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Reliably Well brings you thoughtful conversations from those who are shaping the future of healthcare, focusing not just on the technical side of the industry, but on the human element, the stories, the struggles and triumphs of individuals who are driving change. Join us for candid discussions that highlight both the challenges and rewards of working in a field where humanity and healthcare intersect.

Today’s guest is truly an honor for me to introduce. She’s someone whose work has influenced me both personally and professionally, Dr. Suzanne Coven. Born and raised in New York City, she’s a physician, a writer, and a storyteller who spent over 30 years caring for patients at Massachusetts General Hospital, where she now holds the Valerie Winchester Family Endowed Chair in primary care medicine and serves as the writer in residence.

She also teaches at Harvard Medical School and co-directs the media and medicine program and has been published everywhere, including the New Yorker and the New England Journal of Medicine. In her memoir, Letter to a Young Female Physician, Dr. Coven offers an indelible account that turns humorous and profound from a doctor, mother, wife, daughter, teacher, and a writer who sheds light on our desire to find meaning.

and on a way to be our own imperfect selves in the world. I’m also excited to share that her next work, The Mirror Box, is on the way. Dr. Coven will also be this year’s Jim Sproul Collaborative Keynote Speaker during our annual Reliance Healthcare Leadership Forum, and it’s an honor to welcome her as our guest for today’s conversation. Dr. Coven, welcome. And if my camera was facing the other way, I still have a copy of the William Carlos Williams poem

I suppose I should. The one where he talks about the medical journals. ⁓ your workshop that you did with me, I still think about it every time I step into my office. So thanks for joining us on Reliably Well. Thanks so much for having me. It’s really a joy. Dr. Coven, I’ve heard a ton about you working with Sumner. He speaks often of you and I’m excited to meet you next month when you speak for us.

We’ve heard a lot of your story with that bio that he introduced you with. And for those that have not met you, have not heard, spent time hearing ⁓ your story from Sumner and those that ⁓ might not be planning to come to ⁓ our collaborative next month, tell them a little bit about your story. What’s the story of Suzanne Cove? You know, the thing is, as you get older and older, your story gets longer and longer.

but I will attempt to be concise. So ⁓ I was born and bred in Brooklyn, New York. My dad was an orthopedic surgeon who also was a painter, an art collector, a collector of rare books, and a self-taught scholar of the novels of James Joyce. My mom was a board housewife and civic volunteer.

who decided to go to law school when I entered high school, which was a pretty radical thing for a 44-year-old woman to do in 1970. Anyway, I have two older brothers, and they were not interested in following my dad into medicine. I was, and I followed him to his office sometimes after school.

and developed x-rays for him and the smelly chemicals, which is how it was done back then. ⁓ But I really saw two major roadblocks ⁓ to me being a doctor. The first was that I was a girl, and I really didn’t know any ⁓ female doctors. ⁓ The second, though, was a more formidable obstacle for me, which is that I was not

particularly gifted at science or math. And I didn’t particularly enjoy those subjects in school. So I went off to college, and I was an English major, and I was determined to be a writer. ⁓ And I lasted three months in my first job as the assistant to the assistant editor of a magazine that nobody read in Washington, DC. And at that

I thought, know, dumber people than me have probably passed organic chemistry and even done well in it. So I went back to school and I took all the pre-med ⁓ courses ⁓ and then I went to medical school and medical training and then a lot of years passed. ⁓ So I promise I won’t take you through my whole life year by year. A lot of years passed. And then when I was in my

40s I Thought well wait a minute Whatever happened to her whatever happened to that English major I was very busy with my internal medicine practice and ⁓ Have raising three kids and you know life was busy, but there was this itch To reconnect with that person. I was so I started taking night courses

at Harvard’s community ed program. And this was purely recreational. was literally, my midlife crisis was I signed up to write English papers. And it started to occur to me that that might be something more than a hobby. This was around the time that Atul Gawande was becoming popular. And I thought, well, I admired him very much.

didn’t think I wanted to do that kind of writing exactly, but I thought maybe I could somehow combine writing with medicine, but I didn’t know how. And ⁓ what evolved, and for writers in your audience, ⁓ sometimes you have to wait for your subject to find you. You can’t go looking for it. ⁓ It turned out, and this is going to sound terrible,

and I’m saying it for shock value, but it happened to have been true, is the thing that interested me most was me. Me as a doctor. What was it like to be me in that exam room? Well, one thing led to another, and I ended up writing a column in the Boston Globe called In Practice, about what it was like to practice medicine. And ultimately then I decided I really wanted to professionalize

my writing. At the age of 52, I went back to graduate school and got a master of fine arts. And then ultimately what happened was I had an opportunity to bring my literary life into the hospital when I started leading a monthly literature and medicine group. Over time, that morphed into this writer in residence role. And then ultimately, after 32 years in practice,

When it came time to think about laying down my stethoscope, I thought, maybe I could do this full time. And Sumner mentioned the Valerie Winchester chair, the Winchester family was very generous in supporting me to do this work full time. So what I do now, which is the best job ever, is I run reading and writing groups for healthcare workers.

and I coach healthcare workers in their writing. And there are a lot of healthcare workers who have stories to tell, as I’m sure won’t surprise you. And I write books. So that’s the story. So how many, I mean, we could take a lot of twists and turns here. Yeah. But I’m sure that some of our listeners now were thinking, okay, ⁓ I’m in healthcare, but I don’t have an MFA.

And I actually wasn’t an English grad. I was biochemical engineering grad. These folks that are showing up to the reading and writing workshops, they’re not all English grads with an MFA, right? this- None of them are. Right. So what have you found is this kind of magic that happens when you host this and somebody’s really-

may be uncomfortable, but they have this desire to maybe tell their story or like it’s almost therapy for them, I would think to an extent, right? Yes, it can be therapeutic, but it can also be art making. ⁓ What I find consistently ⁓ is that healthcare workers and particularly health professionals and particularly doctors will tell me I’m a bad writer or I don’t get poetry.

I haven’t read a poem since 10th grade. And I feel like one of the main contributions I can make is to assure people that this is not like science or engineering or medicine even. You can’t be bad at reading a poem. You can’t even be bad at writing a poem. This is our birthright. ⁓ Language is our birthright as human beings.

And so I try to create a really safe space where people feel free to experiment. I like to ⁓ assure ⁓ people there is no evidence-based poetry. There is no right and wrong answer. This isn’t like looking up the potassium. This is a whole different thing. And what happens over and over again, if I can use little tricks to get past people’s defenses, is

they find that they actually are wonderful writers. ⁓ Now, a particular challenge that you alluded to is people who have learned to write in scientific, academic, medical jargon and need to make a shift. That’s a lot of the coaching that I do is for folks in that dilemma. And what characterizes ⁓

that kind of writing. Well, first of all, it’s not personal. The I pronoun is discouraged. You’re not supposed to really have any opinions. Even in a review article or a medical editorial, they’re not really your opinions. They’re the evidence shows. in the future, clearly the challenge is that we must bap bap bap bap. And what happens if we lay that aside and hear what your truth is? Now, that doesn’t mean that everybody ⁓

I work with is writing personally. There are folks who are doing straight nonfiction. There are folks who are doing reportage, folks who are doing ⁓ op-ed. But a lot of people, the majority of people, what they come to me for is they want to write personally. Because of something that I always feel is a great irony of medicine, which and

when I say medicine, is encompassing all clinicians, therapists, nurses, and so forth, is that our professions attract people, people. We are very apt. We love people. We love people’s stories. And then what happens to us professionally? We get locked up in rooms with one person at a time. We’re discouraged from talking about

these experiences because of HIPAA, but also because of the ⁓ restrictions on our time, which have become ever more intense. And we record our observations in an electronic medical record, which for its virtues, and it does have certain virtues, I’m old enough to remember when we had paper charts that were held together with rubber bands.

and filled with inscrutable handwriting. And I can tell you that was no bargain. But we’re stuffed with stories, and not just any stories. We don’t work in the bank. Stories of life and death. And what do we do with that? Well, we may not find an outlet for it. Some of us may not need an outlet for it. Maybe whacking a tennis ball is enough. But for many people, there is a desire.

to tell a story. And there is no reason why someone who was a bioengineering major ⁓ can’t do that. That’s awesome. So you’ve you ⁓ shared a very brief, ⁓ inappropriately concise with all of its depth and twists and turns kind of your story. And all of us who are in medicine care for patients in a particular way, probably by those who have influenced us the most. I’d love to hear

⁓ Who is someone or who are a few people who’ve had the greatest influence on your life? You know, that’s a real toughie because I have been blessed. I was blessed with wonderful, loving, fascinating parents and ⁓ siblings and ⁓ a husband of very long standing, also a physician, also an English major. I’ve had wonderful teachers and

colleagues. So I think ⁓ the person I would choose is someone I actually only met once and for 90 minutes. And that was Oliver Sacks, the great neurologist writer who died just 10 years ago this summer. And my next book, which is coming out in just about a year, is a memoir about a medical condition I experienced

but it is also ⁓ an homage of sorts to Sachs. So why is he so important to me? He’s a very interesting figure. In some ways, a relic of the 19th century when doctors were versed in the humanities and the classics and the natural sciences. ⁓ He was very well read. He knew about botany and geology. And of course, he was wonderful writer, but he was also a practicing.

neurologist. The reason he was so influential to me has been is that when I started reading him, I realized that he was doing what I yearned to do, but didn’t even have the words ⁓ to articulate ⁓ that yearning. So what was he doing? Well, he was taking a very

expansive view of both medical writing and of doctoring. Here’s an example that ⁓ really encompasses both. So one of the books that he’s probably most famous for is Awakenings. ⁓ people may have heard of that because they’ve seen the movie that came out, I think, in 1990 with Robert De Niro and Robin Williams.

Anyway, ⁓ what Awakenings was about was ⁓ his using L-Dopa, then a fairly new drug, on a group of patients in a nursing home in the Bronx who were in a catatonic suspended animation state for 40 years. This was in the 60s this happened. They had been that way since they had contracted presumably a post-viral encephalitis.

in the 20s and he gave them LDOPA and they came to life. Well, that was pretty amazing. And he wrote this up in the usual science journals, but he was dissatisfied with that writing. He didn’t feel that it captured who these people were. He decided he didn’t want to write case reports. He wanted to write what he called

biographies. So that’s the medical writing piece. The doctoring piece, which I’m not sure I was ever inspired to emulate entirely, is that he lived essentially on the campus of this nursing home. And he spent hours a day talking with these patients and playing ball with them once they were reanimated.

being with them. something that I wrote about in my first book is that we talk a lot now about boundaries and setting appropriate boundaries. And women, particularly, are told to do this. And I’ve sometimes wondered if this is always good advice. Because in practice, what I always found is that I was doing my best

clinical work when I was right on the edge of the boundary, right on the edge, where I was meeting another human being as the human being that I am, always being appropriate, of course, always keeping in mind whose benefit we were there for, but not being so rigid about my doctorly role. So as a writer,

And as a physician, he was porous, if you will. And I’ll say one more thing about him. You know, all specialties have stereotypes. I don’t have to tell you what they are. I don’t have to tell you what the internist is. But of course, the stereotype of neurologists is that they don’t really care about people. They just care about diagnoses and lesions and that they’re rather cold and rather cerebral.

He was anything but that. He was a humanist and a humanitarian as a physician. And his 10 years after his death, his work continues to inspire me. Hence this book that I’m working on. That’s an amazing influence. And I think it’s so impressive that 90 Minutes supersedes the lifetime that other people

have exposed you. It does make us think about how impactful some moments can be on us. You have spent in your memoir recounting your experience as a physician and some of the challenges that you faced, particularly as a female at that juncture in the evolution of the

the profession and there are challenges that certainly have evolved ⁓ now, as you mentioned about the medical record, certainly has evolved and brought on its ⁓ challenges to all of us. COVID has brought on ⁓ a different set of challenges to all of us. What do you think is the biggest barrier, the biggest challenge, the biggest hurdle

that clinicians face today as they practice medicine. Joe, I want to go back to something you just said before that question, very briefly, when you said that 90 minutes superseded other influences. It is true that that was among the most power-packed 90 minutes of my life, but 90 minutes plus many years of reading his 12, 14 books.

But you make a good point. I mean, I’ve written about mentorship. it is some of my most potent mentors ⁓ have been people who mentored me with a single conversation or even a single comment. ⁓ So your point is well taken. But to challenges, OK. So I give a lot of workshops. And I always ask in advance, what do you think people are interested in hearing about and talking about? And the answer is almost always the same.

burnout. And burnout is a huge issue. But it can be a little hard to define. I mean, we have the Maslach burnout inventory. And we all know the statistics about burnout, ⁓ particularly in women. And the numbers, particularly of young women leaving medicine early in their careers is a real ⁓ crisis. ⁓

But I think burnout means different things to different people. And I think different people are burned out by different things. You know, we talk about moral injury. That’s become fashionable about a different way of talking about burnout, that somehow you’re faced with a situation where you’re working in ways that don’t align with your values. I want to go back to what I was saying about boundaries. ⁓

I think a big challenge ⁓ for me from the beginning of my career, and I’m not sure I ever got it right, was how close to get to patients and how far to stay from patients. Because on the one hand, if you’re too close, that absorbed trauma year in, year out can really get to you. ⁓ And I don’t think we should underestimate that.

But on the other hand, if you get too far away, then you’re ⁓ sort of losing one of the great pleasures of the practice. And so one thing that concerns me very much is that I think a very well-intentioned ⁓ palliative for burnout ⁓ at my hospital, at hospitals around the country, has been finding ways

to spare clinicians extra interaction with patients. So it’s tricky, right? Because who wants to face 100 electronic messages a day? And is that really feeding our souls? But on the other hand, particularly in longitudinal care, if you’re a primary care physician, say, who never interacts

with your patients when they’re in trouble, unless they’re sitting right in front of you. And even then, maybe the hours are carved out such that you’re not even the one who sees them. Are you really getting nourishment from the relationships which really are at the core ⁓ of why we do this work? So I think that I call it the boundary dilemma. And I think it’s always been a dilemma.

It has been since Hippocrates and I think it still is. and it’s not even just the ⁓ boundaries to theoretically protect oneself, but it’s also the boundaries that sometimes are imposed with this obsession with efficiency, right? Right. ⁓ That I have to, I may not want to set this boundary because it is the joy of interacting with the human that I have.

but I must set this boundary because I have metrics and I’ve got to see so many patients per hour and I’ve got to get this person discharged by 9 a.m. So therefore, I cannot hear about your dogs that are at home that you miss very much because you’re in the hospital because I must get you discharged or else, right? Right, yeah. There are actually a lot of TikTok videos currently ⁓ on the internet. ⁓

sort of making fun of this very thing where you see the, you know, the clinician backing out of the door and you hear, you know, wah, wah, wah, wah, wah in the background about the dogs and the story and so forth. I had an experience a few years ago, I’ve told this story many times, can’t remember if I told it in my book, where I had severely smashed up my shoulder, I had surgery, I was out ⁓ for several weeks, it was my right arm, of course, and ⁓

When I came back, I had been gone about nine weeks. And the policy was I had to go to occupational health ⁓ to get an accommodation for my ramping back in. Well, the occupational health nurse decided, I thought somewhat randomly, that for the first three weeks back, I had to do everything in twice the time. My follow-ups were a half an hour.

and my urgence were half an hour and my physicals were an hour and my new patient visits were an hour and a half. It was the happiest three weeks of my entire clinical career. Why? What I noticed during that time was a few things. First of all, I was calmer, which made the patient calmer. So that was one thing. The whole temperature in the room was down.

The second thing I noticed is that I was less likely to order tests or write prescriptions in order to end the visit.

The third thing I noticed in acute visits or problem visits is that the first 15 minutes were very focused on the symptom. And when we got, and what are you going to do about the symptom? And what tests am I going to get? What are you going to give me? And then when we got to about minute 17 or 18, you know, we started talking about the good for nothing sign in line, the et cetera.

Now, that doesn’t mean that everything I saw in primary care was psychosomatic. ⁓ I don’t even like that term because, of course, everything is psychosomatic. We’re all connected. But it took 15 minutes to sort of discharge the tension and then get to, you know, what can we really do to move you forward here? What is really what’s bothering you? ⁓

You know, I found myself wondering how much I had missed over the years by not having that, not having that time. I also felt during those three ⁓ weeks that I had saved the system a lot of money because as I said, I was not ordering so many tests and I was a little appalled with myself to realize or or referrals.

I was a little appalled to realize that I had been using testing referrals, prescriptions, in order to get the patient to the door to get to closure. Yeah. And just like thinking about your typical emergency department on a Monday afternoon or early evening, I just can’t help but think what might it look like, Joe, if

I think that’s a great study to think about what’s the CT utilization rate on a busy Monday versus a slow Friday. I wonder if there’s no correlation. Yeah, I love that. You know, somebody must have done some similar study, but after that experience, I did find myself wondering, you know, if we could do a study where we just gave clinicians more time and then

you know, see what the, ⁓ you know, the cost incurred did. Yeah. You know, the emergency room, I don’t have to tell you, you know better than I do, ⁓ is really, ⁓ you know, a place where there should be room for stories. ⁓ My colleague, Jay Barrack, who’s at Brown, he wrote a wonderful book.

of emergency room stories. It’s not as if people come to the emergency room and they sort of leave their humanity at the door because after all, it’s the emergency room. mean, people come to the emergency room with the same stories that people come to their annual visit with. Yeah, and perhaps with even more vulnerability, right? Yes. It’s a scary place. So we could perseverate there and

double click on that and which we might need to in the future. ⁓ I have some thoughts in my mind about that, but at Relias, we ⁓ are trying to be different to the best of our ability and what what guides us and hopefully grounds us are these five passions and the primary passion is people ⁓ and following that is innovation, quality, value and excellence. I could take

A little bit of a leap that I don’t think is too far of a leap, that the passion that most aligns with you is people. But I don’t want to put words in your mouth, but of those five passions, what resonates most with you and perhaps what we haven’t talked about yet, why does that resonate with you? ⁓ Yes, 100 % people. Because I think all of medicine really is about

relationships. In fact, I will go at even one further than that and you may feel free to roll your eyes at this if you’re so inclined. I think it’s about love. You know, when I gave up my practice after 32 years, I got, well, the wonderful thing about being in practice in primary care for a really long time is at the end, everybody loves you because if they didn’t love you, they would have left.

So you accrue a practice full of people who think you’re wonderful. And ⁓ I got a lot of flowers and bottles of wine ⁓ and so forth and wonderful notes. And some of them came through the electronic medical records, some of them were handwritten. And none of them said, ⁓ you you made such a smart diagnosis of me, though I made a few.

And none of them said, you know, that antibiotic you chose that time, you know, you really nailed it, which I did at least a ⁓ times. ⁓ And also I did get one piece of mail ⁓ in that context that was negative that expressed disappointment, but it wasn’t, it wasn’t, boy, you messed up my diagnosis. The positives.

which as I say, you’ve been in practice a long time, they’re mostly gonna be positive almost by definition at that point. ⁓ They said stuff like, ⁓ remember that time you visited me in the hospital. Remember that time I told you something I had never told anybody else. And the negative said, I did not feel supported by you in that situation. And they were right.

So the successes were successes of connection. And the failure was a failure of Or if you will, the successes were about love. And the failure was a failure of not enough love. Now, I always have to ⁓ add this, which is to say that I am not saying

that all you need to do is be really nice and loving, and you actually don’t need to know anything, and you don’t to have to do anything. I’m saying you need both. There’s a wonderful quote I quote in my book by Gavin Francis, who’s a Scottish physician writer. I think actually might even be an E or a physician. I’m not sure. Anyway, he says that

that medicine is an alliance of science and kindness. And I think that’s what he’s getting at. You can’t have one without the other. ⁓ Even in the most technical specialties, I don’t feel that you can be an effective clinician if you are unkind or unempathic or disinterested in your patient. ⁓ I also say in the book that, you know, early in my practice,

I would hear about a specialist here and there who was really top notch, but they had terrible bedside manner. And I would warn my patient, just don’t worry about that. You don’t need any new friends. Just go to them. They’ll take care of you. But as the years went by, I stopped referring my patients to those specialists because I thought I wouldn’t

I wouldn’t want to go to them myself. ⁓ Now, I think you need different things from different clinicians. I think what you need from your primary care doctor is a little different than what you need from your surgeon or your psychiatrist for that matter. ⁓ But you have to have some basic level of both expertise, hopefully more than basic level.

but also of kindness. Dr. Coven, I feel ⁓ endowed with a great ⁓ sense of perspective from this conversation. I’m so glad that I’ve been a part of this. I want to ask you, you you’ve got a CV full of accomplishments that I wish I had. I wish I ⁓ borrow some of those and put on my own.

⁓ What, looking back on your journey, looking back on the things that you could claim to be ⁓ proud of, what stands out as that achievement that you’re most glad to announce? I’ve said it in ways to other guests, what’s that thing that’s in the eulogy, that’s on the tombstone that you want to make is in every…

Not yet, not yet. Is it in every bio? What’s that thing that’s there and what did it take to reach that milestone? You know, I’m not sure it ends up on the tombstone or in the obituary. Certainly not on the CV, but it’s the moments of connection. It’s the moments when you feel very close to a patient and they feel very close to you.

and you really feel like you’ve done right by them and they know it. But also as a writer, you know, when I get a random email from a first year medical student and she says, and it’s almost always a she given the nature of my book and its title, ⁓ and she says, you know, I just was feeling very shaky about all this and not even sure I was in the right place and

You know, your book made me feel like I could do this. And it’s those moments of connection where you feel, I often tell my writing mentees, you only have one job. It’s very simple. You only have one job. Tell the truth. Whatever the truth is, tell the truth. And I think that’s true in medicine as well. Now that doesn’t mean be

you know, be blunt, be cruel, et cetera. It means, you know, really connect with what the truth is. And the truth might be, what does this patient need from me right now? That could be the deepest truth of the situation. But if you are telling your deepest truth, whether in the exam room or in the ER or on the page, and that truth is connecting with another human being,

on this sorry wounded planet, beautiful wounded planet. There is nothing better than that. There’s no CV, there’s no prize, there’s no promotion, there’s no ⁓ income. There is nothing that’s better than that. Yeah, amen. So we always like to close the podcast by asking our guests to…

prove they’re human, kind of like the reCAPTCHA thing when you’re trying to make an online purchase where you click all the motorcycles. ⁓ I’m so bad at that. I too. I just proved it. I never get it on the first run. Yeah, I don’t either. I’m like, please just let me type in the letter. Don’t make me click the pictures, right? I think you’ve demonstrated that.

I do want to, one of the things that has struck me, and I’d like you to comment on this, and I keep these two slides almost anytime there’s a humanity and medicine talk that I give, which is not many. You’ve given exponentially more than I will ever give. But this is from your New England Journal article from 2017 that I think is the kind of what set off the cascade of the book. And I think

It certainly resonated with me as a clinician and I think it would resonate with other clinicians too. I’m going to read a couple of snippets that I think I’m going to prove that you’re human to the listeners, but then I would love for you to comment on it as well. Right? Well, you do the heavy lifting. Yeah. So you pick out the motorcycles. Yeah. You’ve already done the heavy lifting. I’m just trying to click the motorcycles. So you write early on,

I believe that displaying medical knowledge, the more obscure, the better would make me worthy. You go on to say a little further on in training or in practice, I thought that competence meant knowing how to do things. And you talk about competence and procedures and you know, can you get the central line without a pneumothorax? And if I can do that, I’m competent. You go on to say my first few years in practice, I was sure that being a good doctor meant curing people. felt

buoyed by every cleared x-ray, every normalized blood pressure. I’ve certainly felt that. And then you’re going to say there’s also a more insidious obstacle that you’ll have to contend with, and that’s one that resides in your own head. In fact, one of the greatest hurdles you confront may be one largely of your own making. At least that’s been the case for me. You see, I’ve been haunted at every step of my career by the fear that I’m a fraud.

And then you close with this, which I think is just beautiful and it has been a deep encouragement to me. And this is at the very kind of the last two paragraphs. I’m going to paraphrase. So please forgive me if I leave out the most important part. I now understand that I should have spent less time worrying about being a fraud and more time appreciating about myself. Some of the things my patients appreciate, I appreciate it most about me, my large inventory of jokes, my knack for knowing when to butt in and when to shut up.

My hugs. My dear young colleague, you’re not a fraud. You’re a flawed and unique human being with excellent training and an admirable sense of purpose. Your training and sense of purpose will serve you well. Your humanity will serve your patients even better. Yeah. So here’s the thing. You need, if you’re going to be putting in a central line, you need to know how to do that without dropping a lung.

Right? And curing people is good. And knowing obscure differential diagnoses is good. My point is that those are the easier parts of medicine. What we underestimate is the part that I think is harder. One of ⁓ my dear colleagues, ⁓ still a dear friend who’s now in his 90s,

and was a great mentor to me when I was coming up in practice, used to say, remember, your most valuable tool as a physician is yourself. So you can learn how to put in a central line if you’re so inclined. And you can memorize differential diagnoses, and you should. ⁓ But being willing to bring yourself ⁓ to medicine,

is the biggest gift that you can give. Now, does that mean you have to spill your guts? Does that mean you have to tell your patients or your personal business? Absolutely not. And in fact, for the most part, you don’t want to do that. But it, you know, we’ve all as clinicians and as friends and as parents and as teachers had the feeling where we know that we are holding ourselves back. We are protecting ourselves.

We are not giving all that we could give. And I can tell you, all you have to do is be a patient in the hospital for five minutes or be the family member of a patient in the hospital for five minutes. And you can tell who is giving themselves and who isn’t. And I’m talking about the professor of medicine to the person who brings the lunch tray.

You can tell if they are bringing themselves to the endeavor. And if they are, from the patient’s point of view, that is tremendously healing. And then the last thing I’ll say about this, we didn’t talk about imposter syndrome, but that’s implicit in some of this, is that very often, I think particularly women, will say, ⁓ yeah, I mean,

I’m like, I’m good at, you know, with patience, but that’s nothing. I mean, isn’t everybody? Well, just ask the patients. Everybody isn’t good with patience. And being good with patience isn’t nothing. It’s everything. It doesn’t excuse you from the knowledge and the expertise, but it’s a lot. So don’t…

discount what we rather, I think, disparagingly call the soft skills. This isn’t just some sort of cherry on top extra. It really is the foundation of healing. I don’t want to ruin that closing, but I will share an Oliver Sacks quote with you to come full circle as we close, There you go. In his gratitude essays, he

He says, I cannot pretend I’m without fear, but my predominant feeling is one of gratitude. And my predominant feeling for having you on Reliably Well, Dr. Coven is gratitude. And the predominant feeling for all that will get to hear you at Leadership Forum, I feel confident will be one of gratitude as well. So thanks for joining us today. Well, back at you. Look forward to seeing you next month.

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