EP142: From Diagnosis to Dialogue: Exploring Soft Skills in Medicine with Dr. Zembowicz

Navigating Career and Emotional Intelligence with Dr. Artur Zembowicz

In this episode, we welcome Dr. Artur Zembowicz, an accomplished dermatopathologist, medical director, and educator. Dr. Zembowicz shares his insights on emotional intelligence, the importance of mentorship, and the challenges of making judgments in medical practice. He discusses his personal experiences in improving emotional intelligence, dealing with burnout, and the critical role of preparation and adaptability in both career and personal life. The conversation also touches on the intricacies of providing second opinions in dermatopathology and the value of balancing professional commitments with personal interests.

00:00 Introduction and Guest Background

01:37 Discussing Emotional Intelligence

03:46 Navigating Career Challenges

07:17 Midlife Crisis and Burnout

11:06 Consultant Dermatopathologist Insights

13:54 Final Thoughts and Reflections

Transcript

Christine Ko: [00:00:00] Welcome to today's episode. I have the great pleasure of being with Dr. Artur Zembowicz. Dr. Artur Zembowicz, MD, PhD, is the founder, medical director and principal consultant at Dermatopathology Consultations, LLC, and the founder of dermpedia.org. He is also a Professor of Anatomic and Clinical Pathology at Tufts Medical School and a Senior Dermatopathology Consultant at Lahey Clinic in Burlington, Massachusetts. He has multiple interests, including inflammatory dermatopathology, especially vasculitis, vasculopathies, and drug eruptions, as well as melanocytic and adnexal tumors. He trained in Anatomic Pathology at the Brigham and Women's Hospital in Boston, a teaching hospital of Harvard Medical School. Dr. Zembowicz learned the second opinion consultation trade from Dr. Martin Mihm and launched his independent practice, Dermatopathology Consultations, LLC, which serves more than 200 pathology organizations and receives [00:01:00] 5 to 6, 000 cases per year. He is committed to education and founded Dermpedia.org, a dermatopathology education platform that provides CME. He is also involved in the WHO Classification of Skin Tumors, both the 4th and 5th editions, and serves as the dermatopathology consultant to the National Cancer Institute. He lives in Belmont, Massachusetts with his wife, Margaret, a pediatric anesthesiologist, and they have two adult children. His hobbies include hiking, skiing and racing dinghies. Welcome to Artur. 

Artur Zembowicz: Thank you for inviting me.

Christine Ko: I'm so excited to talk to you about various subjects and wide ranging things. My first question to you would be, what role do you think soft skills like emotional intelligence and having a growth mindset have played in your career?

Artur Zembowicz: That's kind of interesting question because I'm not sure I understand what emotional intelligence is. What is it? Define it for me.

Christine Ko: So there are lots of different definitions. True researchers in emotional intelligence [00:02:00] have one definition. And then I think there's the popular media type of definition. The way I define emotional intelligence is simply that you can name your emotions, how you're feeling, and also then regulate them. You recognize that you're getting angry and you regulate it and help the situation to become better. At least for ourselves, we can try to name what we're feeling. A big problem I've learned is, I thought I was just really remedial emotional intelligence, but I've learned through Brene Brown. She did this recent book called Atlas of the Heart, where she defines like, I don't know, close to 90 emotions or something. But she says that really most adults can only name three emotions. And so, imagine if you can only name three versus if you're more sophisticated and you can name like 90. It's the same as like in dermatopathology, where maybe I only know three diagnoses at first, but then I can become more sophisticated and say, Oh, [00:03:00] it's not just melanoma. It's desmoplastic melanoma! Or something like that. So, what do you think? 

Artur Zembowicz: It looks like it's something that I wish I had more. I asked you that question just to maybe buy some time to think about this because, you know, we intuitively, I think, know what the meaning is, on the kind of a basic level. Emotional intelligence, I think it's huge. I think it certainly had, big impacts on my success and ability to navigate the world of academia, and business, and personal life. I think it's very important. Most of us, we take interest when maybe our skill set is not as great. And at some point we realized that we want to improve. I'm very fortunate to be a grandfather, and I'm observing that now nine month old baby as he develops, and I get a sense of certain kind of ability, energy, [00:04:00] willingness, desire to learn. Some people are born with certain set and are fortunate to have a lot of that emotional intelligence. I don't feel that I was that way. I thought this was a little bit of my handicap, but I had to improve. 

Christine Ko: Yeah. So how did you improve?

Artur Zembowicz: By observation, right? But also, I have a certain kind of a skill set. By playing to my strengths, I think that's the key thing, right? We were born with certain set of basic skills, right? I think the key is to play to your strengths and then identify those weaknesses and maybe address them, soften your edge, learn when you get burnt on your emotions or something hurts. You hurt your career and often you can point it not to a technical skill, but your inability, let's say, to coexist with your colleagues to make sure that your mentors or superiors respect you or see you that way. And a [00:05:00] lot of stuff is preparation. I race dinghies. I race sailboats, and you win a race on the shore before the race by preparing yourself, by knowing what the weather is going to be, by knowing your competition, and positioning yourself in a relationship to the fleet, right? You can.... you want to start first because you get your first wind. And I think in many situations in a career, that's very important. So important how you start, that first day on the job, the first month. It's so important because you set your race. 

Christine Ko: Yes. I love your comments. I agree with them. When you're talking about your grandchild, congratulations, by the way. Babies, right? They're exploring. They don't really know anything. So they keep having to learn. They touch something. It's fun. They touch it again. They touch something. The parent says no, or the grandparent says no, they don't. And as you mentioned, in life, in our career, when things don't go well, then we can learn from that, especially if, as you say, emotional intelligence, I do think is a skill, just like you said, with racing dinghies, [00:06:00] how you set yourself up is very important. Okay, great. So, is there something that you had wish you had known earlier in your career?

Artur Zembowicz: I learned a lot. Related to this topic. It's very important to handle your emotions, in a way that don't interfere with your work, with your relationship with your colleagues, with your family. I was very fortunate to have very good mentors. Mentorship is so important. To have people that you can call or talk to when you have a problem or have an issue or you want to learn. It's more difficult for men to do that. I was very fortunate to have someone I would call and say, Stan, I have this issue here. Yeah. What should I do? And his answer was always, Oh, Artur, do nothing, wait it out. So I would say that, healing properties of time, very important. That saved me from writing many angry emails or [00:07:00] getting engaged in conversations that had no chance of succeeding. And so I think that would be one kind of advice I would give to other people. If you have problems, you have feelings, just wait it out.

Christine Ko: I love that. I really do love that. 

Artur Zembowicz: What I've learned. You asked me that question. Be aware of middle life crisis in the kind of mid forties, the late forties. Just a tough period emotionally for folks. It was for me. When you're in your forties, you question your life, you question your success. I see that in people that I'm mentoring that it's around that time when maybe they feel that there's this burnout, there's that kind of a sense, even people who are super successful, they don't feel that way, right? So you might have this feeling, if you didn't make it to be next Bill Gates, you failed, right? 

Christine Ko: Yes. Sometimes I have said I'm having a midlife crisis. To me, just as you said, you've gotten to a certain place in your life. Whether you consider that as having achieved what you [00:08:00] wanted or whether it's that you haven't achieved what you wanted. So in either case, I think both cases, you're, sort of like, am I okay with where I am? And sometimes, even though you've gotten everything that you had ever dreamed of, you can still feel like something's missing, and conversely, even if maybe you haven't even achieved like a third of what you might have wanted when you were whatever age or dreaming at whatever age, you are totally fine with where you are.

Artur Zembowicz: Being comfortable with yourself, being satisfied with yourself. I think that comes in fifties. There's this life cycle, and I think fifties are great.

Christine Ko: It sounds like this sort of midlife crisis is a necessary thing.

Artur Zembowicz: It's baked in, I think. Yeah. You can't avoid it. 

Christine Ko: Would your recommendation on getting through that: to also use time? Don't be too hard on yourself?

Artur Zembowicz: I think what helps is mentorship, is having someone to talk to. And that's [00:09:00] harder for men.

Christine Ko: So earlier with the midlife crisis comment, you did mention burnout and how to navigate through that. Do you have advice on how to thrive and confront burnout?

Artur Zembowicz: To be honest, I've never really felt burnout defined as, Oh, I'm just, I cannot go to work. Or, I'm tired of work. Because now, I've always kept control over what I do through being entrepreneurial. That really helps for sure. If you're always pursuing a new venture, a new project or a new hobby, I think that really helps. In this new world, you have fewer opportunities to deal with burnout through your work. So I think the solution for physicians is going to be to play to your strengths outside of work, like a family, hobbies, sports. And I think that's where newer generation is going. I think there'll be more physicians, they will treat their work as just work. I just go there to make [00:10:00] money and then find more satisfaction outside of work.

Christine Ko: I like what you said about being entrepreneurial. I think that goes along with that growth ,mindset that I mentioned earlier, like that mindset of a nine month old baby, that if you're always exploring and being open to the many possibilities that are out there, you have options. And, so, even though the system might be a certain way, you realize that you have options and you don't feel trapped. I think that's important. 

Artur Zembowicz: Soft skills, you said, or emotional intelligence. For new things, if you want to start new things, what is very helpful  is to be prepared to fail. And that's very difficult for many people. This audacity to try. And I think I was very fortunate myself that I have no really fear of failure. If I fail, it really doesn't bother me.

Christine Ko: You've always been like that? 

Artur Zembowicz: Yeah. I see many very bright students or trainees that never failed. I think that is something good to have that experience. [00:11:00] Yeah. 

Christine Ko: I agree. Yes. The audacity of trying, of putting something out there. That's great. Our conversation so far, I think, relates to you being a consultant dermatopathologist, that you give second opinions or maybe sometimes third or fourth opinions on difficult cases. I'm sure that as a consultant, you see, sometimes, either true errors, where it's really the wrong diagnosis, or just you don't quite agree with how someone else diagnosed a certain case. Do you have thoughts on how you deal with that?

Artur Zembowicz: How I deal with that. First of all, I do all my best not to disagree. I have this concept of reasonable diagnosis, right? If I saw that case for the first time and no one ever saw it, I would sign it out in a certain way. But, if a case already carries a diagnosis, I take that into consideration and I modify my diagnosis, if it's [00:12:00] reasonable. When I do my dermpedia workshops, for instance, with Phil Leboit, who's also one of the top consultants, we think the same way. We're not as dogmatic as people might think. And not forcing our opinions because most of the opinions are reasonable. The umbrella of reasonable diagnosis is quite broad. Most of the time, it's not that impactful on patients or on management. We know that experts disagree, right?

Christine Ko: Yeah. There's a range of what might be a reasonable diagnosis. There is quite an umbrella, to use your term, of what's reasonable, and to pretend or act there isn't, I agree with you, I think that's wrong. But I guess just to push this a little bit, what I struggle with is when it's still a reasonable diagnosis, what someone else said, but, I strongly [00:13:00] feel I have a certain interpretation, and it would really make a difference for the patient, one versus the other. That's where I find it a little difficult because I can recognize that the prior diagnosis is reasonable, and I don't know what the right answer is. 

Artur Zembowicz: Yeah, that's a little bit different situation. It's very rare, fortunately. It's a very rare situation, actually. But then, if it's reasonably wrong, then you have to provide the right, because you want to push that you don't want to harm the patient. But at the same time, you want to help to bring that conflict into some sort of conclusion. So you want to acknowledge the challenging situation or difficult interpretation, emphasize that it's very reasonable, but you still can offer maybe a different perspective. I would try to soften the impression that the wrong diagnosis was wrong. I always want to bring the wrong diagnosis under the fold. 

Christine Ko: Yeah. Yeah. Sounds good. Do you have any final thoughts?

Artur Zembowicz: No, it was just fun chatting with you and I [00:14:00] really think it's very interesting because we rarely have opportunity to exchange our kind of experience, and I'm actually very much interested in sharing experience. There's this concept of evidence based medicine, right? That sounds so logical, but still a big chunk of medicine is not evidence based, it's judgment. So I have interest in judgment, right? And how you share that, how you teach people that, right? Making judgments is a kind of different skill. 

Christine Ko: Yeah. Thank you so much for doing this with me. It's been really fun.

Artur Zembowicz: Yeah. Thanks. That was great fun.