Explore The Space

Dave Berke is a retired Marine fighter pilot and Top Gun instructor who now is a part of the leadership team at Echelon Front. He is back for a fourth time on Explore The Space to continue our exploration of team based culture. Every time we have these conversations, I’m fired up for the next one. Key Learnings * We start off with another round of Quick Hitters! * When work spills over into life * Why excelling at work is a recipe to do well elsewhere * Keeping friends and family informed as a cornerstone of work-life balance * Communication skills as a hard-won lesson in maintaining relationships and building a successful career

Lizzie Johnson is a reporter for the San Francisco Chronicle who covers wildfires in California. She joins us on the eve of the one-year anniversary of the Wine Country Wildfires of 2017 to reflect on what happened, how the community has rallied, and the challenges still facing the recovery. Key Learnings * Becoming the “Fire Girl” * Arriving in Santa Rosa after the fires started * Reporting from the ruins of Coffey Park * How this wildfire impacted the sense of safety for people across the world * Being a reporter and allowing people speak their truth about their experience * How communities respond to a disaster and how it evolves over time * Impressions of the recovery in Sonoma County at one year * Global perceptions of the wildfire, climate change and an international “voyeuristic sense of horror” * The one-year anniversary coverage

Emily Silverman is a Hospitalist and the creator of “The Nocturnists” podcast and live show. If you love stories from the dark corners of medicine, and the light and lively corners as well, “The Nocturnists” is an amazing place to spend some time. We cover the origins of the show, how stories humanize physicians and healthcare, and the amazing growth of her project. Key Learnings * How her love of storytelling, writing and “The Moth Podcast” led to “The Nocturnists” * The first live event of “The Nocturnists” in January, 2016 * How her project is helping satisfy the public demand for powerful medical stories * Thoughts on the power differential between doctors and the public and how stories can help humanize physicians * Why doctors put up emotional shields and the “hidden curriculum” of medical training * Themes that are emerging in the stories being told * The coaching process being used by the storytellers she works with and how to incorporate into clinical practice * What the future of her project looks like * Being a Hospitalist and a podcaster

Maureen Bisognano is a nurse who has held many roles over her extraordinary career in healthcare, most recently as President of the Institute for Healthcare Improvement. She now serves as Chair of the Advisory Board for the Well-Being Trust, which is a national foundation dedicated to advancing the mental, social, and spiritual health of the United States. She joins us for a remarkable conversation about the origins of the Well-Being Trust, the work done thus far to address “diseases of despair”, some truly amazing program ideas, and the first steps forward. Please note, at the top of the episode we share a few words upon hearing of the suicide of Dr. Bongani Mayosi. Key Learnings * What are the diseases of despair? * The challenge laid out by Providence-St. Joseph Health in helping found the Trust * Getting a foothold on mental health at a national level * Initial goals: improving access to care, determining social determinants of health, & focusing on children * The invention of a socialance instead of an ambulance to address access to mental health care upstream * Creating #bewell, #beheard, #bethere as a part of a youth campaign on social media * Sourcing and harvesting programs and ideas on a global level * A revolutionary Call & Check program to address social isolation in Jersey, England using the postal service * Strategic goals of the Well-Being Trust * Parallels with the opioid epidemic * Taking care of yourself while taking care of other people Links The Well-Being Trust: http://wellbeingtrust.org The National Suicide Prevention Lifeline: https://suicidepreventionlifeline.org Call & Check Visits program from Jersey Post

The Badwater 135 is one of the toughest footraces on the planet, Michelle West is preparing to run it for the third time. We caught up with her less than 24 hours before she starts running 135 miles through Death Valley, CA and had an amazing conversation with someone on the cusp of an extraordinary challenge. This is an incredibly unique discussion just before she embarks on one of the hardest physical tests that exists. Key Points * On the eve of the Badwater 135, one of the toughest footraces on the planet * Preparing in a place of extremes * How Michelle is readying her body and mind the night before the race Facing heat, thunderstorms, and sleep deprivation * Finding motivation and inspiration in the face of a profound challenge * The impact of experience at Badwater and in life when “you know what’s waiting for you.” * The hardening that comes with difficulty and challenge * Experiencing joy and euphoria after coming through hardship. Links Badwater 135 race site Badwater 135 race webcast National Multiple Sclerosis Society

Dr. Mona Hanna-Attisha is a Pediatrician who brought the epidemic of lead exposure in the water supply of Flint, Michigan to national exposure in 2015. She has become an example for physicians and scientists of how and why they can and must stand up on social issues. She joins us to discuss her incredible work, the importance of courage and how to build it, and her wonderful new book “What The Eyes Don’t See.”  She reminds us too, that the strength she displays “is in all of us. This is all of our jobs.” Key Points *  Advocacy as a path into the profession of medicine *  Using her megaphone and the power of “What The Eyes Don’t See” * Doctor as renegade and as detective * How did she think of lead exposure in water in the first place * Building the resources to speak truth to power as a physician * Where Dr. Hanna-Attisha’s courage comes from * The tools needed for physicians to leverage the impact they can have on society * Dealing with the onslaught of pushback by building a team around you * What could happen if doctors rallied en masse around social issues * Teaching others to be both renegade and physician * Creating a comprehensive clinic to address social determinants of health. * What Dr. Hanna-Attisha is most proud of and what she regrets through her journey to date * The beginning of the journey in Flint.

Sarah Sellers is a Certified Registered Nurse Anesthetist who shocked the world this past April when she came out of nowhere to finish in 2nd place at the Boston Marathon. She joined us to discuss her remarkable achievement, the importance of being in the moment, and how her work in healthcare and her marathon training are bound together. Key Topics * What does a Certified Registered Nurse Anesthetist do? * Finding time to run amidst a full work schedule * The discipline and value of “being in the moment.” * Qualifying for the Boston Marathon by winning her first marathon * Setting goals for Boston * The epic weather during the race * The value of camaraderie amongst the competitors * The famous picture and the smile * Going back to work * Maintaining focus and being able to adapt to change * Lessons from her success at the  Boston Marathon that connect to working with patients * Can hospital food be part of a nutrition plan for marathon training?

Dr. Colleen Kraft is the President of the American Academy of Pediatrics and she has been a pivotal voice in helping us understand the scope of the immigrant child separation crisis. She joins us to discuss the physical, emotional, and developmental harm these children are exposed to as well as where things stand with reuniting them with their families. Key Topics * How and when the issue of child separation came to Dr. Kraft’s attention * Images from the detention centers as a national Rorschach test * Is infrastructure in place to provide proper nutrition, healthcare, hygiene and basic care? * The lack of knowledge around what is going on in detention centers * The triggers and effect of Toxic Stress on children * Key steps in mitigating Toxic Stress and the importance of being reunited * Has there been pushback to Dr. Kraft and the AAP’s efforts? * Impact on children who are American citizens * How can people contribute? * What will be the next major phase in this crisis Links ProBAR RAICES American Academy of Pediatrics Statement on child separation  

Sam Quinones is an investigative journalist who wrote an extraordinary book about the opioid epidemic in America called “Dreamland.” He joins us to talk about the tremendous challenges he found in writing the book, how the book helped break the story of the opioid epidemic, and his brilliant insights on the road forward in this epidemic. In parts frightening and inspiring, this is an amazing discussion Key Points * Starting his investigation into the opioid epidemic * The collision of opioid prescribing and heroin marketing * The spread of “the horror story monster” * Why prison is the best place to interview a drug dealer * Finding people with a story to tell about opioid addiction * Why so many addicts hid their story for so long * The darkest moments in “Dreamland” * Constructing the book so the story takes life * Importance of pain strategies that don’t rely solely on opioids * Novel approaches at the community level to tackling the epidemic * How an isolating drug is prompting Americans to work together * Finding inspiration in the ways communities can and are rebuilding

Pamela Wible is a Family Practice physician who has taken on the cause of physician suicide. We discuss the acuity of the problem and the disconnect between public understanding and the reality of the problem. Sadly, Dr Wible is probably correct when she surmises that almost every physician in America knows someone in medicine who killed themselves. The conversation also moves through how the problem can begin to move towards improvement. Key Learnings * Why Dr. Wible took on the issue of physician suicide * 951 physicians dead by suicide * How do non-physicians understand the idea of physician suicide * Why physicians are at high risk for suicide * The SOAP note approach to the issue of physician suicide as a societal issue * Why the issue is so difficult to discuss * The impact of “sucking it up” * Dealing with tragedy as part of the solution * Where physicians go to cry * Suicide awareness & prevention as a recruiting & retention tool * Reaching out for help Links Dr. Wible’s home page “What I’ve learned from 949 doctor suicides” Do No Harm film site

Dave Berke is back and we continue our deep-dive into assessing and building team culture. In our 3rd conversation, we get into the importance of selflessness in driving culture, ensuring a team has a sense of purpose and creating shared experience to bring people together. Plus, another round of Quick Hitters! Show Notes * Generalizability of culture conversations to any type of team or organization * The demands of tackling culture and avoiding “easy outs.” * Importance of positive culture in a high pressure moment * What is the fabric of good culture? * Aligning priorities and linking the tactical to the strategic * The dividing line between good and great culture * The 3 Pillars: selflessness, sense of purpose, shared experience * Recognizing circumstances are the same regardless of profession or industry * The burden of getting it right * Culture building as a process * What’s next: converting ideas into practice * Another round of Quick Hitters

Zack Shinar is an Emergency Medicine physician, an international expert on resuscitation and highly sought-after speaker who is launching a new conference called Emerge. This conference is designed to introduce high school students interested in medicine to some of the most amazing things that doctors get to do on a daily basis. We dive into the incredible opportunity this conference provides to help light a fire under the next generation of physicians. Show Notes * What is Emerge all about? * Seizing the narrative around what it’s like to be doctor * Anticipation about the conference and the clinical content * Introducing the cerebral, tactile, and psychosocial aspects of being a doctor * The close-knit nature of medicine and getting to enter this community * The diversity of medicine and physicians * The future for Emerge and #beadocinadecade * Shaking off sense of malaise around being a doctor * How Mark and Zack made the decision to become a doctor * Establishing a marketplace of ideas * Helping to access and launch the next generation of doctors Tags: high school, conference, medicine, emergency medicine, ECMO, Badwater, ultramarathons, reanimate, mentorship, hands-on, diversity, medical school, residency, cardiothoracic surgery, #beadocinadecade, stories, storytelling

Meg Tirrell is a reporter with CNBC focusing on biotech and pharmaceuticals, and she joins us to discuss CNBC’s new conference “Healthy Returns”. The conference brings together powerhouse minds from healthcare, business and tech; Meg will be right in the thick of it. Our conversation covers politics, the opioid epidemic, and how to ensure the patient voice is heard. A fascinating discussion of what is sure to be a truly unique event.

Steve Beeson comes back on the the podcast to discuss the power of coaching in medicine. Steve was my coach early in my career after residency; there is no one better to speak on how to use coaching to pull the main levers for human contentment and the way we can turn simple skills like narrating a physical exam into a wave of cultural transformation.

Dr. David Troxel is the Medical Director for The Doctor’s Company, which is the largest physician-owned medical malpractice insurer in the United States. He joins us to help demystify one of the most anxiety-provoking topics in healthcare for both physicians and patients, as well as explore the value of transparency when reviewing cases and discussing errors.