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Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills

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to build their own research program, whether or not they have a mentor.

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As clinicians, we spend a decade or more as trainees learning to take care of patients.

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When we finally start our careers, we want to build research programs, but then we find

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that our years of clinical training did not adequately prepare us to lead our research

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program.

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Through no fault of our own, we struggle to find mentors, and when we can't, we quit.

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However, clinicians hold the keys to the greatest research breakthroughs.

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For this reason, the Clinician Researcher podcast exists to give academic clinicians

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the tools to build their own research program, whether or not they have a mentor.

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Now introducing your host, Tiosi Onwemona.

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So I'm talking today about disconnecting from your clinical identity, and I'm talking about

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it because of what Morgana brought up, and it's all of our stories.

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It's not just her story, it's all of our stories.

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So if you recall, there was this thing where you probably finished all of four years of

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college.

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Most people have a short track program where they can combine college and medical school,

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but most of us did the four years of college, and then we did four years of medical school,

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and then we did three years of residency training, and maybe we've gone on to do three or more

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years of fellowship training.

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But it's been a long time, first of all, trying to get into medical school, almost like the

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whole idea of scratching at the door, let me in, I want to be a doctor, I want to save

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lives, let me in.

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And then you finally get in.

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So there's all the years that you built up just trying to get in, just trying to be the

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doctor.

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And then you get into medical school, and there's all that time trying to learn what

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a doctor is supposed to learn.

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And then you graduate, and there's all this time spent learning how to be the doctor that

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you've been preparing to be or learning about being all these years.

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And so even though when you do the math, maybe the period of training might be about 10 years,

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give or take a few, depending on what your specialty is, it's really been a couple of

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extra years in terms of all the work you had to do just to get to the place of even doing

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the whole medical school thing anyway.

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So let's just say, by the time you get to where you are done with your training, first

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of all, you're just tired of training because you're just like, get me out of here.

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Can I just be an adult?

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Can I just be my own person?

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Please let me be my own doctor.

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But there's also the whole of your identity that's now wrapped inside this thing that's

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medicine.

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And I don't know about you, but for me, when I started, actually, it wasn't even when I

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started, it was in the middle of medical school.

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I just felt like, holy cow, this is such a soul sucking identity problem.

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Everything is wrapped around medicine.

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I'm always studying.

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I'm always going to see patients coming from seeing patients.

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It just felt like it was just sucking all of me up.

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And I don't know about your experience, but it really did feel soul sucking to me, even

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in medical school, where I was like, I can't do this.

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This is just, I used to be a whole person before I came into medical school.

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Why is it now taking over my whole life?

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I don't see people.

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I'm sleeping all the time.

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When I'm not sleeping, I'm studying.

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When I'm not studying, I'm in the hospital.

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It really did feel all consuming.

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And it almost felt like a vice or like, what's the word?

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It was like something closing in on me, trying to take over my life.

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Anyway, so fast forward to being an attending.

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And it actually never went away.

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And I always really felt like I was choking.

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And it took me a long time to get to the place where I realized that if I was ever going

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to take my life back, whatever taking the life back meant, I would have to be the one

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to step in, right?

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Because we exist in a culture where people overwork.

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We exist in a culture where people feel like sacrifice is the only way forward.

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We exist in a culture where it's the patient's welfare or nobody's welfare.

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And so many times we are kind of trained, especially for women or underrepresented in

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the academy, to sacrifice our lives on somebody else's altar.

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It may be the altar of the patient, which feels very noble and good and right.

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It may be the altar of the academic environment.

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The institution needs you.

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You don't show up, nothing will happen.

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Or it may be sacrificing our lives on the altar of, oh, this is what it takes to succeed

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academically.

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Therefore, you must XYZ.

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That will always be something that's trying to claim us.

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And the challenge is that we are very entrenched in this identity of the physician is giver,

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the physician is sacrificer, the physician is hard worker, the physician is non-complainer,

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the physician is do everything.

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And it's hard.

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It's like we've been training for so long to have this identity that swallows us up.

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It's hard to think of life outside of this identity.

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However, we must.

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I read this thing somewhere that it was like somebody's epitaph, like the thing they put

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on the grave when you die.

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And it was like, he was born a man, died a doctor.

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The identity is sometimes unshakable from your personal identity.

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Everywhere you go, you are the doctor.

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But I want to say that we were whole people, whole people before we came into medicine.

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And medicine will end for us.

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It will end for all of us in some way.

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Some of us will, I don't know, continue to keep the identity burning and seeing patients

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until we die.

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Some of us will be forced to retire even when we don't want to.

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We're like, no, if I'm not doctoring, who am I?

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What can I do?

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I mean, people really do have crises when they have to give up doctoring.

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So it's a big deal.

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It's a big deal.

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But what do I want to invite you to think about?

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I want to invite you to think about the identity you had before you came into medicine.

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Now you can never be the same again, right?

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There's no going back to who you used to be.

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It's too late.

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It's like you passed through the fire, that you've been burned beyond recognition.

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And there's a new you, and there's no going back and getting the old person.

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But it is important to recognize that you used to be somebody different.

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Before you came into medicine, you were capable, you were strong.

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And if you didn't go into medicine, you would have been okay.

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You would have found your way.

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You would have had a great career.

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The same drive and energy that you bring to medicine is the same drive and energy that

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you would have brought to another sphere of life.

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And so you are a whole and capable person.

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And it's important to say that because sometimes there is a stripping of our identity by medicine

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where it's like, if you're not a doctor, who could you be?

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And it's a lie, right?

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It's the whole scarcity mindset.

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In reality, you could be many things.

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Your physician training empowers you to be many things.

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And yes, it may involve going back to the beginning, to the beginning, and learning

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something new or retraining in a different way, but you are...

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It's toti potential, right?

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It's the multipotent stem cell.

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There's nothing you cannot become.

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And I think to some extent, like military training, you pass through, you can handle

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a lot of things relative to many people in the general population who have not had as

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much stress as part of their evolution as a person.

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So I think the first thing I want to share is that you can do anything.

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And that's important.

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You know that.

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Like fundamentally, you know that, but there's also the sense of like, am I going to give

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away the four years of med school and the thousands of dollars I paid in tuition?

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I'm not...

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Like, there's a sense that we've sunk so much into medicine that we're afraid that if we

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lose it, we've lost so much of an investment.

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But again, I want to say you can do anything.

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Every investment you've ever made in medicine is an investment that you always have.

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Like you never lose it.

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Everything you've invested into becoming the person you are as a physician, someone who's

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really like, you know, operates at a high level, is able to work hard, is able to push

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through challenges, is persevering, able to advocate for people, all of that, you still

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keep that and you can apply it to anything you want in life.

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And so your investment in medicine, even if you're counting the costs or maybe you haven't

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even paid off your student loans.

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At the end of the day, you still own it.

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You still have it.

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You're not losing anything.

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You can be anything you want to be.

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Okay.

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The second thing is that whether you want to be anything you want to be or not, your

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time in medicine is going to come to an end.

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It just is, right?

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Now, I'm not trying to be morbid and say you're going to die.

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I mean, we all are and that's okay.

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But the reality is at some point you might retire.

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Some people have been disabled and left medicine.

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Some people have been forced to leave whether through job cuts or some other unforeseeable

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challenge.

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But at the end of the day, whether we leave after a long and happy career of planned retirement

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or we leave abruptly or we leave because just something else has pulled us in a different

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direction, our medical careers are going to end.

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And then the question is, are we ready?

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Are we ready for life beyond?

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Now I'm not trying to push everybody into the future to say, let's forget about today

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and just go into the future.

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But it is important to be future thinking, right?

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That's why we talk about, oh, are you ready for retirement?

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How much have you saved up in your 401k?

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All of that stuff that frankly, we're just too busy to even think about like, no, I just

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need to get through today.

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Don't tell me about 30 years from now.

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I just need to survive today.

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But the reality is that tomorrow is coming.

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But what does that mean?

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What does that matter?

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Well, it's relevant because it means if you're not going to be a physician forever and ever,

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amen.

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You're going today to be ready for that eventuality, right?

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For that certainty of the day medicine is not like all of your life.

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And I'm specifically talking about like, just how do you disconnect your identity such that

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it doesn't have to be a painful separation whenever the time comes.

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And I'm not even talking so much about disconnecting your identity as much as how do you grow?

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How do you grow all the other parts of you that actually frankly have withered away and

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almost died because you've been so focused in medicine?

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How do you grow your financial wisdom?

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How do you grow your business acumen?

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How do you grow your ability to learn new things or to have new hobbies?

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How do you do that?

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How do you become a whole person again?

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Because honestly, our training kind of leaves us, I mean, very strong, very strong as physicians,

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very strong, very cool people, but lopsided.

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There are many things that we're not as good at.

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For example, we're not very good at negotiating because negotiating is just not part of our

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training.

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It's just not what we do.

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And so if we're going to learn to negotiate life, negotiate and grow and not just negotiating

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money, but just negotiating in general, it's a skill you haven't developed.

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If you're going to grow as an entrepreneur, it's not a skill.

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Even though many physicians own their own practices, entrepreneurship is not a skill

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you develop as part of your training.

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And so it's how do you, in the midst of your busy, super busy schedule where you barely

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can think about life, how do you create space to be more of who you already are?

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This is not go and try to become someone else.

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How do you create space for expanding all of you?

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And what does that look like for you?

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What does that look like for you?

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So I think this is the point at which I want to pause and I just want to invite you all

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to just speak about what are some of the ways that you take time for you to think about

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you outside of who you are as a physician.

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It took a long time to get here, a long time.

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And so the idea that you're just going to like, you know, switch off like, oh, I finished

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residency today, I got my life back is not really real, right?

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Because you know, there have been some, what is it called, neural networks that have been

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rewired.

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And if you're going to unwire them, it's going to take a long time to do that.

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And so really this is a journey.

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It's a journey.

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So I think it's not so much like, oh, if you haven't started thinking outside of the box

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of being a clinician, something's wrong with you.

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It's not that.

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It's just recognizing that it's taking you a long time to get here.

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You're wrapped up in an identity that sometimes lies to you and tells you this is all there

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is and there's more to you.

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And I think it's an encouragement to say, how do you create space to remember who you

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once were and who you want to be, right?

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Who else you could be and what you need to do, invest today to create the opportunities

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for tomorrow.

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And I think one of the conversations we had earlier before you all came on with Margana

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was that sometimes you're just burned at the end of the day.

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You're just tired.

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You don't want to talk to anybody.

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You don't want to be anywhere.

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You don't want to do any.

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You just want to recover.

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And it's real.

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Like the work we do is hard and you literally have to come back home and recover from your

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work.

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So there isn't even a chance to say, well, what do I want to do today?

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How do I want to refresh?

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You're just like, save me somebody, please.

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I have to do this again tomorrow.

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And so I think that the struggle is real.

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The struggle is real.

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And so I think the whole goal, the whole point of this is not necessarily to offer any solutions

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because I don't necessarily have any.

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It's just to recognize that it's a journey.

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It'll take time.

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And what may be more important than doing anything right now is thinking big, is thinking

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beyond who you are right now, is remembering that there's so much more to your universe

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than just your clinical medicine.

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And even if this is the thing that you are so good at right now that it seems like nothing

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else really is available to you, just to remember that, hey, the universe is huge.

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Your space, your role in it is big.

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And to begin to just think, think outside of the box because it's thinking first that

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allows you to take steps that you may not take otherwise.

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But it's allowing yourself to think.

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Not like when you think, oh, what if I didn't do medicine?

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Sometimes there are alarm bells.

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I don't know about you.

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They go off in my head saying, what do you mean?

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What if you didn't do medicine?

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$100,000 of debt are still remaining.

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Stop thinking that.

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It's just a thought.

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What if I didn't do medicine at all?

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What if I retired and became an accountant?

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What if?

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And I think the thought experiment is just to allow you to expand your mind and think

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about what else could be and to help you start to think about, well, what needs to be different

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today to allow me to be who I want to be tomorrow?

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But again, it's a work in progress.

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It takes time.

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And it's thinking.

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It's also connecting with people who are not where you are, connecting with people outside

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of medicine in different ways.

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It's connecting with people who are not in your specialty because even within medicine,

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we think differently depending on how we practice, is connecting with networks of people who

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are you used to hang out with, maybe not your high school buddies because you're so disconnected

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now, but the people who nourish you, the people who love you, the people who remember you

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before you became the big time doctor that you don't even think that you are.

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Making those connections so that you expand your community.

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But it's also thinking about, well, how do I become independent financially so that I'm

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not always tethered to this role where I feel like unless I'm working clinically, I may

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not even make any income.

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And that may be a longer term thought, but still important to start to think about.

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What might I listen to or what opportunities may I make available just so I can think differently?

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Anyway, so I think these are things to think about.

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I do think, and maybe this is something I can solicit your comments on too, I do think

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we have a different experience as women in medicine compared to men for sure.

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I think that our challenges are somewhat different and our burdens are different too.

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And for that reason where I think, and again, this may just be a broad generalization that

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you can just take and throw in the trash, there may be more space for men to the extent that

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there might not be as much for women, but maybe that's just my thought.

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Anyway, I'll tell you how I think about it now.

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I definitely feel like I work hard.

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And some days I think I'm like, what am I doing here again?

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Why am I here?

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But I realized that I've made an investment in medicine that I intend to cash in on and

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whatever that means.

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I'm not just talking financially.

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I really am not talking financially.

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So I recognize sometimes when I'm working hard, when there are hard days, I think, wait

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a minute, why am I working hard again?

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I'm like, ah, this is my goal.

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Ah, I have a goal.

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Okay.

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I have a short-term goal.

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And this short-term goal, once I get to it, that I don't necessarily have to do all these

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things.

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But I also think about it, how do I thrive now today?

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Well, how do I thrive today so I don't have to wait?

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In seven months when I finish being called junior faculty, then life will be good.

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When you find yourself saying, if, then, if whenever I, then I will, then you know that

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you're kind of like in this cycle, this vicious cycle, because there's never an arrival point

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when you graduate.

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And then you graduate.

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It's like, well, okay, when I start my first job and then you start your first job, it's

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like, okay, no, no, no.

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When I get my first house, so when I get the second, it just keeps going.

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When you find yourself in that cycle of deferring happiness until, deferring peace until, it's

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a sign that maybe you should stop and say, well, how do I make life better for me right

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this moment?

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How do I make it work in spite of all the challenges that are going on?

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How do I make it work?

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So I'll end with an example of a way I feel like, you know, it feels like a hybrid way

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that I'm doing it.

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I don't necessarily recommend this for anybody else, but hey, it worked for me.

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It's working, at least it's working.

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So last week I went and gave a talk at NMA, the National Medical Association.

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It was in New York this year.

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And I was supposed to give a talk on Sunday morning at 7.30 AM.

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And I agreed to this talk months ago.

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So when I finally get this email from family members saying, we're doing this family reunion,

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surprise birthday party Saturday night.

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I'm like, I've already committed to this Sunday talk and I want to honor my commitment.

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So I was like, okay, how about I'm not going for the party?

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And then everyone was RSVPing and my siblings were coming.

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And I mean, there was family coming in from all over.

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I'm like, this is like an opportunity.

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It's an opportunity to get together.

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So I say, I'm going to go to this party and then I'm going to fly out at night to go to

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give my talk.

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And if you fly a lot, you know that you should never like take the last flight of the day

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because you just never know what will happen to that last flight of the day.

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So I skipped the last flight of the day and I took the second to the last flight of the

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day, which was the 9 PM flight.

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So the party goes on for an hour.

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I get the notification that the flight is delayed.

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I spend 30 more minutes with family.

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That's so cool.

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Great time.

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And then I go to the airport, flight is canceled.

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I buy another ticket to go to Philly because I'm like, if I just get to Philly, I can take

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the 5 AM train and I can still make it at 7 30.

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And then we're on the tarmac for two hours and then that flight is canceled too.

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And so now it's Sunday morning.

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I missed most of the party because I was at the airport.

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I'm not where I'm supposed to be to give my talk and I have no idea what to do.

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Anyway, so I record the talk and I send it to them, which they watch and it worked out,

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was well received and all of that.

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Finally found a flight to go to New York the next day, which it was like, what's the point

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of going?

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My talk is over.

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But another thing I had planned during that time was to meet with family in New York so

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that we could, we could actually was another reunion in New York.

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So actually if I didn't make it to the talk, I would have missed that.

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So anyways, I did make it to New York.

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We did do the family reunion and somehow in the middle of like, like at the end of breakfast,

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I was like, Hey, I have this session I'm going to.

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I'll see you all later.

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And I go to the session and then I leave the session and I come back.

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And so how did it work?

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00:20:23,840 --> 00:20:28,520
At least I thought back on it and I was like, wow, you know, like, you know, usually people

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would say just separate work from family and work when you end work and then do family

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when you do family.

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And sometimes it works to just kind of like mix and match.

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Just to say that there is not one way that works well.

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There's just the way that works for you.

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How do you make it work?

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Right?

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How do you make it work?

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And, and sometimes it's being creative and thinking outside the box, you know, like there's

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00:20:52,360 --> 00:20:54,040
this whole idea.

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00:20:54,040 --> 00:20:57,040
My daughter has this idea that families are supposed to sit at the table and have dinner

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every evening at 6pm, which I laugh at.

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Like, where did you get this from?

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Like, what TV show are you watching?

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Like, who does this all the time?

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And maybe you guys do not, not saying anything against that, but just to say that for every

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person is something different that works.

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And it's important to just recognize that your life is unique.

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Nobody has your life.

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Nobody has your challenges.

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Nobody has, you know, your ambitions, your hopes, your dreams, your goals, and whatever

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it is, just embrace who you are and where you are.

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And don't let anybody judge you.

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Don't let anybody tell you there's a way to be, or there's a way to do things.

401
00:21:28,940 --> 00:21:32,360
It's really just, hey, is this where you want to be right now?

402
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Is this what you want to be doing?

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And if that's the fact, if that's it, then just embrace it and go with it.

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Thanks for listening to this episode of the Clinician Researcher Podcast, where academic

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00:21:50,880 --> 00:21:56,280
clinicians learn the skills to build their own research program, whether or not they

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have a mentor.

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00:21:57,680 --> 00:22:03,780
If you found the information in this episode to be helpful, don't keep it all to yourself.

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No one else needs to hear it.

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00:22:05,560 --> 00:22:09,600
So take a minute right now and share it.

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00:22:09,600 --> 00:22:15,080
As you share this episode, you become part of our mission to help launch a new generation

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00:22:15,080 --> 00:22:34,640
of clinician researchers who make transformative discoveries that change the way we do healthcare.