Healing the Healers with Dr. Wendy Lau

Healing the Healers with Dr. Wendy Lau

In this deeply reflective and heartfelt episode of The Conn Job, host Dr. Ann Conn sits down with Dr. Wendy Lau to explore the emotional, spiritual, and systemic realities of practicing medicine today.

Dr. Lau shares her transformative journey from emergency medicine physician in New York to becoming a Zen priest at Upaya Zen Center, where she now helps clinicians reconnect with compassion, embodiment, and meaning in medicine. Together, Dr. Conn and Dr. Lau discuss physician burnout, moral injury, compassion training, embodiment practices, and the urgent need for healing spaces within healthcare.

The conversation weaves personal stories, wisdom from meditation and spiritual practice, reflections on the COVID and HIV pandemics, and practical tools clinicians can use to sustain themselves while working in an increasingly corporate medical system.

This episode is an honest and moving exploration of what it means to remain deeply human while caring for others.

In This Episode, They Discuss:

• Why Dr. Wendy Lau left emergency medicine and found healing through Zen practice
• The hidden emotional cost of modern medicine and physician burnout
• The concept of “moral injury” in healthcare
• How medical training disconnects clinicians from their bodies and humanity
• The importance of embodiment, meditation, and introspection for physicians
• Compassion vs. empathy — and why compassion is renewable
• The GRACE framework for compassionate clinical care
• Navigating grief, helplessness, and systemic dysfunction in medicine
• Why physicians need community, debriefing, and spaces for honest conversation
• The role of retreats and spiritual practice in sustaining healthcare workers
• How clinicians can compassionately respect their own limitations

About Dr. Wendy Lau

Dr. Wendy Lau is an emergency physician, meditation teacher, Zen priest, and author of The Inner Practice of Medicine. Through her work with Upaya Zen Center, she teaches clinicians how to cultivate compassion, resilience, embodiment, and self-stewardship in the face of suffering and systemic challenges in healthcare.

Her work focuses on helping healers reconnect with meaning, presence, and humanity in clinical practice.

Key Takeaways from the Conversation

• Compassion is not performative — it is trainable and restorative.
• Physicians are often trained to suppress their humanity rather than work skillfully with it.
• Burnout is not simply an individual failure; it is often a response to systemic dysfunction.
• Embodiment practices help clinicians reconnect with themselves and their patients.
• Healing spaces for physicians and healthcare workers are essential.
• Community and honest conversation can transform isolation into connection.

Mentioned in This Episode

• The Inner Practice of Medicine by Dr. Wendy Lau
• The GRACE compassion training model
• Being With Dying clinician retreats
• Physician moral injury and self-stewardship
• Meditation and embodiment practices for healthcare workers

“Compassion is not just beneficial to the person receiving it — it also nourishes the person giving it.”

If This Episode Resonated With You…

Please share it with a physician, nurse, therapist, caregiver, or healthcare worker who may need this conversation right now. Healing the healers matters.

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Transcript

SPEAKER_01 0:00

Hi, Dr. Ann Khan today with another episode of the con job. Today I'm delighted to have Dr. Wendy Lau as a guest. Wendy was born in Hong Kong. She went to boarding school in America and then received a computer science degree from Yale. Decided she wanted to work more intimately with people and went on to attend medical school at Cornell. She then trained in emergency medicine and she's board certified in emergency medicine and addiction medicine. After an experience with burnout, she decided to leave traditional clinical practice. She went to UPaya, a Zen Institute, and is now a Zinn priestess. She works with health care providers, trying to create resilience. She wrote this beautiful book called The Inter Practice in Medicine that I read and enjoyed so much. It was very important and healing for me at the time that I read it. I recommend it highly, and I continue to draw on the principles from that book. So today I'm just looking so forward to talking with Dr. Wendy Lau. Thank you. All right. Good morning, Dr. Wendy Lau. Wendy, thank you for joining me today. We were recently together at a retreat, and um I think I first found out about you when I read your book, The Enter a Practice of Medicine, which I'd like to talk about today. But um I would like to start with can you tell me about the decision and how it how it unfolded for you when you left the practice of emergency medicine and um moved to Upaya and ultimately became a Zen priestess?

SPEAKER_02 1:53

Thank you so much, Anne, and and so thank you for having me here. And it was really wonderful to meet you in person just very recently. Um and yeah, that that decision was not, you know, a pre-planned decision. Um I, you know, got into medicine like many of us did um in order to heal and serve people. Um but it got to a point, uh, maybe a a few years after uh training, like five years out or so, it got to a point where I was no longer feeling like I was effectively healing. I was doing everything technically correctly. I was trained well, I was, you know, doing emergen emergency medicine uh in New York, but uh I felt like my inner landscape was um impatient, and uh it was getting more and more unempathetic or compassionate, um, that I wasn't um doing what I was really practicing in my meditation um practice. Um I've had a meditation practice since medical school. Um I had an inkling that um I would need it uh for for medicine. And I started just exploring and um and and then kind of uh got myself into a regular uh meditation practice and yoga practice and all of that with a teacher, and you know, we talk about being kind to people, being compassionate, and being able to heal from that kind of place, but I wasn't feeling it when I was at work, and I felt kind of like an imposter. And it came to a point where I got so burnt out um in emergency medicine that I wasn't sure how I could do another 30 years of it. I was looking down, you know, my career path um and saw this long road that I wasn't sure if I'm gonna be able to um travel down. So I took a little time off. Um I took some time to, you know, um get stronger in my meditation practice, and I found, and during that time I found Roshi Joan Halifax, um center, um, where they where we have these uh clinical uh programs, programs for clinicians. Um and I think um Anne is gonna come explore this with us soon. Um there's a program called Being with Dying for clinicians. Um half are physicians, half are nurses, and this is specifically designed for these are clinicians who don't have this kind of training to look at our own um how we look at our own mortality and our how we hold our own vulnerabilities. And talk about moral injury, we talked about um, you know, how to be more present in our clinical practice and and all of it together in this beautiful community of clinicians. So I came to experience that in 2016, um, just you know, as a participant, and I also took the Grace training, which is the compassion training that was developed for clinicians. Um, and um I talked to Roshi and um started going on the Nomads Clinic, which is a pilgrimage and a medical um service trip to very, very remote areas of Nepal. And that is also life-changing. So that year I kind of explained, uh experienced the full gamut of Upaya clinician offerings and just felt suddenly that something clicked. Um, that somehow I wasn't able to connect my spiritual practice with my clinical practice, and those uh programs and being in Nepal and being with this beautiful community um helped me connect them. And so I went back to work um for a few more years um with this in mind and also starting to bring this kind of work out to clinicians as well. I started doing, you know, grand rounds and um uh and also meditation teaching with with physicians, mostly emergency physicians. And then I just decided I wanted to take some time off again um to get deeper. And this was right before the pandemic. And so I took some time off, and then all of a sudden the pandemic happened, and I found myself at UPaya. And I had a choice to either go back to work or get deeper in this sort this kind of service, which I found was very fulfilling because my initial um intention was just to serve and heal. And I think I feel like this um teaching this way was able to help the to heal the healers, basically. So I ended up writing this book in a practice of medicine uh to combine everything I learned and my own uh clin and also in my own clinical practice and be able to speak in the voice of the physician. Um you know, uh as physicians usually don't want to listen to to um uh other voices as much and they and we trust you know our colleagues a lot more. So I wanted to write a book that speaks directly to our colleagues um and talk about these kind of difficult um topics that we don't usually talk about. And I feel like this is kind of like the missing curriculum in the in medical education. Um that this kind of you know inner practice is so needed if we want to continue practicing in clinic in clinical practice, um, especially in a broken system to help us continue to be able to serve. And um my wish is to uh bring this to younger people as well, to to our residents and messages, so that they can start off their career um with this kind of learning and this kind of experiential knowledge of our own, you know, our own bodies, our own uh experience within ourselves rather than trying to ignore, you know, when when we're starting to get burnt out or starting to, you know, be too tired, be more present for ourselves so that we can serve in a better way.

SPEAKER_01 8:46

Well, thank you for that description. And for me, your book succeeded. Okay, it was the when I read the book, it was the perfect medicine, so to speak, for how I was feeling, and it just gave me um I was able to draw into myself to handle some of the things that um that are difficult in practicing medicine in today's current corporate environment. And I guess I want to circle back to the 1990s, you know, when I was in medical school, I can literally remember them. People would say, Oh, you can't get attached to your patients. Yeah, and I knew that was wrong. Okay, I had come to medical school a little later, like you had after another career in chemical engineering. I think for you it was computer science, so these technical fields. I think we shared wanting to be closer with people, and I too developed a meditation practice in my 20s that has been sustaining for me. But anyway, I was being told, like, don't get attached to your patients, and you know, the hierarchy in medicine training, I didn't feel like I could say that's wrong. I just kept my mouth quiet, but I was like, no, this isn't right. And then I remember when I actually got to clinical care, a lot of the physicians would say, That patient died on me. That was a common thing, and uh I mean, patients don't die on us, they die because that's what is gonna unfold at that moment, and um yeah, so for me, the way I can remember early on, you know, I did neurology, and there's so many deaths. And when I was like in my very first beginning of it, somebody would come in and have a small stroke because their heart wasn't beating in, you know, normally. And at that time it was cumadin. They would come to clinic and I would be like, Oh, okay, take the cumadin, you won't have another stroke. Then I would be in the hospital two weeks later, and the person would come in and die, and they hadn't taken their cumadin. And I really thought I'm not gonna be able to do this. I just thought I can't, I don't know if I can tolerate this. And there were multiple situations like that. But then finally I came to realize I'm like, my job is to offer the treatment and explain the treatment and offer compassion. It's actually their job to decide whether to do it or not. Like it was overpersonalizing it. You know what I mean? It's I can't, yeah. We only have so much, you know, people's lives are complicated in ways we don't understand, but we can't understand because every life is so unique. But that was like a crisis point for me where I needed to accept my limitations or I wasn't gonna be able to continue. Unfortunately, I was able to. But um, my hope, I'm so grateful for you know, you and what you're trying to do, and I'd like to be a part of it too, because we can teach people better and give them tools to thrive in you know what we face. And um, you know, we were just kind of blowing in the wind back then, and nobody there was no um guidance. I mean, the guidance I had was from like my own spiritual teaching and and stuff, and we didn't even really talk to each other after all these terrible deaths. So I'm I'm glad things are changing, and um your book is so valuable, and I just honor you and thank you for writing it. Yeah.

SPEAKER_02 12:25

Thank you so much. Thank you so much. That's that's exactly it. I think um in medical education we're cut not even explicitly and also implicitly taught to kind of stuff our humanity, to become inhuman basically in order to deal with these things. Yes, maybe there's you know a way that we can be uh to not attach too much, but also we need to acknowledge our very human reactions to what to facing suffering. This is our job. Our job is to face suffering. We watch people in pain. We you know also have to inflict pain sometimes in order to heal. And so all of these things can kind of burden us and and weigh us down if we don't know how to release them and don't know how to know where our limit is. And you had said uh, you know, knowing our limit. And um I find that uh, you know, being able to be in touch with ourselves is so important. That's why I called the book Inner Practice of Medicine, is so that we can actually learn how to get in touch with um what it is that we're feeling. And um, I always like to read this quote from uh Cinder Rushton, um, who is uh nurse at ethicist. Um she's the bunting chair of ethics at uh Johns Hopkins University. And um, she wrote this book called Moral Resilience, and she talks about this term called self-stewardship, which we like to teach a lot in our courses because it distinguishes this sense of um, or what people call self-help or self-care from what we're actually talking about as inner practice. Because self-care sounds like it's something that we have to do to make ourselves be okay, like this kind of outer thing, or like, you know, you know, people say, you know, maybe you should just go do some yoga. I mean, that's that's like another thing to do on someone's in someone's like busy life. Maybe that is right for you, but seeing it as like an external, something added, it's not what we're talking about. So here's the definition that she gives that I find so um just helps me look at how I make decisions for myself and how I know what my limit is. So she says self-stewardship embodies a commitment to know oneself, to responsibly and mindfully manage one's personal resources, to recognize and compassionately respect one's limitations, and to choose actions that are wholesome and life-affirming.

SPEAKER_01 15:19

How beautiful. I mean, when I hear that, what comes up for me is I think in medical training we're just expected to go beyond our limitations.

SPEAKER_03 15:30

Yeah.

SPEAKER_01 15:31

And I know when I did finish training, it was really like a few years I was like, I was kind of in recovery from like I needed to reel in and set reasonable boundaries, and I was just a constant expectation that I would have no limits and take care of absolutely everything, and it was a huge adjustment. Um, and I would say it's probably a lifelong adjustment because then it becomes that was just massive, but then the it's on a continuum, I find, more subtly. But that it's it is inhumane the way we we train because you're expected not to respect your bodily limits, need for sleep, food, restroom, all that. Yeah.

SPEAKER_02 16:14

Yeah, it kind of trains out of us out of being an embodied human being. So we're we're told to not eat, not go to the bathroom when we need to, to not uh respond to our need for sleep or rest. And and over time it teaches us to cut us off from our bodies. And um interestingly, uh, we teach this a lot in our in our clinician programs too, and um we've actually broaden uh embodiment as we go along in the training to retrain ourselves because um the way that we can allow for compassion to arise and to be empathetic to someone else is to actually feel through our bodies. So if we are cut off from how we ourselves feel, we have no idea what other people are feeling. So in order for us to even be connected with our work, um, be resourced by feeling into um our compassion, we have to be back in touch and reawaken this sense of being connected. So in our courses, we always have um, say, being in being with dying that you're gonna come to, um, Mary Taylor, who is a beautiful, wonderful um embodied teacher of yoga, always guides these um body exercises in between each thing that we, you know, each each um session of talking. Um so we're not just up here like we always are in our heads, but we actually engage the full body in order to learn.

SPEAKER_01 18:02

Right. I think that is so important to listen to the body because I think, in my experience, recognizing what's going on in my body can help me see what's going on in other people's bodies.

SPEAKER_00 18:18

Yeah.

SPEAKER_01 18:19

Especially because as a pain doctor, interventional pain, I mean, I can sometimes I can just before they even talk, or in while talking, I can see this tension, the posture, the facial expression, the hand movements, all these things are being communicated. And there it's very valuable deep communication that can be transmitted through that. Um yeah, I it's sometimes I can feel into that when I'm having when I'm calm and centered and I had enough to eat and enough enough sleep the night before, and I'm not sick, then I can I'm more available for that, which is nice, which I appreciate.

SPEAKER_02 19:03

Yeah. And and one of the things that we teach a lot also is that um in the grace training, which is a compassion training, compassion is not what we were taught in medical school, where it's a script where we're like, this is how you act like a compassionate person. Compassion is actually um beneficial not just to the person who is receiving it, but also to the person who is giving it, and also the to the person who is witnessing it as well. Um and when we can feel into that compassion for someone as we're working, it actually resources us because it connects us back to our intention to serve. It gives us meaning to our work rather than doing everything mechanically. We can feel into our own intention and remember that we went into this difficult, you know, um career, not just to, you know, not just to do the things mechanically, but actually to serve and heal. And that gives us a resource that is deep, especially when things are difficult.

SPEAKER_01 20:16

Right. So I get the Dalai Lama, I believe, says compassion is the radical act of these times. And um, you know, that kind of wisdom. For me, I agree with you. I mean, compassion is different than empathy. Um, and you know, that's I think Roshi Joan talks about Matthew Rico's work, which has been had a lot of meaning to me also, because empathy is feeling with into MC, and compassion is this intention to act and to relieve suffering, and it's ever renewable, it's invigorating. When I'm in over-identification, that's exhausting. Yeah, okay, that's you know, just my and that I found that to be true not only in my work but in my personal life. Um, so that these are very deep, beautiful teachings, and it's truly a spiritual practice. A practice needs to be worked on, practiced.

SPEAKER_02 21:15

Well, I mean, we teach that actually compassion, even though it's um the feeling of compassion uh when compassion arises, it's a spontaneous thing. But what generates compassion is actually trainable. It's not something that's when you know when I was in medical school, I thought that either you have it or you don't have it. There's some nice people and then there's some not so nice people. That's not how it works, actually. We can actually train for compassion to arise. So that's what the GRACE training is for. The GRACE is an acronym. Um, so G R A C E. This is something that uh Roshon and Had developed over the years for clinicians at first, and then now we actually train lawyers, we train teachers, we train social workers, and in Japan there's actually a Grace Society, and we go over to teach there, and they have a whole team that teaches it to doctors and nurses. So I'll give you a quick um overview of what uh grace means. So the Greek G of Grace stands for gathering attention. So you can imagine if you're distracted or um just divided or dispersed, the three Ds. If you're saying for me in the ER, if I am thinking about the next patient or what I have to do next, and then I walk into this patient's room, there's no way compassion can arise because I'm not even there. I'm not even present. So the G of grace is gathering our attention, and we teach techniques like breathing in and dropping our attention down and feeling the sensation of our feet on the ground so that we're totally here before we walk in the room. And then letting ourselves be undistracted. That's the G of grace. The R of grace is recalling our intention. That's what we were just talking about, our deep intention to serve, or I'm here to serve this patient. So if I walk into a room and already I am impatient and wanting to get to the next thing, or that I'm uh, you know, I know that there's like it the ER is really busy, and I think that I'm, you know, I'm there to just, you know, get rid of this patient or trying to get out of there, then there's no way compassion can arise either. So the R of Grace is an invitation to recall that I'm here to serve this person. Right now it's just about this person, and that I'm not here just to get this done, but to able to be able to heal and see what they need and be able to speak in the way that they, you know, they need me to, and to see the big picture of what they need. That's my intention. So I take a breath, recall my intention, feel it in my body, and remind myself that's the R of grace. The A of grace is attune. But first, we attune to ourselves first. This is what we were just talking about about embodiment as well. So we attune to ourselves. Oh, I actually need to go to the bathroom first before I see this patient. Or that I'm hungry, I need to get a bite, or that I'm holding on to some anger that I had because I was just talking to someone and they were like all riled up and I'm in this state of kind of uh arousal. So I attuned to myself, I recognize that I'm holding this and see if we we can go back to our okay, now I'm here to just serve this patient. I'll let go of this from before and just be here. And then I attuned to the other person, the patient, as I walk into the room. Now I'm ready to attune to them because now I have cleared what I'm holding or my biases that I might be holding. Um, and so that's the A of grace, attuning to self and then other. And then the C of grace is considering what will serve. Considering in a way that is about not bringing in our own um preconception of what should be done. And it's not just about diagnosis and treatment, it's not just about our clinical part of it, and that is part of it, of course. We're not letting go of our um, you know, our expertise about that, but we're coming in fresh also, without biases, without our preconceived notion. So we consider the big picture. So maybe you walk in the room and you notice that there's a family member there who is kind of nervous or is uh uncomfortable. Oh, maybe you consider that that person, you know, you need to address that person as well. Have them sit down. Or you notice that the patient is, you know, um just um in pain and they're not able to listen to you, or they're distracted by something else. Maybe address that first. Then you can tell them what is needed needed to be done. So seeing the big picture, considering what considering what will serve, bigger than just the clinical part of it. How we might talk to the patient, maybe we need to use a different tone. Maybe we need to sit down, maybe we need to, you know, rearrange something. So, or bring someone else in. So that's C of grace. And then the E of grace is to engage in that compassionate action, and then after we do that, ending. Ending meaning we acknowledge what we've done, acknowledge this uh moment that we've had with the patient, and also acknowledge what's not done. Sometimes there's stuff that can't be done, like you said, in our in our um system. Sometimes, you know, there's maybe I send I discharge this patient in the ER, knowing that they might not be able to actually follow up the way that I took I'm telling them to. Maybe they can, maybe they cannot. Yeah, and then I'm holding on to this kind of residual feeling of dissatisfaction or shame or guilt, acknowledging that, being able to let that go, knowing that I've done the best I can in the circumstance that's given to me, and then be able to move on and see, you know, to the next thing without holding on to this residual guilt and shame. So that's GRACE. Um, and we train that in uh uh weekend um training, like a three-day training, and then we we we do exercises for each of these. But then once you've actually gotten this down, it can be done within three breaths. As you're walking to see your patient, you're grounding yourself, you're recalling your intention, you're tuned to how you're doing, and then you walk in the room, you're attuned, and then all of this can be done in in situ without you know too much time. So it's a very practical way of so that we can arouse this kind of compassionate action and set the field so that it can happen.

SPEAKER_01 29:04

Yeah, that's just a beautiful psychological arc to go through to be fully present. And I mean, deep knowledge um has gone into that, and I value it. And yeah, I mean, I honor that and want to do it. I think in my experience, it's more difficult than ever. I mean, I've been practicing for 25 years, and so I've seen the transformation of our system. And having also gone to Asia and been in the hospitals and see what it's like when a medical system is not commercialized and how different that is. Because now, you know, as medicine is becoming more corporate, and you know these corporations have a fiduciary obligation to make money. And we as physicians, you know, we're committed to the patient and to public health, and sometimes those things feel such at odds. It's painful. I feel it as painful. And before we got on, I was sharing a story from this week that I um with a patient. And the thing about this story is it's actually not that unique. So just to give, like, you know, a succinct version of what happened, is one of my longtime patients came to me, and um what we've noticed is deductibles for insurance have gone higher and higher. And many people have a $7,000 deductible now. So the patient comes to me when I walk in the room, I'm like, oh, she looks pale. That's the first thing I noticed before I talked. And then she started coughing before she or I talked. And I'm like, Whoa, what's happening here? And so, you know, I asked her what had been going on, and she said, Oh, well, I've had the flu. I got the flu. And so, you know, I'm just like, so what happened? How were you diagnosed? And she told me she was taking care of her grandson who had the flu. He went to the pediatrician, and a few days later she got sick. And she explained to me that she didn't go to the doctor because she couldn't afford it. And um, she knew there were flu medicines, but she thought they were really expensive, and she, you know, she was gonna have to pay all that cash as she didn't go. And then she proceeded to tell me that um, like a week later, she actually got shingles on her face, which is so deeply painful. And again, she didn't go to the doctor for the same reasons, and she also had a misunderstanding that the shingles medicines are really expensive, but they're not. And I told her that, tried to reassure her if she had shingles that the medicines aren't expensive. And then she proceeded to tell me that she couldn't continue with our treatment right now. Okay, so she has chronic neck pain, and I burn the nerves in her neck. It works really well, but she doesn't have the money for the copay, so she can't have the therapy right now. And I'm listening to all this, and I'm thinking, while I'm hearing her cough, that she could have pneumonia because after flu, people and shingles, their immune system takes a dip for a short time and they can get pneumonia. So um I was discussing that possibility with her, but I was feeling so sad, and I was feeling helpless because this lady is can't basically can't access what she needs because of her high deductible and her challenging financial situation. So that was an example. I mean, I was just with her listening to her and expressing concern and my sadness for her, but that I had trouble shaking off because um I just don't see an easy solution. I mean, I was with her, I offered my presence and what I could, but I felt sad about it. I think I still do feel sad about it, and some helplessness. So it's just challenging. Um, at least anyway, I was hoping for your feedback and your thoughts about the transformation of our system and um the barriers. Anyway, I'd like to hear your reflections, please.

SPEAKER_02 33:21

Well, I I just want to hear how you work with um that sadness and um the feelings that are left over in in your experience and in your spiritual practice.

SPEAKER_01 33:33

Well, I do tell my nurse, I'm close to my nurses. Okay, so they I share with my nurses, and that does help. Okay, first of all, they need to know what's happening so we can you tactically try to take care of her, okay, and get plans and help, like we know her financial situation. So sharing first sharing with my nurses because it helps me not carry it alone, and it helps us plan and know what the patients are going through. Okay, so um, yeah, I mean, I met my meditation practice has been transformative for me. It helps ground me. Um, I'm working within a system that, again, I mean, my power is limited. Okay, I can offer her love and compassion. Um, I feel like my job more and more is to help people navigate our system. Okay. I give them, which is of course tactical, but you know, I just try to honor and do um, it's like self-havening, some people call it. Like I go to my office, I talk to my nurse, then after she leaves, I just try to take deep breaths, okay, and do like um, you know, being with it, just trying to be with it. Um, you know, the feelings of what has happened and let them run their course. Because when I've noticed if I try to deny and pretend it doesn't work that well. So those are some of the tactics that I'm trying to use to handle things like this, which seem to happen more and more.

SPEAKER_02 35:11

I mean, it's so difficult because our system is broken. And um we are, you know, our values of service is being opposed by the values of capitalism in our system. And, you know, the biggest, you know, I I don't know how to fix the system and I don't have an answer for that. Um I wish I do. Um, but in order for us to continue to work in the system, we have to recognize how um the system is affecting us. And and like you said, letting the feelings go through uh without trying to to suppress them is important. And what you said about your nurses is super important. That's having a community to be able to talk about and um you know I we have been uh doing um a physician retreat here uh based on the book, um, and it was the first two were so healing for me uh personally, um, because we had 30 physicians in the room from different specialties and different stages of practice and different places working in different places, but all having um the same uh you know medical training um from medical school with the same kind of language. But I realized um at the first one that we've never, you know, after medical school, none of us really talk to each other across all the specialties. And we it was so refreshing to have everybody in the same room, you know, with the same language but have different kinds of experiences, and then it was just so healing. Everybody had so much wisdom, and we were able to share um our own experience and be re have that be reflected in each other, and having all that different um experience in our own specialty that are so different but yet so the same. Isn't it funny? We've I I just realized I never talked to anybody um outside of my specialty, other than you know, in in emergency medicine we do, but we talk to other specialties, but they're never, you know, fun uh conversations. We're always giving other people things to do. So um it was super refreshing.

SPEAKER_01 37:42

Yeah, yeah. So that's it brings up a story. Um, you're right, we don't talk across specialties a lot, but something spontaneous happened. It was so unusual during the pandemic. Okay, I my and my colleagues we trained during the HIV pandemic, basically. And so we were at this party um for a colleague, and it was kind of in a break in the pandemic. And these are doctors in the community, I don't know that well, like cardiology. I mean, I know them, but I don't spend a lot of time with them. And just spontaneously, all this pain started pouring out about the HIV epidemic. I mean, that's years ago. Okay, it really, I mean, I felt tearful. It was just, I think it was just stories about things that had happened, you know, at Charity Hospital in New Orleans, a big public safety net hospital during the HIV epidemic. And I had been noticing that during the COVID pandemic, some of this stuff was just coming back to me spontaneously, and I really hadn't discussed it with anybody. And at that event, it was just a spontaneous outpouring. Um, it was very interesting, and actually, I think it was healing. I mean, we were clearly carrying these memories, and what was so hard, you know, it's young people dying in very difficult ways, and this is before HIV was like a treatable illness. You know, now can we have long-term suppression? At that time, it was just coming out, and most people weren't on it. So I agree that we don't talk enough, but there was just a spontaneous outburst of like it was actually very loving at this party, and so I felt so happy that it happened and um and grateful, and it doesn't happen enough. And I do think it was driven by the pressure, the emotional pressure people felt in the COVID, um, you know, during the COVID pandemic.

SPEAKER_02 39:39

Yeah. Yeah, and so I think it's our job to create more of these kind of spaces where we can come together and and talk. And, you know, a lot of the problems that we have in the medical system, you know, s stems from us, you know, not talking to each other. And you know, um, and there's like, you know, a loneliness pandemic or epidemic anyway in this country. But I think, you know, people who are in professions that are kind of um like you know, like medicine or law, um, people who have a lot of education, who are taught that we are supposed to be experts in our field, have actually even more of a more of that kind of loneliness epidemic. So we need to create more spaces where we can talk together.

SPEAKER_03 40:31

Yeah, right.

SPEAKER_01 40:32

So being an expert doesn't make us less human. Being an expert's fine, it's a beautiful thing. But I mean, all the humanity is still, you know, with us. And um, and that's a beautiful thing too. But I think sometimes we haven't acknowledged it enough and tended to it and loved it enough. Yeah, yeah. And um I guess that makes me think of what happened in this retreat that we were both at when there was a medical emergency.

SPEAKER_00 41:01

Yeah.

SPEAKER_01 41:01

Um, yeah. So um basically, you know, at work we kind of have one our persona for better and worse, okay, about what's you know, and so on a retreat like this, you know, it just was meditation and you know, a great community. And um so we would go down to see sunset on at the beach by our retreat center, and so a lot of us would go down so beautiful every evening. And so one evening, like the third day in maybe I was walking down and I saw a lady laying on her side next to the water, and somebody was starting chest compressions on her. This is this male nurse. And so, you know, I went to her side and um so did another doctor and other people, and um she had had what we call a pulseless cardiac arrest, and then she had gone into the water and of course inhaled some water, and um she had no breathing and no pulse, and um, you know, the the ER nurse really had great skill. He clearly knew how to do chest compressions really well, and it was I was so grateful. So, if we were clearing her mouth and doing the things, it was a long code, really long, probably seven minutes total, which is forever. It feels like forever. She did ultimately get her um breathing and respiration back, and it really felt like a miracle because she completely recovered. She did not have a neurological injury, but it was pretty shocking um that this happened, and then um, you know, we got you involved. And I don't know, would you like to tell what it was like for you?

SPEAKER_02 42:49

Yeah, sure. I mean, I wasn't there on scene um at the time on the beach. Um, I only ho heard about it afterwards at dinner. And, you know, I went to check on um the person who who had that episode, and she was taken to, you know, a local clinic and made sure that she was okay and that she was getting transferred to a bigger hospital to get checked out. And then, you know, once I saw that she was fine, um, what I was most worried about was um our uh nurse who was there on the scene who uh performed the the resuscitation because I had known that um this person had um had to take some time off of work because of um the trauma that that they had felt um at work and had some kind of PTSD. And you know, I've seen that a lot uh in in my career as well of you know, people needing to take time because of, you know, traumatic situations that they've experienced at work. And then then coming to this retreat and having to do a resuscitation on the beach um out of hospital. was was I thought probably a bit traumatizing. So my primary um concern was was about that person, that nurse. So I later, you know, found them and just wanted to to see if they wanted to um to debrief um and talk about it. And they were fine and okay. But you know it's it's hard for us when we're out of hospital because you know in the hospital we're we have a whole team. We have everything we need. We know it's going to be okay no matter what, even if, you know, because we have a you know people to to help us. And um also we are protected by our you know our identity as a nurse or a doctor um that you know we can you know kind of be protective behind this kind of shield of identity. But when you're on the beach while you're trying to relax that's not there. So I wanted to check on him and make sure that everything was okay. But you know it he was okay. But um you know we wanted to make sure that you know he had a space to debrief and it was so beautiful. All the clinicians get gathered in the cafe and we all talked and ate snacks and it was you know it felt like a a time of just um again kind of like what you experienced um with with all the physicians there um being able to talk about you know to debrief and talk about how we normally don't debrief and how uh you know we we can do better we can do better.

SPEAKER_01 45:40

Yeah yeah yeah I did um it was nice because we did all gather together and support each other and it was in a relaxed way that we usually don't have time to do at work. Yeah and I appreciated that and people shared their other experiences. The ER nurse shared experiences that brought um this person to the place of having PTSD and I mean um yeah I noticed for me it brought up old codes that I've been involved in and I mean and during this code I was just clearing the patient's mouth and checking their pulse just like playing a supporting role he was really running it but um it was nice that we could come together and then we were able to like check in over the next few days in this calmer environment so that was nice and she did well of course that felt like such a relief such deep thanks and her sister came back and talked to us at all so we got the entire arc that we don't get a lot of this happened then we all got to talk and then we actually got almost like resolution in that there was they she kept the sister came back and so it felt really nice I don't know if I would call it complete but it felt really nice um and restorative and so I felt so grateful.

SPEAKER_02 47:15

Yeah yeah yeah yeah we you know that's like you know like the what we talked about in grace the ending ending is important and of course sometimes we can't get the actual ending to be nice. You know this time it was luckily very fortunately she was fine but even when things don't go well how do we come back and understand that we've done the best we can and not hold on to that guilt and shame if things are not exactly perfect.

SPEAKER_01 47:47

This really went very well but how do we hold ourselves how do we debrief with others how do we um end in a way that we we don't carry this story um with us in a way that you know burdens us so those are things that that we like to talk about in you know in our compassion training as well because it's not just about showing compassion but it's also about this compassion that includes ourselves that we can that we can um see that we've we are you know a we are doing the best we can in in an imperfect kind of situation yeah that's I mean very valuable to think about because um I mean we can apply our skills perfectly and beautifully with well developed skills and difficult outcomes can unfold. Yeah that happens um so I think when I was younger and I wasn't confident in my skills it was even more difficult because then I was questioning myself now I mainly feel confident in my skills so that part's easier but I again it's just situations have a lot of complexity and I'm appearing in a person's life at a moment and I my job is I try to think of it like I apply my skills I send love and good intentions and some of it's out of my hands um and that it helps me be calmer when I'm confident in my skills. Okay but it's not easy. Yeah what are your thoughts on that?

SPEAKER_02 49:30

Well but we're actually also talking about the system um not letting us do our job in a way that we want to not a for example not being able to spend as much time as we need to with a person. And that you know can cause moral injury um over the long term and that's that kind of um uh tension between what we know is the best thing that we can do and what we actually can do is what causes that kind of moral injury and can and can over the long term burden us and cause burnout. And the worse the system gets the more this can happen. So we need to recognize this tension and know that this is you know there's some things that are are not ours to fix as not ours to hold if if you know and we do the best we can in the circumstance that's given to us and know how to let go of what's not ours and that's very important.

SPEAKER_01 50:32

It's important and I mean everybody does this their own way for me I take off and I go to things like the retreat years ago I wouldn't take off as much and now I know that I need to take off so that I can continue to do it. If I didn't take off and you know go to meditation retreats and go on vacations um it helps me recover. That's one of the many tools that I use and um but it's there's no way to tie a bow around it. I wish I knew how to fix our medical system also and I don't um I do have I mean we can rely on change that's one thing we can rely on and that is an avenue for hope like Rebecca Solman says and so it will be evolving and changing and that is opportunity that good things will come forth.

SPEAKER_02 51:27

So that is possible we'll we just have to see um what happens yeah yeah that's why I love that definition of self-stewardship and it says that we we recognize and compassionately respect one's limitations and to choose actions that are wholesome and life affirming sometimes that action can be we need to take time off we need to step away we need to reduce our hours that that can be what is needed so we have to see what is actually right for us. Right introspection yeah so um what have we not talked about or what have you not said that you'd like to add as we come to the end because that's what we're talking about having these kind of avenues of being able to be together in conversation about difficult um topics that we face every day. And so all of us together with my work with your work maybe we can you know bring more people in to have these kind of conversations so that we can be able to serve better but also bring in systemic change.

SPEAKER_01 52:58

Right so we need a network of people talking about these things because you know boundaries you're taught to do boundaries that that's fine but and that's really important but there's a systemic problem that needs to be moved um so that flourishing can happen for patients doctors nurses everybody in the medical field of course all that you know that just propagates through families and society you know that we know so yeah I just you try to keep our voices going um to facilitate um love connection compassion and um you know positive skillful movement around these issues.

unknown 53:50

Yeah.

SPEAKER_01 53:50

Thank you so much.

SPEAKER_02 53:52

Thank you for having me and thank you for the work you're doing. Thank you. Thank you so much.