How Do You Feel?: How to Confront Burnout Successfully

[00:00:00] [SPEAKER_00]: If you enjoy podcasts like this, you should check out our other shows on Health Podcasts Network.

[00:00:06] [SPEAKER_00]: For example, Health Care for Humans, hosted by Dr. Sundar, expands our understanding of the history and culture

[00:00:13] [SPEAKER_00]: of different communities and how to provide culturally responsive care.

[00:00:18] [SPEAKER_00]: There's an episode you should check out where guest Dr. Durran details the systemic barriers faced by individuals with DACA status

[00:00:25] [SPEAKER_00]: and highlights the importance of addressing these barriers.

[00:00:27] [SPEAKER_00]: Check out Health Care for Humans on your favorite podcast platform or visit healthpodcastnetwork.com

[00:00:49] [SPEAKER_01]: Hello and welcome back to Beyond the Paper Gown. I'm your host, Dr. Mitzi Krockover.

[00:00:55] [SPEAKER_01]: I am so glad you joined me today for what I believe you'll find is an incredibly important and enlightening conversation.

[00:01:04] [SPEAKER_01]: You know as a physician, I've seen firsthand the toll that stress and burnout can take on healthcare providers,

[00:01:09] [SPEAKER_01]: including at times in my own professional journey.

[00:01:13] [SPEAKER_01]: And my guess is that many of you who are listening have felt overwhelmed or burned out in your own lives and careers,

[00:01:19] [SPEAKER_01]: whether you're in health care or not.

[00:01:22] [SPEAKER_01]: And if you're a woman, chances are you're also a caregiver on top of everything else you do,

[00:01:27] [SPEAKER_01]: which comes with its own set of stresses.

[00:01:30] [SPEAKER_01]: Well today we're going to dive deep into those issues with someone who's not only an expert in the field,

[00:01:35] [SPEAKER_01]: but has lived through it herself.

[00:01:37] [SPEAKER_01]: Today you're going to hear from Dr. Jesse Gold, a psychiatrist who has treated many health professionals

[00:01:43] [SPEAKER_01]: and seen the impact that COVID had on exacerbating what was already a serious issue.

[00:01:50] [SPEAKER_01]: Dr. Gold has just written a book that I couldn't put down.

[00:01:53] [SPEAKER_01]: It's called How Do You Feel?

[00:01:55] [SPEAKER_01]: And it offers a raw, honest look at the mental health challenges faced by healthcare workers.

[00:02:01] [SPEAKER_01]: She'll also talk about her new position as the inaugural Chief Wellness Officer of the University of Tennessee System,

[00:02:09] [SPEAKER_01]: working with another at-risk population, college students.

[00:02:13] [SPEAKER_01]: But here's the thing, even if you're not in health care, I promise you'll find so much value in our conversation today.

[00:02:20] [SPEAKER_01]: Not only will you get a whole new insight and appreciation for the healthcare providers in your life,

[00:02:26] [SPEAKER_01]: but we're also going to talk about burnout, work-life balance, and how to recognize when you or someone you care about or work with might need help.

[00:02:37] [SPEAKER_01]: Dr. Gold offers practical advice that applies to all of us, whether we're doctors, teachers, parents, or students.

[00:02:44] [SPEAKER_01]: We'll also discuss how the pandemic has affected mental health across our communities,

[00:02:48] [SPEAKER_01]: why it's so hard for many of us to ask for help, and what we can do to create healthier work environments.

[00:02:56] [SPEAKER_01]: And as I mentioned, Dr. Gold shares her own experiences with burnout, which I found incredibly brave and inspiring.

[00:03:04] [SPEAKER_01]: Before we get started though, just a reminder that this podcast is for information and education only and should not be seen as medical advice.

[00:03:12] [SPEAKER_01]: We encourage you to consult a healthcare provider for your specific issue.

[00:03:27] [SPEAKER_01]: It is my pleasure to introduce Dr. Jessie Gold, who is a psychiatrist, and she is the inaugural chief wellness officer of the University of Tennessee System,

[00:03:40] [SPEAKER_01]: and the author of How Do You Feel, which we are going to talk about extensively because it is a terrific book.

[00:03:48] [SPEAKER_01]: Welcome, Jessie.

[00:03:49] [SPEAKER_02]: Thank you so much for having me.

[00:03:51] [SPEAKER_01]: My pleasure. I tell you, I did enjoy this book. I read it in about two days and not because it was so quote easy, but it was just so engaging and in any case.

[00:04:02] [SPEAKER_01]: And just for our listeners, it's a book that you wrote, I guess during or right after the pandemic that profiles patients, not specific patients,

[00:04:11] [SPEAKER_01]: but kind of an amalgam of profiles, if you will, and their struggles as well as yours.

[00:04:18] [SPEAKER_01]: And I just want to start out by asking you what was the reason that you wrote the book and what did you want readers to take from it?

[00:04:27] [SPEAKER_02]: It's a really good question.

[00:04:28] [SPEAKER_02]: You know, I think that we talk a lot about healthcare worker mental health and we never really get to see what it looks like the way that I do.

[00:04:36] [SPEAKER_02]: So as a psychiatrist, I have had the opportunity to see healthcare workers as patients and that's a very different way of seeing healthcare workers.

[00:04:44] [SPEAKER_02]: I've also had my own lived experiences and then, you know, over the pandemic did a lot of outreach and education around like how to manage our own mental health and healthcare.

[00:04:53] [SPEAKER_02]: And I think with those experiences, I've seen a lot of different things that people don't have the ability to see.

[00:04:59] [SPEAKER_02]: And I think it's really important that people know what their healthcare workers are dealing with, but also how common those struggles are.

[00:05:06] [SPEAKER_01]: Absolutely.

[00:05:08] [SPEAKER_01]: And just to set the stage, you talked about everybody had challenges.

[00:05:13] [SPEAKER_01]: And so how did the pandemic in general really exacerbate the existing mental health problems of our population?

[00:05:22] [SPEAKER_02]: So I think everybody struggled.

[00:05:23] [SPEAKER_02]: If you can point me to someone who didn't struggle during the pandemic, I would probably tell you they were lying because I think in so many ways, nobody was used to dealing with something like that.

[00:05:33] [SPEAKER_02]: And it changed work.

[00:05:34] [SPEAKER_02]: It changed caregiving.

[00:05:36] [SPEAKER_02]: It changed healthcare.

[00:05:37] [SPEAKER_02]: It changed how we viewed sort of terms and illness.

[00:05:40] [SPEAKER_02]: Like there were so many different things that came with the pandemic that no one was prepared for.

[00:05:45] [SPEAKER_02]: And nobody had control of it, which is a big thing for anxiety, like lack of control.

[00:05:49] [SPEAKER_02]: So I think everybody was affected.

[00:05:52] [SPEAKER_02]: I think certain populations may be more than others and healthcare workers would be one of those populations.

[00:05:58] [SPEAKER_02]: I like to say it's not like the COVID fairy came down from the clouds and all of a sudden we were sad.

[00:06:03] [SPEAKER_02]: We were really sad and burnt out before the pandemic.

[00:06:07] [SPEAKER_02]: And it's been a longstanding issue.

[00:06:08] [SPEAKER_02]: It's a longstanding issue that I've cared about, that many people have cared about, but it wasn't in the forefront of everyone's mind in the same way, I think.

[00:06:16] [SPEAKER_02]: When you think about clapping outside of the hospitals or things like that, it kind of threw that into everybody thinking about frontline workers in a different way.

[00:06:25] [SPEAKER_02]: All of a sudden, oh, those people are human and this is really hard for them.

[00:06:29] [SPEAKER_02]: And they're still going to work and we're home.

[00:06:31] [SPEAKER_02]: And what is that like?

[00:06:32] [SPEAKER_02]: And so I think people sort of saw it then, but I saw it before and it was bad before.

[00:06:37] [SPEAKER_02]: And then COVID came with different stressors and different experiences and kind of compounded things and kind of made it worse in the long run.

[00:06:45] [SPEAKER_02]: And so things like trauma have no timeline.

[00:06:48] [SPEAKER_02]: So it's not something either where because you experienced something in the pandemic when someone waves a magic wand and says the pandemic's gone, that you're also all of a sudden better.

[00:06:57] [SPEAKER_02]: It might be something you don't see for years.

[00:06:59] [SPEAKER_02]: And I think that's really important for people to realize too that it's not like this stressor didn't cause longstanding problems in people or that there are things we won't even realize for a while.

[00:07:10] [SPEAKER_02]: So we have to kind of conceptualize it that way.

[00:07:12] [SPEAKER_01]: And to your point, a lot of healthcare professionals came in the pandemic already with challenges.

[00:07:20] [SPEAKER_01]: And so talk a little bit about what those challenges are and were and what is the impact on them.

[00:07:29] [SPEAKER_02]: Of course.

[00:07:30] [SPEAKER_02]: So the numbers are bad.

[00:07:31] [SPEAKER_02]: So I'll give you some numbers because I think everybody loves the number and it contextualizes some things.

[00:07:36] [SPEAKER_02]: And sometimes having the numbers is validating for the people struggling but also for everyone else.

[00:07:41] [SPEAKER_02]: So we were burnt out at rates about 50%.

[00:07:44] [SPEAKER_02]: So it depends on who you ask.

[00:07:46] [SPEAKER_02]: It depends on who's getting, you know, surveyed and how they're getting surveyed.

[00:07:51] [SPEAKER_02]: But no matter what, about 50%.

[00:07:53] [SPEAKER_02]: That's more than other fields.

[00:07:56] [SPEAKER_02]: It's more than fields that are similar to ours.

[00:07:58] [SPEAKER_02]: So similar lengths of education, similar workplaces, that sort of thing.

[00:08:02] [SPEAKER_02]: So really high rates of burnout and burnout.

[00:08:04] [SPEAKER_02]: I'll just define it because I think it's not defined well in the way that we talk about it.

[00:08:09] [SPEAKER_02]: I think people think being burnt out is like, I'm tired from work and it's not.

[00:08:14] [SPEAKER_02]: It's this constellation of three things which is like emotional exhaustion, which to a lot of people is like the end of the day you're just done.

[00:08:21] [SPEAKER_02]: One of the things with it is just sort of feeling disconnected from your work.

[00:08:24] [SPEAKER_02]: I think when I say that, I sometimes say like that thing that makes you who you are,

[00:08:29] [SPEAKER_02]: the thing that like someone would go to you over a different doctor or a different nurse, that thing is less.

[00:08:34] [SPEAKER_02]: And then the third thing is a reduced sense of personal accomplishment.

[00:08:37] [SPEAKER_02]: So you're just getting less things done.

[00:08:39] [SPEAKER_02]: So that's what burnout is when we're talking about it.

[00:08:41] [SPEAKER_02]: So it is this big sort of pervasive thing that's coming from the workplace and it's a workplace based condition.

[00:08:47] [SPEAKER_02]: So that's just burnout.

[00:08:49] [SPEAKER_02]: We also have depression and anxiety and PTSD and things like that at high rates.

[00:08:54] [SPEAKER_02]: So an example for a depression statistic would just be that 28% of residents are experiencing depression.

[00:09:00] [SPEAKER_02]: That's higher than the general population significantly.

[00:09:04] [SPEAKER_02]: That's in single digits and we talk about it a lot, right?

[00:09:07] [SPEAKER_02]: You know, one in 15 healthcare workers have thoughts of suicide,

[00:09:10] [SPEAKER_02]: which I think is also really important for people to realize that it's not mild depression.

[00:09:15] [SPEAKER_02]: It's severe depression in a lot of senses and we often don't get help until it gets to the more severe period.

[00:09:21] [SPEAKER_02]: And I think that's relevant too.

[00:09:23] [SPEAKER_02]: So if I'm painting a sort of depressing picture for people, I think it is, right?

[00:09:29] [SPEAKER_02]: It was, and that's pre-pandemic.

[00:09:31] [SPEAKER_02]: And I think it's important for people to realize that all of the population has struggled in COVID.

[00:09:36] [SPEAKER_02]: All of the population had issues before COVID,

[00:09:39] [SPEAKER_02]: but maybe we didn't talk about it in healthcare workers enough before COVID.

[00:09:43] [SPEAKER_02]: And if like that was just a setting for the conversation to get pushed to the forefront, I'm okay with that.

[00:09:51] [SPEAKER_01]: You know, I kind of wonder about if I was a lay person and I listened to what you just said,

[00:10:01] [SPEAKER_01]: how concerned should I be, you know, very selfishly about the physicians that I'm consulting and...

[00:10:12] [SPEAKER_01]: Or should I be?

[00:10:14] [SPEAKER_02]: It's a really good question.

[00:10:16] [SPEAKER_02]: So part of the reason to write the book and be thinking about the book is not just like,

[00:10:20] [SPEAKER_02]: there's some healthcare worker and that's interesting, but there's another aspect to it which is all of us get care.

[00:10:26] [SPEAKER_02]: And those people that are giving us that care are really struggling and how does that impact you?

[00:10:31] [SPEAKER_02]: And I think it's important that you recognize that it could because maybe it's not talked about enough.

[00:10:37] [SPEAKER_02]: And there are lots of studies that show because of the work we do, if we're burnt out,

[00:10:42] [SPEAKER_02]: there's more likely to be patient errors, it's more likely for people to stay in the hospital longer.

[00:10:47] [SPEAKER_02]: It's more likely to cost more money to the hospital too.

[00:10:50] [SPEAKER_02]: Like lots of these things directly impact the system and the person within it and that's you as the patient.

[00:10:56] [SPEAKER_02]: So that's a really important thing to point out.

[00:10:58] [SPEAKER_02]: I think also retention of people in medicine should make you concerned.

[00:11:03] [SPEAKER_02]: So if you really like your doctor and you would like your doctor to stay in medicine or you really like your doctor

[00:11:10] [SPEAKER_02]: and they're the only doctor for a hundred miles, that's where I would be really worried as a patient is

[00:11:16] [SPEAKER_02]: that if we don't start to deal with this as a system, as a culture, as is a medical system too,

[00:11:23] [SPEAKER_02]: just like in school and training, if we don't start to really take this seriously,

[00:11:27] [SPEAKER_02]: we're going to have problems having enough people being seen because we already have that problem.

[00:11:32] [SPEAKER_02]: It's already a shortage issue.

[00:11:34] [SPEAKER_01]: So if we already have a shortage.

[00:11:40] [SPEAKER_02]: Probably most things I see nurses as patients, I see the people who clean hospitals as patients.

[00:11:44] [SPEAKER_02]: I see the people who greet people.

[00:11:46] [SPEAKER_02]: I see people's administrators.

[00:11:47] [SPEAKER_02]: It's a little village in those settings.

[00:11:50] [SPEAKER_02]: I think it's important that people realize that it trickles down of course,

[00:11:54] [SPEAKER_02]: but it also is really pervasive in this whole little village of the system that if someone's burnt out

[00:11:59] [SPEAKER_02]: and they work with you, you might be more likely to be burnt out.

[00:12:02] [SPEAKER_02]: That makes sense.

[00:12:03] [SPEAKER_01]: I think during the pandemic, even though I wasn't seeing patients, I had close friends that were

[00:12:08] [SPEAKER_01]: and they and their coworkers were facing such challenging situations with patients who perhaps

[00:12:16] [SPEAKER_01]: weren't following recommended health guidelines.

[00:12:19] [SPEAKER_01]: And it really put those workers at risk as well as flooded the already overflowing ERs,

[00:12:25] [SPEAKER_01]: even as these healthcare workers are already dealing with burnout and stress.

[00:12:30] [SPEAKER_01]: I can't imagine how incredibly frustrating that was for these medical professionals

[00:12:35] [SPEAKER_01]: who just want to do their job, take care of patients.

[00:12:38] [SPEAKER_01]: But then the patients don't seem to be doing their part to reduce their risk.

[00:12:42] [SPEAKER_01]: Could you discuss how these situations impact healthcare workers and touch on the concept of moral injury?

[00:12:49] [SPEAKER_02]: Moral injury when we're talking about that is witnessing or participating in something that goes against

[00:12:56] [SPEAKER_02]: basically your morals and values.

[00:12:58] [SPEAKER_02]: That's why the word morals is it in there.

[00:13:00] [SPEAKER_02]: But in a lot of ways, there are times that are smaller where that has been a problem.

[00:13:06] [SPEAKER_02]: So insurance companies could tell a doctor they can't prescribe that medication and they want to prescribe

[00:13:12] [SPEAKER_02]: that medication and they went to school to prescribe that medication and they think they know what's best

[00:13:16] [SPEAKER_02]: because they went to school for it and that's what they would like to do for the patient.

[00:13:19] [SPEAKER_02]: But insurance won't cover it and so a patient has to have a different medication, something like that.

[00:13:24] [SPEAKER_02]: That's a really small kind of very common daily occurrence in our lives as physicians and nurses

[00:13:32] [SPEAKER_02]: and other professionals too.

[00:13:34] [SPEAKER_02]: And I think we don't quite realize how much that affects us, but that's, we think there's something

[00:13:41] [SPEAKER_02]: that should be done for a patient and we can't do it because of an external force or something

[00:13:47] [SPEAKER_02]: and that goes against our morals because we want to help people.

[00:13:50] [SPEAKER_02]: That's why most of us do this.

[00:13:51] [SPEAKER_02]: In a bigger sense during the pandemic, we were seeing that with things like ventilators or PPE.

[00:14:00] [SPEAKER_02]: So not having enough of protective gear and you're running into help people and everyone told you

[00:14:07] [SPEAKER_02]: they were single use and we were just tossing those like crazy every other time, right?

[00:14:12] [SPEAKER_02]: We were like, oh, I went in and I'm not supposed to wear this ever again.

[00:14:16] [SPEAKER_02]: But all of a sudden, masks are weak use and that is a different thing than you were taught

[00:14:21] [SPEAKER_02]: and not feeling safe at work can feel like a moral injury too because it might be a value

[00:14:27] [SPEAKER_02]: or according to your morals to be able to feel safe in your workplace.

[00:14:31] [SPEAKER_02]: So I think that happens or having to choose who might get some kind of treatment over another person

[00:14:37] [SPEAKER_02]: is witnessing something that goes against that.

[00:14:39] [SPEAKER_02]: I think we hear about it a lot too with sort of the political intersection with medicine.

[00:14:46] [SPEAKER_02]: In the ways that you would hear on the news but I think it's like healthcare workers

[00:14:50] [SPEAKER_02]: want to do the thing that's best for their patient.

[00:14:53] [SPEAKER_02]: They know what's best for their patient and they can't intervene early enough based on various rules

[00:14:59] [SPEAKER_02]: or things like that or they can't even provide the care that they think is the best medical care

[00:15:04] [SPEAKER_02]: and we see that a lot.

[00:15:05] [SPEAKER_02]: That's really hurtful and that's really hard to kind of conceptualize and deal with day to day.

[00:15:10] [SPEAKER_02]: The symptoms of moral injury kind of look like PTSD but it was a different name because it wasn't quite PTSD.

[00:15:20] [SPEAKER_02]: That's how they kind of thought about it.

[00:15:21] [SPEAKER_02]: It was more about this sort of thing that went against your morals and so you see a stress reaction,

[00:15:27] [SPEAKER_02]: you see change in sleep, you see overwork.

[00:15:29] [SPEAKER_02]: We like an overwork in medicine.

[00:15:31] [SPEAKER_02]: So if I keep working and I work all the time, I don't have to feel anything.

[00:15:36] [SPEAKER_02]: So we just keep going and going and eventually that catches up to you.

[00:15:41] [SPEAKER_01]: Sure.

[00:15:43] [SPEAKER_01]: And to that point, you were working, working, working, working and didn't even know you were burnt out.

[00:15:50] [SPEAKER_01]: And so I'm sure that there are others in that same situation.

[00:15:55] [SPEAKER_01]: So talk a little bit about that if you don't mind.

[00:15:57] [SPEAKER_02]: Of course.

[00:15:57] [SPEAKER_02]: I'm happy to talk about my own experience if it can help anybody.

[00:16:00] [SPEAKER_02]: You know, I think it's like silly is the wrong word but kind of embarrassing that I am a person who rattled off the definition of burnout.

[00:16:12] [SPEAKER_02]: Like no problem that I give lectures on burnout at least weekly and during the time of the book daily.

[00:16:19] [SPEAKER_02]: And yet I couldn't go, oh, like how do I apply that to me?

[00:16:24] [SPEAKER_02]: Right?

[00:16:24] [SPEAKER_02]: So I'm seeing frontline workers virtually doing psychiatry.

[00:16:29] [SPEAKER_02]: I'm doing a lot of outreach and education around the same information.

[00:16:33] [SPEAKER_02]: So just sort of overloaded with things and writing a lot and doing all of that.

[00:16:37] [SPEAKER_02]: And I'm just falling asleep every day at 3pm.

[00:16:40] [SPEAKER_02]: Like I'm exhausted.

[00:16:41] [SPEAKER_02]: Like I can, if I didn't have a patient, that would be good because I would like to go take a nap.

[00:16:46] [SPEAKER_02]: But it was like this kind of sleep that my body couldn't fight.

[00:16:50] [SPEAKER_02]: Like when you're in class and you start sleeping and you just know that like you're falling asleep in class and you shouldn't be falling asleep in class.

[00:16:57] [SPEAKER_02]: But there's nothing you can do about it like that feeling, but really heavy every day.

[00:17:02] [SPEAKER_02]: And so because of that I would like fall asleep and then wake up and it'd be like 8pm.

[00:17:06] [SPEAKER_02]: And then my sleep's off because of course it's off, but I couldn't fight it.

[00:17:09] [SPEAKER_02]: And so then my sleep got all out of whack and like any good doctor person.

[00:17:14] [SPEAKER_02]: My first thought was this is just how you're supposed to feel our work is hard.

[00:17:20] [SPEAKER_02]: I've never been in a pandemic before medicine goes in phases of feeling hard anyway.

[00:17:25] [SPEAKER_02]: I'm just tired because work makes you tired the end.

[00:17:28] [SPEAKER_02]: And that was my first thing that didn't seem to be true because it didn't go away.

[00:17:33] [SPEAKER_02]: Then my second thing was it's a physical illness because despite being a psychiatrist,

[00:17:40] [SPEAKER_02]: that is my go-to response just like anyone.

[00:17:43] [SPEAKER_02]: I'm tired.

[00:17:44] [SPEAKER_02]: What's the differential diagnosis for fatigue?

[00:17:47] [SPEAKER_02]: Somebody can fix something.

[00:17:48] [SPEAKER_02]: So I said I'm going to go to my primary care doctor and I'm going to figure out what's wrong with me.

[00:17:52] [SPEAKER_02]: And my primary care doctor didn't really even want to do labs.

[00:17:57] [SPEAKER_02]: Kind of was like I'm not sure that you need that.

[00:18:00] [SPEAKER_02]: And I was like, I don't think you understand what I do for a living.

[00:18:04] [SPEAKER_02]: I would tell you if I'm sad, I'm not depressed, blah, blah, blah.

[00:18:07] [SPEAKER_02]: And we got labs and I had low B12 and I thought it was going to be the best thing that ever happened to me.

[00:18:13] [SPEAKER_02]: I was like all I need is a shot.

[00:18:17] [SPEAKER_02]: People love B12 shots.

[00:18:19] [SPEAKER_02]: They always talk about it.

[00:18:20] [SPEAKER_02]: So I was like that'll give me more energy.

[00:18:22] [SPEAKER_02]: That's all I need.

[00:18:22] [SPEAKER_02]: So I did that and I felt like a little bit better but not really.

[00:18:27] [SPEAKER_02]: And I was like something still really often.

[00:18:31] [SPEAKER_02]: I really didn't think about it until my therapist told me,

[00:18:35] [SPEAKER_02]: you're a frontline worker who sees frontline workers during a global pandemic.

[00:18:40] [SPEAKER_02]: What else could it be?

[00:18:42] [SPEAKER_02]: And I like laughed because I like a good humor as a defense mechanism.

[00:18:48] [SPEAKER_02]: But I also am like that was awkward.

[00:18:50] [SPEAKER_02]: I'm going to feel like that's funny, you know?

[00:18:52] [SPEAKER_02]: It's just I started laughing and you know, she's like why are you laughing

[00:18:56] [SPEAKER_02]: because she's a therapist.

[00:18:57] [SPEAKER_02]: And I was like, I just feel like it's ridiculous that I didn't notice

[00:19:04] [SPEAKER_02]: that when I do this every single day and this is very much in my field.

[00:19:09] [SPEAKER_02]: It's not just I'm a psychiatrist.

[00:19:11] [SPEAKER_02]: It's like I'm a burnout person.

[00:19:13] [SPEAKER_02]: Like this is embarrassing.

[00:19:14] [SPEAKER_02]: And you know, she said kind of to paraphrase basically something like

[00:19:19] [SPEAKER_02]: that's why people go to therapy, you know?

[00:19:22] [SPEAKER_02]: Like second set of eyes is always helpful.

[00:19:25] [SPEAKER_02]: You're not your own doctor.

[00:19:26] [SPEAKER_02]: You're not very good at applying what you preach.

[00:19:29] [SPEAKER_02]: All of us are bad at that.

[00:19:30] [SPEAKER_02]: It's just the way it is and you didn't recognize it

[00:19:33] [SPEAKER_02]: because you're so busy focusing on everyone else and all of their symptoms.

[00:19:38] [SPEAKER_01]: You know, isn't that kind of a symptom of burnout that you really aren't connected to what's going on?

[00:19:44] [SPEAKER_02]: Yeah.

[00:19:44] [SPEAKER_02]: In so many ways, I like there's a point at which you're going through the motions

[00:19:47] [SPEAKER_02]: and you know my patients often say things like I didn't make an error.

[00:19:53] [SPEAKER_02]: I didn't hurt anyone.

[00:19:54] [SPEAKER_02]: So there was nothing wrong with me because I'm not hurting anyone

[00:19:57] [SPEAKER_02]: and we have this like bar of we're fine until this is really going to be a problem for patients

[00:20:03] [SPEAKER_02]: and we mostly are able to kind of navigate that like not always

[00:20:07] [SPEAKER_02]: but I definitely have patients that come at that point because all of a sudden they're worried

[00:20:13] [SPEAKER_02]: they might like make an error hurt a patient.

[00:20:16] [SPEAKER_02]: And that shouldn't be our bar, but it is our bar.

[00:20:19] [SPEAKER_02]: And as a result, like we kind of don't notice when we're like at 80% of ourselves

[00:20:25] [SPEAKER_02]: or then we're at 70% of ourselves or whatever.

[00:20:27] [SPEAKER_02]: We're just kind of like I'm still doing my work well

[00:20:30] [SPEAKER_02]: and I have to show up and I'm not putting this on anybody else.

[00:20:33] [SPEAKER_02]: So therefore like I'm good, you know, like this is fine

[00:20:37] [SPEAKER_02]: and we don't tend to pay attention to like the rest of our life either.

[00:20:41] [SPEAKER_02]: Like college students do the same thing you say how are you?

[00:20:45] [SPEAKER_02]: And they say my grades are good and you said that's great.

[00:20:49] [SPEAKER_02]: What about the rest of your life?

[00:20:50] [SPEAKER_02]: And they are like, oh, I haven't left my room in two weeks.

[00:20:53] [SPEAKER_02]: I wear sweatpants all the time.

[00:20:55] [SPEAKER_02]: I don't talk to anybody else.

[00:20:56] [SPEAKER_02]: And you're like cool.

[00:20:57] [SPEAKER_02]: So you're doing really well obviously.

[00:20:58] [SPEAKER_02]: You know, like that was sarcasm if that wasn't clear enough.

[00:21:02] [SPEAKER_02]: But you know, I think it's just very easy to focus on these like objective measures

[00:21:09] [SPEAKER_02]: of success that come from grades or work performance

[00:21:13] [SPEAKER_02]: or patient evaluations or whatever it is.

[00:21:16] [SPEAKER_02]: And we miss that like our life is actually much fuller than that.

[00:21:20] [SPEAKER_02]: And it's very easy to let a lot of things drop off

[00:21:23] [SPEAKER_02]: and sort of robotically do work.

[00:21:26] [SPEAKER_01]: And then I think the other piece of it as you described is that it's so insidious.

[00:21:32] [SPEAKER_01]: It's just you don't go from zero to 60.

[00:21:34] [SPEAKER_01]: You go to zero to five to 10.

[00:21:36] [SPEAKER_01]: By the time it's really, you're really symptomatic.

[00:21:40] [SPEAKER_01]: Talk a little bit about how you dealt with it.

[00:21:43] [SPEAKER_02]: Yeah.

[00:21:44] [SPEAKER_02]: I mean, the thing about insidious also that I would point out is like

[00:21:47] [SPEAKER_02]: you also look at your coworkers and they all look miserable too.

[00:21:50] [SPEAKER_02]: And so, you know what I mean?

[00:21:52] [SPEAKER_02]: Like your baseline is like, well, the person next to me is like kind of

[00:21:57] [SPEAKER_02]: not sleeping, not eating, not functioning either.

[00:21:59] [SPEAKER_02]: So I think this is how I'm supposed to do, right?

[00:22:03] [SPEAKER_02]: Sure.

[00:22:03] [SPEAKER_01]: And it's almost like a badge of honor too.

[00:22:05] [SPEAKER_01]: Yeah.

[00:22:05] [SPEAKER_02]: You're like, I'm working real hard.

[00:22:07] [SPEAKER_02]: Have you noticed how important I am?

[00:22:08] [SPEAKER_02]: Residency was always like that.

[00:22:10] [SPEAKER_02]: And so when you struggle, especially when you start to struggle,

[00:22:14] [SPEAKER_02]: you just go, I think this is how I'm supposed to feel.

[00:22:16] [SPEAKER_02]: And I think this is just what my job is like every day and how I'm

[00:22:20] [SPEAKER_02]: supposed to feel doing my job.

[00:22:21] [SPEAKER_02]: And so you just don't get help because it doesn't make sense that you would.

[00:22:24] [SPEAKER_02]: And if you did, it would also be like something that identified you

[00:22:28] [SPEAKER_02]: that was not what you wanted to do and you don't want to be

[00:22:32] [SPEAKER_02]: identified in that setting.

[00:22:33] [SPEAKER_02]: And so for me, you know, it took a long time even though,

[00:22:37] [SPEAKER_02]: you know, I'm at home and I'm a psychiatrist and I specialize

[00:22:40] [SPEAKER_02]: and burn out and all these things, right?

[00:22:42] [SPEAKER_02]: To actually do anything.

[00:22:43] [SPEAKER_02]: And by the time that I was at the point of doing something,

[00:22:47] [SPEAKER_02]: I was needing to do more drastic things.

[00:22:50] [SPEAKER_02]: So take time off, really book in the time off and reset.

[00:22:54] [SPEAKER_02]: My therapist describes that as sort of like taking a pail of water

[00:22:58] [SPEAKER_02]: out of a sinking boat with holes, which I think is really true,

[00:23:01] [SPEAKER_02]: which is like you're going to go back to sinking because you're

[00:23:04] [SPEAKER_02]: still a boat with holes in the water.

[00:23:06] [SPEAKER_02]: But like you did give yourself like a little extra buoyancy

[00:23:08] [SPEAKER_02]: for a little while.

[00:23:09] [SPEAKER_02]: So, you know, once you do that, if you go right back to the same

[00:23:13] [SPEAKER_02]: thing and you don't change anything, that's not helpful.

[00:23:15] [SPEAKER_02]: So I had to do that to reset and then go back and sort of try

[00:23:20] [SPEAKER_02]: to figure out how to cope.

[00:23:22] [SPEAKER_01]: Because again, this was during the pandemic.

[00:23:24] [SPEAKER_01]: And we were locked down.

[00:23:25] [SPEAKER_01]: Yes.

[00:23:26] [SPEAKER_02]: And why like do I hate this?

[00:23:28] [SPEAKER_02]: And I ended up like not hating it as much, but I had to try a

[00:23:31] [SPEAKER_02]: lot of things out to figure out what I could do.

[00:23:34] [SPEAKER_02]: You know, for me, like journaling, I like to do because

[00:23:36] [SPEAKER_02]: I like writing, but sometimes it gets confused with work

[00:23:39] [SPEAKER_02]: writing and I have to sort of figure that out.

[00:23:42] [SPEAKER_02]: I like really try to manage my sleep.

[00:23:46] [SPEAKER_02]: So I mentioned sort of like my sleep was one thing and then

[00:23:49] [SPEAKER_02]: another thing.

[00:23:50] [SPEAKER_02]: And so I actually was like, oh, your sleep really impacts

[00:23:52] [SPEAKER_02]: your mental health.

[00:23:53] [SPEAKER_02]: Doctors don't just say that to be annoying, right?

[00:23:55] [SPEAKER_02]: So paying attention to how late I used my phone and was

[00:23:59] [SPEAKER_02]: upscrolling, moving my phone out of my room, getting a real

[00:24:03] [SPEAKER_02]: alarm clock for a while and resetting that.

[00:24:06] [SPEAKER_02]: So I didn't look at my phone the last thing I did and look

[00:24:09] [SPEAKER_02]: at it the first thing in the morning.

[00:24:11] [SPEAKER_02]: You know, being mindful that social media was contributing

[00:24:14] [SPEAKER_02]: to my mental health decline as well.

[00:24:16] [SPEAKER_02]: I mean, I think in so many ways during that time, I relied

[00:24:21] [SPEAKER_02]: on social media for friends and connection for hearing stories

[00:24:25] [SPEAKER_02]: about what other people were going through and not feeling

[00:24:27] [SPEAKER_02]: alone in that sense.

[00:24:28] [SPEAKER_02]: But also those stories weren't easy stories.

[00:24:31] [SPEAKER_02]: And I had to sort of recognize that that was affecting my

[00:24:35] [SPEAKER_02]: sleep that I did need to monitor how it was feeling on social,

[00:24:39] [SPEAKER_02]: that it was helpful where it was helpful, but it also had

[00:24:41] [SPEAKER_02]: some harm.

[00:24:42] [SPEAKER_02]: And so had to be a bit more mindful about that.

[00:24:45] [SPEAKER_02]: Therapy is always big for me.

[00:24:47] [SPEAKER_02]: So I went weekly.

[00:24:48] [SPEAKER_02]: I still go weekly.

[00:24:49] [SPEAKER_02]: I think it should be framed more like something that makes

[00:24:53] [SPEAKER_02]: you better at your job instead of something used in a

[00:24:55] [SPEAKER_02]: crisis.

[00:24:56] [SPEAKER_02]: And it has always been really helpful for me.

[00:24:59] [SPEAKER_02]: I also take medication, which I'm comfortable talking about

[00:25:02] [SPEAKER_02]: too, but and I've been on medication since college.

[00:25:06] [SPEAKER_02]: So that sort of just helps with my baseline to not have to

[00:25:10] [SPEAKER_02]: worry about that as much.

[00:25:12] [SPEAKER_02]: But you know, all those things kind of come together to how

[00:25:15] [SPEAKER_02]: you cope and reset.

[00:25:17] [SPEAKER_02]: And you know, I'm a work in progress though.

[00:25:19] [SPEAKER_02]: Like I don't want people to think.

[00:25:21] [SPEAKER_02]: Yeah, like I don't want people to think that like I had this

[00:25:23] [SPEAKER_02]: episode.

[00:25:24] [SPEAKER_02]: I've never been burnt out again.

[00:25:27] [SPEAKER_02]: Like I've been burnt out again, but I think I'm a little

[00:25:31] [SPEAKER_02]: bit better at recognizing it.

[00:25:32] [SPEAKER_02]: And I think that's really important because I think it's

[00:25:36] [SPEAKER_02]: inevitable a lot of times that you'll get into periods where

[00:25:39] [SPEAKER_02]: it's going to impact your life in a different way.

[00:25:42] [SPEAKER_02]: But if I wait until I'm sleeping every day after work for

[00:25:45] [SPEAKER_02]: weeks, like that's not what I need to be doing.

[00:25:48] [SPEAKER_02]: I need to go, oh, I'm starting to get really angry.

[00:25:50] [SPEAKER_02]: A big sign early sign for me is like if somebody sends

[00:25:54] [SPEAKER_02]: me an email, like my reaction is like I want to throw

[00:25:57] [SPEAKER_02]: my computer across the room.

[00:25:59] [SPEAKER_02]: Like if someone sends me one more email or one more

[00:26:02] [SPEAKER_02]: patient inbox message, like I can't like the level of

[00:26:05] [SPEAKER_02]: anger I feel is just totally out of proportion.

[00:26:08] [SPEAKER_02]: That's nothing to do with the content.

[00:26:10] [SPEAKER_02]: And that's an early sign for me because the reason for

[00:26:14] [SPEAKER_02]: it, which I know through therapy is because someone's

[00:26:16] [SPEAKER_02]: asking me for something and I have nothing left to give.

[00:26:19] [SPEAKER_02]: Right.

[00:26:19] [SPEAKER_02]: And so emails, inbox messaging is just another way

[00:26:22] [SPEAKER_02]: for people to ask for things.

[00:26:24] [SPEAKER_02]: And so as much as I'm a work in progress, I'm at

[00:26:27] [SPEAKER_02]: least a work in I identify this earlier and can make

[00:26:31] [SPEAKER_02]: changes earlier, you know, not perfectly by any means,

[00:26:35] [SPEAKER_02]: but I think in a better way.

[00:26:38] [SPEAKER_01]: You know, I resonate with the whole anger.

[00:26:40] [SPEAKER_01]: I remember being a resident and being on call and

[00:26:43] [SPEAKER_01]: having not slept for 36 hours or whatever and

[00:26:47] [SPEAKER_01]: feeling angry, but just being not really angry at

[00:26:50] [SPEAKER_01]: the patient, but just being angry in general

[00:26:52] [SPEAKER_01]: because I was so tired and so fried.

[00:26:56] [SPEAKER_02]: And you feel bad.

[00:26:57] [SPEAKER_02]: You feel guilty like you go, I'm not supposed to be

[00:26:59] [SPEAKER_02]: mad at this person.

[00:27:00] [SPEAKER_02]: This person is really nice.

[00:27:01] [SPEAKER_02]: What's wrong with me?

[00:27:02] [SPEAKER_02]: And I think anger is triggered by all sorts of

[00:27:04] [SPEAKER_02]: things, but sort of in the patient care situation,

[00:27:08] [SPEAKER_02]: it's like you're not mad at them most of the time.

[00:27:11] [SPEAKER_02]: You're just kind of mad at the system and that's

[00:27:14] [SPEAKER_02]: what burnout is causing.

[00:27:15] [SPEAKER_02]: It's coming from the system and you're frustrated

[00:27:17] [SPEAKER_02]: with the system and they're just a representative

[00:27:19] [SPEAKER_02]: of it just like you are right.

[00:27:21] [SPEAKER_02]: So like a patient can't get mental health treatment

[00:27:24] [SPEAKER_02]: because the wait list is too long and the way

[00:27:27] [SPEAKER_02]: our country thinks about these things is too long

[00:27:30] [SPEAKER_02]: or someone wants a follow-up and I don't have

[00:27:32] [SPEAKER_02]: one for two months, right?

[00:27:33] [SPEAKER_02]: That's really, really frustrating and you're

[00:27:36] [SPEAKER_02]: going to yell at me, but you're not yelling

[00:27:37] [SPEAKER_02]: at me.

[00:27:38] [SPEAKER_02]: You're yelling at this system and you know

[00:27:40] [SPEAKER_02]: you don't want to yell at me, but you have

[00:27:42] [SPEAKER_02]: no one else to yell at and that's sort of

[00:27:44] [SPEAKER_02]: like I think that same reaction which is

[00:27:47] [SPEAKER_02]: like the system is inherently the issue,

[00:27:50] [SPEAKER_02]: but you can't fix the system and you're

[00:27:52] [SPEAKER_02]: frustrated about the system and it just comes

[00:27:54] [SPEAKER_02]: out where it comes out and sometimes that's

[00:27:55] [SPEAKER_02]: with co-workers and you might be like

[00:27:58] [SPEAKER_02]: that person is not very nice lately

[00:28:00] [SPEAKER_02]: and that might be a sign that you should

[00:28:01] [SPEAKER_02]: talk to them and ask them how they're doing

[00:28:03] [SPEAKER_02]: and actually spend time with that because

[00:28:05] [SPEAKER_02]: they're not being nice probably

[00:28:08] [SPEAKER_02]: because they're struggling.

[00:28:09] [SPEAKER_01]: Now that's a really good point.

[00:28:11] [SPEAKER_01]: Let's talk a little bit about stigma too

[00:28:14] [SPEAKER_01]: because I think that's why a lot of

[00:28:16] [SPEAKER_01]: people in general but certainly

[00:28:18] [SPEAKER_01]: health professionals may not seek

[00:28:20] [SPEAKER_01]: or be very reticent to seek care

[00:28:22] [SPEAKER_01]: and talk about it

[00:28:24] [SPEAKER_01]: in the context of one of your patients

[00:28:26] [SPEAKER_01]: that you described.

[00:28:28] [SPEAKER_01]: I'm trying to think of, I can't remember

[00:28:29] [SPEAKER_01]: the name that you gave him, but I believe

[00:28:31] [SPEAKER_01]: he was a resident and it was

[00:28:34] [SPEAKER_01]: he just really didn't want

[00:28:35] [SPEAKER_01]: to fess up if you will

[00:28:38] [SPEAKER_01]: because he was afraid of the reaction

[00:28:40] [SPEAKER_01]: he was going to get.

[00:28:41] [SPEAKER_02]: So that patient's name is Luke

[00:28:43] [SPEAKER_02]: but in so many ways that you know

[00:28:45] [SPEAKER_02]: that's a composite patient and I hear

[00:28:48] [SPEAKER_02]: the same thing every single day.

[00:28:49] [SPEAKER_02]: I think there isn't probably a day

[00:28:51] [SPEAKER_02]: where I don't hear something like that

[00:28:53] [SPEAKER_02]: which is, you know, hey Dr. Gold

[00:28:55] [SPEAKER_02]: do you have to write all that in the chart?

[00:28:57] [SPEAKER_02]: Hey Dr. Gold can I pay you in cash?

[00:28:59] [SPEAKER_02]: Hey Dr. Gold I need to be out of work

[00:29:01] [SPEAKER_02]: and have you write like

[00:29:03] [SPEAKER_02]: you know something to my supervisor

[00:29:05] [SPEAKER_02]: can you just say that I have back pain.

[00:29:08] [SPEAKER_02]: You know these things that

[00:29:09] [SPEAKER_02]: like are sad because we're

[00:29:11] [SPEAKER_02]: in health care and it would be really nice

[00:29:13] [SPEAKER_02]: if we didn't stigmatize mental health

[00:29:15] [SPEAKER_02]: but we do because we know other people

[00:29:17] [SPEAKER_02]: do and because training taught us to

[00:29:19] [SPEAKER_02]: and health care tends to be like

[00:29:21] [SPEAKER_02]: you shouldn't tell someone they're going to take your license

[00:29:23] [SPEAKER_02]: and that is hard or

[00:29:25] [SPEAKER_02]: if you tell someone it's a weakness and then

[00:29:27] [SPEAKER_02]: you're not as strong and that's a problem

[00:29:29] [SPEAKER_02]: or you're not as competitive and that's a problem.

[00:29:31] [SPEAKER_02]: There's some data that basically

[00:29:33] [SPEAKER_02]: says like med students if you

[00:29:35] [SPEAKER_02]: ask them, you know

[00:29:37] [SPEAKER_02]: do they think getting mental health treatment

[00:29:38] [SPEAKER_02]: is a weakness or anything like that? They say no

[00:29:41] [SPEAKER_02]: but then they say like

[00:29:43] [SPEAKER_02]: well my supervisors would think so

[00:29:45] [SPEAKER_02]: my patients would think so

[00:29:46] [SPEAKER_02]: my coworkers like you know

[00:29:48] [SPEAKER_02]: colleagues and students would think so

[00:29:50] [SPEAKER_02]: and residency applications would think so.

[00:29:52] [SPEAKER_02]: So just because I might think that

[00:29:55] [SPEAKER_02]: for myself the world is telling

[00:29:57] [SPEAKER_02]: me I shouldn't and that world

[00:29:59] [SPEAKER_02]: is deciding your entire future

[00:30:01] [SPEAKER_02]: and that data

[00:30:02] [SPEAKER_02]: shows too that then if they got help

[00:30:04] [SPEAKER_02]: they won't talk about getting help

[00:30:06] [SPEAKER_02]: so all that does is create a cycle of silence

[00:30:08] [SPEAKER_02]: because nobody's talking about it

[00:30:11] [SPEAKER_02]: and so if you don't have a friend who's getting help

[00:30:13] [SPEAKER_02]: you don't know that you could

[00:30:14] [SPEAKER_02]: or if you don't have a supervisor who's getting help

[00:30:16] [SPEAKER_02]: you don't think that they will understand that you are

[00:30:19] [SPEAKER_02]: and so

[00:30:19] [SPEAKER_02]: it comes from

[00:30:21] [SPEAKER_02]: everywhere in culture

[00:30:23] [SPEAKER_02]: I think it has improved

[00:30:25] [SPEAKER_02]: but I do think that

[00:30:27] [SPEAKER_02]: you come in with all of whatever baggage

[00:30:30] [SPEAKER_02]: around mental health you have to begin with

[00:30:32] [SPEAKER_02]: and it just gets compounded.

[00:30:35] [SPEAKER_01]: Say you're

[00:30:37] [SPEAKER_01]: again a patient

[00:30:39] [SPEAKER_01]: what kinds of things

[00:30:40] [SPEAKER_01]: should you be worried about

[00:30:42] [SPEAKER_01]: or should you be looking for?

[00:30:45] [SPEAKER_02]: You know what I would say

[00:30:46] [SPEAKER_02]: to patients first and foremost

[00:30:48] [SPEAKER_02]: is to think about

[00:30:50] [SPEAKER_02]: thanking your healthcare worker

[00:30:52] [SPEAKER_02]: you know gratitude goes

[00:30:54] [SPEAKER_02]: a long long way and

[00:30:56] [SPEAKER_02]: everybody who's ever really said

[00:30:58] [SPEAKER_02]: thank you to me not just like thanks

[00:31:00] [SPEAKER_02]: but like wrote it down or something

[00:31:02] [SPEAKER_02]: I remember or I keep

[00:31:04] [SPEAKER_01]: and I have a whole box of those from my patients

[00:31:07] [SPEAKER_01]: too

[00:31:08] [SPEAKER_02]: I'm a psychiatrist so I don't get a lot of them

[00:31:10] [SPEAKER_02]: but when I get them they get saved

[00:31:11] [SPEAKER_02]: and I think people realize that we do that

[00:31:14] [SPEAKER_02]: and I think that they think we're thanked

[00:31:16] [SPEAKER_02]: all the time because what we do

[00:31:18] [SPEAKER_02]: helps people and of course

[00:31:20] [SPEAKER_02]: people thank us

[00:31:21] [SPEAKER_02]: as much as I do think it's important

[00:31:24] [SPEAKER_02]: that patients or

[00:31:25] [SPEAKER_02]: the general population understands

[00:31:28] [SPEAKER_02]: that we're human and we struggle too

[00:31:29] [SPEAKER_02]: I hope that they realize that

[00:31:31] [SPEAKER_02]: there are ways to be helpful around

[00:31:34] [SPEAKER_02]: that and that we do very much

[00:31:36] [SPEAKER_02]: value the relationship so much

[00:31:38] [SPEAKER_02]: that like we both said

[00:31:40] [SPEAKER_02]: we have boxes right like that's

[00:31:42] [SPEAKER_02]: a big deal and like those words

[00:31:44] [SPEAKER_02]: as simple as they can be can make

[00:31:46] [SPEAKER_02]: a big big impact

[00:31:48] [SPEAKER_02]: you know if I'm a patient too

[00:31:50] [SPEAKER_02]: I think just acknowledging

[00:31:52] [SPEAKER_02]: our humanity is important

[00:31:54] [SPEAKER_02]: so I said that part of the reason

[00:31:56] [SPEAKER_02]: we don't disclose is we're afraid

[00:31:58] [SPEAKER_02]: patients wouldn't want to see us

[00:32:00] [SPEAKER_02]: like I would want to see

[00:32:02] [SPEAKER_02]: a doctor that has

[00:32:04] [SPEAKER_02]: the ability to admit that they need

[00:32:06] [SPEAKER_02]: help and gets help for it and then is

[00:32:08] [SPEAKER_02]: doing better much more than I

[00:32:10] [SPEAKER_02]: would want to see a doctor who doesn't

[00:32:12] [SPEAKER_02]: but I think that that's not necessarily

[00:32:14] [SPEAKER_02]: always the conversation and

[00:32:16] [SPEAKER_02]: there's no good way to tell your doctor

[00:32:18] [SPEAKER_02]: that or to say that but I

[00:32:20] [SPEAKER_02]: or to tell your patient that

[00:32:21] [SPEAKER_02]: but I do think that it's important

[00:32:24] [SPEAKER_02]: that people see our humanity

[00:32:26] [SPEAKER_02]: and are okay with it like

[00:32:29] [SPEAKER_02]: we're not perfect

[00:32:30] [SPEAKER_02]: but we really do care about you

[00:32:32] [SPEAKER_02]: and we're going to do a really good job

[00:32:33] [SPEAKER_02]: and sometimes we're going to struggle too

[00:32:37] [SPEAKER_01]: we've talked about burnout

[00:32:38] [SPEAKER_01]: and I think that you know again

[00:32:40] [SPEAKER_01]: there may be people that are listening

[00:32:42] [SPEAKER_01]: that can really

[00:32:44] [SPEAKER_01]: connect even if they're not a healthcare provider

[00:32:47] [SPEAKER_01]: what are some of

[00:32:48] [SPEAKER_01]: the parallels

[00:32:50] [SPEAKER_01]: that we've just talked about

[00:32:52] [SPEAKER_01]: with non-healthcare professionals

[00:32:54] [SPEAKER_02]: yeah I'd love to tell

[00:32:56] [SPEAKER_02]: you literally everything right so

[00:32:58] [SPEAKER_02]: I think healthcare is this like

[00:33:00] [SPEAKER_02]: microcosm of an extreme

[00:33:02] [SPEAKER_02]: caregiving role

[00:33:03] [SPEAKER_02]: but that everyone is a caregiver

[00:33:05] [SPEAKER_02]: in some capacity especially women

[00:33:07] [SPEAKER_01]: especially women

[00:33:08] [SPEAKER_02]: especially women I don't even have to tell

[00:33:12] [SPEAKER_02]: like women that we never put

[00:33:14] [SPEAKER_02]: ourselves first because we don't and that

[00:33:16] [SPEAKER_02]: is a big issue and healthcare

[00:33:18] [SPEAKER_02]: workers don't either and I think that

[00:33:20] [SPEAKER_02]: you know as much as the book

[00:33:22] [SPEAKER_02]: talks about healthcare workers as an example

[00:33:24] [SPEAKER_02]: there are so many things that

[00:33:26] [SPEAKER_02]: they're talking about that they're struggling with

[00:33:27] [SPEAKER_02]: that every single person deals with

[00:33:30] [SPEAKER_02]: and struggles with in the workplace

[00:33:32] [SPEAKER_02]: it's just a different workplace or at home

[00:33:34] [SPEAKER_02]: and it's just a different situation you know

[00:33:35] [SPEAKER_02]: and I think things like perfectionism

[00:33:38] [SPEAKER_02]: I think things like

[00:33:39] [SPEAKER_02]: overwork I think things

[00:33:42] [SPEAKER_02]: like burnout are so

[00:33:44] [SPEAKER_02]: so common

[00:33:45] [SPEAKER_02]: and I've given talks

[00:33:47] [SPEAKER_02]: across like other workplaces for the same

[00:33:50] [SPEAKER_02]: reason I've given lots of talks

[00:33:52] [SPEAKER_02]: about how it intersects with gender

[00:33:53] [SPEAKER_02]: and women and you know women are more burnt

[00:33:56] [SPEAKER_02]: out shocker right

[00:33:57] [SPEAKER_02]: even in a double doctor

[00:33:59] [SPEAKER_02]: household where both people

[00:34:01] [SPEAKER_02]: like our physicians the data

[00:34:03] [SPEAKER_02]: would show that over COVID

[00:34:06] [SPEAKER_02]: healthcare worker women

[00:34:08] [SPEAKER_02]: were more likely to step back do reduced

[00:34:10] [SPEAKER_02]: hours take on child care

[00:34:12] [SPEAKER_02]: be affected by the stress of all

[00:34:14] [SPEAKER_02]: of that right and that just compounds I already

[00:34:16] [SPEAKER_02]: told you what the heck we were dealing

[00:34:18] [SPEAKER_02]: with otherwise right that's just another

[00:34:20] [SPEAKER_02]: thing that compounds it and

[00:34:21] [SPEAKER_02]: and when they looked at the data there

[00:34:23] [SPEAKER_02]: there was a difference in depression scores

[00:34:25] [SPEAKER_02]: between the physician women and the physician

[00:34:27] [SPEAKER_02]: men and it wasn't there before

[00:34:29] [SPEAKER_02]: so like we have to realize that

[00:34:31] [SPEAKER_02]: these things that we uniquely deal

[00:34:33] [SPEAKER_02]: with do make us unique as

[00:34:35] [SPEAKER_02]: a population to be talking about how

[00:34:37] [SPEAKER_02]: it impacts us healthcare worker or not

[00:34:39] [SPEAKER_02]: caregiver always

[00:34:41] [SPEAKER_02]: and all of us are dealing with a lot of the same

[00:34:43] [SPEAKER_02]: things I think the things that

[00:34:45] [SPEAKER_02]: you know the things that we do

[00:34:47] [SPEAKER_02]: to grow and get better

[00:34:49] [SPEAKER_02]: from some of this stuff is all there are

[00:34:51] [SPEAKER_02]: also often really hard for women so

[00:34:53] [SPEAKER_02]: boundaries

[00:34:54] [SPEAKER_02]: saying no

[00:34:56] [SPEAKER_02]: very hard as especially

[00:34:59] [SPEAKER_02]: as a woman because people told you

[00:35:01] [SPEAKER_02]: weren't supposed to and so you say

[00:35:03] [SPEAKER_02]: I'm not supposed to say no I'm

[00:35:05] [SPEAKER_02]: supposed to say yes everything and we do

[00:35:06] [SPEAKER_02]: so much work that nobody

[00:35:09] [SPEAKER_02]: is compensating us for nobody

[00:35:11] [SPEAKER_02]: is even appreciating us for and

[00:35:13] [SPEAKER_02]: we're just going and going and going and so it's

[00:35:14] [SPEAKER_02]: important that you realize that that's going

[00:35:17] [SPEAKER_02]: to like make you burnt out and affect you

[00:35:18] [SPEAKER_02]: mentally that it's okay to put yourself

[00:35:21] [SPEAKER_02]: first and that doesn't make you selfish

[00:35:22] [SPEAKER_02]: and that you do have to say no sometimes

[00:35:24] [SPEAKER_02]: and that doesn't make you a bad person

[00:35:26] [SPEAKER_02]: you took care of yourself and that's really important

[00:35:28] [SPEAKER_02]: and I think for women especially

[00:35:30] [SPEAKER_02]: self-care is often viewed as like

[00:35:33] [SPEAKER_02]: well I'm not then taking care

[00:35:35] [SPEAKER_02]: of the other person and we need to

[00:35:37] [SPEAKER_02]: frame it more like actually you're doing a better

[00:35:39] [SPEAKER_02]: job taking care of that person because

[00:35:40] [SPEAKER_02]: you put yourself and first

[00:35:43] [SPEAKER_02]: and took care of you so

[00:35:44] [SPEAKER_02]: you could take care of that person and

[00:35:47] [SPEAKER_02]: sometimes the things that I'm thinking

[00:35:48] [SPEAKER_02]: in dealing with I go is this because I'm

[00:35:50] [SPEAKER_02]: in health care is this because I'm a woman

[00:35:52] [SPEAKER_02]: is this because you know because I think it's like

[00:35:54] [SPEAKER_02]: so many things that are in there

[00:35:56] [SPEAKER_02]: and there's so many different

[00:35:58] [SPEAKER_02]: like sort of cultural concepts

[00:36:00] [SPEAKER_02]: emotions in general

[00:36:02] [SPEAKER_02]: is a big thing for women are you

[00:36:04] [SPEAKER_02]: allowed to have them which ones are you

[00:36:06] [SPEAKER_02]: allowed to have who said

[00:36:08] [SPEAKER_02]: so which ones are good or bad

[00:36:11] [SPEAKER_02]: you know if I am

[00:36:13] [SPEAKER_02]: emotional if somebody going to think I'm not

[00:36:15] [SPEAKER_02]: good at my job anymore if I have feelings

[00:36:17] [SPEAKER_02]: and I somehow not going to be able to do

[00:36:19] [SPEAKER_02]: the things that I want to do and so

[00:36:20] [SPEAKER_02]: in so many ways

[00:36:22] [SPEAKER_02]: figuring out your emotions figuring out

[00:36:24] [SPEAKER_02]: how to cope with this stuff figuring out

[00:36:26] [SPEAKER_02]: how to cope with caring for others

[00:36:28] [SPEAKER_02]: as often before yourself

[00:36:31] [SPEAKER_02]: is a universal

[00:36:33] [SPEAKER_02]: experience but a uniquely

[00:36:36] [SPEAKER_02]: compounded female one

[00:36:38] [SPEAKER_01]: if someone is recognizing

[00:36:40] [SPEAKER_01]: that they have a problem

[00:36:42] [SPEAKER_01]: and they are making the

[00:36:44] [SPEAKER_01]: attempt to do the self-care

[00:36:46] [SPEAKER_01]: but it still seems to be

[00:36:48] [SPEAKER_01]: a challenge for them

[00:36:50] [SPEAKER_01]: when should they go and get more professional

[00:36:52] [SPEAKER_02]: help so I would

[00:36:54] [SPEAKER_02]: say a lot of the symptoms

[00:36:56] [SPEAKER_02]: might be the same but the things

[00:36:58] [SPEAKER_02]: to pay attention to are is it getting worse

[00:37:02] [SPEAKER_02]: were you

[00:37:02] [SPEAKER_02]: feeling like you were tired one day

[00:37:04] [SPEAKER_02]: a week after work and now it's every day

[00:37:06] [SPEAKER_02]: were you drinking one day a week after

[00:37:09] [SPEAKER_02]: work and now it's every day right these things

[00:37:11] [SPEAKER_02]: that you would consider worsening

[00:37:13] [SPEAKER_02]: that's important how much

[00:37:14] [SPEAKER_02]: is it impacting your day to day life

[00:37:16] [SPEAKER_02]: what things do you want to be doing

[00:37:18] [SPEAKER_02]: are you not because of the way you're feeling

[00:37:21] [SPEAKER_02]: anxiety, anger, sadness

[00:37:23] [SPEAKER_02]: whatever that feeling is

[00:37:24] [SPEAKER_02]: what things do you want to be doing and that is

[00:37:26] [SPEAKER_02]: not just in work in school again

[00:37:28] [SPEAKER_02]: that you're not able to do

[00:37:30] [SPEAKER_02]: did you say no to social events

[00:37:32] [SPEAKER_02]: did you stop going to your like spirituality

[00:37:34] [SPEAKER_02]: whatever you religion

[00:37:36] [SPEAKER_02]: that you care about did you stop

[00:37:38] [SPEAKER_02]: participating in a hobby whatever it is

[00:37:40] [SPEAKER_02]: those things matter so

[00:37:42] [SPEAKER_02]: is it impacting your day to day life and how much

[00:37:44] [SPEAKER_02]: and then the last being severity

[00:37:46] [SPEAKER_02]: so you know if it's at the point

[00:37:48] [SPEAKER_02]: where

[00:37:50] [SPEAKER_02]: you're not sleeping, you're not eating

[00:37:52] [SPEAKER_02]: you're not functioning you have suicidal thoughts

[00:37:55] [SPEAKER_02]: things like that

[00:37:56] [SPEAKER_02]: that's automatic ask for help from

[00:37:58] [SPEAKER_02]: someone thing you know I think

[00:38:00] [SPEAKER_02]: we are often more comfortable talking

[00:38:02] [SPEAKER_02]: to appear first

[00:38:04] [SPEAKER_02]: and I think sometimes that's okay

[00:38:06] [SPEAKER_02]: when you're at a certain level because

[00:38:08] [SPEAKER_02]: they can help you and tell you ideas

[00:38:10] [SPEAKER_02]: and get you to the right places

[00:38:12] [SPEAKER_02]: talk to someone

[00:38:14] [SPEAKER_02]: I think that would be my encouragement

[00:38:16] [SPEAKER_02]: no matter what that all sorts of things

[00:38:18] [SPEAKER_02]: social support

[00:38:20] [SPEAKER_02]: helps and across

[00:38:22] [SPEAKER_02]: the board and data probably one of the few

[00:38:24] [SPEAKER_02]: protective factors that doesn't

[00:38:26] [SPEAKER_02]: mean you have a thousand friends that means

[00:38:28] [SPEAKER_02]: you have one

[00:38:30] [SPEAKER_02]: one good person you can talk to

[00:38:31] [SPEAKER_02]: and you can do real

[00:38:32] [SPEAKER_02]: and vulnerability

[00:38:33] [SPEAKER_02]: and even if you feel like it's somehow against

[00:38:36] [SPEAKER_02]: all of those different intersecting cultures

[00:38:38] [SPEAKER_02]: there's one person you can do that with

[00:38:40] [SPEAKER_02]: and that's super important

[00:38:41] [SPEAKER_02]: and so as much as it is

[00:38:43] [SPEAKER_02]: important to get professional help when it's

[00:38:45] [SPEAKER_02]: worsening when it's impacting your life

[00:38:48] [SPEAKER_02]: when it's severe sometimes we can't

[00:38:50] [SPEAKER_02]: for lots of reasons like

[00:38:52] [SPEAKER_02]: schedule

[00:38:55] [SPEAKER_02]: money, the system

[00:38:56] [SPEAKER_02]: there's so many things and I wish

[00:38:59] [SPEAKER_02]: that I could be a psychiatrist who said

[00:39:00] [SPEAKER_02]: just go ask for help and make a

[00:39:02] [SPEAKER_02]: psychiatry appointment but I'm like a very

[00:39:05] [SPEAKER_02]: realistic psychiatrist

[00:39:06] [SPEAKER_02]: who would say that doesn't always work

[00:39:09] [SPEAKER_02]: and you might do that and you might have to still

[00:39:11] [SPEAKER_02]: wait so make sure that you find other

[00:39:12] [SPEAKER_02]: things that you can do and other people who know

[00:39:14] [SPEAKER_02]: that they should be looking out for you because

[00:39:16] [SPEAKER_02]: as much as my therapist was looking out for

[00:39:19] [SPEAKER_02]: me

[00:39:20] [SPEAKER_02]: a friend could have done that too

[00:39:22] [SPEAKER_02]: said hey like

[00:39:24] [SPEAKER_02]: that's burnout or

[00:39:25] [SPEAKER_02]: you ever think you were burnt out

[00:39:27] [SPEAKER_02]: right it's a second set of eyes

[00:39:29] [SPEAKER_02]: it doesn't have to be a therapist though

[00:39:31] [SPEAKER_02]: you know I'd love to say that

[00:39:33] [SPEAKER_02]: for everybody we should be doing that

[00:39:35] [SPEAKER_02]: I just know that the way our culture

[00:39:37] [SPEAKER_02]: is set up and our structure is

[00:39:39] [SPEAKER_02]: we just don't

[00:39:42] [SPEAKER_01]: talk a little bit about and I'm sure you've done some thinking

[00:39:45] [SPEAKER_01]: about this we talked about the health care system

[00:39:46] [SPEAKER_01]: and the training system that we went through

[00:39:48] [SPEAKER_01]: that was really punishing in a lot of ways

[00:39:51] [SPEAKER_01]: we look at

[00:39:53] [SPEAKER_01]: the workplace there's not a consistent

[00:39:55] [SPEAKER_01]: way of asking for help

[00:39:57] [SPEAKER_01]: without perhaps

[00:39:59] [SPEAKER_01]: compromising yourself or at least people think that

[00:40:01] [SPEAKER_01]: and even at college which we're

[00:40:03] [SPEAKER_01]: going to talk about in just a moment

[00:40:06] [SPEAKER_01]: there's not always

[00:40:07] [SPEAKER_01]: uniform policies that help

[00:40:09] [SPEAKER_01]: support students

[00:40:11] [SPEAKER_01]: who are having troubles

[00:40:13] [SPEAKER_01]: do you want to say something about that

[00:40:15] [SPEAKER_02]: do you want to fix the system

[00:40:17] [SPEAKER_02]: you know so here's

[00:40:19] [SPEAKER_02]: the thing I think about this like

[00:40:21] [SPEAKER_02]: there are system problems and there are culture

[00:40:23] [SPEAKER_02]: problems and a lot of people

[00:40:25] [SPEAKER_02]: can't fix the system problems

[00:40:27] [SPEAKER_02]: because it's not within their power

[00:40:28] [SPEAKER_02]: but a lot of people focus only on the system

[00:40:31] [SPEAKER_02]: problems so they get

[00:40:33] [SPEAKER_02]: very very mad about all of it

[00:40:35] [SPEAKER_02]: and there they have no control

[00:40:37] [SPEAKER_02]: over any of it we have to think

[00:40:39] [SPEAKER_02]: about what we can do as an individual

[00:40:41] [SPEAKER_02]: and as a group and what we can

[00:40:43] [SPEAKER_02]: do is a way to get control

[00:40:45] [SPEAKER_02]: back and what we can do

[00:40:47] [SPEAKER_02]: is how we talk about this how we

[00:40:49] [SPEAKER_02]: talk about it with each other how normal

[00:40:51] [SPEAKER_02]: it feels how common

[00:40:53] [SPEAKER_02]: it is to talk about struggles that we

[00:40:55] [SPEAKER_02]: can change because if we make people feel

[00:40:57] [SPEAKER_02]: like it's okay to ask for help we make people

[00:40:59] [SPEAKER_02]: realize that at a certain point they should

[00:41:01] [SPEAKER_02]: and those are signs and symptoms of it

[00:41:03] [SPEAKER_02]: that helps just as much as the stuff

[00:41:05] [SPEAKER_02]: that I have to do as a system person

[00:41:07] [SPEAKER_02]: right the only way to be thinking

[00:41:09] [SPEAKER_02]: about that is to figure out how

[00:41:11] [SPEAKER_02]: you can live within the broken system

[00:41:13] [SPEAKER_02]: how you can survive within a broken

[00:41:15] [SPEAKER_02]: system how do you find

[00:41:17] [SPEAKER_02]: meaning and purpose in the stuff that you're

[00:41:19] [SPEAKER_02]: doing which is also super protective

[00:41:21] [SPEAKER_02]: how do you find support in the things that

[00:41:23] [SPEAKER_02]: you're doing how do you find a way to cope

[00:41:25] [SPEAKER_02]: within the context of what space

[00:41:27] [SPEAKER_02]: and time you have and

[00:41:29] [SPEAKER_02]: what does that look like and can you have a healthy

[00:41:31] [SPEAKER_02]: workplace for you even if it's not

[00:41:33] [SPEAKER_02]: perfect because that's going to be

[00:41:35] [SPEAKER_01]: really hard. Well as you're

[00:41:37] [SPEAKER_01]: speaking it

[00:41:39] [SPEAKER_01]: makes me think about the

[00:41:41] [SPEAKER_01]: fact that you know instead

[00:41:44] [SPEAKER_01]: of revamping the system

[00:41:46] [SPEAKER_01]: you as potentially part of the

[00:41:48] [SPEAKER_01]: system if you're an employer

[00:41:50] [SPEAKER_01]: if you're a manager

[00:41:51] [SPEAKER_01]: if you're a attending

[00:41:53] [SPEAKER_01]: on the wards or whatever

[00:41:55] [SPEAKER_01]: faculty member

[00:41:57] [SPEAKER_01]: you can have that culture

[00:41:59] [SPEAKER_01]: within your sphere

[00:42:01] [SPEAKER_01]: and be much more open to

[00:42:03] [SPEAKER_01]: what's going on perhaps. Yeah I mean

[00:42:06] [SPEAKER_02]: so I'm a person who just told

[00:42:08] [SPEAKER_02]: you my like entire life story

[00:42:09] [SPEAKER_02]: in terms of my mental health right but not everyone

[00:42:11] [SPEAKER_02]: has to do that being vulnerable

[00:42:13] [SPEAKER_02]: is like hey I didn't sleep well last night

[00:42:16] [SPEAKER_02]: hey being a doctor's heart

[00:42:17] [SPEAKER_02]: hey juggling motherhood

[00:42:20] [SPEAKER_02]: and this is very complex

[00:42:22] [SPEAKER_02]: hey I'm late because my kid was sick

[00:42:24] [SPEAKER_02]: and I didn't get here those

[00:42:26] [SPEAKER_02]: kind of things that we don't realize we're

[00:42:28] [SPEAKER_02]: doing sometimes that we probably take for

[00:42:30] [SPEAKER_02]: granted make somebody else go

[00:42:32] [SPEAKER_02]: oh sh like we're allowed to

[00:42:34] [SPEAKER_02]: talk about this like that's something

[00:42:36] [SPEAKER_02]: someone else is dealing with like that person

[00:42:38] [SPEAKER_02]: I admire is dealing with that whatever

[00:42:39] [SPEAKER_02]: that is we all should find

[00:42:42] [SPEAKER_02]: ways to sort of be checking in on each other

[00:42:44] [SPEAKER_02]: in a more caring way and a more

[00:42:46] [SPEAKER_02]: vulnerable way because it's just to make

[00:42:48] [SPEAKER_02]: us all stronger for it. That's so true

[00:42:58] [SPEAKER_01]: So shifting a little bit

[00:43:00] [SPEAKER_01]: because one of our most at risk populations

[00:43:02] [SPEAKER_01]: are young people

[00:43:04] [SPEAKER_01]: and you have taken a new position

[00:43:06] [SPEAKER_01]: at the University of Tennessee

[00:43:08] [SPEAKER_01]: and that is as

[00:43:10] [SPEAKER_01]: the chief well-being officer and I believe

[00:43:12] [SPEAKER_01]: you're the first chief well-being officer

[00:43:14] [SPEAKER_01]: so what does that mean

[00:43:16] [SPEAKER_01]: and what are you doing

[00:43:17] [SPEAKER_02]: so the fun thing about being new at jobs

[00:43:20] [SPEAKER_02]: is it's ill-defined but the hard

[00:43:22] [SPEAKER_02]: thing about being new at a job is it's

[00:43:23] [SPEAKER_02]: ill-defined especially when you're the first person

[00:43:26] [SPEAKER_02]: so wellness is a very broad

[00:43:28] [SPEAKER_02]: term I think if you asked

[00:43:30] [SPEAKER_02]: everyone they would have a different definition

[00:43:32] [SPEAKER_02]: of it but what I would say

[00:43:33] [SPEAKER_02]: is important about it is

[00:43:35] [SPEAKER_02]: that it's not just emotional well-being

[00:43:38] [SPEAKER_02]: so when we talk about wellness we're talking

[00:43:39] [SPEAKER_02]: about physical health spiritual health social health

[00:43:42] [SPEAKER_02]: environmental sort of like how

[00:43:43] [SPEAKER_02]: the world that you live in is impacting

[00:43:45] [SPEAKER_02]: you right there's all these there's

[00:43:47] [SPEAKER_02]: eight domains really but it's

[00:43:49] [SPEAKER_02]: important that that word is seen as

[00:43:51] [SPEAKER_02]: this broad thing and part of the reason that

[00:43:53] [SPEAKER_02]: everyone has a different definition is they

[00:43:55] [SPEAKER_02]: tend to take one of them or something like

[00:43:57] [SPEAKER_02]: that that's their kind of priority

[00:43:59] [SPEAKER_02]: so with that as an understanding

[00:44:02] [SPEAKER_02]: in the University

[00:44:03] [SPEAKER_02]: of Tennessee system there are

[00:44:06] [SPEAKER_02]: five campuses

[00:44:08] [SPEAKER_02]: that have a mix of graduate

[00:44:09] [SPEAKER_02]: students and undergraduate students

[00:44:12] [SPEAKER_02]: and then obviously faculty and staff

[00:44:14] [SPEAKER_02]: and my job is to kind of

[00:44:15] [SPEAKER_02]: figure out how can

[00:44:18] [SPEAKER_02]: somebody who has a really

[00:44:20] [SPEAKER_02]: big perspective birds-eye-view

[00:44:21] [SPEAKER_02]: perspective over this be helpful

[00:44:24] [SPEAKER_02]: that could be as

[00:44:26] [SPEAKER_02]: sort of simple to some

[00:44:28] [SPEAKER_02]: people but obviously actually quite complex

[00:44:30] [SPEAKER_02]: as trying to understand what data

[00:44:32] [SPEAKER_02]: we have and how we would be defining

[00:44:34] [SPEAKER_02]: our baseline and then

[00:44:35] [SPEAKER_02]: what we should be looking at moving forward

[00:44:37] [SPEAKER_02]: kind of as a global kind of comparison

[00:44:40] [SPEAKER_02]: between campuses it could be

[00:44:42] [SPEAKER_02]: how do we change culture

[00:44:43] [SPEAKER_02]: from the top and like what do

[00:44:46] [SPEAKER_02]: I model that can be helpful for people

[00:44:48] [SPEAKER_02]: and how do we make

[00:44:50] [SPEAKER_02]: wellness a conversation

[00:44:51] [SPEAKER_02]: across the board

[00:44:53] [SPEAKER_02]: it could be

[00:44:55] [SPEAKER_02]: trainings and education around this

[00:44:58] [SPEAKER_02]: for groups and you know for me my

[00:45:00] [SPEAKER_02]: first sort of charges students

[00:45:02] [SPEAKER_02]: there's almost 60,000 students

[00:45:04] [SPEAKER_02]: across campuses

[00:45:05] [SPEAKER_02]: people might go well you just talk about healthcare for a very long time

[00:45:08] [SPEAKER_02]: like why are you working with college students

[00:45:10] [SPEAKER_02]: too but I've been a college student

[00:45:12] [SPEAKER_02]: provider as well as a healthcare worker

[00:45:15] [SPEAKER_02]: like you know

[00:45:16] [SPEAKER_02]: psychiatrist the whole time I worked on

[00:45:18] [SPEAKER_02]: college campuses as the psychiatrist in

[00:45:20] [SPEAKER_02]: three locations

[00:45:21] [SPEAKER_02]: because I did it during training and during med school

[00:45:24] [SPEAKER_02]: as well so I've always had

[00:45:26] [SPEAKER_02]: clinical exposure to it but I never actually

[00:45:28] [SPEAKER_02]: did like this sort of broader

[00:45:30] [SPEAKER_02]: administrative work around it so I'm kind of excited

[00:45:32] [SPEAKER_02]: because it

[00:45:34] [SPEAKER_02]: like lets me do both because

[00:45:36] [SPEAKER_02]: I'm situated at the health science

[00:45:38] [SPEAKER_02]: center campus all those students

[00:45:39] [SPEAKER_02]: are nursing, pharmacy, dentistry

[00:45:42] [SPEAKER_02]: medicine, PA, OT, PT

[00:45:44] [SPEAKER_02]: all of this stuff right so it's like

[00:45:46] [SPEAKER_02]: that whole little village but just how we train

[00:45:48] [SPEAKER_02]: them so focusing on

[00:45:50] [SPEAKER_02]: students and sort of like

[00:45:51] [SPEAKER_02]: you know trying to help them

[00:45:53] [SPEAKER_02]: early on so that when they do go to the

[00:45:55] [SPEAKER_02]: hospitals they're in a bit

[00:45:57] [SPEAKER_02]: better shape perhaps as much as we

[00:45:59] [SPEAKER_02]: can and you're right like college

[00:46:01] [SPEAKER_02]: kids have really really struggled

[00:46:03] [SPEAKER_02]: college kids or college age sort of transitional

[00:46:06] [SPEAKER_02]: youth have

[00:46:07] [SPEAKER_02]: always struggled just like healthcare workers

[00:46:10] [SPEAKER_02]: have always struggled and the pandemic

[00:46:12] [SPEAKER_02]: made things worse for them for different

[00:46:13] [SPEAKER_02]: reasons but also brought

[00:46:15] [SPEAKER_02]: that to light right and in so

[00:46:17] [SPEAKER_02]: many ways just as I don't view my book as

[00:46:19] [SPEAKER_02]: a pandemic because again people would

[00:46:21] [SPEAKER_02]: grown I think the pandemic

[00:46:23] [SPEAKER_02]: just sort of like magnified these things

[00:46:25] [SPEAKER_02]: and made them more obvious to people

[00:46:27] [SPEAKER_02]: and college is already a time where you

[00:46:29] [SPEAKER_02]: have identity development where you're living alone

[00:46:31] [SPEAKER_02]: maybe the for the first time away from family

[00:46:33] [SPEAKER_02]: where you're

[00:46:35] [SPEAKER_02]: experimenting with things where

[00:46:37] [SPEAKER_02]: you're the age that

[00:46:39] [SPEAKER_02]: bipolar and schizophrenia even come out to

[00:46:41] [SPEAKER_02]: begin with so you're in this

[00:46:43] [SPEAKER_02]: sort of high risk group and then

[00:46:45] [SPEAKER_02]: you add in these like changes

[00:46:47] [SPEAKER_02]: no one could have predicted but obviously

[00:46:49] [SPEAKER_02]: we're severely compounding

[00:46:51] [SPEAKER_02]: an existing problem and

[00:46:53] [SPEAKER_02]: you know it's very similar for me in

[00:46:55] [SPEAKER_02]: that sense where it's like these two populations

[00:46:57] [SPEAKER_02]: that I've had the privilege

[00:46:59] [SPEAKER_02]: of caring for through this time

[00:47:02] [SPEAKER_02]: but including before

[00:47:03] [SPEAKER_02]: have been really really impacted

[00:47:05] [SPEAKER_02]: and I have the ability to do more

[00:47:07] [SPEAKER_02]: probably because of that because people

[00:47:09] [SPEAKER_02]: are investing in it more because they know that

[00:47:11] [SPEAKER_02]: they should and I'm okay with that

[00:47:14] [SPEAKER_01]: and in your experience

[00:47:16] [SPEAKER_01]: what do you wish more teens

[00:47:18] [SPEAKER_01]: or maybe even their parents knew

[00:47:19] [SPEAKER_01]: about mental health and well-being

[00:47:22] [SPEAKER_02]: that it's a spectrum

[00:47:24] [SPEAKER_02]: and that it's normal

[00:47:25] [SPEAKER_02]: so I think that

[00:47:27] [SPEAKER_02]: we

[00:47:29] [SPEAKER_02]: sometimes over pathologize feelings

[00:47:32] [SPEAKER_02]: to the point where people

[00:47:33] [SPEAKER_02]: want a diagnosis and they want to be

[00:47:35] [SPEAKER_02]: seen by someone like me I think some of that

[00:47:38] [SPEAKER_02]: comes from places like tiktok

[00:47:39] [SPEAKER_02]: I think sometimes we minimize emotions

[00:47:41] [SPEAKER_02]: and I don't think there's anything in between

[00:47:43] [SPEAKER_02]: like I haven't really felt like there's a lot

[00:47:45] [SPEAKER_02]: of like that's super normal

[00:47:47] [SPEAKER_02]: let's see how it evolves like maybe you just need

[00:47:49] [SPEAKER_02]: to sit with your feelings and see if you're okay

[00:47:51] [SPEAKER_02]: right like have you tried this coping

[00:47:53] [SPEAKER_02]: skill whatever it is and so I think it's

[00:47:55] [SPEAKER_02]: important that people realize it's not just like

[00:47:57] [SPEAKER_02]: emotions are bad or emotions

[00:48:00] [SPEAKER_02]: like there's too many emotions

[00:48:01] [SPEAKER_02]: and like therefore you have to go get

[00:48:03] [SPEAKER_02]: help from a professional but that it's

[00:48:05] [SPEAKER_02]: like a spectrum and that mental health

[00:48:07] [SPEAKER_02]: exists on a spectrum and we need to think

[00:48:09] [SPEAKER_02]: about it like that and that's

[00:48:11] [SPEAKER_02]: an important like sort of concept

[00:48:13] [SPEAKER_02]: that I think is missing

[00:48:15] [SPEAKER_02]: in how we've talked about it

[00:48:17] [SPEAKER_02]: and I think would make a big difference

[00:48:19] [SPEAKER_02]: in kind of what

[00:48:21] [SPEAKER_02]: people are doing for it as a result

[00:48:24] [SPEAKER_01]: absolutely and to that end

[00:48:26] [SPEAKER_01]: why did you call your

[00:48:28] [SPEAKER_01]: book how do you feel

[00:48:30] [SPEAKER_02]: so many reasons

[00:48:32] [SPEAKER_02]: I mean I think it is

[00:48:33] [SPEAKER_02]: something that we don't ask ourselves enough

[00:48:35] [SPEAKER_02]: which is why the you is there

[00:48:37] [SPEAKER_02]: so it's not how do you like we

[00:48:39] [SPEAKER_02]: feel it's how do you

[00:48:41] [SPEAKER_02]: feel because when you're a person

[00:48:43] [SPEAKER_02]: caring for other people you don't ask yourself

[00:48:45] [SPEAKER_02]: that and the you is the keyword

[00:48:47] [SPEAKER_02]: there I think that

[00:48:49] [SPEAKER_02]: you know with friends and family that's true

[00:48:51] [SPEAKER_02]: to that we probably need to ask that

[00:48:53] [SPEAKER_02]: more and then as a psychiatrist

[00:48:55] [SPEAKER_02]: is probably like the most common thing that

[00:48:57] [SPEAKER_02]: you know I ask and it's probably

[00:48:59] [SPEAKER_02]: kind of stereotypical in this like let's

[00:49:01] [SPEAKER_02]: make fun of a psychiatrist on TV way

[00:49:03] [SPEAKER_02]: but inherently like it's

[00:49:05] [SPEAKER_02]: key to my job is like to dive

[00:49:07] [SPEAKER_02]: deeper and not just hear the story

[00:49:09] [SPEAKER_02]: but to understand the feelings behind it

[00:49:11] [SPEAKER_02]: and we don't always do

[00:49:13] [SPEAKER_02]: that you know sometimes it's just information

[00:49:15] [SPEAKER_02]: and people process the information

[00:49:17] [SPEAKER_02]: but there's often so much more to it

[00:49:19] [SPEAKER_02]: and psychiatry training teaches you that

[00:49:21] [SPEAKER_02]: but being a friend doesn't always

[00:49:23] [SPEAKER_02]: and being a friend to yourself

[00:49:24] [SPEAKER_02]: doesn't always and I think that that is

[00:49:27] [SPEAKER_02]: why the you in particular

[00:49:29] [SPEAKER_02]: is important to me

[00:49:31] [SPEAKER_01]: what did I not ask

[00:49:33] [SPEAKER_01]: you that you wanted to make sure we discussed

[00:49:35] [SPEAKER_02]: that's my favorite psychiatrist question

[00:49:38] [SPEAKER_01]: that was like

[00:49:39] [SPEAKER_01]: I went into the wrong

[00:49:40] [SPEAKER_01]: what else is there that I didn't know

[00:49:43] [SPEAKER_02]: I was supposed to ask you know

[00:49:44] [SPEAKER_02]: I mean I appreciate you asking a lot

[00:49:47] [SPEAKER_02]: about the book you know it took me

[00:49:49] [SPEAKER_02]: three years and in a lot of ways like

[00:49:50] [SPEAKER_02]: I process so much of my experience

[00:49:53] [SPEAKER_02]: and my patients experiences through

[00:49:55] [SPEAKER_02]: that and it was sort of like

[00:49:57] [SPEAKER_02]: journaling even though it doesn't come off

[00:49:59] [SPEAKER_02]: like a journal there's some aspects of it that are

[00:50:01] [SPEAKER_02]: and I think that we

[00:50:03] [SPEAKER_02]: forget how powerful that can be for us

[00:50:05] [SPEAKER_02]: and how healing and I think that was

[00:50:07] [SPEAKER_02]: a big thing for me I'm a little

[00:50:09] [SPEAKER_02]: putting it out into the world is

[00:50:10] [SPEAKER_02]: vulnerable and hard in a lot of ways

[00:50:13] [SPEAKER_02]: but I hope that in

[00:50:14] [SPEAKER_02]: being vulnerable other people can see

[00:50:16] [SPEAKER_02]: themselves and other people will relate

[00:50:18] [SPEAKER_02]: and feel seen and and and feel

[00:50:20] [SPEAKER_02]: understood in some capacity even if it's

[00:50:22] [SPEAKER_02]: not all of it even if it's just

[00:50:24] [SPEAKER_02]: understanding their friend who's in healthcare even

[00:50:26] [SPEAKER_02]: it's just understanding their healthcare worker but

[00:50:28] [SPEAKER_02]: really understanding how universal

[00:50:30] [SPEAKER_02]: so many of these things are and

[00:50:34] [SPEAKER_02]: feel like they're not alone

[00:50:37] [SPEAKER_01]: well it's a great book

[00:50:39] [SPEAKER_01]: and it's coming out when

[00:50:40] [SPEAKER_02]: it comes out October 8th

[00:50:42] [SPEAKER_02]: you can pre-order it a bunch of places now

[00:50:45] [SPEAKER_02]: which helps me a lot because I'm

[00:50:46] [SPEAKER_02]: a debut author and a new author

[00:50:48] [SPEAKER_02]: and it tells people that people are interested

[00:50:50] [SPEAKER_02]: in this topic and lets other

[00:50:52] [SPEAKER_02]: people write things on this topic

[00:50:54] [SPEAKER_02]: and I would hope that people

[00:50:56] [SPEAKER_02]: would even like learn a little bit about

[00:50:59] [SPEAKER_02]: psychiatry from it. I think psychiatry

[00:51:01] [SPEAKER_02]: is still more stigmatized than

[00:51:02] [SPEAKER_02]: therapy and that we've normalized therapy

[00:51:04] [SPEAKER_02]: a bit more but meds is like this whole

[00:51:07] [SPEAKER_02]: other thing and psychiatrists

[00:51:09] [SPEAKER_02]: haven't helped that I would hope that

[00:51:11] [SPEAKER_02]: in reading it people are like oh that's

[00:51:13] [SPEAKER_02]: what they think about or oh that's why they

[00:51:15] [SPEAKER_02]: go into this and oh that's

[00:51:17] [SPEAKER_02]: what you do as a psychiatrist and I

[00:51:19] [SPEAKER_02]: don't think we have a lot of that in a way

[00:51:20] [SPEAKER_02]: for people because I think that

[00:51:22] [SPEAKER_02]: psychiatry is sort of its own little

[00:51:24] [SPEAKER_02]: island and I would hope that

[00:51:26] [SPEAKER_02]: it makes you know that if you do need

[00:51:28] [SPEAKER_02]: medication it's just another tool

[00:51:30] [SPEAKER_02]: and the person that's going to talk to

[00:51:32] [SPEAKER_02]: you about it is just going to be another

[00:51:34] [SPEAKER_02]: person who cares and I think that

[00:51:36] [SPEAKER_02]: that's important for people too.

[00:51:37] [SPEAKER_01]: I think that's a great

[00:51:39] [SPEAKER_01]: message. Well I'm going to

[00:51:41] [SPEAKER_01]: end with asking you one more important

[00:51:43] [SPEAKER_01]: question and is that

[00:51:45] [SPEAKER_01]: did you attend the Eris

[00:51:47] [SPEAKER_01]: concert and do you have

[00:51:49] [SPEAKER_01]: a favorite lyric that you want to share

[00:51:51] [SPEAKER_01]: with us? I

[00:51:53] [SPEAKER_02]: saw Taylor Swift open for

[00:51:55] [SPEAKER_02]: Keith Urban when I was in college

[00:51:57] [SPEAKER_02]: so I've been a long time fan

[00:51:59] [SPEAKER_02]: and I went to

[00:52:01] [SPEAKER_02]: Chicago and

[00:52:03] [SPEAKER_02]: I am going to London

[00:52:05] [SPEAKER_02]: which I'm very excited about

[00:52:07] [SPEAKER_02]: in part because she added

[00:52:08] [SPEAKER_02]: tortured poets but also because

[00:52:10] [SPEAKER_02]: it worked out.

[00:52:12] [SPEAKER_02]: So I'm very excited about that.

[00:52:14] [SPEAKER_02]: Song Lies you say

[00:52:16] [SPEAKER_02]: my favorite song? Or a favorite lyric

[00:52:19] [SPEAKER_01]: because I noticed that you quoted her

[00:52:21] [SPEAKER_02]: in your book. I quote her a lot

[00:52:22] [SPEAKER_02]: in the book because she's

[00:52:24] [SPEAKER_02]: very good at being

[00:52:26] [SPEAKER_02]: quotable. Right now

[00:52:28] [SPEAKER_02]: I'm a big fan of I cry a lot

[00:52:30] [SPEAKER_02]: but I'm so productive it's an art

[00:52:32] [SPEAKER_02]: which is

[00:52:33] [SPEAKER_02]: in the song I can do it with a broken heart

[00:52:36] [SPEAKER_02]: in tortured poets

[00:52:37] [SPEAKER_02]: and I think it's because

[00:52:40] [SPEAKER_02]: it's just so realistic

[00:52:42] [SPEAKER_02]: right which is like especially

[00:52:44] [SPEAKER_02]: to probably everybody listening to this podcast

[00:52:46] [SPEAKER_02]: in your audience and especially to people

[00:52:48] [SPEAKER_02]: in healthcare which is like

[00:52:49] [SPEAKER_02]: yeah I have a lot of feelings but

[00:52:51] [SPEAKER_02]: I pour it into work and I work really

[00:52:54] [SPEAKER_02]: hard and nobody would know that I was crying

[00:52:56] [SPEAKER_02]: because I did everything that I was supposed

[00:52:57] [SPEAKER_02]: to do and I was still going and

[00:52:59] [SPEAKER_02]: you know that's so

[00:53:01] [SPEAKER_02]: true and it is kind of

[00:53:03] [SPEAKER_02]: an art and it is an unnecessary

[00:53:05] [SPEAKER_02]: thing that so many of us have learned to do

[00:53:07] [SPEAKER_02]: and still be good at and I

[00:53:09] [SPEAKER_02]: think about that a lot with patients. I think about

[00:53:11] [SPEAKER_02]: that a lot with me and I sort

[00:53:13] [SPEAKER_02]: of wish that wasn't the case but it's

[00:53:15] [SPEAKER_02]: very much the case so I relate

[00:53:17] [SPEAKER_02]: very much to the lyric.

[00:53:19] [SPEAKER_01]: Well Dr. Jessica

[00:53:21] [SPEAKER_01]: thank you for spending so much time with me

[00:53:23] [SPEAKER_01]: it is such a delight

[00:53:25] [SPEAKER_01]: to talk with you and again your

[00:53:27] [SPEAKER_01]: book was wonderful. I wholly

[00:53:29] [SPEAKER_01]: recommended it to everybody.

[00:53:31] [SPEAKER_02]: Thank you I so appreciate that

[00:53:33] [SPEAKER_02]: and I am so honored to be on your

[00:53:35] [SPEAKER_02]: podcast. Oh thanks.

[00:53:52] [SPEAKER_01]: As we wrap up this enlightening conversation

[00:53:54] [SPEAKER_01]: with Dr. Jesse Gold author of

[00:53:56] [SPEAKER_01]: How Do You Feel and Chief Wellness

[00:53:58] [SPEAKER_01]: Officer for the University of Tennessee

[00:54:00] [SPEAKER_01]: System let's recap some key

[00:54:02] [SPEAKER_01]: takeaways.

[00:54:04] [SPEAKER_01]: Burnout is a pervasive issue

[00:54:06] [SPEAKER_01]: in healthcare that existed long before

[00:54:08] [SPEAKER_01]: the pandemic but COVID-19

[00:54:10] [SPEAKER_01]: brought it into a sharper focus

[00:54:12] [SPEAKER_01]: but it's not exclusive to

[00:54:14] [SPEAKER_01]: healthcare. Symptoms

[00:54:16] [SPEAKER_01]: of burnout are emotional exhaustion

[00:54:18] [SPEAKER_01]: feeling like you're disconnected

[00:54:20] [SPEAKER_01]: from work and a reduced sense

[00:54:22] [SPEAKER_01]: of personal accomplishment.

[00:54:25] [SPEAKER_01]: Mental health struggles

[00:54:26] [SPEAKER_01]: are universal affecting people

[00:54:28] [SPEAKER_01]: across all professions and walks

[00:54:30] [SPEAKER_01]: of life.

[00:54:32] [SPEAKER_01]: Self-care and setting boundaries are

[00:54:34] [SPEAKER_01]: crucial especially for caregivers

[00:54:36] [SPEAKER_01]: and women however

[00:54:38] [SPEAKER_01]: if your feelings and symptoms continue

[00:54:40] [SPEAKER_01]: even with self-care measures

[00:54:42] [SPEAKER_01]: it's important to seek support

[00:54:44] [SPEAKER_01]: and help. And I would add

[00:54:46] [SPEAKER_01]: that if you continue to have symptoms

[00:54:48] [SPEAKER_01]: or begin to have symptoms of depression

[00:54:50] [SPEAKER_01]: such as a change in sleep, energy

[00:54:53] [SPEAKER_01]: appetite or any thoughts

[00:54:54] [SPEAKER_01]: of harming yourself seek

[00:54:56] [SPEAKER_01]: medical attention.

[00:54:58] [SPEAKER_01]: The suicide crisis hotline is

[00:55:00] [SPEAKER_01]: 988 and that's available

[00:55:02] [SPEAKER_01]: 24 hours 7 days a week.

[00:55:05] [SPEAKER_01]: We also have listed

[00:55:06] [SPEAKER_01]: resources specifically for healthcare professionals

[00:55:09] [SPEAKER_01]: who may be experiencing mental health challenges.

[00:55:12] [SPEAKER_01]: We all need to do our part

[00:55:13] [SPEAKER_01]: in changing workplace culture

[00:55:15] [SPEAKER_01]: to be more open about mental health.

[00:55:18] [SPEAKER_01]: Again, I highly recommend

[00:55:19] [SPEAKER_01]: Dr. Gold's book How Do You Feel

[00:55:21] [SPEAKER_01]: as it offers a deeper dive

[00:55:23] [SPEAKER_01]: into these topics providing valuable

[00:55:25] [SPEAKER_01]: insights for healthcare workers, patients

[00:55:27] [SPEAKER_01]: and anyone interested

[00:55:29] [SPEAKER_01]: in mental health and well-being

[00:55:30] [SPEAKER_01]: and links to ordering the book are found

[00:55:33] [SPEAKER_01]: in our podcast notes.

[00:55:35] [SPEAKER_01]: Thanks so much for spending time

[00:55:37] [SPEAKER_01]: with me today. I hope you'll check out our

[00:55:39] [SPEAKER_01]: website at beyondthepapergown.com

[00:55:42] [SPEAKER_01]: for articles, news and events

[00:55:44] [SPEAKER_01]: and while you're there

[00:55:45] [SPEAKER_01]: subscribe to our newsletter for even more

[00:55:47] [SPEAKER_01]: information on women's health

[00:55:48] [SPEAKER_01]: and upcoming episodes.

[00:55:51] [SPEAKER_01]: And please subscribe to our podcast

[00:55:52] [SPEAKER_01]: on your favorite podcast platform.

[00:55:55] [SPEAKER_01]: Thanks again for listening

[00:55:56] [SPEAKER_01]: and take good care.

[00:56:10] [SPEAKER_01]: Our episode was produced by Patrick

[00:56:12] [SPEAKER_01]: Shambayati and me and our

[00:56:14] [SPEAKER_01]: associate producer is Kyla McNoyan.

[00:56:53] [SPEAKER_00]: We hope you enjoyed this episode.

[00:56:57] [SPEAKER_00]: We'll see you in the next one.