Transcript
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Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills
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to build their own research program, whether or not they have a mentor.
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As clinicians, we spend a decade or more as trainees learning to take care of patients.
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When we finally start our careers, we want to build research programs, but then we find
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that our years of clinical training did not adequately prepare us to lead our research
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program.
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Through no fault of our own, we struggle to find mentors, and when we can't, we quit.
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However, clinicians hold the keys to the greatest research breakthroughs.
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For this reason, the Clinician Researcher podcast exists to give academic clinicians
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the tools to build their own research program, whether or not they have a mentor.
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Now introducing your host, Toyosi Onwuemene.
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Welcome to the Clinician Researcher podcast.
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I'm your host, Toyosi Onwuemene, and it is an absolute pleasure to be talking with you today.
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Thank you so much for tuning in.
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And for those of you who are catching this a long time after it's been recorded, I just
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want to say that I'm so excited that you are coming to this episode because I think it's
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going to help you, and I'm hoping it's going to save lives.
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And I really do mean that.
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I'm hoping that this is an episode that's going to save your life.
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And if it's not going to save your life, it's going to save somebody else's life.
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And I want to ask you to think about who that person is and forward it to them.
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Okay, so I hope I have you intrigued.
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This episode is going to save lives.
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And that's not because people are donating to charity as a result of this episode airing,
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but really, I think it's an important episode so that more of us could be healthy.
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And the reason, the prompting for this episode, so this is the week of my animal meeting.
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It's actually a weekend and a few days into the week.
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And it's just brought a lot of introspection.
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And today's particular episode comes from a conversation I had with a beautiful colleague
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who, wow, I've known her for a few years.
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And I met her at today's animal meeting and asked how she was doing.
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And she had a major life crisis.
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She had a major life crisis that caused her to pause and rethink her career.
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And I remember she was sharing her crisis.
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I mean, it was a big deal.
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And I can't share any more detail than that because it is personal.
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But I remember stopping and thinking, oh, my goodness, I had a similar crisis.
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And I've had a similar crisis, which I can share about, but maybe I'll share about in
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a different episode.
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Because this is really about my colleague's story, even though I'm not sharing the details.
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But it was an important pause because I asked, how is life different now?
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Because you've had this major change in your life.
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How are things different today?
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And she talked about the importance of fierce boundaries that she's now established.
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She's like, you know, I had a total reframe of my perspective.
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I understand what's now important to me in my life.
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And now I have fierce boundaries.
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I don't want to do any of these things that make me crazy.
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My life was crazy.
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I mean, it was just a really great conversation because then I got to share about my experience
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and how I've trying to change the way I live in the academy because of the experience I
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have had.
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And I asked her, I'm like, did we have a midlife crisis?
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So we're both considered mid-career.
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I'm like, does this count as a mid-career crisis?
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And I don't know.
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I don't know.
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And one of the things she said, which was so important, and the reason I'm bringing
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you this episode today is she said, I wish I didn't wait until there was a crisis.
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I wish I had made the decision for myself before I had to make the decision.
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And so that's what brings me to this episode is to talk to you about how to save yourself
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before the crash.
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Because here's the thing about the crash that's coming.
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It's going to come in one way or the other.
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And maybe for some of you listening to me right now, you've had many crashes.
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And what hasn't happened is the big crash, the crash to end all crashes.
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But the crash will come because for many of us in medicine, the way we live life is not
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sustainable.
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And for some weird reason, we've been able to sustain it for a long time.
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For some of us, we've sustained it for years.
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For some of us, it's been decades.
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But if a bus is hurtling off a cliff without brakes, it's only a matter of time before
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something bad happens.
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You know, the crash is inevitable.
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And so this episode is an attempt to say, hey, can we pause and reflect and think about
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how we could do things differently so that we don't get a crash?
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So I'm saying the crash doesn't have to be inevitable.
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And how can we pause?
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You know, I want to take a moment here and I want to recognize everyone we've lost in
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2023, everyone we've lost in medicine.
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And you know, in talking with this colleague, I talked about faculty members, women faculty
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members who have been lost to me at my institution.
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And she talked about men at her institution who had been lost in violent ways.
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And so in all honesty, it kind of makes me a little bit sad as I share this episode with
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you.
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So I want to pause and actually just take a moment of silence.
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And I want to recognize that so much is lost when physicians lose their lives for whatever
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reason, whether it's, you know, taken in a place of despair, or it's taken by illness
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that overwhelms us before we're ready.
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Yeah.
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Okay.
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I want to come back to a positive note because I'm feeling sad now.
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But this is about how to save yourself before the crash.
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I think it's really important because, wow, we're so busy.
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We're so busy.
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We don't have time to think about our health.
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We don't have time to think about our emotional health, our mental health, our physical health
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until we're forced to.
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And so the first thing I want to share in line with how to save yourself before a crash
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is to pause.
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Number one is to pause.
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And the reason we need to pause is because until we pause, we may not have time to think
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critically.
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We're so busy in medicine.
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We're moving from one deadline to the next deadline.
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We're moving from one thing of patient care to the next thing of patient care.
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There's always something.
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We're super busy.
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We're holy, holy cow.
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We're always busy, right?
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We're holy busy all the time.
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And until we pause, we may not have time to reflect and think.
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And so the first thing to do is to stop.
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Pause.
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And what does it mean to pause?
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It really does mean taking time in your schedule, taking time.
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Take a day, take two days and just pause.
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It's not the same as going on vacation.
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You know where you pack everybody and the dog, put them in a car, then travel across
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country and you're like, you're pausing, you're not pausing.
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You're still in full speed.
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Like you're still full steam ahead.
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You're not pausing.
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But to pause really does mean to take time out to rest and reflect.
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And so I'm inviting you as a first step to pause.
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The second thing I'm inviting you to do is to spend some time in deep, honest introspection.
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And so the pause is to allow you to create space for some deep, honest introspection.
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And why is this necessary?
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Because in medicine, gosh, there's so much sickness.
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There's so many people who are not healthy.
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Oh yes, they're successful.
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Oh goodness, they have all the things to show.
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They've got the manuscripts, they've got the grants, they've been funded, they've got the
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named professorships, they've got everything, or at least it seems as if they do.
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They are not well.
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They are sick.
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And it's a pervasive thing in medicine.
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Burnout is pervasive.
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People who are not mentally and emotionally well, it's pervasive.
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And there's some stigma associated with any mental ill health.
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But it's very common.
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And people are medicating.
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There's a lot.
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And so looking around, we are surrounded by people who are just moving, going, going,
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going without pausing for deep introspection.
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So if you're going to pause, you're going to spend time in deep introspection.
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You're doing something that is countercultural in medicine.
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There is a sense that, oh, you keep working.
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And then when you're retired, sure, if you want to retire, you can spend all this time
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introspecting.
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But I am asking you to do that now, before you have to, or before maybe you don't even
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have time to.
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But to really spend time in deep, honest introspection and reflection.
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And I'm going to say honestly, this is something that may not easily happen for you, just with
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the way your life is structured right now.
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And it may be that you need help.
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You need someone to come alongside you in this deep, honest introspection.
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Now, if you have any mental health concerns, you do need a licensed mental health professional
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to talk with.
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Maybe you need to talk with a therapist.
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If you're not concerned about mental health issues and maybe you feel like, no, no, I'm
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not, I feel like I'm okay.
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I can do this.
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Maybe working with a coach makes sense for you to do this deep, honest reflection and
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introspection.
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I'd be happy to be the coach that helps you do that.
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But spend time in deep, honest introspection.
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This is important.
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You got to do it away from the people who are not doing this.
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And maybe you've got to do this away from your mentors who sometimes are not healthy
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themselves.
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They're very successful.
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Don't get me wrong.
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They're doing everything.
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I mean, they are just amazing.
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And some of them are not healthy.
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And so spend time in deep, honest introspection.
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And what do you do?
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What do you do in this time of deep, honest introspection?
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Well, it's number three.
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It's asking yourself, is this the life I want from me?
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Is this the life I want from me?
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The challenge in medicine is that there's so much that we see that is normal.
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You know, physicians working overtime, you know, working nights, working weekends, working
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all the time.
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And it can feel like that's normal.
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And so when you look around you and you feel like, OK, well, all this is normal.
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I must just have to do it too.
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And I'm just, again, asking you to pause and ask yourself, is this the life you want for
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you?
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And sometimes that's a hard question to answer, actually, because it's like, well, what other
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life is there in medicine?
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Is there any life that's not crazy busy all the time where I feel like I'm about to pull
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my hair out?
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It's so busy.
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Is there any other life?
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I want to say the answer is yes.
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But only if you pause long enough to ask yourself the life you're living right now.
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Is that the one you want for yourself?
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And I hear people saying, well, it's just this first grant.
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If I can just get this first grant out the door or no, no, no, no, no, no, it's just
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this manuscript.
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This is the manuscript of my career.
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If I can just get this manuscript out the door, why hear somebody else say, no, no,
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no, this is the promotion.
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This is the one promotion that's going to make all the difference.
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Oh, and I've heard that.
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I hear that all the time.
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And none of it is true.
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There's not one grant.
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There's not one manuscript.
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There's not one promotion.
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It doesn't end.
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It keeps going.
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And sometimes, you know, people, I lull myself into the lie of, well, you know, I'm just
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busy right now in this season.
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As soon as this grant is over, life goes back to normal.
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But you know, it's not true.
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There is no back to normal.
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There's only this crazy pace that you've been keeping up for a while and so many people
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around you are also doing as well.
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And so ask yourself the question, is this a life I want for myself?
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And if you're struggling, if you're like, I don't know, I don't know any other life.
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I don't, I don't know.
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It's helping me.
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I'm, you know, becoming well known.
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People are calling me.
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I'm giving talks all over the country.
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I don't know if I can have any other life.
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Then maybe the question you want to answer is, is this the life you want for your loved
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one?
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So maybe if you have children, like, is this the life you want for them?
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Or maybe if you have a great friend, like, is this the life you'd want for them?
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Right?
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Ask the question, is this the life you want for yourself?
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And if you're struggling to answer that question, ask, is this the life I want for someone that
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I love and care about?
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The reason you want to ask that question is because if there is anything short of yes,
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absolutely, then something's got to change.
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If there is any pause, any hesitation, any sense that the life you're living now is not
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the one you want for yourself, it's time to pause.
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I mean, you're kind of already pausing because you're spending time in deep, honest introspection.
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Now, if you are answering the question, is this the life I want for myself?
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And you say no.
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Or you say, well, yeah, but if there is anything short of an enthusiastic, absolutely, yes,
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this is the life of my dreams, then it's time to ask for something different.
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It's time to make different decisions.
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Because wherever you are in your life right now, you're there because you chose.
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That's a choice you've made, or it's the result of multiple choices you've made.
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And granted, there are a lot of bad examples around you.
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And so if you've made this choice, it's because it's what you see and you have accepted as
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the default.
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But if for whatever reason, though, it's not the life you want for yourself, and I think
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this is going to be most of us the answer, it's like, I like some of it, but I don't
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like all of it.
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Then ask yourself, and this is number four, what pieces of the life I have now do I want
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to keep?
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Well, part of what I have do I like?
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Because you know what?
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I was talking about this with a colleague earlier.
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Medicine is fun.
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We enjoy what we do.
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We love to care for our patients.
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We love to care for other people.
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We love our scholarship.
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We love the opportunity to create new knowledge.
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We love what we do.
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We absolutely do.
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And that's great.
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And I want you to think about all the things that you love and you want to keep about your
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work, the intellectual stimulation, the opportunity to interact with colleagues who are brilliant,
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the opportunity to do scholarly work for a living.
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I mean, all those things are so awesome.
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And then number five is to ask yourself, well, what pieces can I do without?
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What pieces do I just not want?
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Every third night call maybe.
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You're like, well, I could do that easily when I was 27, but I don't know that I can
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do it so well at the age of 54.
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And it's OK to just have that thought because your mind is going to want to say, well, who's
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going to do it?
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Well, if I don't do it, no one else is going to do it.
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No, I can't even think like that.
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I know.
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Your mind is going to start to play games and play tricks on you and it's going to want
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you to not think that way.
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But just consider this a thought experiment.
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You're not making any commitments.
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You're not making any decisions.
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You are just thinking.
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And so you're going to say, what pieces do I not want to keep?
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Maybe it is the overnight call.
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Maybe it's the trauma call that you take every third night.
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Maybe it's the baby delivery.
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If you're an OB-GYN, you're like, you know what?
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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
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want to do this OB call anymore.
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Just think about it.
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What pieces can you do without?
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One of the parts you love, that was number four.
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And what pieces can you do without?
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And it really is a place of being honest.
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And I have to tell you that this is hard.
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It's hard for us as physicians because we have the sense of duty, the sense of responsibility.
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And even if it's not just us, we're like, well, if I don't do it, then all my colleagues
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are going to have to be saddled with it.
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And I don't want to put them in that position.
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And you keep going on and on.
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And then it's hard for you to be honest with yourself because the conflict is so real.
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It's so great.
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You're like, I can't even think like that.
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It seems like treason.
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It seems like the wrong thing to think.
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I'm just asking you to think.
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I'm not asking you to make any commitments.
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And so if you're feeling panicked right now, I just want you to pause.
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I just want you to pause and say, hey, mind, it's OK.
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This is just a thought experiment.
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It's going to be OK.
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And just talk yourself down out of that really high heart rate that's kind of evolving right
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now because you're thinking about the pieces of medicine that you don't like, that you
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can do without.
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The next thing I want to invite you to do is go to the future.
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So I want you to close your eyes right now.
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And then I want you to transport yourself 30 to 40 years into the future.
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And if you're a little bit older and you're like, I don't know about 30 or 40 years, OK,
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just go 20.
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Just go 25.
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Go into the future and find your future self and check in with your future self.
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Hey, future self, what regrets do you have?
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What do you wish that you had done differently?
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And spend some time with your future self and ask that question.
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Hey, future self, what regrets do you have?
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And really listen because your future self has something to tell you.
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There's a whole guided meditation that you do to get to your future self that really
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is kind of outside of the scope of the podcast.
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And I would love to do it with you.
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Shoot me a DM, we'll get together so we can do it as you think about whether coaching
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is right for you.
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But do go to your future self and ask, what regrets do you have?
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And listen, listen to what your future self tells you.
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Because I have to tell you that there are some of the things that are so high on your
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priority list right now.
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Some of the things you're doing right now that are working you into the ground.
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So many things you're doing right now that are making you sick.
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Your future self is going to say, I regret investing so much time in doing all of that
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stuff.
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And it's really important you check in about regrets.
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Because number seven is for you to come back to the present, come back to today and do
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something about it.
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Do something about it.
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And the reason it's important to do something about it is because if you do not do something
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about it, nobody else will.
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We're better or for worse.
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We have a culture in medicine where everybody assumes that everybody else is doing well.
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And everybody assumes that somebody else's responsibility, it's your responsibility
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to take care of yourself.
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Your responsibility to say if you're not feeling well.
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Your responsibility to take the help that you need.
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Your responsibility to do all these things.
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And I agree, you are responsible.
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I think we need to support each other more than that.
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Where if we see someone in trouble, we're like, hey, you look like you're in trouble.
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I need to help you get the intervention you need.
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We really do need that kind of culture where we're looking out for each other.
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But that's not what we are.
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We're in this culture where we expect so much from ourselves and from each other that we're
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not asking, hey, are you okay?
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Are you well?
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Are you safe?
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We're not asking those questions.
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And so until the culture changes, and I don't know if it ever changes, you have a responsibility
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to yourself to do something about the things that are not allowing you to be healthy, no
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matter what they are.
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And yes, people are going to look at you funny.
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And yes, people are going to say, well, you know, clearly you don't have what it takes.
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Because in medicine, unfortunately, we do that.
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But I'm inviting you, I'm inviting you to be countercultural, to stop and think about
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yourself, to stop and think about your health, to stop and think about the regrets you're
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going to have with the life that you may be living right now.
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And ask yourself, how can I do things differently?
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And I do want to acknowledge that this is a hard question.
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And I do want to acknowledge that it takes time to come to the right answer.
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It is not always straightforward.
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It is not even as easy as quitting your job because there's so much, so much wrapped up
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in that.
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It's not even as easy as saying, well, I'm not going to do these things anymore.
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There is so much, so much involved in it.
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And so to be honest, you're going to need to get help.
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And some of that help is going to come from being in community with other people who are
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thinking like you are, as to how can I live and enjoy the parts of my job that I enjoy
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and still be healthy in the process?
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Because we can do this career.
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We can do this career in a way that's healthy, in a way that's consistent with our values.
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We can do this career.
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And I don't want you to buy the lie that it can only be done at like a fast, super fast
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pace where you're either all in or you're just nothing.
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Don't believe that lie.
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It's not true.
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But I'm inviting you to return to the present and do something about it because if you don't
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do something about it, if you don't do something about your experience, nobody else is going
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to do that for you.
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Okay.
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That's number seven.
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So seven things that I talked about.
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Number one, pause.
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Number two, spend time in deep, honest introspection.
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Number three, ask yourself, is this the life I want for myself?
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Number four, find out what pieces you actually want to keep.
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Number five, what pieces can you do without?
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Number six, go forward into the future, 20, 30, 40 years from now, and meet with your
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future self and check in about your regrets.
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And then number seven, come back to the present.
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Do something about it because if you don't do something about it, nobody else will.
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All right.
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I'm inviting you to health.
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I'm inviting you to wealth.
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I'm inviting you to joy.
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I'm inviting you to a career that you love that serves you and is healthy and does not
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lead you off the cliff, that does not lead you off the deep end, that does not allow
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you to crash.
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I'm inviting you to think differently about your career.
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And I'm inviting you to forward this to somebody else who needs to hear this, who needs to
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be encouraged that it is okay to take time out and make a decision about how you want
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your career to be from this day forward.
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It doesn't have to remain the same.
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And so please share it with someone who needs to hear this because we got to save more lives.
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More physician lives need saving.
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And yes, we hear about the people who don't make it.
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We hear about our colleagues who've died.
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But what we don't hear about is our colleagues whose lives are like totally wrecked because
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they didn't make changes, whose health is wrecked.
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We don't hear about that as often.
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And so I just invite you, you know, someone who needs, who needs to pick me up, who needs
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encouragement today, and then making the right choice and rethinking the way they do their
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career and maybe that person is you.
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I just invite you to just invite others into the space of deep introspection and reflection
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about what a healthy career looks like and what steps you can take to get there.
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All right.
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It's been a pleasure talking with you today.
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Thank you so much.
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Have a great day.
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I'll talk to you again the next time.
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Thanks for listening to this episode of the Clinician Researcher Podcast, where academic
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00:25:06,060 --> 00:25:11,780
clinicians learn the skills to build their own research program, whether or not they
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have a mentor.
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00:25:12,820 --> 00:25:18,940
If you found the information in this episode to be helpful, don't keep it all to yourself.
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00:25:18,940 --> 00:25:20,660
Someone else needs to hear it.
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00:25:20,660 --> 00:25:24,720
So take a minute right now and share it.
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As you share this episode, you become part of our mission to help launch a new generation
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of clinician researchers who make transformative discoveries that change the way we do healthcare.