Creating intrinsic value and worth

0:00 Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills to build their own research program, whether or not they have a mentor. As clinicians, we spend a decade or more as trainees learning to take care of patients. When we finally start our careers, we want to build research programs, but then we find that our years of clinical training did not adequately prepare us to lead our research program. Through no fault of our own, we struggle to find mentors, and when we can't, we quit. However, clinicians hold the keys to the greatest research breakthroughs.

0:40 For this reason, the Clinician Researcher podcast exists to give academic clinicians the tools to build their own research program, whether or not they have a mentor. Now introducing your host, Toyosi Onwuemene. Welcome to the Clinician Researcher podcast. I'm your host, Toyosi Onwuemene, and it is such a pleasure to be talking with you again today. Thank you so much for tuning in. Today, I'm talking about recognizing your intrinsic value and your worth. I'm talking about recognizing your intrinsic value and your worth. And the reason that this episode comes to you today is because of an episode or an experience I had recently traveling on an airplane.

1:26 So this week, I'm traveling to my annual meeting, and I end up on the plane next to a medical student. So apparently, so my meeting this year is in Vegas, and Vegas, apparently, I didn't know this, is a conference capital of the world. So many people go there to have conferences. Well, you know, one of the reasons I didn't know this was true is because I've had many conferences since I started in medicine, and none of them have ever been in Vegas. So for whatever reason, Vegas may be the conference capital of the world, but apparently not for the conferences I go to. Anyway, so it happened this year that our conference happens to be in Vegas. And so what I say all that to say that it's not really a surprise that I'm sitting next to someone who's also going to a conference in Vegas, because most of us who were on the plane to Vegas that day were actually going for conferences, which is kind of interesting.

2:17 I shouldn't say most of us. I'm sure some people are going for not conferences, but anyway, going for reasons other than a conference. But anyway, so I'm sitting down next to a medical student who's on her way to her very first medical conference, and she doesn't have her paper she's presenting this year, but she's going to network. She's going to meet people who are going to improve her chances of getting into a residency that's super highly competitive. I'm not going to share the residency because she's going to be listening to this and she'll know that I'm talking about her. So I just want to keep it under wraps as much as possible. But anyway, so this is really important to her to get into this really competitive residency.

2:58 One of the ways she's learned to do it is to go to a conference and network. Great. Nothing wrong with that. But she's like, okay, I want to make sure you know what am I going to say so that they're going to like me? How am I going to make myself memorable? And I'm listening to all of this and I'm thinking, Oh, no. Oh, no, baby. No, baby. No. Because I'm thinking if you are not sure of your self worth, then people are not going to be sure either. And if for whatever reason you doubt yourself. I mean, there's some people who put on a good act, they go out there and they pretend to be everything that they're not. And they are able to fool most people. But most of us are not like that.

3:39 Like what we believe is how we project. You know, when you say I can't and you project that I can't and people are like, Oh, well, I guess you can't because that's what you're projecting. So anyway, so I remember listening to her and thinking, Oh, my goodness. I wow. It sounds like you are struggling with your intrinsic self worth and your value. And I want to pause and say that, you know what? I was a medical student 20 years ago. Now I think I started medical school in 2003. And so I recognize that, you know, the feeling of you are so much, you are so much before you went into this thing where you wanted to go to med school. But as soon as you declared that you wanted to be a med student, then all of a sudden you were kind of like in this huge group of pre meds. And there was this sense that you were being weeded out, you know, as you went from one group to the other.

4:24 And then if you went if you were actually at the process where you were, if you actually got to the process where you're actually applying to med school, then it's like, please let me in. I'll just go wherever you accept me, please let me in. And then you finish med school, and then it's time to match for residency. And it's a match. It's like, well, this is a lottery. We might take you and we might not. You might end up in Vegas or you might end up in Houston. We don't know. Right. So the whole process is honestly not necessarily created to build up our self esteem. Or at least not for all of us. Some people kind of have their self esteem untouched throughout the process. But for many of us, it's a demoralizing process because you feel like you're begging every step of the way, please accept me.

5:08 I'll pay my own way. Yes, I'll pay for my own air view. Oh, no, I'll feed myself. I'll do everything. Just take me. Right. That's that's how we grow up in medicine for many of us anyway. I can't speak to everybody's experience. But as a result of that, sometimes there's a coloring of our intrinsic self worth, where we doubt what that intrinsic self worth is. And that is a challenge. And so what I want to share with you are five ways that you can think about building up your self worth. OK, five ways you can think about building up your self worth. And why is it important? It is important because you can't give what you don't have.

5:51 And if you do not think of yourself as valuable, you cannot create value for other people. It's just the bottom line. Yeah, in medical school and academic medicine, we fake it a lot. And for many of us, we're faking it until we're making it. And to be honest, faking it can get you can get you a good bit of the way, but it doesn't take you far. It doesn't let you soar in the mountains. It doesn't let you soar like an eagle. It doesn't really help you thrive. You make it, but you don't thrive faking it. And so what's most important is that you recognize the value that you bring, your intrinsic worth and value so that you can give it as a gift to other people.

6:33 Because until you recognize the gift that you have, the gift that you are, the gift that you carry, you cannot give it to somebody else. And so recognizing your intrinsic value and self worth is so important. Five things. The first is to get away from people who tear down your intrinsic value and your self worth. Yes, this may be the hardest and yet the most important step on your journey to clarifying your intrinsic value and self worth. This may be the single most important thing is to leave the people who tear you down. This is really hard because here's the thing in medicine, we're surrounded by so much subjective feedback that may not actually enhance us as much as it tears us down.

7:22 And the reason it tears us down is because people who are broken and wounded tend to try to break and wound other people as well. They're not even doing it intentionally. It's just all they have is brokenness. So that's all they can give. If all they have is brokenness, then they're just shards of glass waiting to hurt the next person. And so people who are wounded and broken actually tend to wound and break other people too. And so the moment you recognize that you're in a situation where you feel like you're being torn down, where you feel like you're being made to feel less than, it is time to leave that environment. If you're like, wait a minute, I'm on the rotation for another six weeks. What are you talking about? Yeah, that's a really great point. The question is, how do you fortify yourself against this negativity or how do you address it head on?

8:07 How do you say, hey, I get that you yell, but when you yell, I feel X, Y, Z. What I'm saying is it's true that you may not necessarily feel like you have agency and the people who surround you, especially if you're early on in your training, but you should get help. Don't accept it as your default. Don't say it's just six more weeks. I can take this bruising. I can take the battering for it. Don't do it. Just don't do it. Don't take it for six weeks. What can you do about it? And sometimes it takes you being bold and courageous and saying, hey, is it okay if I switch teams? I know people don't usually switch teams until after six weeks, but to some extent I'm feeling a little bit overwhelmed in this particular team and it's not them.

8:51 It probably just is my personality. And I wonder if there's another team that I could be matched with. But what I'm saying, I'm not telling you what to say or what to do. What I'm saying is that if you are in a negative situation, a situation that tears you down, please take steps to get out of it. Don't say I'm just a med student. I have to do this for six weeks. I want you to take the steps to fix it. And I go, no, they're going to fire me from this med school. They probably won't take steps because the more you're being torn down, the more you're being torn down. And the more you're being torn down, the harder it is to recover. And I know that there are a lot of places in medicine where people tear people down.

9:33 It should not be the norm. And I don't want you to accept it. Just because abuse is rampant in the world doesn't mean it has to be your reality. And if you're in an abusive situation and you're looking around and you're saying, well, everybody else is getting abused, I'm saying, I don't know what's happening with everybody else, but don't accept it for yourself. So if the first step, and it's the most important, the hardest step is to get out of environments where you're being torn down. And this is probably a step where you're not going to take, you may not want to take it alone, especially if you feel like you're powerless in the system. I want to pause and say you were never powerless, but sometimes we feel that way. And if you feel that way, it is appropriate to get help.

10:13 This is where a coach could be helpful. For some of you, maybe it's a therapist that's helpful for you to process your thoughts and think, how do I want to do? How do I want to do this? How do I want to handle this? One of the reasons I recommend a coach, clearly I'm biased because I am one, but one of the reasons I recommend a coach is because it's not so much about dwelling in the past of what happened or what could have been done differently. It's really about what do I want to do right now? How do I want to move forward? And to really help you think through what strategies you can use to advance beyond the situation that you're in right now. So anyway, I spent a lot of time on that, but it's so important to say the first step is to get away from where they're tearing you down because no matter what you do, if poison is being poured into you, it's going to continue to hurt you.

10:58 So you want to get away from this negative environment. Okay. The second thing you want to do is along those lines, you want to start to create new environments intentionally that are nurturing environments that build you up. How do you do that? Okay. There are people you talk to and when you leave their presence, you feel better than when you started. You feel uplifted, you feel encouraged. Those are the people you want to hang around. You want to begin to cultivate a network of people who encourage you to be who you are, who encourage you in a good way. Now this is not to say like only be around the people who make you feel good.

11:38 To some extent it's yes and it's no. It's that you know what, in medicine there are going to be so many things that are going to make you feel bad. So many things are going to tear you down or we're going to try to tear you down. Yes, why not build up a cadre and fortify yourself with people who are going to lift you up because there's so much negativity in the system. Why not be ready to combat that negativity with a team that supports you with encouragement and positivity? Why not? Why not? Because you're going to have to work with people that you have no power over like the assignments. Like you just get stuck with this resident, there you are. You're stuck with this attending, there you are. So why not, if you can cultivate environments where you are nurtured and supported, why wouldn't you do that?

12:22 Why would you leave your experience to the default? Why would you? And so what I'm encouraging you to do is to begin to pay attention to how people make you feel and begin to grow your networks of people who treat you with respect and honor. I just want to pause there. People who treat you with respect and honor. You know, medicine is a very hierarchical space and people really feel like, hey, I'm your attending. I've earned this 20 years worth of respect. And you know what? People are people and everybody wants to be respected and some people for their seniority. But no matter how senior you are, everybody around you deserves respect. The youngest person on the team, the med student who just came off of basic sciences yesterday deserves respect.

13:07 There is nobody on the team, regardless of their race, gender, color, creed, that does not deserve respect. And so everybody on any team is deserving of respect and you are too. And so that's so important for you to pay attention. Where are these spaces in which I am treated respectfully, even if I don't have the expertise of the other people on the team? Where is it that I'm treated respectfully, even if I look like another or an other compared to the other people on my team? Where am I treated with respect? Pay attention to those spaces and grow those spaces, grow those networks, intentionally cultivate them, meet with them regularly.

13:47 You know that this is a group that respects you. You make sure you're meeting with them on a weekly basis. If you can make it happen, meet with them on a daily basis. For some of you, these networks where you're respected and held in high honor and in high esteem are outside of medicine, it doesn't matter. Wherever it is that you are treated with respect, those are the spaces that I want you to grow and expand. Okay, that is number two. Number three is that you treat others with respect as well. Oh my goodness, I shouldn't have to say this, but I'm going to pause and say it because many times we hate the way that we're being treated by people ahead of us.

14:28 Now we turn around and treat other people behind us the same way. Like we treat other people poorly and maybe we treat the people ahead of us so much better. We give them respect because they're like, oh, they're the senior attending. And then we turn around and we treat med students poorly and that is not okay. You can be like, well, they treated me that way and look at me, I turned out okay. Please stop lying to yourself. Clearly you're sick and you're hurting. Don't deal out. You need to shout sickness and hurting to other people as well. Treat others around you with respect. So, so critical, so important. You want to be treated with respect and honor and you really need to sow what you want to reap.

15:08 And so if you want to reap respect and honor in your environments, that's what you gift to other people. You go out of your way to gift it to people who don't usually expect to receive it. For example, the janitorial staff that's cleaning in the room that you're just walking into to see a patient, treat them with courtesy. Say good afternoon. Hey, how are you doing? It doesn't take three seconds to do that, but it acknowledges them and it shows that you're respectful of them. The reason it's important to do this is because you are saying to yourself that you are a person who gives out respect and dignity to people and that prepares you. It to some extent privileges you or gives you the right to also receive respect and honor in return.

15:56 But if you are going to be someone who's going to walk and work in environments where people are treated respectfully, you're going to start to sow those seeds by treating other people respectfully yourself. All right, that's number three. Number four is to pay attention to when seeds of disrespect are being sowed towards others. Okay, so number three, we talked about you treating others with respect. But number four is now you, is you paying attention to your environment, not tolerating disrespect when it shows up, right? What does that look like? You're on rounds and the attending says something really dirty or disrespectful, you see as disrespectful to the medical students.

16:40 Don't just join the group and start laughing or maybe the group is laughing and you're like, oh, that's not funny, but say something. Now, it doesn't have to be you turning around to the attending and saying, you big bad attending, how dare you? You know, usually in medicine, we don't get to do that, not so easily. But what we could do absolutely is to say, hey, what if we did things this way? What if we did things differently? So there's an opportunity for us to be able to share with other people a better way to do it, right? Elevate the quality of your environment. Don't accept environments that tear people down. Elevate the quality of your environment. Okay, so that's number four.

17:21 Number five is to intentionally go towards environments that are generally healthy. So you know how it is where we're trying to get into med schools or we're trying to get into residency programs where we're like, I don't care how they treat people here. I just want to get into this amazing med school. I just want to get into this amazing residency program. And you're not paying attention to the fact that people are being treated miserably. I want you to pay attention to that. And I want you to choose environments where people are respected. That kind of harkens back to some of the earlier things that we talked about. But it's super important for you to intentionally work towards healthy environments so that you can build a culture of health yourself.

18:03 And the more you find yourself in healthy environments, the more you create healthy environments, the more you encourage healthy environments for other people, the better you do as well, the more you thrive. So that was a short one. But I just want to encourage you not to tolerate environments that are negative, not to create them, not to tolerate them, and to build for yourself environments that encourage and nurture and support you. Because that is the way we change culture. That is the way we change the environment of academic medicine. All right. That's all I have for today. I want to thank you so much for listening. You got to share this episode with somebody else who needs to hear it. And please let me know how this episode resonates with you.

18:45 Send me a message, a DM on LinkedIn. I would love to hear from you. Thank you for listening. I look forward to seeing you again on the next episode of the Clinician Researcher Podcast. Thanks for listening to this episode of the Clinician Researcher Podcast, where academic clinicians learn the skills to build their own research program, whether or not they have a mentor. If you found the information in this episode to be helpful, don't keep it all to yourself. Someone else needs to hear it. So take a minute right now and share it.

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