1
00:00:00,000 --> 00:00:05,860
Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills

2
00:00:05,860 --> 00:00:11,260
to build their own research program, whether or not they have a mentor.

3
00:00:11,260 --> 00:00:17,340
As clinicians, we spend a decade or more as trainees learning to take care of patients.

4
00:00:17,340 --> 00:00:22,380
When we finally start our careers, we want to build research programs, but then we find

5
00:00:22,380 --> 00:00:27,780
that our years of clinical training did not adequately prepare us to lead our research

6
00:00:27,780 --> 00:00:29,200
program.

7
00:00:29,200 --> 00:00:35,480
Through no fault of our own, we struggle to find mentors, and when we can't, we quit.

8
00:00:35,480 --> 00:00:40,580
However, clinicians hold the keys to the greatest research breakthroughs.

9
00:00:40,580 --> 00:00:46,200
For this reason, the Clinician Researcher podcast exists to give academic clinicians

10
00:00:46,200 --> 00:00:51,800
the tools to build their own research program, whether or not they have a mentor.

11
00:00:51,800 --> 00:00:59,600
Now introducing your host, Toyosi Onwuemene.

12
00:00:59,600 --> 00:01:03,360
Well, hello everybody.

13
00:01:03,360 --> 00:01:05,320
Welcome to the Clinician Researcher podcast.

14
00:01:05,320 --> 00:01:09,400
I'm your host Toyosi Onwuemene, and it's a pleasure to talk with you today.

15
00:01:09,400 --> 00:01:11,760
Thank you so much for being here.

16
00:01:11,760 --> 00:01:17,040
Today's episode actually comes courtesy of one of my sessions with my coaching clients,

17
00:01:17,040 --> 00:01:20,960
and I'm inviting you to join us as part of our session.

18
00:01:20,960 --> 00:01:26,160
And if you are thinking about being part of our group coaching, please reach out to me

19
00:01:26,160 --> 00:01:30,960
by direct message on LinkedIn.

20
00:01:30,960 --> 00:01:35,720
I'm also on Facebook and Instagram, but more likely to be reached by LinkedIn.

21
00:01:35,720 --> 00:01:40,320
But I just did want you to get some insight into some of the things we talk about as we

22
00:01:40,320 --> 00:01:43,400
advance faculty and their careers.

23
00:01:43,400 --> 00:01:44,400
Enjoy.

24
00:01:44,400 --> 00:01:51,840
So today, I wanted to share about thinking about our purpose and our vision.

25
00:01:51,840 --> 00:01:55,120
And I gave everyone homework, and it's okay if you didn't do your homework.

26
00:01:55,120 --> 00:01:57,680
We'll talk about your homework at the end.

27
00:01:57,680 --> 00:02:01,560
But just really thinking about what is it that really makes you tick?

28
00:02:01,560 --> 00:02:07,120
Like what really excites you about your career, what you really want to accomplish?

29
00:02:07,120 --> 00:02:13,000
And one of the themes that came up a lot last time was that sometimes you're just in survival

30
00:02:13,000 --> 00:02:14,000
mode.

31
00:02:14,000 --> 00:02:15,000
You're not even in the end.

32
00:02:15,000 --> 00:02:17,040
You're not even really thinking about what do I really want out of all of this?

33
00:02:17,040 --> 00:02:18,620
Where am I really going?

34
00:02:18,620 --> 00:02:23,720
And that's the way it is when you're so busy and feeling like you're just barely stringing

35
00:02:23,720 --> 00:02:25,120
two days together.

36
00:02:25,120 --> 00:02:28,360
It's easy to just go with the flow wherever the flow takes you.

37
00:02:28,360 --> 00:02:31,120
And many times it's not exactly where we want to go.

38
00:02:31,120 --> 00:02:32,760
So I didn't want to share my story.

39
00:02:32,760 --> 00:02:37,060
When I first started, I think I want to start from the point of being a fellow.

40
00:02:37,060 --> 00:02:39,840
I always knew I was going to do sickle cell research.

41
00:02:39,840 --> 00:02:42,560
I always knew I was going to do sickle cell research.

42
00:02:42,560 --> 00:02:44,760
I worked with a...well actually I didn't always know.

43
00:02:44,760 --> 00:02:49,240
I had a faculty member who was a mentor when I was a med student and she would just take

44
00:02:49,240 --> 00:02:51,440
me out to coffee every once in a while.

45
00:02:51,440 --> 00:02:53,840
We would sit and talk about my experience.

46
00:02:53,840 --> 00:02:57,480
At the time I wasn't thinking about hematology because I was going to be an oncologist, of

47
00:02:57,480 --> 00:02:58,840
course.

48
00:02:58,840 --> 00:03:03,440
And my father had died of liver cancer, so I was definitely going to become an oncologist.

49
00:03:03,440 --> 00:03:05,280
But I met with her every once in a while.

50
00:03:05,280 --> 00:03:08,000
She would just ask about how I'm doing.

51
00:03:08,000 --> 00:03:09,240
And that was just a good relationship.

52
00:03:09,240 --> 00:03:14,000
But there was no plan to change and become a hematologist like she was.

53
00:03:14,000 --> 00:03:20,240
However, on my journey to becoming an oncologist, I think I realized that I liked the hematology

54
00:03:20,240 --> 00:03:21,800
piece a little bit more.

55
00:03:21,800 --> 00:03:27,760
And so 9100, when it was 9100, that's the leukemia lymphoma service at Duke, was kind

56
00:03:27,760 --> 00:03:29,160
of more interesting to me.

57
00:03:29,160 --> 00:03:34,960
And Lou Deal, who's one of the older faculty members at Duke, was one of my attendings.

58
00:03:34,960 --> 00:03:36,440
I just really liked that group.

59
00:03:36,440 --> 00:03:41,040
And Amy Abernathy, actually, who's now no longer in clinical medicine, was one of my

60
00:03:41,040 --> 00:03:42,040
attendings too.

61
00:03:42,040 --> 00:03:43,840
So I had a great group of attendings.

62
00:03:43,840 --> 00:03:46,520
And I really loved the leukemia lymphoma service.

63
00:03:46,520 --> 00:03:49,480
So I thought I was going to be a malignant hematologist.

64
00:03:49,480 --> 00:03:54,240
And then I had one experience on the service where I watched a patient overnight become

65
00:03:54,240 --> 00:03:56,160
quadriplegic.

66
00:03:56,160 --> 00:04:00,840
And it just, I don't know, it just broke me because I went home sobbing and just thinking,

67
00:04:00,840 --> 00:04:03,400
okay, it's one thing for the cancer to kill you.

68
00:04:03,400 --> 00:04:06,560
It's another thing for us trying to get the cancer where we kill you in the process.

69
00:04:06,560 --> 00:04:09,680
I mean, he didn't die, but it was just really traumatic.

70
00:04:09,680 --> 00:04:13,920
And so I knew that was the defining moment that I knew I was not going to be a malignant

71
00:04:13,920 --> 00:04:14,920
hematologist.

72
00:04:14,920 --> 00:04:17,200
And then as I started thinking, well, what else am I going to do?

73
00:04:17,200 --> 00:04:22,160
Then hematology, classical, as people want to call it now, came to the fore because I

74
00:04:22,160 --> 00:04:23,960
had a mentor who was doing classical hematology.

75
00:04:23,960 --> 00:04:24,960
And she had sickle cell.

76
00:04:24,960 --> 00:04:27,120
And she saw patients with sickle cell in her clinic.

77
00:04:27,120 --> 00:04:28,880
And so that was, I was going to do sickle cell.

78
00:04:28,880 --> 00:04:35,040
I did my third year capstone talk on transfusion medicine and sickle cell.

79
00:04:35,040 --> 00:04:36,640
I won an award for it.

80
00:04:36,640 --> 00:04:40,360
And then I went off to fellowship in Chicago.

81
00:04:40,360 --> 00:04:43,120
And that was the beginning of a lot of trouble.

82
00:04:43,120 --> 00:04:49,440
So first of all, one thing I missed was that there are patients with sickle cell in Chicago,

83
00:04:49,440 --> 00:04:51,640
but they don't go to Northwestern.

84
00:04:51,640 --> 00:04:53,700
They mostly go to UIC.

85
00:04:53,700 --> 00:04:55,640
That's University of Illinois, Chicago.

86
00:04:55,640 --> 00:05:00,320
And so I didn't have access to the patient population I needed to succeed in any research

87
00:05:00,320 --> 00:05:02,520
endeavor that I was trying to do.

88
00:05:02,520 --> 00:05:07,560
So I eventually needed to be creative and think about, okay, well, how can I get sickle

89
00:05:07,560 --> 00:05:09,200
cell research experience?

90
00:05:09,200 --> 00:05:14,680
And I went to the Children's Health Center and worked with, at the time, Alexis Thompson

91
00:05:14,680 --> 00:05:15,840
was there.

92
00:05:15,840 --> 00:05:18,600
And let's just say it didn't work out exactly as I wanted to.

93
00:05:18,600 --> 00:05:23,120
And I remember one day just crying and saying, I wish I had never come to this fellowship.

94
00:05:23,120 --> 00:05:25,920
I wish I'd never come to Chicago.

95
00:05:25,920 --> 00:05:28,200
Oh, the drama.

96
00:05:28,200 --> 00:05:35,080
Anyway, when I finally came to Duke for my faculty position, I wanted to do sickle cell.

97
00:05:35,080 --> 00:05:37,920
And clearly I was going to come back and do sickle cell because all the patients with

98
00:05:37,920 --> 00:05:42,120
sickle cell were at Duke, at UNC too, but they're a lot at Duke.

99
00:05:42,120 --> 00:05:44,480
And there was no space for me.

100
00:05:44,480 --> 00:05:47,880
So at the time, they had too many faculty members in sickle cell.

101
00:05:47,880 --> 00:05:51,680
And in retrospect, I would say there was always space, but people were trying to close the

102
00:05:51,680 --> 00:05:54,440
door for different reasons.

103
00:05:54,440 --> 00:05:55,440
And I accepted it.

104
00:05:55,440 --> 00:05:57,800
I said, okay, well, I guess there's no space for me.

105
00:05:57,800 --> 00:06:02,200
My backup plan and fellowship, since I couldn't do sickle cell, or I couldn't, in quotes,

106
00:06:02,200 --> 00:06:06,800
was to do hemostasis thrombosis because I knew that at any point in time, it was going

107
00:06:06,800 --> 00:06:09,360
to be applicable to patients with sickle cell.

108
00:06:09,360 --> 00:06:12,660
So when I came to Duke and they're like, eh, we don't really have space for a sickle cell.

109
00:06:12,660 --> 00:06:13,660
What else do you want to do?

110
00:06:13,660 --> 00:06:17,640
I was like, sure, I'll just keep going with the hemostasis thrombosis theme.

111
00:06:17,640 --> 00:06:22,120
And so after I came, then two faculty members left pretty much back to back.

112
00:06:22,120 --> 00:06:25,640
And then they were like, um, Toyosi, you know how you had said you were interested in sickle

113
00:06:25,640 --> 00:06:26,640
cell?

114
00:06:26,640 --> 00:06:28,280
Would you like to take over?

115
00:06:28,280 --> 00:06:33,000
And at that point I was like, no, no sickle cell for me.

116
00:06:33,000 --> 00:06:34,000
Thank you very much.

117
00:06:34,000 --> 00:06:39,720
But anyway, so I will say that long-term, I never came back to sickle cell for my research

118
00:06:39,720 --> 00:06:40,720
career.

119
00:06:40,720 --> 00:06:43,260
I still take care of patients with sickle cell, but it's not what I do for research.

120
00:06:43,260 --> 00:06:46,800
So to some extent, I may have been derailed from that goal.

121
00:06:46,800 --> 00:06:52,080
However, quickly I realized that I didn't really have a plan for my faculty career,

122
00:06:52,080 --> 00:06:53,080
right?

123
00:06:53,080 --> 00:06:56,240
I was just, I was just kind of, you know, I mean, they gave me five clinics a week.

124
00:06:56,240 --> 00:06:59,600
I was doing, well, not five clinics a week, but I was seeing patients five days a week

125
00:06:59,600 --> 00:07:01,280
and I was doing that.

126
00:07:01,280 --> 00:07:04,960
And at the time I was also pregnant with my daughter and it was just rough.

127
00:07:04,960 --> 00:07:05,960
It was so rough.

128
00:07:05,960 --> 00:07:06,960
I hated the whole thing.

129
00:07:06,960 --> 00:07:09,920
I hated the whole thing because I was doing aphoresis.

130
00:07:09,920 --> 00:07:13,320
So it was one of the things I was doing actually all days of the week.

131
00:07:13,320 --> 00:07:16,780
And the part I hated was just these arguments I kept having with providers over whether

132
00:07:16,780 --> 00:07:18,860
we could provide aphoresis or not.

133
00:07:18,860 --> 00:07:22,000
Then I would turn around and argue with nurses about whether they could do the aphoresis

134
00:07:22,000 --> 00:07:23,000
or not.

135
00:07:23,000 --> 00:07:24,000
And it just ran me ragged.

136
00:07:24,000 --> 00:07:27,640
And at the end of every day, I felt like I was just like someone had run me up against

137
00:07:27,640 --> 00:07:32,160
a wall and just bruised me significantly and I needed to recover.

138
00:07:32,160 --> 00:07:33,160
So it was rough.

139
00:07:33,160 --> 00:07:39,300
Anyway, I say all that to say that I was kind of just being tossed and turned, right?

140
00:07:39,300 --> 00:07:42,820
Somebody said there's no sickle cell available, so I just didn't do sickle cell.

141
00:07:42,820 --> 00:07:47,080
And then somebody said, well, here's five days of clinic, five days of seeing patients

142
00:07:47,080 --> 00:07:49,180
a week, even though you're 80%.

143
00:07:49,180 --> 00:07:51,640
And I was like, sure, I guess that's the way it works.

144
00:07:51,640 --> 00:07:56,720
And then I was doing this thing I hated, which was arguing with providers and nurses all

145
00:07:56,720 --> 00:07:57,720
day.

146
00:07:57,720 --> 00:07:59,160
And it was like, okay, this is my job.

147
00:07:59,160 --> 00:08:01,280
I'm just going to grin and bear it.

148
00:08:01,280 --> 00:08:05,000
And so anyway, I feel like I was the poster child for just going with the flow and the

149
00:08:05,000 --> 00:08:07,200
flow was not very good for me.

150
00:08:07,200 --> 00:08:11,840
So Jennifer, not to pick on you, but you talked about being in a supportive environment.

151
00:08:11,840 --> 00:08:16,720
I wasn't in a not supportive environment, but let's just say the outcome I was having

152
00:08:16,720 --> 00:08:18,560
didn't make it seem as if there was support.

153
00:08:18,560 --> 00:08:22,240
It looked like there was support, but the outcome looked like I was being broken to

154
00:08:22,240 --> 00:08:23,240
pieces.

155
00:08:23,240 --> 00:08:30,640
Anyway, so I will say that one of the big breakthroughs of my life, biggest breakthroughs

156
00:08:30,640 --> 00:08:34,080
of my life was really, actually I had several.

157
00:08:34,080 --> 00:08:39,000
As far as research, I have one that I will talk about at a future session.

158
00:08:39,000 --> 00:08:42,360
But today I want to talk about how coaching really helped me.

159
00:08:42,360 --> 00:08:48,080
And one of the most important things that my coach is Judith Holder, and she's a great

160
00:08:48,080 --> 00:08:49,080
executive coach.

161
00:08:49,080 --> 00:08:50,240
She does a couple of sessions at Duke.

162
00:08:50,240 --> 00:08:51,240
She's really awesome.

163
00:08:51,240 --> 00:08:52,640
I recommend her.

164
00:08:52,640 --> 00:08:58,360
And one of the things she helped me recognize was closing the gap between my feelings and

165
00:08:58,360 --> 00:08:59,940
in my response to my feelings.

166
00:08:59,940 --> 00:09:00,940
So I'll give an example.

167
00:09:00,940 --> 00:09:05,240
I'd be the kind of person where I'm walking and then all of a sudden, I'm sad.

168
00:09:05,240 --> 00:09:07,560
And I'm like, wait a minute, why am I sad?

169
00:09:07,560 --> 00:09:15,120
Then I have to retrace the steps and say, oh, oh, it was three hours ago in the chief's

170
00:09:15,120 --> 00:09:19,480
office when he said, ha, even a monkey could do this interpretation.

171
00:09:19,480 --> 00:09:23,640
And in the moment, because I love to please people and make them happy.

172
00:09:23,640 --> 00:09:26,800
In the moment, I may have laughed and said, ha ha, what a funny joke.

173
00:09:26,800 --> 00:09:31,200
But three hours later, it hit me that that hurt me.

174
00:09:31,200 --> 00:09:32,640
But that was three hours too late.

175
00:09:32,640 --> 00:09:33,640
Right.

176
00:09:33,640 --> 00:09:37,840
And one of the biggest things that really helped for me was to shorten the gap between

177
00:09:37,840 --> 00:09:41,800
my feeling in the moment and how I responded to the feeling in the moment.

178
00:09:41,800 --> 00:09:48,800
So I became a feeler again, like actually someone who could actually decipher and interpret

179
00:09:48,800 --> 00:09:52,200
how I felt about situations so that I could respond more in the moment.

180
00:09:52,200 --> 00:09:53,200
OK.

181
00:09:53,200 --> 00:09:57,040
So what does this have to do with your purpose and where you're going?

182
00:09:57,040 --> 00:10:00,620
So I feel like I was a poster child for someone who didn't know where I was going or who didn't

183
00:10:00,620 --> 00:10:01,620
have a plan.

184
00:10:01,620 --> 00:10:02,920
I mean, I just wanted to be a physician.

185
00:10:02,920 --> 00:10:04,240
I just wanted to graduate.

186
00:10:04,240 --> 00:10:05,240
That was it.

187
00:10:05,240 --> 00:10:06,240
That was my goal.

188
00:10:06,240 --> 00:10:07,240
Right.

189
00:10:07,240 --> 00:10:09,640
And as soon as I accomplished that, I don't think I realized that there was a different

190
00:10:09,640 --> 00:10:10,640
goal for faculty.

191
00:10:10,640 --> 00:10:14,280
I mean, I was going to do all the things they said I would do, which was see patients, do

192
00:10:14,280 --> 00:10:16,840
research, you know, the big umbrella.

193
00:10:16,840 --> 00:10:22,720
But this wasn't the same as residency or fellowship where there's a very clear goal in three or

194
00:10:22,720 --> 00:10:25,880
four years you're going to be done as long as you meet all these competencies.

195
00:10:25,880 --> 00:10:26,880
Right.

196
00:10:26,880 --> 00:10:27,960
There wasn't a clear goal.

197
00:10:27,960 --> 00:10:31,440
It just seemed like everything was moving, you know, and it wasn't clear.

198
00:10:31,440 --> 00:10:33,280
I would say, hey, I want to do research.

199
00:10:33,280 --> 00:10:35,480
Oh, and they were like, oh, well, there's no research.

200
00:10:35,480 --> 00:10:36,480
So here, do clinical.

201
00:10:36,480 --> 00:10:39,600
And then I would say, okay, great, I'm doing clinical, but why am I earning a research

202
00:10:39,600 --> 00:10:40,600
salary?

203
00:10:40,600 --> 00:10:45,160
It's like, oh, you know, so I just was always kind of just, I was tossed back and forth.

204
00:10:45,160 --> 00:10:49,520
Anyway, but one thing I knew is that I hated whatever I was doing.

205
00:10:49,520 --> 00:10:54,280
You know, the feeling like I was being bruised every time I was trying to do my work daily

206
00:10:54,280 --> 00:10:55,280
in apheresis.

207
00:10:55,280 --> 00:11:00,780
I hated the feeling of, you know, trying to do research, but I was so busy clinically.

208
00:11:00,780 --> 00:11:06,280
And so to some extent, I figured out my, what I wanted to do based on all the pain that

209
00:11:06,280 --> 00:11:07,280
I had.

210
00:11:07,280 --> 00:11:12,900
So I was running away from pain and therefore entering into what I really wanted to do.

211
00:11:12,900 --> 00:11:20,420
So I want to help you avoid that to the best of my ability by helping us think intentionally.

212
00:11:20,420 --> 00:11:21,920
And how would that have helped me?

213
00:11:21,920 --> 00:11:24,400
Well, when people said, hey, sickle cell is not available.

214
00:11:24,400 --> 00:11:27,160
I may have said, no, no, no, this is really important to me.

215
00:11:27,160 --> 00:11:29,040
If it's not available, I'm not going to do this.

216
00:11:29,040 --> 00:11:30,040
Right.

217
00:11:30,040 --> 00:11:31,760
So I took whatever was given to me.

218
00:11:31,760 --> 00:11:33,960
I assumed I didn't have a choice.

219
00:11:33,960 --> 00:11:37,840
I know now that I did, I did, but I assumed I didn't have a choice.

220
00:11:37,840 --> 00:11:41,840
Now was sickle cell the real thing?

221
00:11:41,840 --> 00:11:44,120
To me, I think it wasn't so much about sickle cell.

222
00:11:44,120 --> 00:11:48,320
And that's probably why I gave it up a little bit more easily was because, was that I really

223
00:11:48,320 --> 00:11:53,860
wanted to have an impact on a disease that's, that affected a minority population.

224
00:11:53,860 --> 00:11:55,360
I know that that was important to me.

225
00:11:55,360 --> 00:11:57,760
And sickle cell was very easy.

226
00:11:57,760 --> 00:12:02,160
I think for many of us who go into classical hematology, I think many of us to some extent

227
00:12:02,160 --> 00:12:04,200
have some resonance with sickle cell.

228
00:12:04,200 --> 00:12:05,920
But anyway, I think it's important.

229
00:12:05,920 --> 00:12:10,920
I mean, talk about seven things that are important to think about as far as defining your purpose.

230
00:12:10,920 --> 00:12:16,480
I think the first thing is that it's easy for us when we run towards an end that we

231
00:12:16,480 --> 00:12:17,960
can see.

232
00:12:17,960 --> 00:12:18,960
Medical school, it's four years.

233
00:12:18,960 --> 00:12:19,960
Great.

234
00:12:19,960 --> 00:12:21,880
I know how this works because other people are doing it.

235
00:12:21,880 --> 00:12:22,880
I can see them.

236
00:12:22,880 --> 00:12:25,040
I know the way to the end.

237
00:12:25,040 --> 00:12:26,040
Residency is the same.

238
00:12:26,040 --> 00:12:29,200
There are people who graduated, I want graduation.

239
00:12:29,200 --> 00:12:30,440
I'm just going to follow the path.

240
00:12:30,440 --> 00:12:33,120
And the same thing for fellowship as well.

241
00:12:33,120 --> 00:12:37,560
So you may not have to define your purpose at the beginning because you're running towards

242
00:12:37,560 --> 00:12:39,120
an end that you can already see.

243
00:12:39,120 --> 00:12:41,560
It's already clear to you what the wind is.

244
00:12:41,560 --> 00:12:48,440
It becomes harder when you leave the path to where there is no clearly defined end.

245
00:12:48,440 --> 00:12:52,800
That's the time at which it becomes really important to be very clear about what your

246
00:12:52,800 --> 00:12:54,160
destination is.

247
00:12:54,160 --> 00:12:57,240
And it's hard to be clear because you don't see it, right?

248
00:12:57,240 --> 00:13:01,320
There's nobody who's like, hey, Diamond, this is the destination.

249
00:13:01,320 --> 00:13:03,920
You just come and be like me, your life will be better.

250
00:13:03,920 --> 00:13:06,440
There's usually no such person.

251
00:13:06,440 --> 00:13:10,640
So when it comes to kind of trying to clarify, why am I here?

252
00:13:10,640 --> 00:13:12,260
What do I want to do?

253
00:13:12,260 --> 00:13:18,040
You're mostly feeling your way to an end that you can't see physically, but you kind of

254
00:13:18,040 --> 00:13:20,080
have a sense of where you want to go.

255
00:13:20,080 --> 00:13:24,280
So to some extent, it's nebulous, but it's really strong inside you.

256
00:13:24,280 --> 00:13:29,960
You just know where you want to go, even though you can't always put words to it.

257
00:13:29,960 --> 00:13:34,240
And so it's really important to define where you're going, especially where the destination

258
00:13:34,240 --> 00:13:39,240
doesn't seem clear to others and mostly to you because the destination really does need

259
00:13:39,240 --> 00:13:41,760
to be clear to you.

260
00:13:41,760 --> 00:13:47,380
The telltale sign of ignoring what you're really supposed to be doing or ignoring moving

261
00:13:47,380 --> 00:13:52,680
towards a thing that really resonates with you is just this feeling of not being satisfied.

262
00:13:52,680 --> 00:13:53,840
You can't even really explain it.

263
00:13:53,840 --> 00:13:57,340
You just know that it's like, oh, I know I have all these awards.

264
00:13:57,340 --> 00:14:02,060
I know people are saying I'm so successful, but somehow this is not it, right?

265
00:14:02,060 --> 00:14:03,600
And it's not even, it's very weird.

266
00:14:03,600 --> 00:14:05,320
You can't even really put it into words.

267
00:14:05,320 --> 00:14:07,920
You just know it's not it.

268
00:14:07,920 --> 00:14:09,420
You can't really explain it.

269
00:14:09,420 --> 00:14:14,800
And that's one of those telltale signs that you got to pay attention to that thing that's

270
00:14:14,800 --> 00:14:16,480
telling you it's not it, right?

271
00:14:16,480 --> 00:14:21,440
I mean, it's very, to some extent touchy feely, but it's real, right?

272
00:14:21,440 --> 00:14:25,080
You feel something is off even when everyone's like, oh, don't worry about that.

273
00:14:25,080 --> 00:14:26,360
No, no, no, you're so successful.

274
00:14:26,360 --> 00:14:27,360
You're super successful.

275
00:14:27,360 --> 00:14:28,360
Stop.

276
00:14:28,360 --> 00:14:29,900
Stop trying to do something different.

277
00:14:29,900 --> 00:14:32,200
But you know that you're supposed to be doing something different.

278
00:14:32,200 --> 00:14:35,080
So that's important to pay attention to.

279
00:14:35,080 --> 00:14:41,780
So I think it's a really deep seated need to figure out what you want to do even when

280
00:14:41,780 --> 00:14:46,760
you can't really put words to it, because if we don't, we are dissatisfied.

281
00:14:46,760 --> 00:14:49,080
If we don't, we get to the end of our careers.

282
00:14:49,080 --> 00:14:52,080
We look back and we feel like we wasted time.

283
00:14:52,080 --> 00:14:56,720
And to be honest, there's so many people I see in academic medicine who are super successful.

284
00:14:56,720 --> 00:14:59,200
They have lots of grants.

285
00:14:59,200 --> 00:15:03,320
They're like, you know, on the poster of everything about the university.

286
00:15:03,320 --> 00:15:07,160
And if you ask them, they think their life sucks, right?

287
00:15:07,160 --> 00:15:12,840
And so that's, we don't want to be successful for others to see and brag about us.

288
00:15:12,840 --> 00:15:15,680
And while we don't feel successful inside.

289
00:15:15,680 --> 00:15:20,560
So if you're going to clarify this fuzzy feeling that you have, that you're not even clear

290
00:15:20,560 --> 00:15:24,700
exactly where you're going, you actually do need to do work.

291
00:15:24,700 --> 00:15:32,360
It takes work to bridge the gap between this is where, who I am right now, and this is

292
00:15:32,360 --> 00:15:33,660
where I want to go.

293
00:15:33,660 --> 00:15:38,000
It takes work, but it's really important work.

294
00:15:38,000 --> 00:15:43,800
And if you're going to do this work, you've got to think of yourself, not just as a physician,

295
00:15:43,800 --> 00:15:46,760
because before you came to medicine, you were a whole person.

296
00:15:46,760 --> 00:15:49,600
You had a whole, you just had a life, right?

297
00:15:49,600 --> 00:15:52,960
And so the fact that you've come into medicine and medicine can be all consuming doesn't

298
00:15:52,960 --> 00:15:54,400
mean that medicine is everything.

299
00:15:54,400 --> 00:15:57,080
It doesn't mean it has to be everything.

300
00:15:57,080 --> 00:16:03,280
And so it takes work that also involves you stepping outside of where you are right now

301
00:16:03,280 --> 00:16:06,920
and thinking about the bigger picture of who you are.

302
00:16:06,920 --> 00:16:11,360
And if you're going to be successful in a way that actually resonates with you personally

303
00:16:11,360 --> 00:16:14,660
as being successful, it is work that you cannot avoid.

304
00:16:14,660 --> 00:16:18,400
You can defer it, you can delay it, you can ignore it for a long time, but it will always

305
00:16:18,400 --> 00:16:19,400
come back around.

306
00:16:19,400 --> 00:16:24,240
It's this thing that's gnawing inside of you waiting to be hurt, right?

307
00:16:24,240 --> 00:16:28,320
So if you're going to do the work, it's an iterative process.

308
00:16:28,320 --> 00:16:30,920
So you might think you have a sense of where you're going.

309
00:16:30,920 --> 00:16:34,280
It's not as if you haven't because you went to medical school, you went to residency,

310
00:16:34,280 --> 00:16:35,960
you're doing fellowship.

311
00:16:35,960 --> 00:16:37,360
You have a sense of where you're going.

312
00:16:37,360 --> 00:16:39,440
So you're doing it.

313
00:16:39,440 --> 00:16:40,440
You're on the path.

314
00:16:40,440 --> 00:16:44,240
But every time there's a major life change, usually it causes you to pause and say, wait

315
00:16:44,240 --> 00:16:45,960
a minute, what am I doing again?

316
00:16:45,960 --> 00:16:47,160
Where do I want to go?

317
00:16:47,160 --> 00:16:52,320
So whether that be you meet a new great significant other, you get married, you have a child,

318
00:16:52,320 --> 00:16:57,240
someone dies, there will always be a life event that causes you to pause, like shakes

319
00:16:57,240 --> 00:17:00,640
your world enough to say, wait a minute, am I on the right track?

320
00:17:00,640 --> 00:17:06,520
And those are good times because sometimes those are moments that accelerate your clarifying

321
00:17:06,520 --> 00:17:11,840
your purpose because your purpose is not a specific disease, even though many times people

322
00:17:11,840 --> 00:17:13,560
are asking us to just choose a disease.

323
00:17:13,560 --> 00:17:14,880
It's not a specific disease.

324
00:17:14,880 --> 00:17:17,560
It's not even a specific specialty.

325
00:17:17,560 --> 00:17:18,560
It's bigger than that.

326
00:17:18,560 --> 00:17:22,480
Your specialty kind of just helps you fuel that, just helps you get there, right?

327
00:17:22,480 --> 00:17:25,840
The other thing I want to say is that most of us come because of impact.

328
00:17:25,840 --> 00:17:30,360
I haven't met anybody who came to medicine just to be like, well, I just didn't have

329
00:17:30,360 --> 00:17:33,280
anything else I wanted to do, so here I am in medicine.

330
00:17:33,280 --> 00:17:35,680
But many people talk about, I came to help people.

331
00:17:35,680 --> 00:17:37,960
I came to make a difference in people's lives.

332
00:17:37,960 --> 00:17:40,280
So that's really about impact.

333
00:17:40,280 --> 00:17:44,920
And based on the perspective of those of us who are gathered here, your idea of impact

334
00:17:44,920 --> 00:17:49,680
may be different from the ideas of people who surround you, especially your mentors,

335
00:17:49,680 --> 00:17:52,080
especially people who matter in the academy.

336
00:17:52,080 --> 00:17:53,600
Like is that what you want to do?

337
00:17:53,600 --> 00:17:55,760
Oh no, nobody does that, right?

338
00:17:55,760 --> 00:18:02,040
In general, people tend to push the desires of people who look like them, or the majority,

339
00:18:02,040 --> 00:18:03,040
right?

340
00:18:03,040 --> 00:18:06,960
Whatever is succeeding because most people are interested in that.

341
00:18:06,960 --> 00:18:09,680
It's impactful because it affects more people.

342
00:18:09,680 --> 00:18:15,400
But for many of us, the impact we want to have is on populations or in places where

343
00:18:15,400 --> 00:18:20,000
people are not necessarily well-resourced or there are not necessarily that many people

344
00:18:20,000 --> 00:18:21,880
working in that area.

345
00:18:21,880 --> 00:18:27,600
Therefore, if you are going to do that, then you have to have courage.

346
00:18:27,600 --> 00:18:33,120
You have to have support because you're going to be going against the grain a lot and that

347
00:18:33,120 --> 00:18:34,600
can be exhausting.

348
00:18:34,600 --> 00:18:38,220
And sometimes you might find that the people who once supported you, as long as you were

349
00:18:38,220 --> 00:18:42,600
doing what they said, the moment you are defining your own path, which is important for your

350
00:18:42,600 --> 00:18:47,600
success personally, some people may not take kindly to that because now you're kind of

351
00:18:47,600 --> 00:18:50,400
going off the beaten track of what they're recommending.

352
00:18:50,400 --> 00:18:52,640
So it does take courage and it does take support.

353
00:18:52,640 --> 00:18:53,640
All right.

354
00:18:53,640 --> 00:18:54,640
That's all I wanted to say.

355
00:18:54,640 --> 00:18:56,840
I'm going to summarize the things that I said.

356
00:18:56,840 --> 00:19:02,240
Number one is that the need to define purpose really begins when you feel your destination

357
00:19:02,240 --> 00:19:03,640
more than you can see it.

358
00:19:03,640 --> 00:19:08,120
So you know where you have a sense of where you're supposed to go, but you can't really

359
00:19:08,120 --> 00:19:11,040
say this is it.

360
00:19:11,040 --> 00:19:14,880
If you're ignoring what you're supposed to be doing, there's a deep feeling of dissatisfaction

361
00:19:14,880 --> 00:19:17,160
you can't explain that comes with that.

362
00:19:17,160 --> 00:19:20,940
If you're in a fulfilled purpose, it's a deep seated need and it's really worth your time

363
00:19:20,940 --> 00:19:23,000
to find it.

364
00:19:23,000 --> 00:19:26,360
Number four, your purpose is bigger than your day to day work as a physician.

365
00:19:26,360 --> 00:19:30,160
You have to step outside of your role in medicine to really figure it out.

366
00:19:30,160 --> 00:19:32,460
Your role in medicine serves your bigger purpose.

367
00:19:32,460 --> 00:19:35,120
It is not the biggest purpose.

368
00:19:35,120 --> 00:19:36,520
If you're going to do the work.

369
00:19:36,520 --> 00:19:41,040
Number five, clarifying your purpose takes work and that work can't be avoided.

370
00:19:41,040 --> 00:19:42,720
Number six, it's an iterative process.

371
00:19:42,720 --> 00:19:47,880
There are different life scenarios will bring you back to the drawing board and number seven,

372
00:19:47,880 --> 00:19:51,960
most of us came for impact, which is going to be different from what generally people

373
00:19:51,960 --> 00:19:53,800
around us agree with.

374
00:19:53,800 --> 00:19:59,880
For that reason, it requires you to have courage in moving forward and also to find support

375
00:19:59,880 --> 00:20:03,600
where you can find it to help you succeed.

376
00:20:03,600 --> 00:20:05,080
Okay.

377
00:20:05,080 --> 00:20:09,880
So this is the point at which I want you to pause and just think about yourself right

378
00:20:09,880 --> 00:20:17,520
now and go back to when you first wanted to go to medicine, why you wanted to be a doctor.

379
00:20:17,520 --> 00:20:19,320
What did you hope you would do?

380
00:20:19,320 --> 00:20:23,100
Like you had no idea exactly what this path would lead you to.

381
00:20:23,100 --> 00:20:27,800
You had no idea that some of us would not have done it if we had known, right?

382
00:20:27,800 --> 00:20:30,520
But that was a dream you have.

383
00:20:30,520 --> 00:20:31,520
You're excited.

384
00:20:31,520 --> 00:20:32,520
Maybe you wanted to help people.

385
00:20:32,520 --> 00:20:37,640
I don't know what, but I want you to think about it and write it down.

386
00:20:37,640 --> 00:20:43,120
You can write it on a notebook if you have a notebook with you, on your phone app note,

387
00:20:43,120 --> 00:20:46,680
note app or your computer or in the chat.

388
00:20:46,680 --> 00:20:49,600
But just take a moment to think about why did you come?

389
00:20:49,600 --> 00:20:52,920
What do you really want to accomplish when you first started?

390
00:20:52,920 --> 00:20:58,840
And now what's the thing that really still makes you excited about being in medicine?

391
00:20:58,840 --> 00:21:01,800
Now for some of us, we're just like, I have no excitement.

392
00:21:01,800 --> 00:21:04,480
If I could quit yesterday, I would have quit anyway.

393
00:21:04,480 --> 00:21:08,140
So if you're feeling that way, just go back to medical school, go back to the feelings

394
00:21:08,140 --> 00:21:12,520
you had early in the beginning when you were like, okay, this is why I want to be in medicine.

395
00:21:12,520 --> 00:21:19,760
Now I'm going to give everyone two minutes to think about it, write it down.

396
00:21:19,760 --> 00:21:23,320
And then we're going to break up into groups and we're going to talk about it.

397
00:21:23,320 --> 00:21:24,600
Well thank you so much for listening.

398
00:21:24,600 --> 00:21:37,080
I look forward to talking with you again next time on the Clinician Researcher Podcast.

399
00:21:37,080 --> 00:21:42,440
Thanks for listening to this episode of the Clinician Researcher Podcast, where academic

400
00:21:42,440 --> 00:21:47,720
clinicians learn the skills to build their own research program, whether or not they

401
00:21:47,720 --> 00:21:49,240
have a mentor.

402
00:21:49,240 --> 00:21:55,200
If you found the information in this episode to be helpful, don't keep it all to yourself.

403
00:21:55,200 --> 00:21:57,080
Someone else needs to hear it.

404
00:21:57,080 --> 00:22:01,120
So take a minute right now and share it.

405
00:22:01,120 --> 00:22:06,600
As you share this episode, you become part of our mission to help launch a new generation

406
00:22:06,600 --> 00:22:19,480
of clinician researchers who make transformative discoveries that change the way we do healthcare.