I love to talk to people who are honest and confident in their honesty! Dr. Richard Carr is an internationally known expert in dermatopathology and pathology, and he speaks honestly about emotional intelligence as a muscle, recognizing our own weaknesses, and tailoring emotional intelligence to the individual. Being hypercritical can be a strength in that you think deeply about things, and it is worth hearing how he deals with hypercritical thoughts. Dr. Richard Carr trained in dermatopathology with Dr. Phillip H. McKee and Dr. Eduardo Calonje at St Thomas’ hospital and the St John’s Institute of Dermatology. He received the Royal College of Pathologists (RCPath) Diploma in Dermatopathology (set at expert referral level) and consults on cases throughout the United Kingdom. After being educated in Sheffield which is north of London, he started practicing in London with “big city ways”. He has now been practicing in the same community for 25 years in Warwick, England. He is a dedicated teacher, locally, nationally, and internationally. He is married with two daughters.
I love to talk to people who are honest and confident in their honesty! Dr. Richard Carr is an internationally known expert in dermatopathology and pathology, and he speaks honestly about emotional intelligence as a muscle, recognizing our own weaknesses, and tailoring emotional intelligence to the individual. Being hypercritical can be a strength in that you think deeply about things, and it is worth hearing how he deals with hypercritical thoughts. Dr. Richard Carr trained in dermatopathology with Dr. Phillip H. McKee and Dr. Eduardo Calonje at St Thomas’ hospital and the St John’s Institute of Dermatology. He received the Royal College of Pathologists (RCPath) Diploma in Dermatopathology (set at expert referral level) and consults on cases throughout the United Kingdom. After being educated in Sheffield which is north of London, he started practicing in London with “big city ways”. He has now been practicing in the same community for 25 years in Warwick, England. He is a dedicated teacher, locally, nationally, and internationally. He is married with two daughters.
[00:00:00] Christine Ko: Welcome back to SEE HEAR FEEL. Today, I'm excited to be with Dr. Richard Carr. Dr. Richard Carr trained in dermatopathology with Dr. Philip McKee, who has also been on this podcast, and Dr. Eduardo Calonje at St. Thomas Hospital and the St. John's Institute of Dermatology. He received the Royal College of Pathologists Diploma in Dermatopathology, which is set at expert referral level, and consults on cases throughout the United Kingdom. After being educated in Sheffield, which is north of London, he started practicing in London with "big city ways". For the last 25 years, he has been practicing in the same community in Warwick, England. He is a dedicated teacher locally, nationally, and internationally, and he is married with two daughters.
[00:00:52] Welcome to Richard.
[00:00:54] Richard Carr: Thank you very much, Christine. It's a great pleasure to meet you for the first time.
[00:00:59] Christine Ko: Yes. I also was very much looking forward to meeting you. Could you first share a personal anecdote?
[00:01:04] Richard Carr: Okay. Well, I've got a story about badminton. I would have been about seven or eight years old. This is back in the early seventies. My father was a formidable man. And we were on a camping site. So a sort of rather low level holiday, money was quite tight, and there was a boy in one of the nearby tents, and my dad said, why don't you go and ask that boy if he would like a game of badminton? I did and spent the whole afternoon just playing badminton with this boy. I came back at the end of the day, and my dad said to me, Oh, how did you get on? And I said, Oh, that guy was brilliant at badminton. Absolutely brilliant. And my dad said, So he beat you then. I said, No.
[00:01:45] I think that would tell you a little bit about my confidence as a child. And it sort of stayed with me throughout my life, the confidence. But that, that could also be a challenge having that level of confidence in life because it's not always a quality that people in the UK particularly appreciate.
[00:02:03] Christine Ko: I'm going to move on to a different question. What do you think of emotional intelligence and how it impacts work versus home life?
[00:02:12] Richard Carr: Okay. You can see I'm smiling a lot.
[00:02:14] Christine Ko: I can hear it in your voice.
[00:02:18] Richard Carr: My quick response would be what's emotional intelligence?
[00:02:23] But I know what you mean by emotional intelligence. And I think like any muscle in my case, it didn't exist or was non existent. Because I can tell you it was not something I'd heard about in my upbringing, and certainly the stiff upper lip sort of environment that I grew up in wasn't to really express emotion. Yeah, this confident seven year old who really knew no bounds to the limits of what they could do... tempering that and understanding that there are other people around you that you impact on would have tremendously helped me throughout my personal life and in my working career.
[00:03:00] I would say I've started to learn about it and maybe strengthen that muscle and work on it. Particularly in my later career, actually, I think I've gone through a lot of my career, probably with a lot of emotional intelligence, not realizing how much I had. But not realizing how much more I could have benefited from actively exercising that muscle and interacting with other people would have been far easier for me.
[00:03:29] Christine Ko: One of your comments is probably actually true for all of us that no matter how skilled we may feel we are at navigating our own emotions and others, we can still benefit from being better at it. And I like how you put it, like exercising a muscle, and I think that analogy makes sense 'cause we all know the more you exercise a muscle in general, usually you get stronger and better at something. So I like that a lot.
[00:03:55] Richard Carr: I think identifying your weaknesses and working on those is obviously the sign of a rounded personality. And I would say I'm not a rounded person. I've been obsessed with many things. And in my family I'm regarded as the normal one, we're talking about seriously obsessional sort of genes and also seriously empathic genes as well from the other side, and mixing those two together is like stirring some sort of ridiculous thing.
[00:04:23] So I would like to have lots of sympathy from all the people out there for people like me with too much confidence who don't realize how important it is to look at the softer skills, which people like you, I would say, have in great abundance. And people like me are hoping to learn from you.
[00:04:40] Christine Ko: You shared with me that your mom is an empath, and I assume you probably learned that from her. I haven't heard that term so much, empath. And I think that people also probably define that in different ways, but my concept, you can correct me. My concept of an empath is someone who really feels and takes on the emotions that are around them. So in a way, emotional intelligence is not about being an empath, actually, because the empath in the worst situation, I think, is just completely flooded by the other emotions around them and cannot necessarily function in the optimal way. It's sort of a generalization. I'm not saying that empaths are ineffective in general, but I think that's just the worst case scenario, maybe. Is that? Is that your?...
[00:05:29] Richard Carr: Yes, thanks for explaining that because I see people in my sphere who have that personality type really struggling. Their emotional intelligence, what they need to work on, is protecting their core from everybody else's pain and the pain of the world that is around us. Their emotional intelligence needs to embrace the idea that they can say, no, they can say, no, I'm not going to take on that person's pain. They are going to set boundaries with the person that's using their empathic nature, who's happy to be looked after, and so on. Both parties in that sort of situation, because often opposites attract, need to be fully aware of the dangers of being too far in any direction.
[00:06:17] Christine Ko: So how have you worked on your emotional intelligence?
[00:06:25] Richard Carr: I think I have been told that I lacked empathy or I lacked engagement. That I was self centered, and that I had unrelenting standards. And what else? That I was autistic, that I was selfish. And I agreed with all of those things. No matter what you could say about a person like that, with those unpleasant personality characteristics, being aware of them gives you the opportunity to flex the muscles and to reduce those negative sides to your personality.
[00:06:59] Unrelenting standards makes you very critical person. So if I'm suddenly being very critical, I have to remember that thought in my head is just electrical activity. It's not real. I'm making up a judgment on something that doesn't exist. Shakespeare said, there is nothing good or bad, but thinking makes it so. I could give an example. For example, let's say I'm walking down the street, and I see a baby run over by a car. Yes, quite dramatic example. And I would have an immediate visceral response, with an immediate physical response. And then I run up to the baby to do resuscitation or try and help. And I see that it's just a rubber doll and not a baby. Immediately, I'm going to experience a whole different wave of emotions, instantaneously. But what happened before the emotional response? My eyes were open, I saw something and I made a judgment that a bad thing had happened. If you can train yourself when you're in a situation where you're judging it as good or bad: it's an electrical activity in your head, and you're then having a visceral, physical response. You're panicking, all because of electrical activity in your head. And then you will say to yourself, why would I be silly enough to let electrical impulses in my head cause me to panic? When we get wrapped up by the stories that we tell in our head, we then express emotion. And all you've got going on in your head is electrical activity. It's interesting, isn't it?
[00:08:22] Christine Ko: That's very interesting because listening to your example about the baby, which is really a doll.... it's electrical activity and also it's really about interpretation, right? Like really the thought we construct. So if I had known from the beginning it was a doll, the initial reaction wouldn't have been there. And, etc. But my initial interpretation of, oh, that's a real baby! Set off a whole different... so it comes to... this comes to diagnosis, right? Because diagnoses are decisions, interpretations, actually, it's my interpretation of a slide, of the features in a slide. Really any decision is really an interpretation of, X, Y, Z. And so I come to whatever conclusion or decision. Given what you've said about yourself being hypercritical and having very high standards, have you created a way to make better decisions for yourself? Either at the microscope, or just in life?
[00:09:24] Richard Carr: I would obviously like to think so, wouldn't I? I'd love to give myself confirmation bias that I have done that. I think, I suppose what I'm saying is that if you're showing a reasonable level of commitment, having a reasonably good work ethic over a sustained period of time, we have to look at things in perspective. That art of medicine, for me, is this balancing of the risks. There's a risk from over doing things, over interpreting things, or thinking of every possible minute, remote possibility, because you're a world expert and you've seen everything. Paying attention to your mental, physical well being. Learning from your mistakes, sailing a bit too close to the wind, and then righting the ship, and sailing into calmer waters. Give yourself a break. Don't do what I did. Learn emotional intelligence better earlier and sort yourself out. Allow yourself to have your family, your career, and your social and play time. And that will be the key to success.
[00:10:28] Christine Ko: Love that. So a related question. We should really do our best for that patient. And like, when I think about when I'm a patient, I don't want just okay. I want my doctors to give it everything they've got. And so there's this sort of difficulty. Obviously, if I just talk about myself, I know I'm not perfect and I make mistakes. I will make mistakes. There's no way to not make mistakes other than to not do something, then I won't make a mistake because I'm not doing it. Whatever work we do, but for us, if we're looking at slides and making diagnoses, there will be mistakes. It's unavoidable, if you're practicing. Definitely a mistake isn't good enough, and if even "okay", which is say not a mistake, but just maybe you could have done it a little bit better, is not good enough, what's a good way to deal with that?
[00:11:20] Richard Carr: We will get judged. It's just remembering to stick to your core values and your core principles. And, if you take the poem If by Rudyard Kipling, " when everything's gone expletive [shit], and everybody's blaming you, but you're true to yourself and follow the same path, then you will truly be a man". I think it's your core values should guide you. And hopefully as a doctor, we hope that our core values and our reasons for entering medicine were generally good, and that we will be guided by those. But you're correct, we all make mistakes all the time. I always say I prefer to learn from other people's mistakes. But, my own mistakes I learned the most from, and they're the ones that are most imprinted on my brain. I would just be completely open about it. I'll be completely open with the patient. I would apologize. I must have made many mistakes because I've seen a lot of glass and that's one of my things that I say to the trainees, try and see as much glass as you can. You will make more mistakes by seeing a lot of glass, back to your point at the beginning.
[00:12:24] Christine Ko: Yeah, I love it. Do you have any final thoughts?
[00:12:28] Richard Carr: I wish everybody out there who's struggling with their mental well being to be kind to yourself. Learn from my mistakes and develop whichever muscle is not well developed. People like myself who are overconfident, probably, and didn't have very good empathic skills. Embrace it, learn it and develop it and make all your relationships better, including your relationship with the glass slide.
[00:12:49] I have lots of people I'd like to thank, Christine. I've had some wonderful mentors over my career. And I would really like to say a big thank you to David Slater, who was one of the people I met in the very early stages of my career as a medical student in Sheffield. He's really supported me a lot in my subsequent career.
[00:13:08] I really would like to say a big thank you to Philip McKee and Eduardo Calonje, who are giants in our field. I was just so lucky to have the privilege of training in St. Thomas's Hospital and just being in their orbit. I would like to say a really big thank you to them.