Good Life Project - Michele Harper | Beauty in Breaking

Episode Date: November 30, 2020

I first heard about my guest today, Michele Harper, when stumbled upon an essay she published earlier this year, entitled When This War is Over, May of Us Will Leave Medicine. It was about the reality of her day-to-day life as an ER doc during the early days of the pandemic. It was a devastating, powerful, deeply human read. That led me to her beautiful and, at times, heartbreaking, yet hopeful New York Times bestselling memoir, The Beauty in Breaking. (https://bookshop.org/books/the-beauty-in-breaking-a-memoir/9780525537380)Graduating from Harvard and the Renaissance School of Medicine at Stony Brook University, for her entire career, Michele has sought emergency medicine positions in hospitals that serve under-resourced communities, often communities of color. She is not just a devout physician and healer, but also an advocate for dignity, equality and change. The seeds for this path were planted very early in life, though a blend of family trauma and deep personal conviction that has compelled her to not just take care of those in need, but also champion their humanity along the way. You can find Michele Harper at:Website : https://micheleharper.com/Instagram : https://www.instagram.com/micheleharpermd/-------------Have you discovered your Sparketype yet? Take the Sparketype Assessment™ now. IT’S FREE (https://sparketype.com/) and takes about 7-minutes to complete. At a minimum, it’ll open your eyes in a big way. It also just might change your life.If you enjoyed the show, please share it with a friend. Thank you to our super cool brand partners. If you like the show, please support them - they help make the podcast possible. Hosted on Acast. See acast.com/privacy for more information.

So I first heard about my guest today, Michelle Harper, when I stumbled upon an essay that she had published earlier this year entitled, When This War Is Over, Many of Us Will Leave Medicine. It was about the reality of her day-to-day life and those around her, her colleagues, as an ER doc during the early days of the pandemic. It was this devastating, powerful, deeply human read. And that led me to her equally beautiful and moving, and at times heartbreaking, yet hopeful New York Times bestselling memoir,

The Beauty in Breaking. So graduating Harvard and the Renaissance School of Medicine at Stony Brook University, for her entire career, Michelle has sought out emergency medicine positions in hospitals that serve under-resourced communities, often communities of color. And she's not just a devout physician and a healer, but also an advocate, an advocate for dignity, for equality, and for change. And the seeds for this path were planted very early in her life through a blend of family trauma and just growing deep personal conviction that has compelled her to not just take care of those in need, but also champion their humanity along the way. So excited to share this conversation with you. I'm Jonathan Fields, and this is a good life project. We'll be right back. risk. Whether you're in your running era, Pilates era, or yoga era, dive into Peloton workouts that

work with you. From meditating at your kid's game to mastering a strength program, they've got everything you need to keep knocking down your goals. No pressure to be who you're not, just workouts and classes to strengthen who you are. So no matter your era, make it your best with Peloton. Find your push. Find your power. Peloton. Visit Peloton at onepeloton.ca. The Apple Watch Series 10 is here. It has the biggest display ever.

It's also the thinnest Apple Watch ever, making it even more comfortable on your wrist, whether you're running, swimming, or sleeping. And it's the fastest-charging Apple apple watch getting you eight hours of charge in just 15 minutes the apple watch series 10 available for the first time in glossy jet black aluminum compared to previous generations iphone 10s or later required charge time and actual results will vary you publish this piece i think it was it was in April, like late April, called When This War Is Over, Many of Us Will Leave Medicine. And it's such a compelling, moving, emotional piece of writing, but also reflecting.

And what I found stunning was this was your personal experience. It was your personal experience. It was your personal story, but it was also a devastatingly powerful commentary on really the state of medicine in general, the state of our collective value set about patients, healthcare providers, and just humanity in general. Talk to me more about where this came from. It's what I've been seeing in medicine over time. I mean, I'm still, I'm not so senior, but I've been at this as an attending physician for over 10 years. And the focus moving from healthcare and more towards the business of medicine, which is really about profits, and it's devastating. And now being through coronavirus at a time when we need health care more than ever during a pandemic, this pandemic, I mean, there's so much devastation, death, pain, suffering. If there's anything optimistic about it, if there's anything purposeful about it, I hope we are learning from it because it's really laid bare issues that have been there for so long. The fact that during a time of a pandemic, during a time of unprecedented

unemployment, people don't have access to care when they need it most, the fact that our healthcare workers, whether they're techs, nurses, doctors, are not valued. We don't have the equipment we need so that we can safely take care of patients. We don't have the equipment we need so that we can live, quite frankly. Still to this day, that is a problem. We don't have the testing we need to keep people in this country safe. These are ongoing problems. There has not been a solution. There has not been a coordinated effort. My hope is that moving forward, we will determine and collectively agree that health care is a right and not just a privilege in this country.

It's interesting to me that that point was being really clearly made, not by you sitting here and sort of like standing on a soapbox saying, this is what I believe, and this is what's really important, but simply by sharing your experience of being an ER doc in what was then one of the hottest areas of the country through this time where your personal experience, your lived experience of essentially moving through every moment of every day was, is this the one? Is this the interaction? Is this the patient?

Is this the moment where Is this the interaction? Is this the patient? Is this the moment where things end for me? And it's so powerful to me that simply sharing your own experience from the inside out said so much beyond your own experience. Yeah. And still for me, I'm an emergency medicine physician, as we've discussed. And it's always been important for me to be in a part of medicine where I have to take care of anyone who comes through the door. I can't imagine being in a position where I have to turn someone away because they don't have funds. I mean, the idea of that for me is unbearable. So I made a decision to stay. I mean, above and beyond the fact that, you know, I have to pay my bills and live. I would still stay to be there for people in their time of need.

And seeing people come in desperate and seeing so many of the disparities, really. I mean, the sickest patients I was seeing are people who are on the front lines, people who've always been on the front lines, but we're just starting to value them for it, like store clerks and mail delivery people. They're the sickest, putting their lives on the line so that we can still have some semblance of a life we knew and get our

groceries and get our mail, certainly older people from nursing homes who are at higher risk. And then the sickest people I'm seeing were the people who were working on the front lines, yes, and then people in prisons as well, people who don't have any autonomy, who can't socially distance, who don't even have access to soap and water, to practice the hygiene we need so that they can be healthy. I mean, it was really, then we can talk about the carceral state in this country and why certain people are incarcerated and certain people aren't. And now it's not only taking away their liberty, but also their lives by incarcerating

them at this rate during a pandemic where they're getting ill from a disease. So I was determined to stay and to do what is right for people who need it most and also determined to speak about it so that we can do what's right for them by making structural changes. Yeah. And I mean, this is a seed that was planted for you. We're talking about in the context of really the last nine months. But that's just the most recent manifestation of something that has been compelling you for decades. This know, this is not a new thing where you care so much about certain communities of people and about a paradigm of healthcare.

The seed, it sounds like, was actually really planted when you were a kid. Yeah, it has been there forever. And it is interesting with this book. For example, people speak about the case where the police brought in a patient and they wanted for me to force an exam on him. And people are saying, typically when I have interviews, oh my gosh, how could you have known the timing? The book came out now when Black Lives Matter is going on and we're seeing the problems in policing. And I'm glad we're having these discussions. It is important for us to talk about it.

But I did start writing this book like six years ago. And part of the reason, one of the reasons I included that case was because these are issues we see all the time that have been concerning me over the decades. Yeah. And I mean, I guess you write about and you talk about you as a young kid also, growing up in a household with a lot of turmoil, with physical abuse, and sort of living in a state of hypervigilance, but also dissociation. Yes. Talk to me more about this. Yeah. So I grew up in an abusive home with

a father who was a batterer. So it was always unstable. Anything could happen at any time that was generally bad and felt dangerous. One event that always stayed with me, this was when I was a young teenager. My brother was trying to restrain my father to prevent him from continuing his attack on my mother. And my father bit my brother's thumb, causing a significant injury to his hand. And I just remember being horrified. I mean, that's just one of many events. But being horrified that someone who's a family member, someone who's supposed to take care of me and my family could do that savage act to someone else in the family, someone I care about. And my brother, it turns out, was my protector. And I remember feeling in that moment that this home was not safe. It wasn't going to be safe. And also, since by that point,

I had more of an access to language being a teenager and not a seven-year-old anymore. Also knowing that I was going to have to do what I needed to save myself and to save those around me. And so I think in many ways, it was that childhood that groomed me to be an ER doctor, because much like in the ER, all I had was a snapshot in time. Is this event that's happening right now going to be immediately life-threatening? Is it likely to blow over? Do I have to make an intervention now, or will it just run its course? So those skills were immediately transferable later.

And it was experiences like that. And then also when I went to the ER and took my brother to the ER to get care, where I saw so many people suffering from all manner of life, like a little girl who came in with a cut or a homeless man who just needed a place to sleep for a couple hours in the waiting room pre-pandemic when people could do things like that. healing and seeing many of them walking out healed, whether it was an asthmatic who now had medications and had been treated and could breathe, that the little girl whose cut was fixed. And I knew that I wanted to be that for people, for people who were in a position to heal, who wanted healing, who wanted change. I wanted to offer that support system for them. Yeah. I mean, in effect also, I wonder if you seeing that and then thinking to yourself, I want to be that for other people was also an acknowledgement of the fact that that existed for all people and you were one of those people. Absolutely. I mean, I saw the potential in that. And it was,

you know, because it was that trauma in my home was just the air that I was breathing. It was my environment. It was hard for me to imagine something different. So when I saw it in real life, in real time, in the ER, I could see it. And I didn't know how, but I knew that as long as I survived, that there was a way out and another side. Yeah. I mean, knowing that there's this thing that exists, um, that then you get to say, okay, almost like, how do I, how do I reverse engineer the path to be that, to do that, to offer that? I guess that was, that really was kind of an inciting incident

for then what would become, you know, your pursuit in education you end up in harvard you end up in stony brook in med school and coming out i'm curious about this underlying state though because when i've talked to a lot of people over the years um sadly who have been through yeah really hard upbringings often with danger often with violence and they have shared this description of hypervigilance constantly. There's never a time where the vigilance goes away. It may get dialed down slightly at certain moments, but it's never gone. And then this weird dual state of both dissociating so that you can survive, but also being deeply invested so that

if you have to step into a place of agency and take action, you can. And it occurs to me that the field that you chose, you know, like training in those things is probably really powerful foundation for surviving in the ER. But at the same time, I wonder how sustaining that in your life as sort of like a driving ethos after you're out of the home environment where it keeps you alive, both prepares you for your career, but I'm wondering if it then wreaks havoc in the rest of your life in some way, shape or form. Well, I don't think it's, it's certainly not sustainable. And there was a certain amount of hypervigilance that I also have to have as a black woman in America. So there's components to this. But the trauma of my childhood and certainly the dissociation I had, I was really focused on my schoolwork. Because for me, school was a way out. Education and achievement was a way out. So I would, there might be violence in my house.

And then 10 minutes later, I'm sitting at the kitchen table, finishing up a report because I just have to, no matter what I had to do well, I had to do A's, I get A's, I had to get out. I was never going to be codependent on anyone the way I saw my mother be codependent. I was going to have agency so that I could help myself and other people. And then it got to a point later in life and I did sustain that through medical school, through residency. And I remember that after residency, when I was starting over, when I was getting a divorce in a new city, in a new job, and experiences, and in my own home. And I never really cried. I did a lot of inner work.

Like I was reading Thich Nhat Hanh. I was always very spiritual and meditating. I didn't yet do yoga, the physical practice of yoga. But there was more that I hadn't yet accessed. And I remembered, this is a true story. I wrote a memoir. It's why I included it. But I remember taking care of a family, really. I got a notification, a newborn had stopped breathing. So we were supposed to repair for this patient coming in. And the minute the baby rolled in, we knew the baby was dead. We knew the baby was gone. There was nothing to do. We worked on this infant far longer than was necessary, far longer than was reasonable, but we did it because we wanted to prove to the family that everything was done for this perfect newborn child that passed away with no warning,

no explanation. And we did it because that's one of the hardest things to go through for the staff as well. So we needed to know for our own hearts and minds that we did everything possible. And that evening when I went home, I remembered just weeping and weeping for the first time ever for that loss. I mean, I have not lost a child, but I remember standing with those parents and the grandmother and the family in the waiting room. And appreciating the fact that they lost so much of their story for what they thought would happen, for everything they planned for, for what they counted on for this life and their family and what was to come for their future. And I know what that sense of loss is at the core of it. I know what it's like to like not have the childhood you wanted or like the marriage you wanted or the story for the family that was to come. And I just cried. And I felt like that was one of the main moments in my life that broke the dissociation.

That now I could be out of the survival mode in that respect. And in the living and thriving mode. And so it began. And then I started the physical practice of yoga. And this journey of just radical honesty. I feel like it was the next part of my personal and spiritual evolution. So that was very critical. Okay. So then the other part is being a Black woman in America. There's always a certain amount of hypervigilance you have to have and a certain amount of

dissociation you have to have navigating these structures which is another conversation yeah but i mean is it another conversation because it's really all part of the same fabric right you know it is yeah you're right it is i just well you know what it's just said which is another part of the question yeah yeah because it's also i mean and and i guess i'll ask it i'm not going to assume you know it it occurs to me like okay so there's there's the layer of being a black woman in america and the hypervigilance that comes with that which is to a certain extent necessary yeah and then there's the level of being black in the practice of medicine in the U.S. and being a Black woman in the practice of medicine in the U.S. Each one of those is its own layer and its own construct

to sort of figure out how to navigate. I mean, does that land as right to you? It lands as true. It is so wrong, but it's true. It's true. So it's exhausting. You know, what are the statistics? Roughly 2% of physicians are Black women. And it is a constant, I was going to say navigating, and in some ways it's navigating,

and in other ways it's battling. Truly, I don't know which example to give just because there's so many. But in the example that people speak about often, where four white police officers brought in a black man saying they had said they saw him swallow drugs and they wanted us to get them out. The patient, who was competent and has rights in America, didn't want to be examined. He said it wasn't true. And he didn't want to be examined, didn't want to be in the ER. My resident, who's a person I'm training, who's a young white woman, went over and said, well, to the person under arrest, you just have to do it. And this is what we're going to do to you. And so I went over now hearing this unfold

in a terrible, unacceptable way and did explain that that is unprofessional, unethical and illegal. And so I, you know, I proceeded to start, you know, I finished my exam and history on him. He said it was, it was okay if I did that. And then I would discharge him from the department. And then she proceeded to invoke what she felt would be a higher authority by calling hospital ethics and legal department to see if she could just override my plan. And they told her actually no, because what I said was correct. And it was important for me to discuss that because that's a perfect example of what it means and what I have to do every day where to remind people, to remind the police, to remind the staff, to remind the person that I was

charged with training that this man has personal sovereignty. That is his right. But having to remind her that when we see all kinds of patients, so disturbing and unsettling to me that she couldn't recognize his humanity. And then being in a position where I am thought to not have the knowledge, the authority to make those kinds of decisions and having to remind her and the department of that. And that is something I have to do on a daily basis in my line of work and also to protect patients that would otherwise be routinely abused. And that's why I'm there.

I'm there to work for justice and wellness and health. But justice can't depend on one person being decent and kind in the moment. The system should be designed for that. And each person is responsible for that. So on a personal level for me, it is exhausting. It's exhausting. I mean, it, they are disturbing, they're upsetting. I tell them to amplify, to create space for the discussions, hoping that it will support people who are willing and ready to act. Because again, because it is exhausting. And so I feel that by speaking about it, it does give some sense of community and connection for people who can feel alone in this work. But I do have to say, I'm actually energized by this particular moment in our society because

people are galvanized in a way that I do feel. I don't think it's just empty words. I think that critical mass is forming to address racism, to address violence against women, to address misogyny. The list goes on. In meaningful ways. So I am hopeful in that respect. need to keep knocking down your goals. No pressure to be who you're not. Just workouts and classes to strengthen who you are. So no matter your era, make it your best with Peloton. Find your push. Find your power. Peloton. Visit Peloton at onepeloton.ca. The Apple Watch Series 10 is here.

It has the biggest display ever. It's also the thinnest Apple Watch ever, making it even more comfortable on your wrist, whether you're running, swimming, or sleeping. And it's the fastest-charging Apple Watch, getting you eight hours of charge in just 15 minutes. The Apple Watch Series X, available for the first time in glossy jet black aluminum. Compared to previous generations, iPhone XS or later required,

charge time and actual results will vary. Mayday, mayday. We've been compromised. The pilot's a hitman. I knew you were going to be fun. On January 24th. Tell me how to fly this thing. Mark Wahlberg. You know what the difference between me and you is?

You're going to die. Don't shoot him, we need him. Y'all need a pilot. Flight risk. You know, it's interesting. You shared a statistic, I think you said somewhere around 2% of all physicians are Black women. I think it's something like 5% for all Black people within the profession. And besides all of the sort of structural and systemic and cultural things that you deal with every day within that paradigm. I'm curious also whether you have a sense of how that affects the nature of

interactions between doctors and patients and also outcomes. I remember a little while back, we had Dr. Joy Harden Bradford on the show, who's a Black woman who's a psychotherapist, just has an amazing podcast called Therapy for Black Girls. And she focuses on therapy for Black women. you know her experience was that the quality of um that so much of the outcome was reliant on a feeling of safety between the therapist and the patient or the client and that a lot of black women felt more comfortable or were more open to going to that place of feeling safe and being more vulnerable and and when when that happens you share more and then you and being more vulnerable. And when that happens, you share more. And then you can process more and the outcomes improve. And I'm wondering if that dynamic rings true to you

sort of in the broader context of medicine. And also, if it does, what the lack of that with only 5% representation means towards actual outcomes. Yeah. The outcomes are worse. An independent risk factor for illness and morbidity and mortality is racism. That's an independent risk factor. So we're seeing, I mean, and sexism, women are more likely to have worse outcomes with heart disease, black people having higher infant mortality,

maternal mortality. It goes on and on. And yes, there is partly not feeling safe, but then largely not feeling safe because you're not as safe. That's why you don't feel as safe. Patients aren't listened to, not taken as seriously. Their symptoms aren't felt to be real. So they're not evaluated in ways that will reveal if there's an underlying medical disease. And then if they're not evaluated in such a way that would reveal underlying disease,

then it's not treated. These are real problems in medicine. We have got to address the implicit and really explicit bias that exists. You know, I had a patient recently who, she's a young Black woman. All I knew was that I saw she had just come into the ER and she was put on her cardiac monitor. And I always make sure to sit in a place where I can see all the monitors. And it looked like she was pretty young and healthy from what I saw on the chart, but her heart rate was fast. We see young people with fast heart rates all the time. It's usually not that big of a deal because you're young and healthy. But I was just, something just concerned me. I just felt it in my gut. And another provider, a mid-level provider, nurse practitioner

went to go see her. And I walked by the room just because I was concerned, just to listen. And I heard him, he was an older white man, just kind of say, oh, you're not taking your medicine. Let me just see your medicine. And I went into the room and I said, oh, you know, what's happening? Is everything okay? He's like, oh no, you know, I know her. She kind of just, you know, doesn't take her medicine or whatever. And I was like, wow, I'm concerned about her heart rate. Long story short, I ended up just taking the case because I was concerned. I did not feel he was treating this with urgency. And I thought we needed to look deeper into it. So then I started speaking to her and she told me about her underlying thyroid disease

and how her heart rate was going faster and faster and how now she was short of breath. And she just didn't feel well. And how she called her endocrinologist who said, I don't think it's your thyroid. I don't know. Talk to your primary care doctor. And then she called her primary care doctor who wrote her for a new blood pressure medicine and said, I don't know. It's like, you're going to be fine. And she called them back again. Meanwhile, no one had examined her. No one said, well, if you're feeling that bad, go to the ER. They just said, you're going to be fine. We'll talk later. She was feeling desperate and unheard and unseen and sick. So came to the ER where I intercepted and she was sick and she couldn't breathe.

I had to give her medicine so she could breathe better for her asthma. Her blood sugar was out of control. Her thyroid disease was out of control. It definitely was an issue that her endocrinologist should have taken care of. And I had to admit her to the intensive care unit that day. And this is what I see all the time. And this woman, true enough, she probably didn't feel safe with her doctors because she wasn't safe with her doctors. And no one heard her or took her seriously. And she was critically ill. Yeah. I mean, when, you know, it's,

when I hear this story, you know, I sit here and I'm listening, I'm horrified. And then the next thing that drops in my head is, Oh, I'm hearing one story. Right. We're living this every day over and over and over and over. And this is, this is not an, I'm hearing one story. You're living this every day over and over and over and over. And this is, this is not an, I'm sure what you're sharing is not an isolated incident. This is just a repeated pattern. You have said, and you have written that more than identifying as a doctor, you identify as a healer. But what I'm, what I'm hearing in an even, maybe not stronger, but as strong way is not just healer, but advocate. Yeah.

You know, that is such a huge part of your heart. Yeah. And I, so before I did this podcast, I, this morning I was looking at your website and I saw your, your personality type quiz you could take. Yeah, the sparky type, right? Yeah. So like 40 minutes before we spoke, I took it. And my type was advocate warrior. Oh, yeah. Which totally lands as true, right? Yes. And I was so happy because I agree with you. Yes, I identify as an advocate, which I feel

for me goes hands in hand with being a healer. And I see no way of being a healer if I am not going to advocate for my patients and these principles and justice. And that requires courage. So I have to be a warrior. So I, yeah, that's how I live. And that is what I feel is required for me to do this work. Yeah. It's just such a part of your DNA. It sounds like so interesting that you did this prototype and you came up and said, I love it. Because when you had that sort of like, okay, so this is pure validation. This is me. But here's my curiosity, and I'm going to turn it back to you. Because one of the questions that we get, we've had close to 500,000 people actually complete that assessment at this point.

So we have some pretty stunning data. And one of the questions that we get often, well, is, well, where does this impulse come from? Where does this thing come from? Is it nature? Is it nurture? And, of course, there's no definitive way to figure that out. We just kind of know it is by a certain point. And I'm curious because when you look back at your history,

there could be an argument that says, well, for you, it's more nurture than nature. It's more the environment and the way that you had to be. But my deeper belief is that it's more nature for most people, that there's something inside of us from the earliest day that says, I need to stand up. When I see something, I cannot just stand. I have to actually do something or say something. I agree with that. That being said, I feel that the nature component can ruin a person. I feel that the nature component can limit a person and take them off track. So I don't want to, let's say, minimize that piece of it. But then I happened to agree that the nature is critical because it didn't have to be this way. I mean, there are many people who come from abusive households where they go on

to replicate that abuse. They go on to just live it, pass it down through generations over and over again. So yes, it's part of who I am. And I always say I'm not religious, but I am spiritual. And I feel it's part of my path and destiny. There are many pivotal moments in my life, and like everybody's life. But one of them, when I was young, like seven years old, when I was playing alone, knowing really so much pain and suffering in my life, being in that household with that family. And I received a message at that time. And this is so true. And

it's like, when you're that young, you can't, you can't like make up a message or a voice. But I heard this message that said, you're going to be okay. You're, you're going to survive. And when I heard that the people I cared about, and I heard the people I cared about in my family would survive too, that I would survive, the people I cared about would survive. And then the other part of that message was, and you have to, because you are going to go on to help many people. So I was a child, a young child. I was so happy, deeply happy in a way that I can't remember being because all I ever wanted was to feel safe.

And in that moment, I felt truly safe and held by this message from this voice that I had seen the TV shows with angels. So I had assumed it was an angel. I was happy about the other part. I mean, I didn't really, I knew it was good to help people. I didn't really understand it, but I never forgot it. And whenever things were difficult, I mean, even in college, I remember that message, which I think gets back to the nature part, even destiny or life path, that that was revealed to me early. And I committed to it. I felt, well, this is my destiny and I'm going to fulfill it.

Yeah. It's amazing that you're just like seven years old and to this day, sitting here in this conversation, you remember it. And it sounds like you remember it like it was yesterday. Yes, I really do. I remember how I felt. I remembered the sun coming through the windows, how it felt on my skin. I remembered how the message felt. I mean, and it felt like a glow. Yeah. Did you share it with anyone back then? With my mother.

She was home. The whole house was quiet, but she was home and in her room. And I darted up the stairs and I was like, you've got to listen to this. This is what I was told. So to this day, she remembers it. She can validate it. So yeah, I told her at that moment because I was so happy and I thought she needed to know we are going to survive. That's amazing. So even in a really interesting way at seven years old then, you also kind of have this sense of like, okay, so this is my path. But also by you telling your

mother that, that's almost like day one of you stepping into the role of being a healer. Yeah, I can see that. And that is how it played out, which is a lot. It's not fair for a child to be in that role, but that is how it was. Yeah. I know once you headed out into medicine also, you're really building on this same thing. You know, you don't, you, you very intentionally choose places to practice where they're under-resourced, um, generally communities of color is where the hospital is, you know, starting at one point you're in Lincoln, South Bronx, and you go to places where you're like, this is where I'm needed. Yeah. I've worked in other settings and, you know, for example, there's larger academic hospitals and they'll have multiple sites.

But my I'm always brought back to and my heart is always most contented clinically when I'm working in predominantly black and brown communities, immigrant, under financially resourced communities. That's where I need to be clinically. In my, what I call my work as a healer and my healing mission, do I feel like there are needs in other communities? Of course. Do I feel that I want to be there in conversation with, in community with, in connection with.

Really anyone doing this work of justice, yes. And those are, I feel, I feel those are under-resourced communities as well, no matter the color or gender or sexual orientation. And that's one thing I love about writing and this literary path, because that's opened up communities as well. But clinically, clinically, that's where I go writing. It's broader. Yeah, it's interesting. You shared earlier that you're not a religious person. But the way you speak about justice feels like justice is your religion. Ah. Yeah, I guess it could be.

I feel like many paths lead to it. Many faiths lead to it. So I guess in that way, it's an open religion. Yeah. But I mean, in the sense that it's sort of when I think about religion, yeah, I guess you describe it all sorts of different ways. But I think fundamentally, most people think about it as, well, you know, it's a set of beliefs and very often the rules by which I live. And it feels like for you, justice is that, you know, it provides the set of beliefs the frame you know the context within which you decide you know like where to invest your energies and your voice and

and what to say and when yeah well that's definitely true that i go along with it it's my religion um see we have now decided today you're a highly religious person. That's fantastic. You mentioned the book also and sort of the role that it plays. So we've been talking mostly about medicine and your medical practice and your choices, but also you came out with this book and earlier in our conversation, and it's called The Beauty in Breaking. You shared that the timing wasn't like, hey, it feels right now that this is actually something you've been working on for some six years or so.

Where does being an ER doc and then taking care of yourself on a level that allows you to be okay being an ER doc is full-time times two already, right? So where does writing drop into your sort of like zone of viable existence along with all of this? Right. I mean, technically speaking, the logistics of the time to write. Well, I feel like I just, or anyone, makes time for what's important to them. So I just made time for it between shifts, my free time. I mean, true enough, when I was writing a lot, pretty much everything else fell apart in my life. And I was just, I mean, I'm just going to be honest. I'm going to be honest and real with people. It's, you know, my condo, everything just messy. So

that's how it happened. But, but again, it was in service of my mission to be part of healing work. I mean, I felt like in writing these stories and in amplifying these voices, whether or not it was the story of the man we spoke about where the police wanted me to force an exam or a woman in the military who I met in the emergency department who was brutalized in the military and was looking for healing. Whatever the story, I want to amplify these voices, create a space for discussion to work for justice. In the ER, I can help one person at a time, maybe one family at a time, maybe one community at a time. But when I speak about Miss Honor, who was raped by her colleagues in the military and then has to find her own way to heal,

as the military then tried to take away, after committing these crimes against her body, then try and take away her livelihood by ruining her record for the crimes crimes against her body, then try and take away her livelihood by ruining her record for the crimes committed against her. And now she has to put herself back together. Sure, I'm there to say they are wrong, to be one of the people, to not be complicit in the silence and speak it out loud that they are wrong and she deserves more. You know, that's good. That helps her healing. But then I want to talk about it

because the people who did this to her were wrong. The structure that condones it by not doing anything about it is wrong. And so we need to address that. And because my religion is justice, I had to write this book to serve that mission. So I made the going to be fun. On January 24th. Tell me how to fly this thing. Mark Wahlberg. You know what the difference between me and you is? You're going to die.

Don't shoot him. We need him. Y'all need a pilot. Flight risk. The Apple Watch Series 10 is here. It has the biggest display ever. It's also the thinnest Apple Watch ever, making it even more comfortable on your wrist, whether you're running, swimming, or sleeping. Apple Watch series 10 available for the first time in glossy jet black aluminum

compared to previous generations iPhone XS or later required charge time and actual results will vary. It's interesting to me because as we're in conversation and in the book, when the book on its face comes under the category of memoir, so much of what you write about is other people's stories and so much of the why behind the book at least that you shared is is advocacy is is your ability to shine the light and serve at scale whereas you can work on an individual level in like as a physician but this let you tell stories at scale and shine the light on injustice and also the need for change. But at the same time, it is a memoir. And all of these stories are interwoven with your personal reflection and evolution and sort of like path towards awakening to a whole bunch about yourself. You know, so it was fascinating to me to sort of see

how you dance this really, really hard line to dance, which is to tell your own story. And then at the same time to tell other people's story, to make a bigger societal point. And I'm wondering how you grappled with that as you were working on it? It's interesting because I feel, I truly believe that as human beings, we are connected. And I truly believe that my decision to heal myself, to work on myself, to evolve is good for me. It's good for me and my life path to be a fulfilled, contented human being. But then it also enables me to support other people in their own process of growth. And then if we do that, if we support other people in their process, then we can uplift society. And for me, that's the whole point. So because I believe that so

strongly, I couldn't write a different memoir. It just wasn't an option because for me, everything is about our interconnectedness. And I don't mean the silly little dramas that people like to have. I actually have no interest in those, but I mean, at our core and the deepest level, like this, the challenges that we have as human beings and the opportunity they're in. That's what I believe. So actually the hardest part for this book was me putting more of myself in it because I didn't want it to be an egoic work. That was the hardest part. I mean, my editor had to drag me kicking and screaming. And I love my editor. I mean, I thank him in the book. He's wonderful. There were many times I cursed him in my head. But now he's right. I mean, when he, I thought I had, when I was writing this, I thought I had fully worked through my divorce had to step away. Like I burned a candle and cried. I mean, there was just more, there were like little nooks and crannies that I hadn't gotten to yet.

So there was more healing to be done. So he was right for that reason. But then also, you know, if I'm going to serve my mission of working on myself and being courageous enough to be vulnerable to do that, to help other people in a deeper way, then he was right. I had to do the work so I could put more of myself in there. It is more relatable. I mean, so as a book, as a work of art, I think it's, it made for a better product because it gives people more insight into me, into the other stories, which I think then can, you know, I hear all the time, you were so courageous to be vulnerable in that way. And I'll hear from people who are saying, you know,

I, this is what I'm doing. I'm actually going through a really hard time also. And your book is helping me to look at the difficulties I'm having in my marriage, or I really don't like my career and I'm going to take a leap and do something else. So my editor was right. That was the hardest part for me to change about the book and it was worth it. Yeah. I mean, I also wonder if you sharing the stories and making the points and sharing the point of view that you had in the larger context of your own personal, I kind of hate the phrase healing journey, but I'm not sure how else to sort of describe it. But in the context of that, it allows your point of view and it allows the stories to land differently rather than sort of like just this really just outright indictment. It gives

them a frame of like, I'm, I'm along this journey with everyone else. You know, like I am there, there's injustice that I see and I'm also human. I make my own mistakes and I can get screwed up in my life. I screw things up and I have to work through them. And we're kind of all in this together. And I'm going to share some things that I see that aren't cool. But I'm also going to share that about me. Yeah. I mean, there's a you share a story about a patient who comes into the ER, and I may get the facts wrong, where you look at the chart and you see that that patient had previously assaulted a physician.

And you kind of like decide, you know, he can wait a little bit before I get to him. And then you finally get to him and you're like, oh, uh-oh. Right. You know, so it's like you're not excluding yourself from your own lens on let's look at everything. And I think that's what makes it, that's what makes all of it so powerful and relatable. Yeah, thank you. I do agree. And it was important for me to speak about that. And that case in particular was my disgust with his previous behavior of him assaulting, sexually assaulting a physician who

was trying to help him. Yeah, I was right to be outraged at that. Was I outraged that, I mean, I didn't know for sure, but there was no indication in the documentation that the hospital had addressed that in any way, addressed it in any reasonable way for the physician or holding that patient accountable. Yeah, I was right to be outraged by that too. Also, I didn't know him.

I didn't know if he had grown, if he had changed, but it also didn't matter in the moment, most importantly, because I'm there to take care of a patient who was not behaving in any assaultive or violent way, that I didn't have to address that then. It wasn't my job. And yeah, he waited for a couple of minutes while I got coffee, but he was sick. And so we took care of him. And it was me. He needed to go to the operating room urgently. The surgeon who came on was a woman. Then there was change of shift. I had to get various studies done on him. So the next, once I was all done, the next surgeon who was going to be the one to operate on him would also be a woman. And I thought that

I didn't know anything about him, but maybe if he was going to heal and get better, certainly I would have to take care of him in the best way possible so that he could survive, which I did. And so would these other women. And I wondered, was any of it lost on him, that the people to take care of him, to literally save his life were all women. And so by us doing our own work, maybe he would be healed as well. And most importantly, whatever he decided or did moving forward about his personal healing journey didn't matter fundamentally because I had to live by my code of ethics and we each have to decide what our own code will be for ourselves. So I learned a lot from that case and I'm glad I told that story because I did want to expose how I am in this with everyone else and not perfect,

but dedicated to constant self-inquiry and growth. Yeah. And I think it was really powerful hearing that story. And I think when you zoom the lens out on everything that you wrote and all the stories that you shared and really sort of this whole conversation you know what we're really talking about is constantly revisiting our ability to recognize shared humanity you know and people who look like us and people who look different than us and people who we may perceive as as having done you know like quote bad things um versus you know like angelic things um is is sort of like taking people as they come and understanding,

like, I'm human. I have my foibles. And, you know, like, even though I may be devoted to, to doing good work and everybody else is, is along their own path, you know, that same person, you know, like where, you know, you, you look at that, that patient that you were just talking about and say, well, we don't know what his childhood was like. We don't know what shaped the behaviors that led, you know, to that action, which was highly offensive. And we don't forgive it. the conversation we're in now is all how do we constantly remind ourselves to step back and see if we can see the shared humanity in every person that we meet and i feel like your work of art your work of advocacy your work of healing was a powerful contribution to that kind of mission so it feels like a good place for us to come full circle in our conversation as well. So in the context of this container, the good life project,

if I offer out the phrase to live a good life, what comes up? For me, living a good life is adherence to my purpose in life, truthfully. As long as I adhere to my life mission, it almost doesn't matter how it unfolds. I feel like there is beauty in me being open to the, I know this is going to sound cheesy, but it's really how it's coming out. I feel like there's beauty in me being open to the magic and mystery of the details of how that unfolds. I love that. Thank you. Thank you. Thank you so much. It was wonderful spending time with you today. Yeah, my pleasure. Thank you so much for listening. And thanks also to our fantastic sponsors who help make this show possible. You can check them out in the links we have included

in today's show notes. And while you're at it, if you've ever asked yourself, what should I do with my life? We have created a really cool online assessment that will help you discover the source code for the work that you're here to do. You can find it at sparkotype.com. That's S-P-A-R-K-E-T-Y-P-E.com. Or just click the link in the show notes. And of course, if you haven't already done so, be sure to click on the subscribe button

in your listening app so you never miss an episode. And then share, share the love. If there's something that you've heard in this episode that you would love to turn into a conversation, share it with people and have that conversation. Because when ideas become conversations that lead to action, that's when real change takes hold. See you next time. thinnest Apple Watch ever, making it even more comfortable on your wrist, whether you're running, swimming, or sleeping. And it's the fastest-charging Apple Watch, getting you eight hours of charge in just 15 minutes. The Apple Watch Series X.

Available for the first time in glossy jet black aluminum. Compared to previous generations, iPhone XS or later required, charge time and actual results will vary. Mayday, mayday. We've been compromised. The pilot's a hitman. I knew you actual results will vary.