EP134: Girl Doc Survival Guide: Embracing a Transformative Experience

Introducing the Girl Doc Survival Guide: A Rebranding Journey and Embracing Transformative Experiences in Healthcare and Life

In this episode of the newly rebranded podcast, Girl Doc Survival Guide, host Christine and producer Jamie Slevin introduce the rebranding from SEE HEAR FEEL. The conversation delves into the reasons behind the change and discusses the challenges and transformative experiences faced by doctors, particularly focusing on stress, managing work-life balance, and the impact of parenthood. The episode highlights the importance of emotional intelligence, growth mindset, and the evolving perceptions of newer generations of doctors towards healthcare. Christine shares personal stories and insights about motherhood, particularly the challenges she faced raising a child diagnosed with profound deafness, and the shift in her priorities from work to her family. The episode sets the stage for upcoming guests who will discuss innovative approaches to improving physicians' well-being.

00:00 Introduction and Rebranding Announcement

00:18 Meet the Producer: Jamie Slevin

01:10 The Challenges of Medical Training

04:02 Balancing Parenthood and a Medical Career

05:37 Transformative Experiences and Personal Growth

11:35 Work-Life Balance and Flourishing in Healthcare

19:01 The Impact of COVID-19 on Young Doctors

21:44 Looking Ahead: Future Guests and Themes

Transcript

Christine Ko: [00:00:00] Welcome to the Girl Doc Survival Guide. I'm really excited today to announce that this podcast, SEE HEAR FEEL, is being rebranded and now being called Girl Doc Survival Guide. This is largely due to the efforts of Jamie Slevin, who is now or a producer of this podcast. I'll just give a brief introduction to Jamie, even though he asked that I not do it. Jamie is a podcast producer. He's been working with doctors and leading healthcare experts. He's based in London, England, and he feels very passionate about producing podcasts for doctors, since he thinks that doctors who host podcasts are superheroes. I'm not sure I'm a superhero, but it's fun to think that I could be one. Jamie's been really instrumental in rebranding this podcast, working through what I'm really trying to do. Today we're going to give you a little bit of a behind the scenes. So thank you to Jamie.

Jamie Slevin: Thank you for having me. First of all, this is a fun episode to [00:01:00] do because obviously you host a bunch of these. But you haven't as of yet been in the spotlight in exactly the way we're going to have you today. You are guesting on your own show. As we rebrand to the Girl Doc Survival Guide, one of the things you're going to be talking a lot about is how doctors can manage themselves to go from just survival to legitimately thriving as physicians. And with that context, I want to ask, what made you initially interested in that as a topic? 

Christine Ko: I would say because I've found times in my life, just hugely stressful and wishing that it didn't necessarily have to feel that way.

Jamie Slevin: When you say incredibly stressful, what do you mean specifically?

Christine Ko: For anyone in healthcare, anyone, not just doctors, but I'll just speak about doctors since that's what I do. Medical school itself is very overwhelming. There's a whole new language, the [00:02:00] medical language, that you have to learn. And it's not just language, but then you have to learn all of this knowledge attached to it. In general, people that want to become doctors, that go to medical school, they can handle the work. They have good brains in their heads. They can learn all this stuff, but it is still an endless amount of knowledge that you have to try to learn, and then in residency, even though you're now specializing in a smaller part of medicine as a whole, for me, dermatology, and then I did dermatopathology, it's still a huge amount of knowledge. I still don't know everything in dermatology by any means. I still don't know everything in dermatopathology, which is a smaller body of knowledge compared to dermatology as a whole. I still don't know it all. And I think for someone who is used to achieving at a high level, that in itself can be really hard to realize that you're set up for failure to begin with, you can't learn [00:03:00] it all. You have to be able to say, how can I figure this out for the patient? Because that's the other factor that once you start, in on the clinical side of things in medical school, and then go from there, there is a patient for whom this is all serving. That I think also puts pressure on. Because it's not just about learning something for yourself, but it's about learning it so that you can do it ideally perfectly for the patient so that there aren't any errors, so there aren't any, bad outcomes. In reality, there is no perfection, for a human being, at least, right? And for doctors who are human, there's no way to, first of all, to know it all, and there's no way to make the experience perfect for every patient, even though I think that would ultimately be the goal. So the knowledge and this striving for perfection [00:04:00] for the sake of the patient. There is then the doctor's own life... so I got married after my fellowship and didn't want to have kids during training because I wanted to focus on training. And then had my first child after about three years of working. Kids add a whole nother dimension of what needs to be done in life, right? Someone else that I have to take care of, especially when they're babies. You can hire someone, too. And my kids were both in daycare, but still, you have to arrange that. It's something to think about, something else on my plate. And then my second child, was born and he was diagnosed late, but he was diagnosed as being profoundly deaf. He has auditory neuropathy, and he ended up getting cochlear implants a little more than three months after he was diagnosed. As I said, almost two years old. And I noticed that at these different points, medical school, which was [00:05:00] stressful and overwhelming at times; residency, which was stressful and overwhelming at times; and then having children added on to that. And one, you know, you could say has "special needs", although I think that actually every kid is special needs and has special needs. Sometimes I just felt this is impossible, I can't do it.

Jamie Slevin: How did having kids change things from day one? If you were to look at your life one day before finding out you were pregnant, and then one month, when you have a one month old, how did life in medicine feel in those two circumstances?

Christine Ko: I recently learned about something called a transformative experience. It's a concept by a philosopher who's here at Yale. Her name's Laurie Paul. She came upon this concept philosophically after she had her first child. And I think she's right. For me, having a child was, is, a transformative experience where I [00:06:00] became a different person. Not necessarily right away but over time.

She gives an example in her book of becoming a vampire. You become a vampire, you might try to imagine what it's like that now you drink blood and you have to find where to get your next meal and things like that. But you don't really know what it's like and what it's going to be like, say, to live forever as a vampire. Unless you truly have that experience. I think that was definitely true for me because I was very naive, and I would actually say, without putting myself down, really stupid about it and had no idea what it would really be like to have a baby who's dependent on me. I don't have a big family, and so I was never really around babies. I never really saw someone on the day to day, all the little nitty gritty of you breastfeed or bottle feed the baby, and you have to wash those bottles, and then they take a nap, but maybe only for 30 minutes, and then all of a sudden you're back at it again, five minutes after, and feeding the [00:07:00] baby again, and then changing another diaper and, there was no time to take a shower. Sometimes it felt like there was no time to go to the bathroom. People talk about you just sometimes wear pajamas all day, and I would do that for sure. And it just Is this kind of crazy time where you don't hardly have any time to think, and I had no idea that it would be like that. But in terms of the true transformation, I think it was a mental thing where I, for the most part, no longer really had myself at the main center of my universe, or say maybe me and my husband, but it was like this baby. And I will say that it wasn't an easy transition for me. That transformation, I don't think was necessarily easy or pleasurable because maybe in some ways I am selfish. I want to be at the center of my world. It was hard on me psychologically, I think, to make that transformation, but it just happened over time. I think because the baby is so [00:08:00] dependent, it's, like, what does the baby need right now? Over and over again, rather than, what do I truly need right now? That's good for the baby, right?

Jamie Slevin: I guess there's also the expectation. People talk about motherhood or new motherhood as gifts, and then that misses out the bit where you haven't slept, you can't shower, and you're not the center of your own universe anymore. 

Christine Ko: Exactly. I think you hit the nail on the head that motherhood is glorified, at least definitely in the U. S. And yet you see, like in South Korea, for example, or Japan or even in the U. S. The birth rate is declining because especially in South Korea, for example, my mom tells me women don't want to have kids because they realize that it's a lot of work. And while, yes, I would say it is, definitely, largely positive to have children, actual studies show that parents are "more unhappy" than non parents. Definitely parents are more stressed out than non [00:09:00] parents oftentimes. And I think that's just because life isn't perfect, and human beings aren't perfect, and so, if you're single, for example, you're just managing yourself. If you're part of a couple, then, in some ways you're managing two. And then once you have kids, there's another person to the mix. There are these relationships that get added on, and I think the hard thing for me is that, going back to your comment about motherhood and parenthood being so positive, there is this expectation of that mothering instinct, right? That, oh, even if moms do more, it's because we naturally have this instinct to mother. Men maybe don't have that same instinct. For me, I would just say, I felt like a lot of times I was failing because I don't think I had that instinct. It was all like, work and learning, and it never felt like it came naturally to me. 

Jamie Slevin: At what stage did you become conscious of your well being as this thing to [00:10:00] actively look after versus the autopilot of, of course I want to feel good, but how do you feel good?

Christine Ko: Honestly, I think I am a slow learner in a lot of ways. I found a lot of things stressful, when things are piling on. Especially say if the baby or the toddler, as they keep growing older, if they're sick or, something else gets added on, or if there's something at work, like a conference that I want to do that I've signed up to give a lecture at or something, but it just adds on. 

Referring to your comment of autopilot. In some ways it was autopilot. I signed up for this stuff, and I want to be in, say for me, academics, and there are certain things I need to do in academics. And so I just do them. And for a large part, as I said, still, there are positives. Like, I do love my job. I do love my children, and so it's not like everything's a pain or a drag, but just when you feel like not everything is really fitting in 24 hours. Then I think the first thing [00:11:00] oftentimes that a lot of people do, but especially women, is, what you might need as an individual woman is the first thing to go, right? Because what else can you give up? And I also felt for a long time that, partially because I do love my job, that's my me time. And it's selfish to ask for more than that. So if I love my job, then that should be enough. So I think that really, I just pushed through. And I'm lucky that I had enough reserves and had enough help to do that, but I think it was really the second transformative experience I had when my son was diagnosed as profoundly deaf. I realized that I might have to give up my job, and we might have to move. If cochlear implants didn't work for him, then we would probably move [00:12:00] closer to a school that had something called auditory, oral teaching. And so I figured I'd probably, at least, quit my job for the short term and focus on the move and his new school and learning sign language myself, thinking that I might never go back to being a doctor and doing what I do really love doing. It was like a crisis in my mind, but I absolutely was like, it's the right decision. I knew that was what I would have to do. And so I think that what happened for me was that I realized life can't just be about work. The number one meaning in my life is no longer work. My kids are number one. And, so, it sounds silly, but it was a revelation to me that, Oh, they are really number one. If I have to choose, they are number one, and work isn't number one. My own achievements and my work were number one for a large part of my life. And so I think that's part of the transformative experience of [00:13:00] having kids for me, that at some point, and I wouldn't really be able to tell you when that was, I don't think it was like day one when all of a sudden I gave birth and had the child, right? As I said, it is a slow learn for me. But yeah, I realized it would be kind of upsetting to me to give up my job, but it would be something I would willingly choose to do. It's not like I would be bitter about it.

Jamie Slevin: Your you time was work and then maybe work is now off the table. What did life feel like it was going to look like? Did you have a vision of or expectation of what post giving up work life would be?

Christine Ko: No, I didn't. But I think that also would have been a transformative experience for me, to be a fully stay at home mom and and not be working outside the home for a certain amount of time. I had never done that, and I, I wasn't sure what that would be like. Even during my maternity [00:14:00] leaves, I was working on some papers, I was working on a book, things like that. All I knew was that I would be giving up something that I love, and I wasn't sure how that would really pan out, and maybe I'd be able to come back to it, but medicine moves at such a fast pace I wasn't sure what would really happen. 

Jamie Slevin: In that context, if someone said to you, Oh, you do that podcast thing. What have you learned? What would your kind of back of the napkin answer be?

Christine Ko: One of the things I've learned is people don't have time. People really don't have time. One of the reasons I do this is I want to be conscious of how I'm using my time and what I'm focusing on. And, I don't think I've really learned that lesson yet, how to sort of do that consciously and willingly and not really be on autopilot. That, I think, is the big thing, and it really, covers over everything that I've talked about on the podcast with different guests. Meaning, emotional intelligence, you have to have the [00:15:00] time to be emotionally aware and have the time to regulate your emotions. Having a growth mindset and not being afraid of failure. If you never learned having a growth mindset when you're younger, which I haven't, then you have to have the time to sort of figure out what that really means for you. 

I'm not saying that these things take hours. Sometimes to be aware of a concept, it's really 30 seconds, a minute; learn the definition of what something is. But the growth mindset, emotional intelligence, two things that I think are very meaningful to me, things that I never learned when I was a kid; it takes time to actually get them into my life. Time and effort. Part of the effort for me is to see how other people are doing it, and to reinforce for me through doing this podcast that it is an important thing. So, that's what I mean, that kind of time and space, spending that time, my own time. It teaches me to place importance on these [00:16:00] things that we talk about.

Jamie Slevin: It sounds like it's less an issue of time and more an issue of bandwidth. Because as you say, it takes 30 seconds to look up the definition. But these concepts need to be consumed, it's one thing to know it intellectually and it's another to to do the messy process of integrating it. 

Christine Ko: Yeah you can call it bandwidth or time. I think it's a little bit semantics. Bandwidth is maybe more the trendy term. For me, it's easier to think of it as time because we know there are 24 hours to the day. I think of Tim Ferriss's book, The Four Hour Work Week. It doesn't apply to me because I definitely work more than four hours a week, and I have no plans to only be working four hours per week, not in the near future, at least, and I don't really think it's possible for the vast majority of doctors to only work four hours a week. His book is great, but you literally only work 4 hours, and then you have 20 hours for everything [00:17:00] else that you want to do. So one of the issues for me is, if I love work and as you said, if work is for me, then I don't only want to do it for four hours. I do want to do it for longer, but I don't want to do it 24 hours. Everyone needs sleep at least. But that kind of thing. It just seems there's some magic formula. If I'm average, and I need eight hours of sleep, and then plus a certain amount of work, okay. If we just say it's eight hours, like nine to five, then there's, eight hours left. But the reality is, most doctors, you don't just work eight hours, especially with electronic medical record. So what's the amount of time? Is it okay if I spend one hour more on the electronic medical record, and then I have seven hours left? What formula is correct? For me. So, work life balance. And that's what it comes to. I realized there is no balance, at least not for me. Even the term work life balance puts pressure on the individual. I think that balance question is actually a lie, as if I can create a magic formula for each day that then I would [00:18:00] feel perfectly zen. Instead, I really like a concept that I first heard through ArenaStrive, Brian Ferguson. He talks about flourishing. Like, how can we flourish? So for one individual, for Tim Ferriss, it might be four hours of work is flourishing. And then he gets to travel around the world and live in Germany and learn German for six months and then go to Japan and learn Japanese for six months.

But for me, I think flourishing in such a high stress environment like healthcare would be: learn how to prioritize and take the time for what needs to have the time in that moment. It does take thought, it takes knowing yourself, and knowing the people that are important around you, and knowing what gives you meaning.

Jamie Slevin: Yeah. Cause if you love work and you get work down to four hours, you've actually become efficient rather than effective. You've been ineffective at creating a life that works for you, despite being [00:19:00] highly efficient with your resources. Before we finish up, do you see the doctors coming through now, the doctors in their twenties who you work with? Do they have different beliefs around this stuff than the doctors 10 or 15 years older than you?

Christine Ko: Yes. I have a lot to learn from the younger people in healthcare, the younger doctors. COVID was a transformational experience for all of us, right? But particularly that younger generation, they were in medical school or residency training. The hospitals, the clinics shut down. They also saw how there wasn't enough personal protective equipment; hospitals, governments weren't really protecting health care workers. The younger generation really lived through that before necessarily, maybe, seeing the positives? I think there was no way for them to see that and not have it affect them, transform the way they really see being a doctor. From my [00:20:00] perspective, I think they're smarter than I ever was. They're smarter about being conscious of their time or their bandwidth and saying, well this seems stupid. Like, why should I do that? They, in some ways, are doing things better, and making healthcare better, and ultimately a more humane place to be. And a more humane place for doctors will ultimately, I think, be a more humane place for patients. 

Jamie Slevin: How receptive is institutional healthcare of that ?

Christine Ko: I think it's trending towards being much more accepting of it. Jessi Gold will be on this podcast. She is Director of Wellness for the healthcare system in Tennessee, as well as the five University of Tennessee colleges, translating the wellness movement, and thinking about the individual and what the individual needs from the college student level to health care because it's all the same thing. My kids, who are even younger [00:21:00] than the younger generation of doctors, they had social emotional learning, which I hadn't even heard of ever, from kindergarten. I don't consider myself that old, but I am old, never learned these things. So even though that younger generation of doctors knows these things, and there are people like Jessi Gold, my generation never learned the stuff, and we do need it. We definitely need it, but we didn't learn it. And so we are part of this culture that is very inhumane. We have to become more aware of that and conscious of it and spend the time or bandwidth, our effort on changing this.

Jamie Slevin: Christine, I think that's a really nice place to leave it. Guests that we've got coming on are speaking exactly to that theme, guests who are super cutting edge on changing physicians' approach to their own welfare. And I'm excited to see how it all goes. 

Christine Ko: Yeah, absolutely. I'm [00:22:00] definitely excited about the guests that are coming on. Jamie, as producer, has been reaching out to amazing individuals in health care, and I'm excited for everyone to come along on this journey with us. Thank you, Jamie. Thanks for doing this with me today. 

Jamie Slevin: Appreciate it. Anytime.