Effective Strategies for Dealing with Bullies in Medicine Successfully. #454 Part 3

At this point , so you , just , you just accept it . I'm not saying to accept it . You have to accept that it is a part of your process . It's like giving birth . You know , you're like seven hours into labor and you're like dang . I got another like 10 hours to go . There's nothing you can do to speed it up , embrace the suck .

You embrace the suck and say I'm here , I'm gonna focus on my education , I'm gonna focus on maybe using these experiences for the person that's coming behind me at the next stage of where I'm going , that

that this is not going to happen to me again .

those licks to really be like no , we , not Y'all are not going to do this to the people after me . For me it was once I got to be , you know , a fourth year and a fifth year where I'm teaching , I made sure I didn't teach out of fear .

You know like , okay , I gotta make sure y'all do good , because if I don't do good and the attending is going to be upset , no , we don't take our time and learn how to do this the right way . Because if I teach them with that patience , that kindness , that empathy , they're going to do the same .

But if I teach them the same way , I'm taught what if they don't have the same ? You know emotional intelligence and then it's worse . Right and I think that's what happens in programs like the Jägermeister is that you just had these emotionally unintelligent men but no , seriously , who it was it was .

It almost got worse , generation after generation because it just got more and more malignant and you hear that word with programs of malignancy , like it's a malignant , it's a toxic program , like in medical terms it's cancerous . Right , there's something in the culture of that program and it's like no , you have to be the chemotherapy ,

you have to be the change setter , and that takes a lot of strength . It takes . I always go back to a village . It's not something you do by yourself , right , did ? You have a line .

Sometimes the water is running , Sometimes the electricity is running . It's like the poorest of the poor , and I don't say that in a bad way . It's to say like we came from the struggle right , and so I think that builds in you a certain strength and a certain grit and resilience .

But I also know that that may not not everyone is brought up that way right and so you can't , the hardness that I'm like , just get through it . That's not realistic for somebody .

Like I ain't standing for that , right , because I bring that question because that's a struggle that a lot of people have , like my family didn't send me here for this , or my ancestors didn't send me here for this , or you know , I got , I got loans , exactly . You know , make it like , take us through that , talk us through that , because that's , that's .

And if they turned to me and said , and I'm not , I'm even talking with testing like , hey , so what if I didn't score in the 90th percentile ? But if they said to me , hey , dr Bill , we think that you are just not performing and you need to repeat third year , that was going to be the end of my orthopedic career .

My mom always says I gave America the best of me , which is like me and my sister , but I've given the best of I am today , if I had to go through the process knowing that this has nothing to do with my surgical skill or my knowledge , or it has everything to do with

the fact that somebody don't like me , somebody doesn't want me here , and that became a snowball effect that led to me being held back . That was my line in the sand . Couldn't do it . I would have found a different career . I'd be on CNN with Sandra Goop to talk medical correspondence .

Because I worked in such a male dominated field like you , you know you always have to assert yourself as a woman , but that's just something I was not I mean in any situation that I was not going to put up with , just just on the ethics of it and also just keeping in mind that if it's , if it would have happened to me , it could have potentially happened

to other medical students or any other women that would have came through the program after me .

their residency , and you know they're struggling with resident , with bullying . How do they get out of that ? I know we didn't offer much but you still gave tips on that .

So you know just to kind of wrap this up right , Because you know , sometimes it can be hard for people to recognize that they are possibly applying to or interviewing at a toxic residency , right , and you may just be there . But for the folks like to kind of wrap things up , like , give us those tips again .

Like I love the way how you talked about strategize and so forth . Talk to us about that , keep it objective . Can you just kind of run through those again ?

The second thing is you always need the input of your village . Never doubt , just because you're going through maybe you're the first person that's gone through residency or surgery or medical school that you should still talk to those friends , families and individuals that supported you .

The third thing is don't ever let it roll over more than a week , because when it does as I use the example of my friend it can follow you all five years . It is still appropriate , even if the person doing the bullying is the program director or chairman .

It is still appropriate to meet with a person that is in a position of power and authority to let them know this event has happened to me or is happening to me . I do not like it .

I do not think it is conducive to me having a good surgical or residency training program , and it can potentially interfere with me being the best physician that I'm trying to be , which is why I'm here at this program , that conversation . You always follow it up with documentation in written format digitally per our conversation . Thank you for meeting with me .

I would like to recap A , b and C , and this was your solutions to how we can deal with it . The other thing is the objectives . How do you differentiate between ? Is this bullying ? Is this constructive criticism ? The way that you do that is really focusing in on ?

Are they trying to make me a better surgeon or are they trying to break me down as an individual ? You know that clearly , just based intrinsically on what you feel in that situation . Even if you're someone that doesn't take criticism , well , you almost know when someone is just not being kind , right

, it's just back to toddler days Are you good or are you bad ? So in those situations , you want to keep your own tracking data and for me , I use surgery as an example . How did I perform on this surgery ? Look at the objective things . What was my timing like ? How do you think I did interpreting these x-rays ?

How do you go through all of them , talk with that attending or that chief and document it so that no one can just say , well , I don't think she's good , why Right ? And when you do that , you're also going to be documenting your good and your bad , right ? Maybe you had a complication .

Here's the great thing about having a complication or having something go wrong in a training environment . It's supposed to happen here . I'll give a personal example . Uh , and we love examples , we love examples ankle fracture dislocation .

In orthopedics , when someone has what's called a trimalleolar ankle fracture dislocation , your job as the intern second or third year that is in the emergency room is to reduce it , to splint it , to then either keep the patient or send them out . I had never seen this particular type of ankle fracture dislocation and I was also afraid to ask for help , right .

Those are the best surgeons with the least complications because they take the time , because they're humble , Right . So back to this example . I splintered this fracture dislocation and the ankle was still dislocated , right .

So when we the next morning we have something called fracture conference where you bring up every x-ray that comes up and this is how I was dealt with when they brought up the x-ray I was like humiliated , I was shouted at and I remember the trauma surgeon at the time .

She finally turned to me and said you don't know that you're not supposed to send this out . This is after like a 10 minute berating and I said honestly , no , I'm not familiar with this fracture pattern .

I had never seen it before and I said I would really appreciate if maybe , after this conference , we could go through some case studies and you could show me the techniques on how to best deal with this particular fracture . I've never seen it before in my two years here as a resident . Dr , Bilbre , why are you so mature ?

Oh , I hate you Because the ancestors I hate you .

When I said that and I met with her mouth dropped because now she realized she had failed , as the trauma attending to teach the second year how to recognize a particular fracture , then how to deal with it , and she was so intimidating that I didn't even feel comfortable to call her to say is this correct ? It completely changed it .

Now she was still hard on me for the rest of those five years but it did change the dynamics that she dealt with me a little bit differently than she did with other individuals . So those are my examples . You know , ask for help , be vulnerable , document document , just like how we have to do that for the medical record .

So those are some examples of the things that you can do to protect yourself from bullying , to strategize around bullying and to ensure that you have it's not always going to be smooth the training process . People are people and they have their flaws and it's a cultural issue .

But if you document your experience , that's also the ability for you to reflect on what's going on and to also help to direct individuals on how you need them to interact with you . And you'll use that from residency to fellowship , to early practice and even into your personal relationships , because

sometimes , when somebody offends me , I'm like take a second pause deep breath , stop technique . Right , exactly Before I jump off with four letter words . So yeah , that's my time .

I also want to add that you know there's also support groups that you can get from your peers , right , if you feel comfortable with your peers , you can talk to them about it . There's mentorship programs right , possibly there's counseling right , don't forget about this counseling and mental health services .

There's the employee assistance programs that all residencies have , right . That way , you can talk confidentially and address any type of work-related stress that you're dealing with . There's mental health professionals right , like therapists . We've talked about this on the show . You know there's betterhelpcom .

There's so many different avenues that you can possibly and affordably , you know , talk to someone who can help you get through this process . You may want to consider getting into some workshops , some seminars , where you can talk about some conflict resolution , maybe even deal with some resiliency , possibly .

And then don't forget about this reporting , right , dr Bill Brew talked about this . There's some ways that you can report this . You can report it up to a PD , you can report it back , report it to anyone else who you trust , but there's also anonymous reporting also .

If you don't feel comfortable with that and you know , let's real quick before we get out of here , let's talk about your book .

And I was like , but like there's a strategy behind everything , there's a blueprint behind everything , and my life really is a collection of different blueprints that I have stitched together that have led me to be successful , and I say that with no humility , that's right , big Dr Bill Brew .

I need a room full of people that are writing their book and they're telling their story and they're like let me show you how I got through this and I navigated this . Because the presence of having these strenuous situations , these toxic environments , these bullies , it's never going away . It is just a product of human nature .

We don't live in a civilization where all kumbaya , we're all going to have struggles .

But the book is about equipping you with your toolbox , with the tools that you're going to use on how to navigate those struggles so that you persevere , and so that it's not just persevering and saying I made it through , and then you're all cut up and bloody but you say I persevered and your head is held high and you're like look at what I've been through

and I'm proud of it . And you know I'm not all beat up , I'm not deranged , I'm not emotionally unstable . I can be present for my friends and my family . I'm still the same person and I'm a better person because of it and I haven't changed for the worse .

I'm now impacting my community and I'm changing the culture and you know , your whole mindset shifts when you walk into a room because now patients be like oh , the standard is a black girl with locks , is my hand surgeon , and unless she look like you , like she's a standard , like that's what I want and I'm using that as an example , but it could be whatever .

Your identity is Right Is that we are more than just the surgeon . We are the culmination of our experiences that dictate how we treat other people , and the way we always need to treat other people is with empathy and care . That's , that's the underlying message .

Maybe have Dr Bilbre back and kind of get you through these type of situations . Here's another thing that we didn can talk about it . Maybe have dr bill brew back and kind of get you through these type of situations .

You know , like , here's another thing that we didn't talk about but maybe we could talk about it on a future thing is how do you handle , like , when you're being bullied specifically with , like , the schedule right , because I know I brought it up , but we didn't really talk about the problem . Also , right , those are harder things to like .

Like , how do you justify that and stuff , and be like yo , like why am I taking all this ? But if you are experiencing bullying in residency right now , you know , share your story with us and let us know . Man , this is . This was really great , dr Bilbre . I really appreciate your time . I also appreciate your grind . Were you at Morehouse .

surgery resident from 06 to 2011 there .

Maybe I wasn't there when you were doing your rotation because I was maybe in columbus , georgia , or you know , doing an away rotation , but either way , it's great to see a fellow Morehouse .