Latest / Flourishing in Medicine: From Surviving to Thriving / Flourishing in Medicine: From Surviving to Thriving Episode 1 Ni-Cheng Liang, MD, ATSF

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Flourishing in Medicine: From Surviving to Thriving Episode 1 Ni-Cheng Liang, MD, ATSF · Flourishing in Medicine: From Surviving to Thriving

• 0:00
  Welcome to our first episode of this new podcast, Flourishing in Medicine, from Surviving to
• 0:29
  Thriving. I am your host, Dr. Mick Krasner. And this podcast is being produced by EmPRO with over 35
• 0:37
  years of experience as a regional medical professional liability insurance carrier.
• 0:43
  EmPRO is headquartered in New York State and has been dedicated to protecting New York,
• 0:48
  New Jersey, Connecticut, and Pennsylvania's physicians, healthcare facilities, and healthcare
• 0:55
  providers. EmPRO has also led the industry in peer support activities, and this podcast is yet
• 1:01
  another way in which EmPRO is supporting the needs of physicians. We're really excited to bring to
• 1:09
  you our first podcast. I just want to talk, because this is the first podcast, a little bit
• 1:14
  about the purpose. And the purpose of this podcast is to explore ways that we as health
• 1:19
  professionals, physicians, nurses, nurse practitioners, physician assistants, mental
• 1:25
  health providers, therapists, and others can truly flourish in the complex and challenging
• 1:31
  world of healthcare. Let me read something to you about what really our vision is. The ability of
• 1:37
  physicians and other health professionals to practice high quality care and attain professional
• 1:43
  satisfaction and meaning in their work has been under continued challenge. The effects of the
• 1:49
  pandemic on their wellbeing have only exacerbated changes that have occurred over the preceding
• 1:54
  years in the practice of medicine, exposing even further the fragility of our imperfect
• 1:59
  healthcare systems. This podcast will explore the many ways that we can learn to and do flourish,
• 2:07
  beginning with an exploration of what it means to work right at the frontier of human frailty
• 2:12
  and suffering and to apply biomedical science and compassionate care to address the complexities
• 2:19
  of medical practice. Through conversations with thought leaders, practicing physicians,
• 2:25
  and other health professionals, we hope that listeners to this podcast will be inspired to
• 2:30
  become active participants in their medical communities and be motivated to reframe current
• 2:35
  challenges in ways that they can more effectively build a workable healthcare experience for
• 2:41
  themselves, for patients, and their communities. And today, we are fortunate and extremely pleased
• 2:48
  to have Dr. Ni-Cheng Liang from San Diego, California as our first guest. Dr. Liang is
• 2:56
  the mother of two, wife, cancer survivor, pulmonary specialist, and mindfulness teacher. Dr. Liang is
• 3:05
  the director of pulmonary integrative medicine at Coastal Pulmonary Associates affiliated with
• 3:11
  the Scripps Health Network. She also serves as an assistant professor of medicine at the University
• 3:18
  of California, San Diego School of Medicine while volunteering for the medical student-run free clinic
• 3:25
  for uninsured patients. She attributes allopathic medicine and participating in clinical trials for
• 3:31
  saving her life from cancer, but integrative therapies such as mindfulness, meditation,
• 3:37
  acupuncture, and yoga for continuing to maximize her quality of life. She returned to medical
• 3:45
  practice after cancer treatment really passionate about promoting physician wellness and teaching
• 3:51
  mindfulness to patients, healthcare professionals, and their students. She was voted as San Diego
• 3:57
  top doctor in the annual San Diego Magazine Physicians of Exceptional Excellence Survey
• 4:04
  in 2017, 2019, 2021, and 2022. And she was awarded the 2019 American Lung Associated San Diego Lung
• 4:14
  Health Provider of the Year and Outstanding Mother's Award. She is also the founder of the
• 4:20
  Mindful Healthcare Collective, an organization that seeks to provide free wellness sessions
• 4:25
  during the global pandemic and since, and co-host of the Mindful Healers podcast. So during today's
• 4:33
  conversation, we're going to share some of her inspirations for life in medicine and the
• 4:38
  reciprocal relationship of the healer and patient. She talks about the challenges of the lack of time
• 4:43
  and spaciousness in our medical work and how mindfulness, by helping her to be present,
• 4:48
  seemingly opens the space and slows time. On the importance of meaning and joy in medicine,
• 4:55
  she describes joy and connection and gratitude as balms for wounds that are in healthcare. The
• 5:02
  Mindful Healthcare Collective that she created with her colleague, Dr. Jesse Mahoney, in response to
• 5:08
  the predictable effects the pandemic was having on health professional wellbeing continues to be
• 5:14
  one of many ways that Dr. Liang contributes to helping her colleagues flourish. In this podcast,
• 5:20
  she states to be a healthy, flourishing healer, we have to make healing ourselves part of our daily
• 5:27
  practice. Part of how she heals herself includes dragon boat racing with other breast cancer
• 5:34
  survivors like herself. Poignantly and inspiringly, she shares, there's something to be said about
• 5:39
  bringing joy and feeling empowered after the shared experience of suffering. And now, our
• 5:46
  conversation with Dr. Ni-Cheng Liang. Well, it's really exciting to see you, Ni-Cheng,
• 5:54
  and thank you so much for joining us with our Flourishing in Medicine podcast. I'm going to
• 6:02
  try to ask the interviewees, you and other guests, kind of a similar question with each guest,
• 6:10
  because I'm really curious, in my experience as a teacher, working with students, with practicing
• 6:17
  clinicians, with other health professionals, I've been really impressed by their background story,
• 6:25
  sort of the source story of why they showed up in healthcare, why they decided to make this
• 6:29
  profession, what I've been really moved by are poignant stories of personal experiences with
• 6:36
  suffering, personal experiences, either in their own life, being ill or people close to them. And
• 6:43
  I would just like to ask you then to maybe if you could share us a story about any early or profound
• 6:50
  experience that influenced this choice that really led you to healthcare. You know, tell us a little
• 6:58
  bit about your path, how you got to where you are now, starting way back whenever that started for you.
• 7:08
  I'm really honored to be here. And I'd love to share about my origin story. So I will share a
• 7:16
  poignant memory from kindergarten. That was pretty much the first time that I knew that I wanted to
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  be a physician when I grew up. We had a kindergarten play and I was assigned the task of playing a
• 7:30
  physician. So I have a little picture of me somewhere in the archives of five year old
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  Ni-Cheng wearing a extremely long white coat, because it was oversized with a microphone. And
• 7:45
  that was probably my earliest memory of deciding that I wanted to be a physician growing up,
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  learning about the profession. And then also an early influence was that my aunt, who we had moved
• 8:01
  to Maryland after immigrating from Taiwan, we moved into her home with my uncle, and she was
• 8:12
  a physician in the Air Force at the time. And so for me, looking up to a woman who was Asian
• 8:24
  and American at the same time in an Air Force type position of leadership was really inspirational
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  for me. And I think she was probably one of my earliest influences about wanting to become a
• 8:43
  physician, just watching her and wanting to be like her in some respects.
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  Thank you for being inspired by, especially at that time, a woman in medicine and a woman in
• 8:59
  military and medicine, quite interesting. If you could for a moment maybe go back to that
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  kindergarten experience, you put on this, you don this long white coat that's probably dragging
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  on the floor. Maybe you can't even see your hands because the cuffs are beyond your fingertips.
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  Can you tell us a little bit about what do you recall as the experience of that, both
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  physically, somatically, emotionally, what did it feel like to have that coat on for you?
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  And even what were some of the thinking that was going on as you stood as a kindergarten student
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  in the role of a physician? I remember being inspired by the profession, and also that there
• 9:48
  was a sense of honor in donning this long white coat and what it meant, especially what it
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  represented, especially for other human beings as well, that it was instantly recognizable
• 10:03
  as someone who could help, as someone who was a healer. And I immediately gravitated towards
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  the aspiration for wanting to be able to be that in someone else's life.
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  Lovely. So a lot has happened since that kindergarten time. A lot has happened since you first
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  watched your aunt and her career and inspired you and you went through school and multiple trainings
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  beyond imagination. Can you just maybe in a nutshell, right as a snapshot right now,
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  because of course it's a moving target, how do you would you define your career?
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  How do you would you define your life's purpose? Kind of your why? Because I know a lot of it has
• 10:59
  to do or some of your work has to do with helping other physicians and other health
• 11:03
  professionals in particular. But what do you see as that kind of overarching sort of why for you?
• 11:10
  Wow, that's a really deep question, Mick. In a nutshell, I think that my soul is filled also
• 11:26
  when I'm able to alleviate suffering. And so it's not just the suffering of other patients with
• 11:35
  pulmonary ailments or someone that I can help improve upon their relationship with stress.
• 11:44
  But it's really just in general. So it's all comers. It doesn't matter who you are,
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  where you're from. If I can help in some way, it also is so rewarding for me as well. So it really
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  is a reciprocal relationship. I get a lot out of those human connections that are formed too,
• 12:09
  in this healing relationship. You know, what I'm hearing and what I'm thinking about from what
• 12:15
  you're saying is compassion is a big part of that, you know, tending to the suffering of others and
• 12:21
  doing something, taking some action. And that often I think about how we have evolved as a
• 12:29
  human species, being a social species to this is a conserved part of our being is being compassionate
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  toward others. Actually, it's as important to our survival as say, the other aspects of the acute
• 12:41
  stress response, which you know very well, working in critical care sometimes, fight, flight, freeze.
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  We've got this turning toward and connecting, tend and befriend, we can call it. And part of the
• 12:56
  way it's preserved in evolution is that like you described, we feel good, something happens. We are
• 13:05
  flooded with some neurohormonal chemicals that tell us this is a good and a right thing. So
• 13:11
  when you have those experiences, maybe can you just describe what is that feeling? What is that
• 13:19
  real deep satisfaction, joy, which is probably different than the pleasure of eating ice cream
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  or, you know, watching a good movie. There's a mind and body alignment that occurs
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  when that happens. When you know, so deep inside that this is what I was meant to do.
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  And that in my body, that's a very mindfulness question. It feels like
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  the heart opening. There's a warmth. There is an alert, but calm, even and balanced focus.
• 13:59
  And there's also joy that's all mixed into it. When I work with someone who all of a sudden
• 14:06
  gets it for themselves, meaning that they realize they actually have the power to help themselves as
• 14:16
  well. I think that's probably the most gratifying experience as a physician and the mindfulness
• 14:23
  teacher that I have. You know, you mentioned joy. And yeah, I think you and I both are really
• 14:32
  committed to that concept of helping others find it, rediscover it, have more of it, let's say,
• 14:40
  in their work, especially our colleagues or other physicians and other health professionals.
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  So as I want to shift to, you know, what it means to flourish in medicine, how we can,
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  how a conversation like this may help others as well. What do you see as the greatest challenges
• 14:59
  that health professionals face today in terms of their ability to be energetic, compassionate,
• 15:06
  and their work to have attention, commitment, feel robust and alive in their work? You know,
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  what do you think some of those challenges are? What have you found in your work?
• 15:18
  Yeah, after having especially been intimately involved with
• 15:24
  the pandemic response, and then kind of coming into this integrated pandemic,
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  I don't want to say post pandemic, because it's actually not over yet.
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  I definitely have seen a highlight and emphasis on the lack of spaciousness
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  within the profession. There's tremendous time scarcity.
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  The lack of spaciousness, the time and space and resources to allow healers to, one, heal themselves
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  so that they can heal others and continue to heal others. And two, the lack of time and space
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  and resources to be able to optimize that healing relationship with those who are in the
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  field. I think that in a nutshell really captures what I've been feeling.
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  You, like I, have chosen at least as part of our healership toward our fellow health professionals
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  is to use mindfulness as kind of a technology, we could say, or way of being to address that.
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  Can you describe a little bit how
• 16:37
  the mindfulness approaches can address this issue of time and space?
• 16:45
  Yeah, I find that practicing mindfulness enables me to truly be present with the patient. So
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  allowing my mind and body to be there at the same time
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  with my patient has tremendous impact on my mental health.
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  Being able to be there at the same time with my patient has tremendously been helpful for me
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  in not feeling so rushed, even though there is the reality of time scarcity. Each human connection
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  I can broach as an opportunity to practice mindfulness with them.
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  And also, as I learned from you, using mindful communication and the active listening techniques
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  of allowing the patient to simply tell their story and tell us as healers
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  what we can do to help them. Oftentimes if we give them
• 17:49
  a little bit of open space, especially in the beginning of the connection,
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  the patients will tell you exactly what's wrong and exactly what they need,
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  but we only need to hold space for them and listen.
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  And so in this time scarce world of current modern medicine, I find that going back to
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  the ancient wisdom that's found in mindfulness practice helps me root back into connecting with
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  my patient in a way that is still gratifying and not time scarce. And in fact, because I'm mindful,
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  time seems to almost pause or elongate. There's an expansiveness when mindfulness is being
• 18:38
  practiced with another human being that I really enjoy. And it's also quite necessary as well.
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  Otherwise, I don't feel like I'm able to be the most helpful healer that I can be.
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  I just want to circle back to joy in medicine. I'm thinking about the listeners listening to this
• 19:06
  podcast and maybe we're making assumptions like when we talk about how important joy is to
• 19:14
  medicine. And so I'd like to articulate that and maybe give you a chance to articulate that.
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  Why is it important to have joy and meaning in our medical work for us as health professionals?
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  Why is it important for us and for our patients and for the teams and
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  systems within which we work? I think joy is one of the anecdotes to burnout, frankly. I think
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  joy and gratitude and connection are all bombs for wounds that are deep in healthcare.
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  I think that unless it's cultivated intentionally though, it's not easily accessible. So
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  it's not easily accessible. So in some ways, we also have to take ownership of our
• 20:15
  experience in medicine as well. And also be creative outside the box thinkers of how
• 20:24
  to practice medicine in a way that is in alignment for us despite the current very real
• 20:31
  constraints, not just with time, but also with administrative burdens and billing and all of the
• 20:37
  other kind of more bureaucratic issues that are here in modern medicine and the modern healthcare
• 20:46
  system. But I don't necessarily have to take up so much space if we have the privilege and the
• 20:56
  luxury to be able to practice medicine in the way that we want to. So for instance,
• 21:05
  I recently just completed an integrative medicine fellowship and that journey has been largely
• 21:12
  inspired by my own journey as a cancer patient from when I was a second year fellow in pulmonary
• 21:20
  medicine. And I realized that I couldn't continue to give 200% every time that I was practicing
• 21:31
  medicine. I needed to take care of myself in order to take care of others. And having been a very
• 21:41
  active cancer patient for a year going through a clinical trial with five months of chemo and
• 21:47
  three surgeries, taking the year off from fellowship to heal both inside and out,
• 21:55
  coming back to medicine. And that was actually how I came upon practicing mindfulness was using
• 22:01
  that as something to help me heal more completely as not just a cancer patient, but as a healer.
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  Because the wounds there were very deep and they still, some of them are still there, but
• 22:13
  definitely in the process of healing. And in doing so, I also became an integrative medicine patient
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  and it was some of the integrative medicine approaches that to this day continue to optimize
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  my quality of life as a survivor. And so having completed my integrative medicine fellowship
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  because of my experience as a cancer patient, now I'm able to incorporate education for the patient's
• 22:44
  self-management that goes beyond prescriptions. It goes beyond watch and waiting approaches.
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  Not to say that those very important approaches in medicine aren't valuable because they are,
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  but they can be integrated, for lack of a better word, with adjunctive evidence-based therapeutics
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  that have largely been forgotten in the very time-scarce reality of the healthcare system today.
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  Like the basics of the pillars of health, like nutrition as medicine, let food be thy medicine,
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  getting quality sleep, stress reduction, moving the body, those basic tenets of foundational
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  well-being, so important, but oftentimes doesn't get addressed in such a short traditional
• 23:48
  allopathic clinic visit. And so one of the more innovative, I like to think innovative for me,
• 23:55
  things that I've done in the last year has been to incorporate group clinic visits that have
• 24:01
  brought patients of all different diagnoses, actually, they don't have to have the same
• 24:08
  pulmonary diagnosis together in a room, which I'm really grateful to be able to do in this
• 24:14
  integrated pandemic era, and allow them to connect while holding space for them and while providing
• 24:24
  some interactive education for them, because oftentimes they realize that they're actually
• 24:27
  doing a lot more for their health than they originally had thought they were, and to be able
• 24:34
  to reflect that back to them and to have them become the educators also in this group clinic
• 24:40
  visit, in sharing their own direct experience, I think is tremendously empowering and healing
• 24:45
  for them that goes beyond that of a one-on-one clinic encounter. So I get a new sense of
• 24:54
  gratification, and it's a new sense of alignment for me when I'm leading these group clinic visits.
• 25:05
  So that's just an example of how we can work within the constraints of the system that are
• 25:12
  very real for many of us in medicine, but that we can also practice in a way that's in alignment for
• 25:21
  us. Yeah, thank you. Thanks for sharing what you're doing in those group visits and other
• 25:28
  ways that that cancer experience has changed your life. I think it's been a really good
• 25:34
  change in your healership. Also, thank you for sharing your illness because we're all human.
• 25:43
  We all will encounter illness, aging, death, and those dynamics, and so what this speaks
• 25:51
  so openly about is really inspiring. I wanted to mention one thing. Paula Gardner, you may know
• 25:59
  Dr. Gardner from Cambridge Health Alliance, who is a mindfulness teacher and also studies group
• 26:06
  visits, and she uses mindfulness actually in her group visits. And so she's a mutual colleague who
• 26:12
  you've probably run across her work, but our listeners might want to also look her up as well
• 26:17
  in the work she does in group visits. You talk about the effects of that cancer experience and
• 26:25
  how you utilized integrative medicine mindfulness as well as traditional allopathic care for yourself
• 26:31
  and how that's translated into how you work with patients. Can you say a little bit about
• 26:38
  how it has motivated and inspired you as I've seen written about you, you to turn toward your
• 26:45
  colleagues and provide something for them to help them flourish, to help them build resilience and
• 26:53
  develop more joy in their work, the connection between what you just shared with the cancer
• 26:59
  in your treatments and that part of your life? So after the more intense parts of cancer treatment,
• 27:08
  I knew that coming back into medicine, part of my newfound identity and way of being was to share
• 27:17
  my story in hopes of helping others, coming back to the desire to alleviate suffering, knowing that
• 27:23
  I wasn't alone. And yet, I felt that stories like mine weren't being shared enough about bringing
• 27:34
  the real aspects of suffering as healers. We are all wounded healers when we talk about it
• 27:44
  talk about it and share. And so wanting to live more in alignment after my cancer journey,
• 27:56
  part of the living in alignment included sharing my story with other healers and helping them also
• 28:05
  come to realize the benefits of mindfulness and hopefully, and ultimately like on their own terms.
• 28:16
  So sharing ways that I have used mindfulness in my own practice and my own wellness maintenance routine
• 28:24
  and also just becoming a very intense student again, through going through mindful practice,
• 28:38
  teachers, retreats with you and also mindful space stress reduction training. It really galvanized
• 28:47
  and lit a passion within me to want to learn more about how to teach it and how to
• 28:56
  bring it to even more healers such that they might be able to also alleviate suffering
• 29:03
  for themselves and also for everyone that they come into contact with. So my values are
• 29:09
  compassion and authenticity and bringing my story and the mindfulness piece all integrated within it
• 29:21
  aligns greatly with my values. And so going into the pandemic now fast forwarding 10 plus years,
• 29:28
  knowing that we as physicians were about 50% burnt out going into the pandemic depending on
• 29:38
  subspecialty, but average was running around there. It wasn't going to take a randomized
• 29:45
  controlled trial or any research to know that during the pandemic and after the pandemic burnout
• 29:53
  rates were going to be higher. Like that was an implicit
• 29:55
  part of what we were about to delve into as a medical community. And so I put together this
• 30:04
  grassroots of friends and colleagues really that you were part of as well earlier on,
• 30:14
  where I had worked with them in some capacity or had known of their work and luckily they
• 30:21
  were all very enthusiastic and generous with their time and we put together the mindful
• 30:28
  healthcare collective. And at one point we were offering anywhere from two to three free wellbeing
• 30:34
  sessions, inclusive of mindfulness, coaching, yoga classes, as well as emotional freedom technique,
• 30:41
  which is a tapping technique used to decrease the intensity of the pandemic. And so we were
• 30:48
  able to decrease the intensity of difficult emotions and also a helpful way to process
• 30:54
  difficult situations and emotions and bringing them to healers for free. And we still do that,
• 31:02
  just not as frequent. And we've been doing that now for three plus years, really honored to be
• 31:09
  the founder of that group and also to have worked with and continue to work with
• 31:16
  healers who are also seeking to heal the healers. And so that's another kind of arm of my,
• 31:26
  not necessarily identity, but kind of what I do and what I like to help flourish.
• 31:33
  And that brings an aspect of alignment and reward and gratitude into my own life that is also
• 31:47
  really fulfilling for me and feeds my soul as well.
• 31:53
  Yes, the mindful health collective, I think is a really innovative and very generous way that you
• 31:58
  and especially your colleague that you work closely with, Jessica Mahoney offer and also
• 32:05
  grow yourselves within. Do you have any examples that you could share of say colleagues in that
• 32:13
  health collective whose lives have been enhanced by participation? I think our listeners would
• 32:20
  love to hear that it's possible to be in groups of colleagues. That's one of the things that we're so
• 32:28
  impoverished for is actually having a collegial sangha, we could call it a collegial community
• 32:34
  where we can not only share the technical aspects of our work, but actually the
• 32:43
  aspects of meaning and joy. Yeah, I will share that with, for instance, the most continuity-based
• 32:56
  sessions that we've had have been actually the weekly yoga session, near weekly yoga sessions put
• 33:02
  on by Dr. Jessie Mahoney. There has been kind of almost like a core group that show up every week.
• 33:09
  And so there is some comfort and connection, even if the class is done with Jessie teaching,
• 33:20
  having the same people show up and seeing those people practice from all over the world.
• 33:27
  Actually, we have some members from Ireland and Canada, for instance, that join the classes
• 33:33
  that in and of itself is really joy-filling. And then for the more interactive sessions that we have
• 33:40
  had with emotional freedom technique, for instance, by Dr. Jill Weiner, I've seen some pretty
• 33:49
  miraculous changes occur with one of those sessions and in working with
• 33:57
  healers who are willing to be vulnerable in sharing their suffering and then having Jill
• 34:03
  literally tap them through processing a difficult situation and then seeing the relief on their face.
• 34:13
  Over the few minutes of the tapping, it's very apparent from a physiologic standpoint.
• 34:19
  It's from body language that things are shifting. And then from the mindfulness sessions, of course,
• 34:30
  we started holding something called TNB, which is about monthly, where some of the leaders of
• 34:37
  the mindful healthcare collective would facilitate a session. And I started to see that change in
• 34:46
  the way that they would facilitate a session. And I started off one of these sessions with just
• 34:53
  basically a mindful exercise of tea drinking. And one of the participants commented that it was nice
• 35:02
  to have these regular sessions because it was giving her a sense of accountability, but also
• 35:10
  a community with really rewarding connection and sharing that was deep and kindred
• 35:29
  that I think has been missing in the last three years, especially with the
• 35:35
  social isolation that has been part of the pandemic experience for much of the world.
• 35:48
  We will definitely include the mindful healthcare collective in the show notes so that listeners,
• 35:55
  your colleagues among them will be able to connect with that because it's such a great resource.
• 36:00
  Can you just tell us a little bit about your podcast, about the mindful healers podcast,
• 36:04
  what you're focusing on, what kinds of things would we likely hear in conversations from that podcast?
• 36:12
  Yeah. So the podcast came out from the mindful healthcare collective and also from the
• 36:19
  collaborative relationship that I have with Jesse Mahoney. So we talk a lot about direct experiences.
• 36:29
  Me and Jesse's lives are oftentimes the inspiration for our podcast episodes. And
• 36:38
  she's coached me during some of the episodes. So listening to coaching in action,
• 36:45
  and then also how we have brought mindfulness into different aspects of our own lives.
• 36:51
  We've also brought on guests. Hopefully, Mick, you will be one of our guests in the near future
• 36:57
  and how they have applied mindfulness into their own lives. So we bring in different perspectives.
• 37:05
  And while it's named the mindful healers podcast, you'd think that it's for healers.
• 37:09
  I think that the breadth of topics that we cover from parenting to being a healer in today's world
• 37:16
  of modern medicine to being an entrepreneur, I think there are universally beneficial themes
• 37:28
  and topics that we cover. So thank you so much for helping us.
• 37:34
  We will definitely include that as well in the show notes. So we're kind of coming to
• 37:41
  close to the end. And I did want to do a little thought experiment with you.
• 37:46
  I'd like you to think about as best you can what it would be like to be a patient. Let's start with
• 37:52
  that. And then encounter with the patients. So I'm going to start with you, Mick.
• 37:58
  What it would be like to be a patient. Let's start with that. And then encounter with a health
• 38:04
  professional who is flourishing, who is energetic, who is compassionate and robust. And imagine what
• 38:12
  this experience would be like for you. And then I'd like you to just share what that would be like
• 38:17
  on the receiving end. And then I'd like you to also imagine next, as a health professional in a
• 38:26
  patient encounter, what would that experience be like for you to be flourishing, committed,
• 38:33
  energetic, compassionate, attentive, and robust. We could add mindful to use our common language
• 38:41
  as well. So both from the receiving end as a patient and also when you are that physician,
• 38:49
  what's that like for you? What are those experiences like?
• 38:58
  On the receiving end as a patient to have a healer
• 39:05
  be in the active process of healing me, who's coming into the room, who is flourishing.
• 39:12
  I think that immediately, even before the first word is spoken, I'd have a sense of comfort and
• 39:23
  also excitement and anticipation about working with this healer who is coming into the room with
• 39:33
  such positive energy and warmth and desire to help. I think all of that can be conveyed
• 39:41
  without any words. So there is a sense of hope for me as a patient
• 39:52
  that I think in and of itself is also very healing.
• 39:58
  So on the flip side, as a healer who's flourishing,
• 40:03
  and while I'm not flourishing like all the time,
• 40:06
  because I am human, but I am grateful and feel very honored to be able to practice in an environment
• 40:14
  where I feel that I can practice medicine a vast majority of the time in alignment and on my own
• 40:23
  terms. I have a sense of purpose even before I walk into the patient's room and I feel like
• 40:34
  into the patient's room. And when I walk into the patient's room, I can be genuinely, authentically
• 40:40
  warm and caring and inviting and unafraid to show up just as myself, imperfectly perfect
• 40:50
  in my wounded healer state and all of my authenticity. And that to me brings great joy
• 40:59
  to be able to show up as myself in that way. And even more excitement to work with them
• 41:08
  and to foster that very deep, rich human connection that I so enjoy.
• 41:14
  That's great. May we continue to have such experiences both from being a patient as well
• 41:21
  as working as a healer. So one last question then if there's anything you want to add,
• 41:27
  feel free. Do you have any general or specific recommendations to people that you identify as
• 41:34
  your fellow health professionals? Just about what could be helpful? What kinds of things they may
• 41:42
  want to consider just to help them flourish in medicine? Definitely easier said than done. And
• 41:49
  it's been a practice 10 plus years in the making as I often still, despite having taken all these
• 42:00
  courses, some with you, Mick, I often still revert back to old habits that used to serve me well,
• 42:11
  but was decades of ingrainment of striving for perfection and people pleasing tendencies. So
• 42:20
  when that arises, and it's the mindfulness practice that has allowed me to notice when
• 42:27
  those habits arise and don't serve me today,
• 42:32
  I am in the practice now of being more self-compassionate. I'm really great at
• 42:42
  giving a lot of compassion to others, but it's going to be a lifelong journey for me to be
• 42:48
  kinder to myself. And then to have judgment about not being kind enough to myself is like another
• 42:57
  layer of additional self-judgment. So just noticing all of that, that you're not alone,
• 43:06
  that there has been an indoctrination of unhelpful ways of being, that we now, especially in this
• 43:19
  integrated post-pandemic era, can feel empowered to speak up and also to share,
• 43:29
  and also to be kinder to ourselves when it arises. So I think the self-compassion cultivation piece
• 43:40
  is really important. And I think finally medical schools are incorporating more of that. But
• 43:46
  certainly when I went to medical school, it was, and even just well-being was not
• 43:51
  part of the curriculum. So I think to be a healthy, flourishing healer, we have to make
• 44:04
  healing ourselves part of our daily practice, whatever that looks like. And then lastly,
• 44:10
  also to give ourselves permission to do more of what it is that we want.
• 44:13
  I think we forget about our hobbies that we once had. And more recently in my shift this season
• 44:25
  of my life, it's been more about more family and what I want to do. And right now I'm focusing my
• 44:33
  efforts on dragon boat racing and playing volleyball again after more than 10 years. And
• 44:39
  that's been so fun and joyful. And in doing more of what it is that I like and want to do,
• 44:47
  I can show up as a healer all the more warm and compassionate and authentic and energetic,
• 44:56
  because I'm taking care of myself in a way that brings me joy.
• 45:01
  That's great. Thank you. And you mentioned the dragon boat racing. I'm sure you've heard
• 45:07
  about it. And you mentioned the dragon boat racing. I'm glad you mentioned it.
• 45:11
  Maybe briefly, because I think it's very inspiring if you could just describe what happened in your
• 45:18
  trip to New Zealand and who were your team members? What was this team made of? I think that's also
• 45:23
  really inspiring too. Yeah. So about four years ago, I was invited to join an all-women cancer
• 45:32
  survivor dragon boat team. So shout out to team survivor San Diego here in San Diego, my home team.
• 45:40
  Actually, because I was leading a mindfulness workshop for the Young Survival Coalition,
• 45:46
  which is a breast cancer support group for women who were diagnosed under the age of 40.
• 45:53
  And one of the participants came up to me because she knew I was a paddle boarder
• 45:58
  and said, hey, you should check out this team. And I had dragon boated kind of informally in college.
• 46:03
  And from a cultural perspective, as I identify as Chinese, Taiwanese, American,
• 46:10
  from a cultural perspective, dragon boating originated in China. So I was very much inspired
• 46:16
  to join this all-women cancer survivor team. So we race a couple of times a year. I just got back
• 46:26
  from the Long Beach Dragon Boat Festival. We'll be racing in San Diego. And then the trip that you
• 46:32
  alluded to was in April. And that was from the International Breast Cancer Paddlers Commission
• 46:41
  festival, which happens every three to four years in very exotic locations.
• 46:49
  I think the one before that, for instance, was in Italy, exotic for us Americans,
• 46:55
  I should say. And the more recent one was in New Zealand. And yeah, we had over 2,000 paddlers that
• 47:06
  were breast cancer survivors from all around the world join us in this multi-day dragon boat racing
• 47:14
  festival. And it was a whole other level of camaraderie and connection.
• 47:21
  There's something to be said about bringing in joy and feeling empowered after this shared
• 47:29
  experience of suffering. That's really heartwarming and fulfilling. I feel like I've used the word
• 47:38
  sizzling a lot, but that's really what it is. It's really a lot of fun. And that's actually part of
• 47:44
  why I was late this morning was because I couldn't find my way to the festival. And I was
• 47:51
  late this morning because I couldn't find my dragon boat paddle and I have practice later today.
• 47:55
  So just being real and being human.
• 48:01
  Thank you so much. And I really appreciate your honesty, your openness, and just your story.
• 48:07
  It's inspiring. I hope this is going to be an audio version as we get started, but we will go
• 48:14
  video. And I'm hoping maybe we'll bring it back at some point in the next year with maybe with
• 48:19
  have you as guests with a video where we can continue the conversation, especially around
• 48:24
  the mindful health collective, healthcare collective. Thank you all for listening to
• 48:29
  the podcast. We will include a summary of today's podcast and links to Dr. Ni-Cheng Liang and other
• 48:35
  references that were discussed in the show notes. I would like to conclude today's podcast as I
• 48:42
  plan to conclude each subsequent podcast with some practical exercise to help you flourish
• 48:48
  during your work. The intention is for you to have a toolbox of skills that you can draw upon to
• 48:55
  enhance purpose, meaning, and wellbeing, things that you can incorporate into your workday.
• 49:03
  Today, I'd like to introduce to you a brief contemplative practice that you can do from
• 49:07
  time to time that takes no longer than the space of a breath or two that can help bring you to a
• 49:15
  present moment's awareness of the activities that you are engaged in with the objective of enhancing
• 49:22
  your sense of purpose and meaning. It's a well-known practice. You may have heard of it. It's called
• 49:26
  the STOP practice. That's right. STOP, S-T-O-P. Perhaps you're familiar with it. Basically,
• 49:35
  STOP is an acronym in this practice and it stands for the following. S for stop, T for take a breath,
• 49:44
  O for observe. Observe what's actually going on. What is your present experience? And P, proceed.
• 49:54
  I used to use this practice when I was in clinical practice regularly 20 plus times a day every time
• 50:01
  I'd enter into the room of a new patient or enter into a new encounter, placing my hand on the
• 50:09
  handle of the door, noticing the contact, and then engaging in this one-breath practice.
• 50:16
  So let's do it together. Even though you're listening to this podcast,
• 50:23
  take a figurative stop in this moment and take a breath and observe what's going on
• 50:35
  and then proceed.
• 50:36
  So this is a practice that you can do when you're entering the patient's room, when you're
• 50:40
  beginning a phone call, when you're responding to a MyChart message, when you're having a conversation
• 50:48
  or beginning to enter a conversation at home with your loved ones, when you're in the supermarket,
• 50:55
  many, many opportunities to do this practice. I hope you find this simple exercise useful
• 51:02
  to you and look forward to having you join us for our next episode of Flourishing in Medicine
• 51:06
  From Surviving to Thriving. For more information about EmPRO, please visit www.myempro.com.
• 51:15
  For more information about me and my work, please visit www.mickrasnermd.com or www.mindfulpracticinmedicine.com.
• 51:32
  See you next time.