Reimagining your career for health and happiness

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 an absolute pleasure to be talking with you today. Thank you so much for tuning in. And for those of you who are catching this a long time after it's been recorded, I just want to say that I'm so excited that you are coming to this episode because I think it's going to help you, and I'm hoping it's going to save lives.

1:22 And I really do mean that. I'm hoping that this is an episode that's going to save your life. And if it's not going to save your life, it's going to save somebody else's life. And I want to ask you to think about who that person is and forward it to them. Okay, so I hope I have you intrigued. This episode is going to save lives. And that's not because people are donating to charity as a result of this episode airing, but really, I think it's an important episode so that more of us could be healthy. And the reason, the prompting for this episode, so this is the week of my animal meeting. It's actually a weekend and a few days into the week. And it's just brought a lot of introspection. And today's particular episode comes from a conversation I had with a beautiful colleague who, wow, I've known her for a few years.

2:08 And I met her at today's animal meeting and asked how she was doing. And she had a major life crisis. She had a major life crisis that caused her to pause and rethink her career. And I remember she was sharing her crisis. I mean, it was a big deal. And I can't share any more detail than that because it is personal. But I remember stopping and thinking, oh, my goodness, I had a similar crisis. And I've had a similar crisis, which I can share about, but maybe I'll share about in a different episode. Because this is really about my colleague's story, even though I'm not sharing the details. But it was an important pause because I asked, how is life different now? Because you've had this major change in your life.

2:50 How are things different today? And she talked about the importance of fierce boundaries that she's now established. She's like, you know, I had a total reframe of my perspective. I understand what's now important to me in my life. And now I have fierce boundaries. I don't want to do any of these things that make me crazy. My life was crazy. I mean, it was just a really great conversation because then I got to share about my experience and how I've trying to change the way I live in the academy because of the experience I have had. And I asked her, I'm like, did we have a midlife crisis? So we're both considered mid-career. I'm like, does this count as a mid-career crisis?

3:31 And I don't know. I don't know. And one of the things she said, which was so important, and the reason I'm bringing you this episode today is she said, I wish I didn't wait until there was a crisis. I wish I had made the decision for myself before I had to make the decision. And so that's what brings me to this episode is to talk to you about how to save yourself before the crash. Because here's the thing about the crash that's coming. It's going to come in one way or the other. And maybe for some of you listening to me right now, you've had many crashes. And what hasn't happened is the big crash, the crash to end all crashes.

4:12 But the crash will come because for many of us in medicine, the way we live life is not sustainable. And for some weird reason, we've been able to sustain it for a long time. For some of us, we've sustained it for years. For some of us, it's been decades. But if a bus is hurtling off a cliff without brakes, it's only a matter of time before something bad happens. You know, the crash is inevitable. And so this episode is an attempt to say, hey, can we pause and reflect and think about how we could do things differently so that we don't get a crash? So I'm saying the crash doesn't have to be inevitable.

4:54 And how can we pause? You know, I want to take a moment here and I want to recognize everyone we've lost in 2023, everyone we've lost in medicine. And you know, in talking with this colleague, I talked about faculty members, women faculty members who have been lost to me at my institution. And she talked about men at her institution who had been lost in violent ways. And so in all honesty, it kind of makes me a little bit sad as I share this episode with you. So I want to pause and actually just take a moment of silence.

5:34 And I want to recognize that so much is lost when physicians lose their lives for whatever reason, whether it's, you know, taken in a place of despair, or it's taken by illness that overwhelms us before we're ready. Yeah. Okay. I want to come back to a positive note because I'm feeling sad now. But this is about how to save yourself before the crash. I think it's really important because, wow, we're so busy. We're so busy. We don't have time to think about our health. We don't have time to think about our emotional health, our mental health, our physical health until we're forced to.

6:14 And so the first thing I want to share in line with how to save yourself before a crash is to pause. Number one is to pause. And the reason we need to pause is because until we pause, we may not have time to think critically. We're so busy in medicine. We're moving from one deadline to the next deadline. We're moving from one thing of patient care to the next thing of patient care. There's always something. We're super busy. We're holy, holy cow. We're always busy, right? We're holy busy all the time. And until we pause, we may not have time to reflect and think.

6:58 And so the first thing to do is to stop. Pause. And what does it mean to pause? It really does mean taking time in your schedule, taking time. Take a day, take two days and just pause. It's not the same as going on vacation. You know where you pack everybody and the dog, put them in a car, then travel across country and you're like, you're pausing, you're not pausing. You're still in full speed. Like you're still full steam ahead. You're not pausing. But to pause really does mean to take time out to rest and reflect. And so I'm inviting you as a first step to pause.

7:40 The second thing I'm inviting you to do is to spend some time in deep, honest introspection. And so the pause is to allow you to create space for some deep, honest introspection. And why is this necessary? Because in medicine, gosh, there's so much sickness. There's so many people who are not healthy. Oh yes, they're successful. Oh goodness, they have all the things to show. They've got the manuscripts, they've got the grants, they've been funded, they've got the named professorships, they've got everything, or at least it seems as if they do.

8:22 They are not well. They are sick. And it's a pervasive thing in medicine. Burnout is pervasive. People who are not mentally and emotionally well, it's pervasive. And there's some stigma associated with any mental ill health. But it's very common. And people are medicating. There's a lot. And so looking around, we are surrounded by people who are just moving, going, going, going without pausing for deep introspection. So if you're going to pause, you're going to spend time in deep introspection. You're doing something that is countercultural in medicine.

9:05 There is a sense that, oh, you keep working. And then when you're retired, sure, if you want to retire, you can spend all this time introspecting. But I am asking you to do that now, before you have to, or before maybe you don't even have time to. But to really spend time in deep, honest introspection and reflection. And I'm going to say honestly, this is something that may not easily happen for you, just with the way your life is structured right now. And it may be that you need help. You need someone to come alongside you in this deep, honest introspection. Now, if you have any mental health concerns, you do need a licensed mental health professional to talk with.

9:48 Maybe you need to talk with a therapist. If you're not concerned about mental health issues and maybe you feel like, no, no, I'm not, I feel like I'm okay. I can do this. Maybe working with a coach makes sense for you to do this deep, honest reflection and introspection. I'd be happy to be the coach that helps you do that. But spend time in deep, honest introspection. This is important. You got to do it away from the people who are not doing this. And maybe you've got to do this away from your mentors who sometimes are not healthy themselves. They're very successful. Don't get me wrong. They're doing everything. I mean, they are just amazing. And some of them are not healthy.

10:29 And so spend time in deep, honest introspection. And what do you do? What do you do in this time of deep, honest introspection? Well, it's number three. It's asking yourself, is this the life I want from me? Is this the life I want from me? The challenge in medicine is that there's so much that we see that is normal. You know, physicians working overtime, you know, working nights, working weekends, working all the time. And it can feel like that's normal. And so when you look around you and you feel like, OK, well, all this is normal.

11:13 I must just have to do it too. And I'm just, again, asking you to pause and ask yourself, is this the life you want for you? And sometimes that's a hard question to answer, actually, because it's like, well, what other life is there in medicine? Is there any life that's not crazy busy all the time where I feel like I'm about to pull my hair out? It's so busy. Is there any other life? I want to say the answer is yes. But only if you pause long enough to ask yourself the life you're living right now. Is that the one you want for yourself? And I hear people saying, well, it's just this first grant. If I can just get this first grant out the door or no, no, no, no, no, no, it's just this manuscript.

11:56 This is the manuscript of my career. If I can just get this manuscript out the door, why hear somebody else say, no, no, no, this is the promotion. This is the one promotion that's going to make all the difference. Oh, and I've heard that. I hear that all the time. And none of it is true. There's not one grant. There's not one manuscript. There's not one promotion. It doesn't end. It keeps going. And sometimes, you know, people, I lull myself into the lie of, well, you know, I'm just busy right now in this season. As soon as this grant is over, life goes back to normal. But you know, it's not true. There is no back to normal. There's only this crazy pace that you've been keeping up for a while and so many people around you are also doing as well.

12:44 And so ask yourself the question, is this a life I want for myself? And if you're struggling, if you're like, I don't know, I don't know any other life. I don't, I don't know. It's helping me. I'm, you know, becoming well known. People are calling me. I'm giving talks all over the country. I don't know if I can have any other life. Then maybe the question you want to answer is, is this the life you want for your loved one? So maybe if you have children, like, is this the life you want for them? Or maybe if you have a great friend, like, is this the life you'd want for them? Right? Ask the question, is this the life you want for yourself?

13:24 And if you're struggling to answer that question, ask, is this the life I want for someone that I love and care about? The reason you want to ask that question is because if there is anything short of yes, absolutely, then something's got to change. If there is any pause, any hesitation, any sense that the life you're living now is not the one you want for yourself, it's time to pause. I mean, you're kind of already pausing because you're spending time in deep, honest introspection. Now, if you are answering the question, is this the life I want for myself? And you say no. Or you say, well, yeah, but if there is anything short of an enthusiastic, absolutely, yes, this is the life of my dreams, then it's time to ask for something different.

14:16 It's time to make different decisions. Because wherever you are in your life right now, you're there because you chose. That's a choice you've made, or it's the result of multiple choices you've made. And granted, there are a lot of bad examples around you. And so if you've made this choice, it's because it's what you see and you have accepted as the default. But if for whatever reason, though, it's not the life you want for yourself, and I think this is going to be most of us the answer, it's like, I like some of it, but I don't like all of it. Then ask yourself, and this is number four, what pieces of the life I have now do I want to keep?

14:58 Well, part of what I have do I like? Because you know what? I was talking about this with a colleague earlier. Medicine is fun. We enjoy what we do. We love to care for our patients. We love to care for other people. We love our scholarship. We love the opportunity to create new knowledge. We love what we do. We absolutely do. And that's great. And I want you to think about all the things that you love and you want to keep about your work, the intellectual stimulation, the opportunity to interact with colleagues who are brilliant, the opportunity to do scholarly work for a living.

15:38 I mean, all those things are so awesome. And then number five is to ask yourself, well, what pieces can I do without? What pieces do I just not want? Every third night call maybe. You're like, well, I could do that easily when I was 27, but I don't know that I can do it so well at the age of 54. And it's OK to just have that thought because your mind is going to want to say, well, who's going to do it? Well, if I don't do it, no one else is going to do it. No, I can't even think like that. I know. Your mind is going to start to play games and play tricks on you and it's going to want you to not think that way. But just consider this a thought experiment.

16:21 You're not making any commitments. You're not making any decisions. You are just thinking. And so you're going to say, what pieces do I not want to keep? Maybe it is the overnight call. Maybe it's the trauma call that you take every third night. Maybe it's the baby delivery. If you're an OB-GYN, you're like, you know what? I was able to do this for a long time and I was able to do it OK, but I'm 67 and I don't want to do this OB call anymore. Just think about it. What pieces can you do without? One of the parts you love, that was number four. And what pieces can you do without? And it really is a place of being honest. And I have to tell you that this is hard.

17:03 It's hard for us as physicians because we have the sense of duty, the sense of responsibility. And even if it's not just us, we're like, well, if I don't do it, then all my colleagues are going to have to be saddled with it. And I don't want to put them in that position. And you keep going on and on. And then it's hard for you to be honest with yourself because the conflict is so real. It's so great. You're like, I can't even think like that. It seems like treason. It seems like the wrong thing to think. I'm just asking you to think. I'm not asking you to make any commitments. And so if you're feeling panicked right now, I just want you to pause. I just want you to pause and say, hey, mind, it's OK. This is just a thought experiment.

17:43 It's going to be OK. And just talk yourself down out of that really high heart rate that's kind of evolving right now because you're thinking about the pieces of medicine that you don't like, that you can do without. The next thing I want to invite you to do is go to the future. So I want you to close your eyes right now. And then I want you to transport yourself 30 to 40 years into the future. And if you're a little bit older and you're like, I don't know about 30 or 40 years, OK, just go 20. Just go 25. Go into the future and find your future self and check in with your future self.

18:27 Hey, future self, what regrets do you have? What do you wish that you had done differently? And spend some time with your future self and ask that question. Hey, future self, what regrets do you have? And really listen because your future self has something to tell you. There's a whole guided meditation that you do to get to your future self that really is kind of outside of the scope of the podcast. And I would love to do it with you. Shoot me a DM, we'll get together so we can do it as you think about whether coaching is right for you.

19:07 But do go to your future self and ask, what regrets do you have? And listen, listen to what your future self tells you. Because I have to tell you that there are some of the things that are so high on your priority list right now. Some of the things you're doing right now that are working you into the ground. So many things you're doing right now that are making you sick. Your future self is going to say, I regret investing so much time in doing all of that stuff. And it's really important you check in about regrets. Because number seven is for you to come back to the present, come back to today and do something about it.

19:48 Do something about it. And the reason it's important to do something about it is because if you do not do something about it, nobody else will. We're better or for worse. We have a culture in medicine where everybody assumes that everybody else is doing well. And everybody assumes that somebody else's responsibility, it's your responsibility to take care of yourself. Your responsibility to say if you're not feeling well. Your responsibility to take the help that you need. Your responsibility to do all these things. And I agree, you are responsible. I think we need to support each other more than that. Where if we see someone in trouble, we're like, hey, you look like you're in trouble. I need to help you get the intervention you need.

20:29 We really do need that kind of culture where we're looking out for each other. But that's not what we are. We're in this culture where we expect so much from ourselves and from each other that we're not asking, hey, are you okay? Are you well? Are you safe? We're not asking those questions. And so until the culture changes, and I don't know if it ever changes, you have a responsibility to yourself to do something about the things that are not allowing you to be healthy, no matter what they are. And yes, people are going to look at you funny. And yes, people are going to say, well, you know, clearly you don't have what it takes.

21:09 Because in medicine, unfortunately, we do that. But I'm inviting you, I'm inviting you to be countercultural, to stop and think about yourself, to stop and think about your health, to stop and think about the regrets you're going to have with the life that you may be living right now. And ask yourself, how can I do things differently? And I do want to acknowledge that this is a hard question. And I do want to acknowledge that it takes time to come to the right answer. It is not always straightforward. It is not even as easy as quitting your job because there's so much, so much wrapped up in that. It's not even as easy as saying, well, I'm not going to do these things anymore. There is so much, so much involved in it.

21:53 And so to be honest, you're going to need to get help. And some of that help is going to come from being in community with other people who are thinking like you are, as to how can I live and enjoy the parts of my job that I enjoy and still be healthy in the process? Because we can do this career. We can do this career in a way that's healthy, in a way that's consistent with our values. We can do this career. And I don't want you to buy the lie that it can only be done at like a fast, super fast pace where you're either all in or you're just nothing. Don't believe that lie. It's not true.

22:35 But I'm inviting you to return to the present and do something about it because if you don't do something about it, if you don't do something about your experience, nobody else is going to do that for you. Okay. That's number seven. So seven things that I talked about. Number one, pause. Number two, spend time in deep, honest introspection. Number three, ask yourself, is this the life I want for myself? Number four, find out what pieces you actually want to keep. Number five, what pieces can you do without? Number six, go forward into the future, 20, 30, 40 years from now, and meet with your future self and check in about your regrets. And then number seven, come back to the present.

23:17 Do something about it because if you don't do something about it, nobody else will. All right. I'm inviting you to health. I'm inviting you to wealth. I'm inviting you to joy. I'm inviting you to a career that you love that serves you and is healthy and does not lead you off the cliff, that does not lead you off the deep end, that does not allow you to crash. I'm inviting you to think differently about your career. And I'm inviting you to forward this to somebody else who needs to hear this, who needs to be encouraged that it is okay to take time out and make a decision about how you want your career to be from this day forward. It doesn't have to remain the same.

23:58 And so please share it with someone who needs to hear this because we got to save more lives. More physician lives need saving. And yes, we hear about the people who don't make it. We hear about our colleagues who've died. But what we don't hear about is our colleagues whose lives are like totally wrecked because they didn't make changes, whose health is wrecked. We don't hear about that as often. And so I just invite you, you know, someone who needs, who needs to pick me up, who needs encouragement today, and then making the right choice and rethinking the way they do their career and maybe that person is you. I just invite you to just invite others into the space of deep introspection and reflection about what a healthy career looks like and what steps you can take to get there.

24:46 All right. It's been a pleasure talking with you today. Thank you so much. Have a great day. 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. 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. As you share this episode, you become part of our mission to help launch a new generation of clinician researchers who make transformative discoveries that change the way we do healthcare.