're doing with the nurses and the doctors going, you need to be more resilient. You need to be more kind.
Duncan Brown: As opposed to what are the factors in the system that are suppressing or allowing the status quo to continue. And I think that is the, that's the biggest thing that I want to be focusing on because it's not just about being kind, of course we want to be kind, but kindness alone, you can be the kindest person in, in, in that type of environment. And it doesn't necessarily, it might have an impact on me, but it's not going to bring about [00:56:00] that systemic change that is needed. And so that you can see in healthcare, each person is doing what they need to do to survive, to persevere, and the problem is that the system absorbs those individual changes. And so you see it so often in leadership programs and other team and cultural development, you come back and go, oh gee, well Sharee's been on a course clearly, and, and within two weeks you've reverted to what you were doing before.
Duncan Brown: The hype and the excitement of the, of the team building exercise, we went on a week later, because the change is at the individual level, you are expected to change. And we're doing with healthcare, we're doing with the nurses and the doctors going, you need to be more resilient. You need to be more kind.
Duncan Brown: As opposed to [00:57:00] what are the factors in the system that are suppressing or allowing the status quo to continue. And I think that is the, that's the biggest thing that I want to be focusing on because it's not just about being kind, of course we want to be kind, but kindness alone, you can be the kindest person in, in, in that type of environment. And it doesn't necessarily, it might have an impact on me, but it's not going to bring about that systemic change that is needed.
Sue Robins: I, I identify myself as a, a patient advocate, and I do a lot of patient engagement consulting, and I write a lot about the patient experience. So, um, I don't, I don't like speaking up. I've written before about being a reluctant advocate. Um, I don't like conflict. But we have to. Like, we don't have a choice, or your child is going to miss out on a lot.
Sue Robins: So, um, I think I learned that from Aaron. But then I got breast cancer, [00:58:00] um, nine years ago. It's nine years since my diagnosis. Um, and everyone was like, "Oh, you're gonna be such a great advocate for yourself at point of care, you know, because you've done this for Aaron and worked in the system all these years."
Sue Robins: And, and to be truthful, I was terrible. I was like a little mouse, I would describe myself. I was so terrified. And I think I was scared of dying and, you know, causing pain to my children, and, like, it was all mixed up that way that I didn't speak up for myself, uh, in any way, shape, or form during cancer care.
Sue Robins: So it's interesting, the identities. I think that one I kind of ... I lost that one. I put ... I, I totally shed it when I became a patient myself, and I've thought a lot about it. And I remember being in, um My oncologist's office and sitting on the treatment table and having the gown on. She had sent, uh, her resident in instead, so this young man came in to deal [00:59:00] with me first before she came in at the very end.
Sue Robins: And, uh, he actually asked me, "What do you do for a living?" Which was weird because nobody really asked me about myself. I was just a very generic breast cancer patient to them. It wasn't even a very exciting kind of cancer. I could tell that, you know, it's a dime a dozen. Uh, breast cancer is so common. So anyway, she said, "What do you do for a living?"
Sue Robins: And, and I explained to him a little bit about my speaking and my writing, and he said to me, "Oh my gosh," he said, "We need you to advocate," he said. That's what he said. "You have to keep speaking up." And I could tell he was, like, struggling in some way, poor guy. And I'm like, I'm like, "Me? You need me to speak up?"
Sue Robins: He's like, he said to me, "They'll listen to you more than they'll listen to us." Mm. And I actually thought that was, like, sad. I thought that was very, very sad. Obviously, he had maybe perhaps tried to speak up and he hadn't been seen or heard, but there I am sitting in my, my paper gown with no clothes on, and he felt as in the system that I had more power than he did.
Sue Robins: [01:00:00] And so it just really speaks to the fact that neither patients nor clinicians are listened to or engaged at the higher levels, and that that is frustrating to us because we, none of us feel seen or heard. Mm. And it also made me realize we have more in common than we have differences. Certainly- Yeah ... he had similar struggles to I do.
Sue Robins: So there is a lot of pressure on patients, I think, to do that, to speak up, and what I wish is that we had safer spaces where we could speak up in a safe way, whether that is at point of care in a clinic room, or it's at around a boardroom table. And I think that's something that I, I, I push for very strongly, that it's the safe spaces that, that we need the professionals to help create those safe spaces for us to be able to speak up.
Sue Robins: Mm-hmm. And I, and I worry sometimes health professionals are quite defensive because they feel so passionately about the work that they do, and if somebody speaks up that's contrary to something perhaps they [01:01:00] have to say that they, they ... People don't like that very much. Mm. And it slows down the efficiency in the system as well, which I know in Canada very much our system's built on efficiency, getting as many patients through as you possibly can.
Sue Robins: Um, but I, I think having an advocate would actually help everybody involved. It would make the, the professional's job easier too. But, um, it's a funny thing. There's a lot of power that's involved with healthcare, a lot. A lot. And it's funny that that resident felt powerless, and he thought I had more power than he did- Yeah
Sue Robins: me sitting in my, my paper gown with no clothes on. Like, it's just, like, ludicrous. Yeah. I don't know who holds the power. It, up in the ivory tower somewhere I think. But the acceptance part I think, uh, we cause a lot of our own suffering Because things are one way but we wish they were another way, and the suffering is in between.
Sue Robins: So the acceptance of the way things are, I think, is very, very helpful. ACT [01:02:00] talks a lot about feelings and the fact that all feelings are okay. Like, there's, there's... It's very human to have feelings. That's the human- Yeah ... condition, and how we often try to push away the harder feelings. Um, and they have this image of the beach ball.
Sue Robins: We're always trying to push the beach ball down all the time, and it always pops back up in some way. So, um, you know, just thinking about feelings, and I'm a very feeling-y person. I'm very... That's like I wave my arms ar- uh, hands around like I'm very dramatic and stuff. But there are certain feelings I struggle with, like anger and, um, sadness are difficult feelings for me.
Sue Robins: Um, but there's this great quote from, uh, a poet who actually recently died of cancer just last year. Andrea Gibson, her name is. She's a spoken word poet from the States, and there's a great film about her on Netflix. But she says, "Whatever you've, you are feeling, name it love," she says, and I think about that a lot.
Sue Robins: And so as opposed to judging how we're feeling at the time when things go [01:03:00] hard, if we could just think about it as being love, I don't know. There's just something very calming about it to me, so I love that. Whenever you're feeling, name it love. Just staying in the moment and thinking about acceptance of all kinds of feelings has been quite helpful for me.
Dr Rob Blum: And then ended up doing medicine. Realistically had no idea what that actually was. Um, so didn't have any personal experience with it. It was more of a concept. Um, and I think that in some respects that was helpful in some, in some ways because I didn't have an expectation of what it looked like. Um, and then eventually decided that I would do, um, um, physician training.
Dr Rob Blum: And my first experience with, um, cancer actually was at the Austin Hospital as a resident. And I knew immediately that that's what I wanted to do because what I loved about the work was that, um, it was very much team-based. Mm. So, um, you know, all the components, the allied health, the nursing staff, um, the other [01:04:00] doctors, uh, they all had an equal and important part, and I loved the fact that you would work together and support each other.
Dr Rob Blum: It doesn't matter what challenges-- where the challenges lie, whether it's at home or at work. It-- I feel it's the same. Mm. I think probably the differences are that for your family, um, there's always, there's always the risk, I think, and I th- I, I feel like this does happen particularly in the medical field, that, um, because of the pressures of work and because of where you work, you sometimes can take for granted your family.
Dr Rob Blum: Mm. And there's a real risk in that. Um, so I think the, uh, the difference is that, um, your family is your family. Um, and, and I've certainly been guilty of that myself, that sometimes you can sacrifice your family for your work. Um- But at the end of the day, it, it is still work. And your families, I think, should take priority, but we don't [01:05:00] always do that, right?
Dr Rob Blum: We think they'll always be there- Mm ... till they're not. So I think that's probably the only distinction I would make. But the skill sets, I think, are the same. That's my in- interpretation of it. Mm. Can you, can you name a couple of those skills? What do you think are important? Oh, I th- like, I think, you know, one of the things for me is this concept of the, the being mindful of what's going on.
Dr Rob Blum: And, you know, I think for some people they think, "Well, that's just when you, you know, do some relaxation and deep breathing." But what it is is it's the gap between, um, an experience and a response to it. Mm. So, and I think the, you know, think about as, you know, you know, you know, being aware of how your environment, the situation is, is making you feel, having the space to acknowledge that I'm feeling angry, you know, scared, joyous, whatever.
Dr Rob Blum: And then thinking about, [01:06:00] okay, right, well, what I'm gonna, how am I gonna react to that? I think, you know, often the thing for me that's w- probably most impactful was that, um, until I spent some time looking at these things, you know, it was pretty much brain stem stuff. Mm. And the problem with that is that sometimes when you do the brain s- brain, um, stem stuff and it's something that is high stakes or high emotions, you can be down the track somewhere, and then you think How am I going to get out of this?
Dr Rob Blum: I've gone too far, I've said too much, I've done too much, and now I'm going to have to backpedal a lot. Whereas having that capacity to just take a couple of seconds and think, "Nah, that's actually going to be really dumb saying that. I might do it a different way." I've, I've actually found that really helpful personally because, you know, again, I, I'm blaming my European, uh, genetics here that, you know, we're often very em- emotional and reactive to stuff.
Dr Rob Blum: And, [01:07:00] you know, particularly when you're in positions where you have to lead people, um, uh, it's probably not the best way to operate most of the time. It just happens. Mm-hmm. It just comes out. That's one of the things that I've- Mm ... um, that I've got out of the recalibrate stuff, um, or the, the process of, of doing it.
Dr Rob Blum: I think for me, the o- the other important, um, components of it, um, have been the concept of looking after yourself. Um, and that's, I mean, that, you know, you hear about that all the time. Um, but about prioritizing what's in, what, what do you need to fill your bucket so that you can do the work? And I think probably in the past, again, coming from the, the, the background that I've got, the concept of self-sacrifice, you know, in order to get through university and, and get your exams, that sort of stuff, which you, where you do have to do a lot of delayed gratification.
Dr Rob Blum: But when you get to the end, if you don't, if you don't change up what you're doing, it [01:08:00] starts to become deleterious to you. I, I think one of the important things about, um You know, life work in general is having a, a really, um, good idea of self. Mm. So what, what am I about? Um, what, what are my values?
Dr Rob Blum: What's important to me? Um, 'cause I think if you're clear about that, then when you have to deal with important decisions, you can re- reference that and say, "Does this fit with, um, with what I envisage is important to me?" Um, I think that's something that's really important, um, because, again, if we think about, um, you know, the medical profession, and it probably applies to many other careers, there's, there's a strong sense of what a doctor looks like.
Dr Rob Blum: Mm. You know, what they dress [01:09:00] like, um, what they sound like, um, and it's not true. And, you know, to be honest with you, you know, not everyone in, in, in the field is necessarily supportive or conscious of, you know, s- some of these things that we're talking about. So, uh, which is unfortunate, but it's a reality.
Dr Rob Blum: So I think having someone that you can, that you can bounce ideas off or have a, a support network, I think is really important 'cause it'll help you make better informed decisions. Mm. Sit down and stay still for a minute. Yeah. And just, just think about what's going on and why you're feeling that way. You know, because I feel like, as I s- sort of alluded to before, there's usually another option.
Dr Rob Blum: Mm. You just have to find it. Mm. Um, and sometimes what you th- what you're thinking is happening is not what's happening or you're c- you know, [01:10:00] catastrophizing something. So if you're feeling overwhelmed, just stop and breathe. Mm. And, you know, again, um, if you've got someone who you can bounce ideas off, I think that's al- also very helpful 'cause then they can either validate what you're experiencing or they can say, "Hmm, that's not my, that's not my perception.
Dr Rob Blum: Have you thought about this?" Um, because I feel like, um, I don't know, there's just a sense of urgency that you've gotta, you know, you have to make all these decisions in your career and you've gotta do it quickly and you've gotta do this and you've gotta do that. And it's like, well, who says? Mm.
Dr Andrew Green: I just found general practice really hard going, um, for a whole lot of reasons. Um, high turnover, um, constant, um, re-, um, connecting with a new patient every several minutes was so taxing. Um, and I've got great respect for people who can do it, but I struggled. Um, and [01:11:00] anesthetics is kind of polar opposites from that.
Dr Andrew Green: Um, one patient at a time, a small team around us and, you know, very clear goal. Um, and I think in reality, looking back, the general practice was a burnout for me, um, very early in my career and the change, um, you know, was needed. Um, but really it took me further away from the opportunity to connect with patients.
Dr Andrew Green: So to, to put that down and abandon a, you know, a career that, you know, was in need of practitioners was something that took a little bit of effort and was, you know, there was a, a bit of sadness around that and perhaps some guilt. Um- And in reality, while I was doing both, um, y- yeah, the part of my week that, that felt, um, more uplifting, um, you know, to s- to sort of lean into that wasn't [01:12:00] as hard.
Dr Andrew Green: Like, when I went into anesthetics, it was a relief to not need to connect with people every several minutes. Um, and then in realizing, you know, what that meant in terms of my opportunity to connect, connect with people, um, was like, again, like a, uh, an, an eye-opening, um, moment. So, you know, th- there-- it was an opportunity, I think, to, you know, to start thinking how or what would I do differently.
Dr Andrew Green: I don't think I had any idea what burnout was back then, but looking back, I think there were enough signs that that's what it was. That, that, you know, putting that down and going into something else and, and you wondered if that was, you know, a time of recalibration. And like I say, it may be that that was actually a symptom that I needed to do some recalibrating.
Dr Andrew Green: Um, and that I think that depersonalizing, just seeing people as, you know, a, a, a procession of people that I needed to get through the day, um, rather than, you know, [01:13:00] opportunity to, you know, connect with people, um, was a sign of that as well. Sp- specifically junior doctors are often feeling like, you know, if I work hard enough and make sure I've got all of the skills that go with my specialty at hand, you know, then life will get easier because I'll be okay.
Dr Andrew Green: I'll be a qualified anesthetist and then, you know, I won't worry anymore. Um, but over time, I've come to realize that, you know, that, you know, it doesn't matter how good I get at my job, there'll always be something that will cause me stress or distress, and the additional skill set that I need is how do I handle that-
Sharee Johnson: Mm-hmm
Dr Andrew Green: stress or wherever that distress is coming from, and it might not have anything to do with having, you know, all the s- you know, top-level skills of being a, a good anesthetist.
Sharee Johnson: Mm-hmm. Mm. The art, the art and science of medicine and life.
Dr Andrew Green: Um, so when we started the group, uh, that we had, um, there were four of us that committed to [01:14:00] showing up every week, and it was just the four of us every Wednesday night for two years.
Dr Andrew Green: Um, and, you know, barely one of us missed a single week, um, just to build that safety and connection that would allow us to actually really start going deep on the, you know, the stuff we were struggling with. You know, I'm, I'm gonna own it because I've had- More than a couple of instances from quite different parts of my life where people have said, you know, how calm I seem or how still I am, and I like being that way.
Dr Andrew Green: And I think it comes from being able to, you know, notice something happening and, you know, even my response or my reaction to it on the inside, but not feel like I need to do anything with it straight away. It's just central now for me, and I think that mindfulness is about, you know, the noticing, noticing of what's coming up on the inside, being able to actually physically feel my feelings.
Dr Andrew Green: Some of the work I did in the men's circles was around, [01:15:00] um, you know, being able to name and label feelings. But, um, even in my professional practice, um, in the pointiest end of, you know, critical stuff going on and, you know, a lot of people in medical practice will recognize there are some- sometimes the, the crisis is so severe it doesn't seem like there's even time to think.
Dr Andrew Green: Uh, and I think that skill is applicable there and, you know, it was-- it, um, it amazed me one day when I was-- I caught myself in the middle of managing quite a serious crisis in an operating theater and, you know, I caught myself just close my eyes for a second and take a deep breath, and then be able to turn around and go, "Right, what next?"
Sharee Johnson: Mm.
Dr Andrew Green: And I-- when I noticed that I'd done it, and it's almost giving me shivers now thinking about it, um, you know, at the, the next instance that there was a crisis, I made a decision to do that same thing.
Sharee Johnson: Mm.
Dr Andrew Green: And, um, you know, it, it's not uncommon for people to turn and say, you know, "You [01:16:00] just seem so calm." Mm.
Dr Andrew Green: And, you know, it's not like I am every minute, but you know, it's, it's a skill that can be practiced, and I don't think it's trained as part of anesthetic training.
Cherie Dear: And it was another situation where, no, I wasn't allowed to go because of COVID. And I had to-- I think from that moment, I realized that I had to get, like, assertive in, you know, navigating this system. And I mean, now that the time's passed, I can say it, but I had a friend who worked at the hospital where this doctor was, and I said, "I have to be in that appointment," you know?
Cherie Dear: Like, "He can't go into that alone."
Cherie Dear: And, you know, I guess strings were pulled, I don't know, but I was able to go to the appointment, and we were just told by this oncologist in a very sort of like- brutal way.
Cherie Dear: And to be honest, we ended up moving oncologists because, um, the [01:17:00] bedside manner just did not fit with what we needed, I guess. Um, he basically said, "You're incurable and inoperable, and the type of chemo that we're going to deliver, the Folfirinox, that could be, really fatal as well." Um, and so when we got that news, we just realized that, well, they can't really help us.
Cherie Dear: We might only have nine weeks. Now I need to find the outliers. You know, I'm, I, I believe in the fact that yes, there's statistics. I've got an economics degree, I respect numbers, but I also know that there's always outliers. So then I just, um, you know, decided that we had to take this matter into our own hands, so to speak, because the Western medical system wasn't giving us any hope at all.
Cherie Dear: maintain the hope that you can be the outlier. But I think the other thing too, Sharee, is [01:18:00] Paul and I were realists as well, and so we got our affairs in order so then we could sort of live our best lives. And we fought the whole, well, the majority of the time that Paul had left, but I think that there's a time to fight, and there's a grace in knowing when to surrender. outlier. But I think the other thing too, Sharee, is Paul and I were realists as well, and so we got our affairs in order so then we could sort of live our best lives. And we fought the whole, well, the majority of the time that Paul had left, but I think that there's a time to fight, and there's a grace in knowing when to surrender.
Cherie Dear: what's it like for you having to deliver this terrible news to people? Mm. But I think from our experience, you know, being able to demonstrate that you've got empathy for that [01:19:00] situation. And I guess it must also be a situation of trying to really understand what each individual and each individual family, what they need. to deliver this terrible news to people? Mm. But I think from our experience, you know, being able to demonstrate that you've got empathy for that situation. And I guess it must also be a situation of trying to really understand what each individual and each individual family, what they need.
Cherie Dear: I encourage health professionals probably to
Cherie Dear: leading with empathy, um, that made an enormous difference to us.
Cherie Dear: And the, the health professionals that, that we felt really supported by, even though they couldn't offer us a cure,
Cherie Dear: They were the kindest, they treated us with empathy, not with trying to tell us that everything was going to be okay.
Cherie Dear: Mm. And sometimes the less [01:20:00] said, the better. But just that knowledge that their, their heart is, is sort of with you is enough. the kindest, they treated us with empathy, not with trying to tell us that everything was going to be okay.
Sharee Johnson: You came to uni, and you found all the heads in the jars, which I just can't imagine, Vijay. Um, now I'm saying thank goodness I'm a psychologist. Uh, you know, so that was a recalibration already that you were recalibrating from thinking about being a vet. But this, ... I think you said a vocation, this core sense of purpose that I want to be able to effect change in the world.
Sharee Johnson: Do you feel like you've been able to? Has being a doctor facilitated that desire?
Dr Vijay Roach: Yeah, I do. I think that the, the opportunities will come. And I think it's important to be clear, it wasn't that I thought I was the person to save the world. Mm-hmm. It was more a sense of a, a need to serve. That was what your purpose was, is, is [01:21:00] to, to serve.
Dr Vijay Roach: And I think that that's what medicine provided me with the opportunity to do. With an individual who's in front of you, to serve her, And, and look after her and care for her and provide her with the medical care that she required. To then have the opportunity because of that position and the connections that came with it, to serve in organizations or in, in roles.
Dr Vijay Roach: And it turned out that those roles then became leadership roles. And not for any particular reason. Maybe there are a set of skills that are related to being a leader. Uh, maybe it is a personality thing. Maybe it's a, a desire to, to lead. Uh, but those opportunities certainly came up, uh, repeatedly, and I took those opportunities.
Dr Vijay Roach: I found them interesting. I found them challenging. I enjoyed that role. Sometimes you don't enjoy it, because it can be enormously stressful being in a leadership role. [01:22:00] And, and, and that sort of leadership role that a doctor takes in the nature of their relationship with a patient as well can be enormously stressful, because you can have self-doubt.
Dr Vijay Roach: You can wonder whether you actually know more than your colleagues or whether that person might be better off being looked after by someone else. So that's something that one has to, um, have a degree of humility, but also learn not to be humble to the point where you, you're sort of incapable of doing anything.
Sharee Johnson: Immobilized.
Dr Vijay Roach: Yeah. That's right. And so, but I enjoyed that opportunity to then... And the other thing about, I think, leadership roles, is that you've got a seat at the table as well. So you actually have the opportunity to find out how systems work, how government works, to interact with the change makers and the decision makers, and that becomes really fascinating.
Dr Vijay Roach: And you get a better understanding when we circle back to what we were talking about before, about the problems with the system. Mm-hmm. Is that you actually start to understand [01:23:00] why some of those problems are impossible. Hmm. Uh, or far more challenging than they appear when we're sitting in the armchair being critical about it.
Dr Vijay Roach: Actually- Yeah, you're really, you're- ... it's not that easy ...
Sharee Johnson: you're really in the arena, aren't you, as Brene Brown- Mm ... would say.
Bec Clarke: I think being a clinical manager is really lonely. , When you are protecting your staff from the challenges that exist, , that are coming from the top down. And also, knowing the complex interactions or the complex personal things that are occurring for your staff, and holding that in a professional way. It does make it very lonely at times. And that's something that I've had to learn to, to deal with. And that's part of the reason why I, , run or get in the garden and or have those positive outlets because you can't, hold all of that yourself. Like it's too, too much. And I don't think anyone expects you to hold all of those emotional things. You have to hold it, but you have to know when to step out of the door and put that down to be [01:24:00] able to walk into the door with your family, your kids, and be present.
Bec Clarke: That is a hard thing to learn as a clinical manager.
Bec Clarke: And that was what triggered me to go, it's time for another change. Uh, I know that I, my own self, probably am not being as effectual as I'd like to be.
Bec Clarke: And not that I'd lost passion. My passion is very much there, but I needed to change again. I needed to think about how I could do something different in a different way, but still provide the level of care or service or support to other organizations. That was not an easy decision to make, to step out of.
Bec Clarke: My whole life had been really tailored working in public health service. I thought I would, live and, and then die within a, within a hospital. It was a real shift. It was a complex shift. Your ego, your sense of self is attached to that. And so to step outside of that was a big change.
Bec Clarke: And people said, oh, you're so brave to, to step [01:25:00] outside and, you know, to lose the, all the benefits of being working in government for such a long period of time. But for me, I felt I couldn't stay. I felt like they were brave to stay. I, I really needed, for me, I, I, um, I felt a level of abandonment actually, leaving my people.
Bec Clarke: Where I knew that there were, as there is everywhere, challenges with staffing.
Bec Clarke: So there are all these amazing things that I think is important to know that yes, we are nurses, yes we are doctors, but all of these skills and assets and attributes that we have. It can be placed in lots of different areas, even random areas like adventure racing. So the ability to transition between different careers, different opportunities, are incredible because healthcare provides you, and being a clinician provides you with all these attributes that sometimes you don't think are transferable. amazing things that I think is important to know that yes, we are nurses, yes we are doctors, but all of these [01:26:00] skills and assets and attributes that we have. It can be placed in lots of different areas, even random areas like adventure racing. So the ability to transition between different careers, different opportunities, are incredible because healthcare provides you, and being a clinician provides you with all these attributes that sometimes you don't think are transferable.
mentioned my kind of drop-off at fellowship, and I took a c- a couple of years of, um, you know, opportunity to do different things, a lot of navel-gazing and, and probably soul-searching. We have our finite locus of control and, um, you know, I think being able to realize that, that... What is it? I think Pema Chödrön says this, um, really best.
You know, um, you are the sky, everything else is just the weather. I love that. And, you know, I think... And again, maybe my yoga practice kinda helped me think a little bit more about surrender. Um, you know, 'cause that- that's certainly... You know, what's the, the most difficult pose? It's, uh, Shavasana, and that- [01:27:00] that's a pose of surrender, and actually that's the hardest one.
Um, the work of Professor Amy Edmondson on this topic. You know, kind of just thinking about failure, um, and what it means and the different types. So, you know, I think we, in medicine, we think a lot about, you know, the, the simple failures, which are the, the kinda never events. You know, the, the kinda wrong site surgery and, you know, we should have good, robust clinical governance systems to support and, you know, make those, um, very, very, you know, zero is what we aim for.
Whereas a lot of, you know, error that we see in medicine or failure, whatever, for, you know, in inverted commas, is complex and pervasive, and it involves humans and systems and, and, and, you know, w- we talk about the Swiss cheese when, when all of those holes line up. But the bit that we don't perhaps talk about enough is this concept of intelligent failure and, um, you know, we, we can transplant hearts because of intelligent failure.
You know, all the, the innovation, the growth, um, you know, that's the, the bit where we... [01:28:00] We've gotta remember that in healthcare that actually really matters too, so that should give us some courage to translate into our lives in terms of how we kinda go forward. And I do think there's pockets of, you know, really excellent, achievements.
I still think, you know, how we can take some of those examples, and very much, how do we, you know, take the example, pilot, iterate, and scale in our own environment knowing that, you know, without having to reinvent the wheel every time, and there are, you know, so many of those.
Mm. But, but then I keep coming then back again full circle to individuals, and I think the work that you do, you know, you... I, I love this word agentic, 'cause you are giving agency to us, and you're helping us to develop those core e- you know, intra and interpersonal skills. Mm. Um, because the system is made up of people and, you know, we make the system.
It takes a, you know, we'll take a critical number, um, and, you know, kind of elevation of voice and, and maybe some other skills, what I struggle with is maintaining momentum. Um- Mm-hmm ... and I think many of us who have been doing this for some [01:29:00] time do- Yes ... sometimes if you particularly have some individuals who are doing great work and we've not really thought about succession planning, you know, it could just take a, them to, to have to leave or step back or, you know, change of, you know, o- other leadership or funding, um, and things fall apart, and it's probably the first thing that goes, and I think that's the, the kinda concern.
It's still maybe an added extra, not, not really something that, that we, we do as core business.
[01:30:00]
