How to say, "yes."

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 so excited to be talking with you today because today I am talking about yes. I know I talked about yes yesterday, and the day before I talk about no, and the day before not it was no, but I do want to kind of come back full circle and talk about why.

1:24 Actually, I talked about why you should say yes yesterday. So today I'm talking about how to say yes. And I'm reminded, earlier today I was at a panel discussion, and this was at a panel discussion for our faculty members who are relatively new at my institution, and they're doing this program. It's a career development program. It's called Faculty Development Academy, and it really is about developing yourself as a faculty member. And so I went through the program a couple of years ago, so I sat on the panel, and people ask questions, you answer, you've been through the program before, so it looks like you're the expert. But it was fun on the panel.

2:07 And so after the panel, I had an opportunity to speak with someone who was in the audience. And one of the things she shared was so profound to me. I had to come share it with you. She said, pursue your dream. Who tells you that in medicine? Really? Like in academic medicine, like, oh, you should chase your dreams. But she really did mean it, and I totally resonated in that moment, because what she was alluding to is the fact that many times people tell you this is what you should do. This is what is going to be funded. This is what's popular right now. Don't do that other thing that just seems like not a great idea. Do this thing.

2:48 People have good intentions, and yes, the thing we love, the thing that no one has yet blazed a trail in, if we should choose to go down that path, it will be hard, and it will be challenging, and it will be so exhilarating all at the same time. And what people are missing in the advice they're giving you is the exhilaration that comes from pursuing something that is so meaningful to you, even when it's hard. And I will tell you that even when you choose the easy path, there will still be hardness. It will still be challenging. And which would you choose? The easy path that's not so easy, or the hard path that's easier because you love it.

3:33 And that's why we're talking about yesterday. That's why we're talking about yesterday. And I know yesterday I talked about yes and why you should say yes. Today I'm talking about how you should say yes. And yes is such a powerful word. It's so powerful. And I need to remind you in case you didn't listen to the episodes yesterday or the day before, the day before that, I'm talking about no and yes. And they are two sides of the same coin. And every day you say yes, you say no. And every day you say no, you say yes. Because ultimately, you're a finite being. And at some point, the day ends and you have to start the next day over. And so the reality is that when you say yes to an appointment at 4 p.m., you're saying no to something else you could be doing at 4 p.m.

4:18 It's opportunity cost. And so even though we're talking about yesterday, we really are talking about no because you can't talk about yes without no. But today I'm really focused on yes. The no is in the background now. Yes is what's in the four. And I want to talk to you about five ways to say yes. Five ways to say yes. And the first thing I want to say is you should say yes only when you mean it. Say yes only when you mean it. And here's the challenge. Well, it almost goes without saying. Why would you say yes if you don't mean it? But the thing is, if you're an academic physician, if you are a clinician, scientist, or wannabe, whatever your career, whatever you're doing as a physician, the foundation of you is to say yes even when you don't mean it.

5:18 And part of that is the kind of people we are as physicians, right? The kind of person you are as a physician. But a lot of it, too, is our training. Like, what do you mean you're not going to say yes? You're here to say yes. What do you mean I don't feel like taking a call today? You're on the schedule. What do you mean I don't feel like calling? What do you mean? What do you mean I don't feel like working? What? And one of the challenges, actually, there's actually a term for it. Physicians usually have the problem of presenteeism. I think that's the way you say it. It's like, I'm going to be here no matter what. I may be choking. I may be really sick.

5:59 But I'm coming in to work because this is what I do. And so what I'm saying is that as a physician, you tend to say yes when you don't mean it because you feel obligated. You're like, I got to do this thing. Therefore, I'm going to do it. What if? What if? This is just a thought experiment. What if you only said yes when you actually mean yes? What would that look like? And so sometimes what that looks like is not saying anything. And asking yourself, is this a real yes? The yes I'm about to say, is it a real yes I want to do this?

6:42 Or is it a people pleasing I don't want you to be mad at me? Yes. Because those two are pretty different. And at the end of the day, you might end up at the same decision. You might. You might ultimately say yes to something you thought you might say no to initially. Or what you want to do is make sure the yes comes from inside. So don't say yes until you mean yes. And if you don't mean yes, don't say yes. Don't say yes. Say yes only when you mean it. And it's so important because as physicians who are also leading research programs, gosh, we've got a lot on the plate.

7:22 We've got a lot on our schedule. We're overburdened. There's too much for us to do relative to the time in the day. And that's why we say yes only when we mean it. Because in reality, there's going to be a lot of nos going on in our minds. Things are falling where we're not saying yes to them. But we say yes only when we mean it. Because we want to be consistent. Inside as we are outside. We are aligned inside as we are outside. It allows us to live in harmony with ourselves. So I am inviting you this week to say yes only when you mean it.

8:06 And if for whatever reason you struggle. If like me, you have this thing called a people pleasing challenge where you say yes because you don't want to say no. You don't want to disappoint them. Yep, they totally get it. Absolutely. Absolutely. Saying yes is the easier way to go in the moment. In the long term. It hurts you and it hurts them as well. So if you're a people pleasing person and you need to get together with me and we can talk through how you can improve and saying yes when you mean it.

8:50 And you want to work with a coach, please come find me. I would love to help you think about how to say yes to the things that you only want to say yes to. How to pursue the dream of your career by saying yes only when you mean it. Now I hear some people saying, well, but this is my obligation. I'm on the schedule. Okay, what if I feel like saying no, I don't want to show up. So when I say say yes only when you mean it, there are times when we have to get to a place in our lives where we say this is my obligation and I'm going to say yes to it. And so saying yes is not necessarily about satisfying a feeling.

9:33 It's about aligning with your deeper values and convictions because the truth is sometimes you do have an obligation and then you say, I'm actually negotiating out of this obligation. And so what we have challenges with as physicians is that the moment we've said yes, we think it's unsayable. We think we can't say no. Sometimes we do need to say no because we're kind of acting out a no even though we've said a yes. And so yeah, even if it's an obligation, is it what you want to do? And if it's not, how can you negotiate out of it? Discipline experiment, don't get too excited.

10:15 And if you don't want to do it, why do you do it? And if you do it and really say yes, say yes only when you mean it. Number two is to say yes with conviction. Say yes, right? Say yes, say yeah, of course. Say yes with conviction. And if you cannot say yes with conviction, number three is to say why? Why is your yes a weak yes? What does that say about how you're feeling inside?

10:58 So I want to invite you to say yes with conviction. And if you cannot, if you cannot say yes, ask yourself why you are having a hard time saying yes with conviction. Because the only kind of yes that makes sense is a yes with conviction. You know why? Because a yes with conviction says, I've actually really thought about this. You know, many of the yeses we say are yeses of thoughtlessness. I didn't even think about what my schedule is tomorrow. I just said yes so she could stop asking me, right? It's not a conviction yes. A conviction yes is I thought about it. I thought about the challenges.

11:38 I thought about the benefits. And I still say yes. Mmm, that's such a powerful yes. But it's an informed yes. It's an informed yes. So when you say yes, you're not like, uh, yes. You're like, oh no, yes. I choose. I say yes. I'm not trying to make you happy. I've made my decision yes. Say yes with conviction. Do the work it takes to be able to say yes with conviction. And if for whatever reason you are in a place where you cannot say yes with conviction, ask why. Do the work. Do the work. And honestly, for many of us in medicine, we do not do the work of asking, why is this a weak yes for me?

12:24 This person is the most amazing. Why is it a weak yes? And if we would do the work, we would uncover some deep dark secrets that we need to bring out and know for ourselves so that we can make different decisions. And as physicians, we struggle to do that because our training, part of it is that our training prevents us from being in touch with the real us, the real what we want to do. And so if for whatever reason you can't say yes with conviction, it is a sign. And you should sit with it and say, why? Why am I struggling to say yes with conviction? Okay.

13:05 Number four is again, say yes with conviction. I don't know. It's in my notes. I wrote it twice. I must really, really feel strongly about it. Okay. So number four, what else can I say about saying yes with conviction? In life, there are very, very, very few things you can do well at one time. I know that we kind of are in a multitasking society and so we're always multitasking. And what we really do know is that it's very hard to multitask well. And there's some tasks that perhaps you can multitask at, perhaps because they involve different parts of the brain, but it's very difficult to do two things at the same time to do it well.

13:47 And one of the things that's important is that when we are able to say yes with conviction, it allows us to focus our energy because we've said no to other things. And so when I say, say yes with conviction, I want you to think about the few things you can really give yourself to well and all the other things that can fall away. What is that? Because what's happening when we don't say yes with conviction, there are so many things in our list and things are slipping off. It's like a desk that's so full of clutter and it's just you can't even tell when things are falling off.

14:28 They're just falling off all around you. Saying yes with conviction allows you to say, these are the things I've said yes to. I now say no to all the other things. Anything that comes to try to distract me from these things that I've said yes to, I'm not going to let that happen. And so in a sense, it's aligning with your yes. You said yes with conviction as in you agreed and then aligning your life with the conviction you have made. If you say, I'm a clinician scientist, then you align your life with what it means to be a clinician scientist. And it means you can't behave like someone who's not a clinician scientist because it means you have different priorities.

15:09 And so if you say yes to your life as a clinician scientist, as a researcher, then what you're doing is saying no to a lot of other things. So are you saying yes with a conviction? Are you actually living the life that you profess to want? Are you spending time thinking about your future and how your research is moving forward? Are you spending time thinking about your writing and how you are communicating your science? Are you spending time thinking about your grant strategy and what grants you're submitting and when? Say yes to the path you've chosen. And if you struggle to live the life that's consistent with the path you've chosen, think about why that is.

16:01 Okay. Number five is to say yes to the right thing. What is the right thing? Is it right? Is it wrong? What is the right thing? The right thing is to say yes to the truth that's buried sweetly deep inside you. It is so, so, so, so deep. And why do I know that the truth is deep inside you? Because the phenotype of a physician, I'll tell you the story that helps me understand the phenotype of a physician in the way that I'm talking about it. You know when you were in medical school and you went through all these rotations and one day you did your Peds rotation and you were such a great and friendly person, like you know playing with all the kids.

16:49 You were so awesome. And then you crossed over one day into the next day. You became a surgeon and all of a sudden you were like gruff and you only stay in the room for two seconds. Yelling people on the phone. And then you're done with that and you move to psychiatry and you are calm and very, very cool and collected and seeing all the right things. Oh my goodness. That is our training. Our training is to immediately acclimatize. Is that the right word? Is to immediately take on your environment, the culture of your environment and just make it work.

17:34 Yeah, you don't even really like children, but as long as you're on pediatrics you're going to love them. And you're like, yes, I love children. And we're physicians. We're great at that. And one of the ways you understand that you are struggling, still struggling because you need to break out of that. Like what do you actually really like? And if you're like, I like many things, that's the sign. Oh yeah, you can like many things. I'm not saying you can't like many things. But what is the thing that makes you tick? What is the thing that rocks your world? Yes, in the work you do. What is it? What is that one thing that you do where time melts away, where every worry and every concern is gone because you're just in the zone.

18:22 Oh, there's a term for that. Now I don't remember what that is. What is that peak moment for you? Oh, it's flow. That's the term. It's called flow. What is that thing in your work that when you're in it, you really are in a state of flow? What is it? And if you can't answer that question, it's okay. But there is something, it's inside you. And to say yes to the right thing is to say yes to that voice that's calling out inside you for more. It's calling inside you, calling out inside you for something greater than what you're doing right now. And many times we're so disconnected from what we love because we've been practicing for 10 years maybe.

19:07 If you did a fellowship or if you did surgery, you've been practicing for a long time how to be whatever they need you to be right now. What does this patient need me to be? Great. What does the nurse need me to be right now? Do it. What does my attending need me to be right now? I will do it. You've gotten so good at that. And so what you're going to need to practice, and if you need a coach to help you practice, I'm happy to come help you practice, but what you need to do is to practice connecting, connecting back to the spark that's inside you that is yearning to come out and do something great and make a contribution that is so awesome. And I want to invite you not to accept anything short.

19:50 Don't accept anything less than who you are. Don't accept anything less than passion in your career and satisfaction. Do not accept anything less. Yes, you look around and so many people are burned out and they're complaining and they're whining. It doesn't have to be your default. Yeah, it's the default culture. It doesn't have to be yours. What do you want? What is this career thing going to do for you? It is here to serve you. Your career is here to serve you. It's not you serving the career. It's the career serving you. And if you aren't in a place in your career where you don't feel like your career is serving you, then you should come to that place.

20:36 And I invite you to think about how do you get there? How do you get to the place where you feel like, you know what, this career serves me rather than me being a slave to this career? And part of it is in the truth of the thing that just makes you tick, the thing that keeps you in flow. And there is that. It's buried. It's deep. It's there. It's not another institution actually. And I think for many of us, we're like on the verge of leaving. We're like, no, I can't do this anymore. The answer is not elsewhere. The answer is inside. Sometimes you need help to pull it out. You don't have to have help to pull it out. You can do that. You can figure it out.

21:17 I invite you. I invite you to do that. And I invite you if you want to have a conversation about what could it look like to build a career that you love as a clinician scientist and have joy instead of burdensome suffering or pain or whatever it is that comes with a career that everybody's like, this is just the way it is. What would it take for you to create something different, something you actually want to create? Yes, I invite you to think about that this week. All right. I will tell you I'm done talking about yes and no. But today I said yes. Say it only when you mean it. Number two, say yes with conviction.

21:58 Number three, if you can't say yes, ask yourself why. Number four, say yes with conviction. Oh, I said it twice. And then number five, say yes to the right thing. It has been a pleasure talking with you today. Please share this podcast episode with someone else because they need to hear it. All right. I'll talk to you again the next time. 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.

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