Operate with Zen

Paul Maroni, MD is a urologic oncologist at the University of Colorado in Denver.  He is a repeat guest on OWZ (#41. Joy in the Service of Others… https://www.buzzsprout.com/1811662/10549621) and a good friend.  We share an interest in the physical health of our patients and ourselves as physicians and surgeons.  This conversation focuses on practical strategies (and the science behind them) to optimize physical health and well-being through movement, exercise, and nutrition.  There is no perfect work-out routine or diet.  But being mindful and intentional about how you care for your body and what you want out of your physical being are the first steps to a healthy and sustainable career and beyond!  We discuss lots of external resources and links are provided in the notes.  Enjoy!

Slow Carb Diet, Tim Ferriss: https://tim.blog/2012/07/12/how-to-lose-100-pounds/

Nature Wants Us To Be Fat, by Richard Johnson (Amazon): https://a.co/d/fvubmJp

Knees Over Toes Guy (YouTube): https://www.youtube.com/c/thekneesovertoesguy

By Peter Attia:

Outlive (Amazon): https://a.co/d/0FIdViJ

On Huberman Lab Podcast:
(web) https://www.hubermanlab.com/episode/dr-peter-attia-improve-vitality-emotional-and-physical-health-and-lifespan 

(YouTube)  https://www.youtube.com/watch?v=ufsIA5NARIo

Scott MacDiarmid, MD is a private practice urologist in Greensboro, North Carolina and the author of “Fist Pumps” – a self-help book to lift up physicians and healthcare providers who serve (https://www.amazon.com/Fist-Pumps-Scott-MacDiarmid/dp/1088078184).  Similar to my journey in Operative with Zen, Scott wrote the book thinking, “If I can help one other person.”  We talk about the stresses of being a physician and surgeon in modern American healthcare and strategies to deal with that stress.  Finding purpose, developing (what Scott calls) a suit of armor through mindfulness and gratitude, and seeking your own personal mountaintop – where you find peace, joy, virtue, and contentment – allow us to limit our exposure to the inevitable and deep valleys of burnout.  Lastly, Scott encourages us to care for ourselves and care for our communities as we serve those around us.  Enjoy this conversation!          

Fist Pumps (Amazon): https://www.amazon.com/Fist-Pumps-Scott-MacDiarmid/dp/1088078184

Caprice Greenberg, MD, MPH is the Chair of the Department of Surgery at the University of North Carolina at Chapel Hill and a Surgical Oncologist.  She is the President and Co-founder of the Academy for Surgical Coaching (https://surgicalcoaching.org/) and is responsible for most of the academic literature regarding surgical coaching and outcomes directly or inspirationally.  We talk through the basics of surgical coaching from the operating room to the clinic, executive coaching through professional development for junior surgeons.  We talk about the practicalities of coaching: who should be coaching, who should be coaching, and what are the good qualities for both.  And we discuss all the ways coaching can be delivered – through personal coaches, intraoperative video assessments, and organizations like the Academy for Surgical Coaching.  Enjoy!

The Academy for Surgical Coaching: https://surgicalcoaching.org/

Dr. Greenberg’s Publications on Coaching (Pubmed Search): https://pubmed.ncbi.nlm.nih.gov/?term=Greenberg+CC+AND+coaching 

Ms. Nadine Coull, MBBS, MS, FRCS (Urol) is the Deputy Medical Director of the National Health Services (NHS) and President of the Urology Section of the Royal Society of Medicine.  In addition, she is the Deputy Medical Director of Kingston Hospital.  Nadine never envisioned herself as a leader of a hospital, hospital system, or the NHS – but through deep beliefs in compassion and kindness found herself rising through the leadership ranks first locally then nationally.    She is a strong believer in boundaries – professionally and personally – to promote health and wellness.  We touch on her presidential address, The One with the Pink Bag, offering perspectives of being a strong woman in medical leadership.  And she gives us unique perspective on leadership with an international angle – allowing us to compare and contrast promotions and leadership in the US and the UK. We arrive on an important similarity – “Don’t underestimate the power of kindness.”  I hope you enjoy, I certainly did.

Dr. Mick Malotte, MD is a retired ENT surgeon from California who has been practicing mindfulness as a surgeon for over 30 years.  Not only does Mick practice mindfulness through a daily practice and retreats, but he teaches mindfulness to physicians and surgeons around the country!  Mick gives us a brief history of mindfulness in medicine and helps us understand how mindfulness practices are adopted to medicine and surgery.  We talk about burnout, data and physiology, and the religious and social implications of widespread mindfulness practices!  Importantly, Mick gives us easy-to-perform micro practices that can be performed within our daily practices to be better surgeons, physicians, and human beings.  If you are interested in talking with Mick or exploring mindfulness training at your institution, reach out to Mick through his website.  Enjoy!  

https://www.mickmalotte.com/

“All healthcare is delivered through relationships.”  This is the key statement from this episode of OWZ and highlights that effective communication is a key component of delivering excellent patient care.  Marissa Theofanides, MD is a urologist at Montefiore in the Bronx and expert in communication skills.  She is certified by the Academy of Communication in Healthcare (https://achonline.org/) whose motto is “Better Communication. Better Relationships. Better Care.”  In this podcast, we help you understand that communication is a skill – a skill that can be taught, practiced, and improved upon just like throwing a suture or writing a clinic note.  Dr. Theofanides lays out a framework to improve your clinic communications that is rooted in mindfulness!  Setting an agenda, creating space for effective communication, and assessing understanding highlight the mindful principles of intention, presence, and non-judgement.  There’s lots of practical knowledge in this discussion and it promises to make your clinical interactions and your life better!  Enjoy!!!  

Academy of Communication in Healthcare (ACH): https://achonline.org/

Dr. Angela Smith is a frequent flyer on the Operate with Zen podcast.  She is guru to me and many others for life hacks and practical, personal improvements to be more efficient and to have more ease and enjoyment in our daily routine.  In this podcast, we discuss “A Day of Reflection” – what exactly that means, how to set one up, and how to make it successful.  A day of reflection creates the opportunity to be present for oneself, to assess prior performance (in a non-judgmental way), and to set intentions (or goals) for an upcoming period of time.  Periodic days of reflection will prevent you from aimlessly getting caught up in life.  They will empower you to feel productive and fulfilled no matter if in your personal or professional life.  This podcast is full of practical tips to help you achieve that Day of Reflection and the benefits moving forward.  Enjoy!

Dr. Kelly Casperson, MD is a surgical rockstar!!!  … a urologist and sexual medicine expert, a extremely successful podcaster, author and now Ted-Talker!  Kelly hosts the “You Are Not Broken” podcast (https://www.kellycaspersonmd.com/podcast) which empowers women (“and the partners who love them”) with science and conversations to break down sexuality improve the intimate lives of the tens of thousands who listen each month!  But we are not talking about sexuality in today’s podcast… not really.  Dr. Casperson and I discuss her journey to find purpose and how her true self re-emerged after years of surgical training and practice.  We discuss mindfulness and personality traits, and how a better understanding of yourself and those that surround you enhance our ability to be phenomenal surgeons and doctors.  And yes, human sexuality serves as the backdrop for the entire conversation.  Woven in and out of the context of our lives, understanding sexuality by understanding self, communication, and personal interactions leads us to a more mindful existence and relationships with our intimate partners and others.  Enjoy!

"You Are Not Broken" Podcast: https://www.kellycaspersonmd.com/podcast

"You Are Not Broken" Book (Amazon):  https://a.co/d/hdI7JPT

Ted Talk: https://youtu.be/rqI6YKLmdlk 

Being a cancer surgeon can be tough.  Being a cancer patient even tougher.  Brian Lane, MD is facing both daily.  He is an accomplished surgeon and academic urologic oncologist.  In this thoughtful and honest discussion, we cover facing tough diagnoses as a patient and a surgeon; developing perspective as a patient to help our patients; finding purpose and meaning despite tough circumstances; and ultimately finding peace in faith and community.  This conversation is inspirational and grounding.  I hope you enjoy.

Kevin Turner, MA, DM, FRCS (Urology) is a Consultant Urological Surgeon at Royal Bournemouth Hospital.  In 2015, he helped to start the Surgeon Wellbeing Research Team with colleagues from the Department of Psychology at Bournemouth University.  Kevin and team ran a UK national survey from 2016-2019 – data from which has helped us understand how complications affect surgeons, the pervasiveness of this issue, and helped to create important objective measures and definitions in the field – like the difference between complications and errors.  They also ran a randomized trial of resilience training in surgical trainees based on ACT (Acceptance and Commitment Therapy).  Since then, Kevin has become a leader and mainstay at academic meetings bringing our understanding of the impact of adverse events and complications into a major spotlight.  Backed by data, but full of tremendous personal insight, this conversation is a must listen for surgeons who are interested in understanding why complications hurt us and how we can alleviate that impact to better care for our patients and ourselves.  

More from Dr. Turner: 

Surgery Harms Surgeons. What Can We Do? Journal of Urology. https://www.auajournals.org/doi/10.1097/JU.0000000000002861

Turner, K., Bolderston, H., Thomas, K., Greville-Harris, M., Withers, C. & McDougall, S (2022). Impact of adverse events on surgeons, British Journal of Surgery, 2022. https://doi.org/10.1093/bjs/znab447

Bolderston, H., Greville-Harris, M., Thomas, K., Kane, A., & Turner, K. (2020). Resilience and surgeons: train the individual or change the system?  The Bulletin of the Royal College of Surgeons of England, 102:6, 244-247. https://doi.org/10.1308/rcsbull.2020.170

https://podcasts.ox.ac.uk/impact-complications-and-errors-surgeons