Speaker 1: Hello everyone, and welcome to Talk Nerdy. Today is Monday,
May eleventh, twenty twenty six, and I'm the host of
the show, Doctor Kara Santa Maria, And as always, before
we dive into this week's episode, I want to thank
those of you who make Talk Nerdy possible. I don't
even know if I said it last week, but that
was our six hundredth episode last week. We're now on
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all right, So this week I had the opportunity to
chat with doctor Grace Ferris. She's a physician in Austin,
Texas and an author illustrator of mom Milestones and more
than a million. She's also a contributor to Cup of
Joe and NPR's Health Shots, and her comics have appeared
in a bunch of really incredible publications, including The New
York Times and Vogue, and in art exhibitions all across
the US, Ireland and Austria. And she has a new
book out. It's called See One, Do One, Teach One
The Art of Becoming a doc or a graphic memoir. So,
without any further ado, here she is doctor Grace Ferris. Well, Grace,
thank you so much for joining me today.
Speaker 2: Oh, thanks for having me. It's an honor to be
here talking to you. Kara.
Speaker 1: Yes, it's gonna be a fun chat. Number one, because
you are a Texas physician and I am a born
and raised Texan who is actually working now out here
in LA So I got to ask, are you from
Texas or did you just end up in Texas?
Speaker 2: Oh? I am. I work at one of the hospitals
I work at is where I was born, and the
other one is where I volunteered in high school.
Speaker 1: Oh that's amazing. I love that so much. Oh good,
So okay, So Texas is home. You're down in Austin.
I'm actually from the suburbs of Dallas. I'm from a
town called Plano, But of course, as a Texan that
means I have family in Austin and Houston and San
Antonio area, so you know, the big great state. We're
usually quite connected. Did you ever leave the state for
any of your residencies or fellowships or did you manage
to match and stay in Texas the whole time you
were in training.
Speaker 2: I did go away, so like you, when I graduated
high school, I was like, I need to see the world,
and that starts by going to college far away. And
so I was in New England for college med school residency,
and then towards the end of that period went to
New York City, and so I was gone for twenty years.
I moved back in twenty twenty and I had actually started,
like initiated the move back when my sister had a
baby at the end of twenty nineteen, and so I
interviewed in person here in Austin February twenty twenty.
Speaker 1: Of course, and then we all know what happened. So
where were you in February? So you interviewed in person,
But then where did you go after the interview?
Speaker 2: So? Right, I was living in New York City. I
was working in midtown Manhattan, kind of behind the Lincoln
Center at Mount Sina West, and I was I was
the head of the hospitalist group there and so yeah,
from March twenty twenty until July twenty twenty, I was, yeah,
taking care of patients of COVID in Manhattan.
Speaker 1: Yeah, that is a big seems like it was a
big formative experience for a lot of folks who were
either in those kinds of positions of leadership or I've
known a lot of people who you know, they happened
to be residents or fellows at that time, which meant,
you know, all hands on deck, long hours, just being
thrown into the deep end and learning a lot about themselves,
learning a lot about what they're capable of, and you know,
how to do what we have to do when resources
are limited and there are just a lot of unknowns
and a lot of uncertainty.
Speaker 2: Yeah, definitely, I mean I was you know, I think
it's very different. And to be in training during that
period where you're you're you're it's it's not like it's
optional for you to be there. I think that you know,
where I was. I had been a hospitalist for like
ten years, and so it felt like, you know, this
is my calling and this is something that I'm here
to do. But yeah, I think being in training is
very different.
Speaker 1: Yeah, so as a hospitalist, let's talk about that a
little bit. We'll introduce the book in a second. But
a hospital list it's a term that I learned when
I first started working in a hospital not long ago.
The hospital list is kind of like the I guess
the internal medicine or I guess you could also have
a specialty, right, but it's it's sort of like the
PCP of the inpatient during their stay. Is that a
good way to think about it?
Speaker 2: Yeah? I think that, And that's definitely the birth of
the hospital medicine movement was because PCPs were getting busier
and busier and they couldn't go to all the hospitals
where their patients might be, and so they realized they
need to have like a generalist who can see these
patients in the hospital and then hopefully smooth the transition
when they're going leaving the hospital.
Speaker 1: Yeah. Yeah, that makes sense. And so tell me a
little bit about your you know, training. You told me
about where you trained, but did you study like biochemistry
and college did you actually go like the pre med
route or you know, study something different and then find
medical school and then when you were in med school
medical school, you know, how did you specialize in? What
did that process look like?
Speaker 2: Yeah? Well, so I feel like I was lucky because
in high school, at the beginning of high school, my
mom said, you need to pick a summer activity. You
can either volunteer at the Humane Society or the hospital.
Because I didn't want to go to summer camp, and
so I thought, well, I do the hospital. And I
actually thought it was so interesting. I still feel like
I'm like a hospital nerd. I just thought that this
microcosm of the world inside the hospital was fascinating, and
I liked the community and the different types of things
that were happening. And so in high school I thought, oh,
maybe I'll be a doctor, and so I ended up
applying to this eight year medical program at Brown University
where you study something other than biology as an undergrad
and then you know that you're going to go to
medical school. And so when I got there, I was
thinking about being a chemistry major, and the advisor said, well,
you know, you have plenty of time to do science,
maybe you should think about something in the humanities. And
so I ended up studying Spanish, which was basically the
best thing I could have ever done to prepare for
being a physician, because it's been this gift that I
gave myself a long time ago, learning Spanish, and it
comes in handy every day.
Speaker 1: Oh yeah, especially in South Texas, but definitely the United
States for.
Speaker 2: Sure, everywhere I've worked as a hospitalist. You know, I've
spent like, you know, a third of my career in Boston,
New York and now Austin, and everywhere I've worked, I've
had like a handful of patients every day who speak
Spanish and only Spanish. So that's been really it's been
really wonderful to be able to speak Spanish.
Speaker 1: And so what about the the art the illustrating Where
did that come about? Because of course your your new books,
the one do One Teach One The Art of becoming
a Doctor? Hu art play on words is a graphic memoir, right,
So it's like it tells your story, but you illustrated
the whole thing. So when did you start drawing?
Speaker 2: Well, that was something I didn't I drawn all my life,
and I drew a comic strip in college that was autobiographical,
and I really thought that that would be the end
of that chapter, and I didn't expect to come back
to comics. But then and over the past ten or
fifteen years, there has been a group of healthcare workers
who have started this movement called graphic medicine that is
like a kind of a movement about using comics to
explore healthcare stories. And it's a really interesting it's very interdisciplinary.
We have conferences every year and it'll be like patients
chap you know, hospital chaplains, social workers, nurses, like nurses
who draw comics, you know, people who teach about comics
and universities patients who draw comics, caregivers who draw comics.
And so I got involved with that group and from
there I got back into comics.
Speaker 1: That's so cool. I love that And what a great
way to tell a very personal story, you know, both
kind of the I guess the ease of the reader
to have the illustrations and to see what you're you know,
the scene means that you're describing. And also it really
does make for like a page turner. It makes so
that it's there is an ease in grasping the whole
story that you're telling. And so let's let's talk about
that story. How did you choose what to include what
not to include, like what your storyboard was going to
look like, because this is not fiction, this is autobiographical.
Speaker 2: Yeah, I was so when I when I was starting out,
I thought, okay, there's never been a book about medical
school and residency told in comics for them, but there
are books like that that are essays and kind of
memoir and I read a ton of them when I
was in high school and college, and I was wondering about,
you know, what a medical life would look like and
what the training would be like. And I found reading
them really interesting and useful. And so when I said
out on this project, I thought, you know, I'm going
to make something that's like those memoirs that I used
to read, but I wanted to be in comics form,
so it's kind of easy to digest, It's very accessible,
and I want to pull back the curtain on what
training is like. I don't want to lie and like
make it too optimistic or too positive, but I do
want it to be encouraging and to make it feel like,
you know, there are these beautiful moments and like moments
of discovery that can be really like yeah, really really
wonderful in medicine. So that was where I started. And
then when I started the project, I started with the
anatomy chapter where we're in this gross anatomy lab and
we're all, you know, every all of the students are
assigned to a cadaver, because I think that that in
my experience, that was like a very visceruble, visceral and
memorable part of the training experience, and that's really how
you begin. You know, sometimes people say that the cadaver
in med school is your first patient, and so all
of those memories people some people have asked me, like, oh,
how did you like remember all of this? Is Like
the part in the anatomy lab is so vivid in
my imagination because it's you know, there are so many
smells associated with it that visuals are very distinct from
the rest of training. So I started with that, and
then I tried to highlight a lot of the parts
of the story. I think I tried to pull out
parts of the training that made me feel bad or
made me feel ambivalent, to try to explore those moments,
because I think that those are our struggles that a
lot of people have. And so I think, you know,
pulling out parts about feeling terrible about educational debt or
feeling like you're not you know, fitting with the right specialty,
I think that's a way of kind of exploring how
how do you get through these moments?
Speaker 1: Yeah, and kind of I like how the journey is,
you know, in some respects obviously it is linear, right,
there is a chronology here to this story, and there's
an exposure to all of these different disciplines within the
hospital because as we know, like you work as a hospitalist,
which is like probably the most centralized and interdisciplinary, but
as we know, our healthcare system is quite siloed, and
so there are patients who see certain types of specialists
and certain types of doctors, and they do this thing
and they don't do this other thing. And sometimes when
we are not dealing with the need for that kind
of a referral, we don't know what it's like like,
you know, I work in a hospital, but I still
don't really know what it's like in sort of ob
I've never needed to be an OB I don't have kids,
and I work in a cancer center, and it's just
not something I've been exposed to very much. So I
like that you do a good job of sort of
floating around and telling stories from all of these different places,
and of course that means that very personal things come up,
whether it be the racism that you observe, the sexism
that you experience, or you know, the really beautiful and
the good stories, the stories that kind of I don't know,
help us remember our humanity and the fear and the
sadness and the hope and kind of everything in between.
I mean, it's quite an emotional journey, isn't it.
Speaker 2: Yeah. I mean I think even just going back to
that the cadaver at the beginning, like if that's your
first patient, like obviously it's like it's incredibly intense to
see a dead body, but it's also your very first
patient is giving you this like huge gift. It's such
a generous thing to like, don't your body, and so
to start medicine like with that gift it's just I think, like,
you know, the patients that you see throughout your training,
they are all in different ways, Like you know, they're
teaching you, they're like showing you a lot of like patients,
and yeah, so I think I wanted to show that
and try to make it feel more accessible for somebody
who's like a pre med or even someone who's in
high school and thinking about or even or even not
just medical, but like going into a healthcare field.
Speaker 1: Yeah. Yeah, so is that really like when you thought
about your audience for this book, you were thinking about
your role as somebody with first hand experience, especially a
woman with first hand experience, and how can you share
you know, these are some of the things that you
probably need to expect. These are some of the things
that you're probably going to be dealing with if you
are interested in a career even that's related to this,
But what about patients themselves? Right, because even if there
are some people who will never end up working in
the healthcare system, but they will encounter the healthcare that
is that is a known you know, that's a that's
the reality of life. We will all have a relationship
with the healthcare system.
Speaker 2: Yeah, well, so when I give talks on graphic medicine
to like to the med students or pre meds. One
of the things I like to point out is that
in comics, you know that one of the major parts
of comics is to have the speech bubble and the
thought bubble, and like the speech bubble has like a
very connected line, and then the thought bubble looks more
like it has a curve year line. And you're introduced
to that, like you know, usually as a kid, when
you're reading comics as a kid, And I think when
you think about the speech versus thoughts and how you
can juxtapose them in comics, like I think almost anybody
who's been in a healthcare setting, either on the clinical
side or on the patient side or the caregiver side,
you can see how very quickly comics is a great
medium for talking about that because usually whatever is being
said is not exactly what people are thinking about. And
so I think that in that way, like using comics
to explore that juxtaposition can be can be really interesting
kind of like a quick way to show that.
Speaker 1: I guess, yeah, yeah, yeah, so I'm curious, you know,
you you talk a little bit, and I sort of
mentioned this before, but you talk a little bit about
some of those rotations that you did, the exposure that
you had to different fields of medicine. Of course you do.
You go into depth about your your psychiatry rotation, which
makes me very happy because I am, of course a
clinical psychologist in a hospital, and so I wish more
physicians either paid attention during their psych rotation or actually
did a psych rotation, because that would be helpful. And
so I'm curious a about maybe what some of the
more difficult rotations were for you personally, what some of
the ones that were more meaningful for you, how you
ultimately ended up specializing where you did.
Speaker 2: I think well, And so one of the reasons that
I ended up embarking on this because I hadn't thought
that I would ever draw a graphic novel about medicine.
But I had an encounter in the hospital cafeteria a
few years ago where the med student that I was
working with asked he was thinking about going into urology,
And he asked me, oh, oh, doctor Ferris, did you
ever consider going into surgery? And I had this cascade
of memories, all negatives come back to me, and I thought, well,
I'm not going to open this Pandora's box like right
now in the cafeteria, but I would love to like
revisit this. And so, yeah, for me, the surgery rotation was,
you know, that is the hours that you have for
surgery and some of the kind of the physical the
physicality of it is punishing enough. But then the people
that I worked with during that rotation, you know, we're
not the most welcoming. But you know, one of my
roommates from med school ended up becoming a urologist, so
she probably had a very different experience than I did.
And I think that comes across in the book, that
like the power of the mentors and the people that
you meet along the way, how powerful that can be
in terms of shaping what you end up going into.
At least for me, like seeing people who were great
role models in different fields definitely kind of influenced where
I went.
Speaker 1: Yeah, it's interesting. I think we probably assume that part
of the way that people select a specialty in almost
any highly specialized field is because there's something intrinsic to
your personality or something that is you know, fundamental to
you that you're like hardwired to like this and to
not like that. But ultimately, so many of these responses
are learned, and they're learned through good and bad experiences,
like you said, good and bad mentorship or you know, representation.
There are things there are like aspects of my education
that I think about now and I'm like, if only
I had gone into that with more of an open mind,
or if only I had had a teacher that, you know,
I felt more connected to, or vice versa, maybe I
would be you know, consider myself a person who has
that interest area or a skill in that area. So
so surgery was the not so good one. What did
you really find yourself gravitating towards?
Speaker 2: Well, I did you know? I had a fantastic mentor
on psychiatry and I that rotation, I almost became a psychiatrist.
And I for even the first like ten years of
when I was doing internal medicine, I think I thought
about going back to psychiatry because I thought it was
so interesting and uh and I saw like a lot
of people feel better during that rotation, which was really
interesting and and kind of the changes in E C.
T and how that has changed a lot since like
the Bell Jar days, and it's much more successible now.
But then then right after that, I had another great
role model during internal medicine, And I think when I
saw an internal medicine that you could have a little
bit of everything, I thought that that would be a
good fit for me. And I did really enjoy some
of the diagnosis and internal medicine where there's a lot
of different you're you're taking a lot of labs and
the imaging results and the EKGs and kind of putting
them all together to get a diagnosis.
Speaker 1: Yeah, it's really interesting and I mean it's it's warms
my heart and it's hopeful to me that as a
physician who really took a lot from your psychiatry rotation,
that you probably do implement a lot of I mean
sometimes yes, it's the skills and the knowledge, but even
more than that, it's like the positioning. It's the dispositional
stuff that we learn. Like when you're working around people
with severe mental illness, all the same stuff applies when
you're working around people who are having As I always
say in the cancer center, a normal response to an
abnormal situation. Being in the hospital is so scary and
not knowing what's wrong with your health or feeling like
you're a different person because you now have a new
limitation or you know, the future is uncertain. I feel
like having a therapeutic mentality when you engage with your
patients can go such a long way.
Speaker 2: Oh definitely. I think that there are so many teaching
points and techniques that either I observed or they talked
about explicitly on psychiatry that I still use, like that
I probably used earlier today because we do, you know,
as a hospitals, I see a lot of patients who have,
you know, different psychiatric diagnoses, and sometimes they're that's an
issue too, like while I'm taking care of them. So
it's yeah, I feel like I learned so much and
I'm so grateful for that rotation because it was yeah,
just really uh like yeah, just eye opening in a
great way. Yeah.
Speaker 1: I think it can do a lot to like reduce
the stigma and the preconceived notions and sort of the
separateness of the concepts of like behavior or mental suffering.
I think that historically and societally, we we have uh it,
you know, for worse not for better, a a kind
of dualistic viewpoint which doesn't make sense, it's not evidence
based at all. But that there is brain, and there
is mind, and this is a mind thing, and that
over there is an organic thing. But that's not right,
Like everything's in the brain. And so when we make
that kind of false distinction, it can be incredibly invalidating
for individuals who are suffering from from mental health problems,
especially when there's like a dual you know, comorbidity with
something kind of severe, something that did land them in
the hospital.
Speaker 2: Yeah, yeah, I agree, And I think, you know, I'm
always like I love all the like medical expressions and
like bomos and things like that that come up, and
I tried to scatter them throughout the book. But more
recently a friend of mine who's a nurse told me
she felt like, when you're in the hospital, your hormones
are surging. And I mean I probably, like, you know,
I knew that, but I just love the way she
phreezed it, where it's like you're having this like fight
or flight response sometimes, and like even that that was
only a few years ago, but that has like reframed
a lot for me. Also is thinking about, you know,
right now, this person is having this like intense you know,
their porters all maybe up or you know, and trying
to just be as gentle as possible for sure.
Speaker 1: Like I remember, and you know, again, I work in
a major hospital here in Los Angeles, and I remember
when I had a deep vein thrombosis after a after
an iron infusion. It was a total fluke. It's a
it's a rare but very serious possible side effect, and
it did happen to me, and I ended up in
the er of my own hospital, and I had to
wait a long time because even though I was triage
level two, apparently there were a lot of twos that night.
And I remember, you know, every hour them taking my vitals,
and my blood pressure was high, like it's never been
that high in my life, like I have normal blood
pressure usually, And I was like, oh my god, is
that danger? You know, I have this clot. I'm so scared.
I just love the nurses. We're like, yeah, we've seen higher,
like you're in the yard, Like, no, I'm not worried.
And just the the ease and the way that they
were able to calm my fears, because you just don't know,
even a patient with medical knowledge and with comfort in
the system, when it's happening to you, you just don't know,
and it can be really scary being a patient.
Speaker 2: Yeah, I think that's that's stuff. Like we we see
patients who have some conditions, you know, where you're like,
this is the best case scenario, like this is gonna
be one hundred percent better and you're gonna feel better
and like, you know, but but even that person is
like totally freaking out and so yeah, trying to like
bring as much grace as possible into that situation is
always helpful. I think.
Speaker 1: Yeah, I remember having a supervisor once tell me, and
this is even more so for a hospitalist, especially because
you have probably if you look at your caseload over
the course of a year, it's like hundreds of patients.
But when I remember our supervisor telling me, like, we
always have to remember that you are their only psychologist,
Like you may have thirty forty patients, but they only
have one you. And when you remember that, I think
it can really help change the way that you talk
to your patients. It can help bring you back to
that place of like, right now there's just us and
you are the only person experiencing this, and you were
the you know, this is everything to you, whereas it's like, eh,
you're gonna be fine, like, you know, so often we
have that like, ah, this person's doing great, Like, yeah,
I'm not worried about you at all, but they're like
freaking out. You know. It's like, well, I'm sick enough
to be in the hospitalso something's going on here. Oh yeah,
it's it's such an interesting experience. So tell me, you know,
what are some of the things that you hope as
you were putting together this book and choosing which stories
to tell that, what are some of the lessons that
you are hoping that young, young physicians or people who
are interested in going into medicine would take from it.
And I guess what I mean by that, to be
more specific, is I think that the way that medicine
is taught now is a massive improvement over historical models.
But I still think we have a long way to go.
And I think that that kind of patient centered, humanistic care,
although I'm seeing more and more physicians who really prioritize
that we've all had those experiences in the hospital with
those very academic physicians who have no bedside manner and
who in some ways they may be doing a lot
of good in terms of curing or healing or treating,
but they may be doing a lot of harm in
terms of medical trauma or that person's interest or ability
to seek help in the future. So I'd love to
hear a little bit as you were, you know, working
on this book, as you were writing this story about
some of those those lessons that you integrated.
Speaker 2: I mean, I think the main one is like, yeah,
this was like there were times when this was like
a grind and it was you know, difficult, and I
didn't know if it was the right choice. One of
the themes I kind of like explored was like is
this the worst decision or the best decision? And like
how am I going to figure that out? But I think, like, ultimately,
and I still feel this way that it's you know,
it's been the such like a moving career. If it's
something you are interested in, it's definitely, like I think,
and like a gratifying and just a really interesting career.
And something I think about a lot now is that
all the people I meet who are in med school
or residency are people who felt called to inter medicine,
like after the pandemic and like so they saw like
the worst case scenario, you know, and still felt like
this might be the career for them, and I find
that very inspiring. So I did want it to feel
kind of inspirational. But also I thought, you know, looking
back on some of the memoirs that I enjoyed, I
felt like there needed to be more about debt, because
that is something that my things over many people's heads,
and I think it's not talked about as much and
is like kind of sometimes a secret shame. And so
I wanted that to be present because I can't kind
of like paper over that. And then in terms of
the like less from my teachers, some of the some
of the phrases that are sprinkled in, like I think
the wish, worry, wonder technique, that's a pallty of care
technique that's used to think about a hard decision or
to think about something that's hard, where you say, like,
you know, I wish that you know, the the cancer
wasn't get getting worse, but I like wonder, but I
worry that it, you know, might be getting worse, and
I wonder what you would want next or and that
I think that framework helps for like a lot of
difficult conversations even in just life. And so I think
that that's been really helpful to me. And then some
of the techniques, like the response of listening from psychiatry,
I think that that also is helpful kind of outside
of medicine as well.
Speaker 1: Yeah, definitely. So going back before we talk a little
bit more about that sort of that wish worry wonder framework,
you talked quite a bit about medical debt and the
fact that it is a bit taboo that it is
sort of not talked about as much. What were you
hoping to accomplish and how did you choose to approach that.
Was it really about like reducing the stigma or was
it sort of like preparing people like this is going
to be the reality of your life and like you
you need to work on your sort of financial literacy
because you're going to be dealing with this for a while.
Speaker 2: Oh. I think I think probably more just like normalizing yea,
this is this is something that's going to be there
and it kind of fades over time, but was something
that was very intense, especially early on in my training.
But I think, yeah, I think the more it's like
under discussion and the more it's like put into like storytelling,
I feel like that it will lead to more progress
in terms of how you know what options there are
for people.
Speaker 1: Yeah, yeah, and it's it's true. I mean, it's sad
that this is the reality for so many I have
so many friends who are physicians who are dealing with,
you know, quite a lot of early debt. Although you're right,
like eventually it becomes less crushing, and it's not just physicians, right,
I think increasingly this is the reality for uh, for
young people overall. Is if you if you go through
the steps to get an education, and especially if you
continue with a postgraduate degree and you have a highly
specialized education, especially in an applied field, right because of
course some research degrees are fully funded, a lot of
them are, but applied fields like medicine, like psychology, like
we have to pay for this out of pocket, at
least here in the United States. That's our model. So
not easy to do. Not easy to do when you're
not when you're young, not easy to do when like me,
I went back in my mid thirties to get my PhD.
And not easy to do as an adult either. I'm
curious about your experiences. So when you were let's say,
when you were an intern, for example, was that fresh
out were you like what twenty two years old when
you started.
Speaker 2: Oh yeah, I was twenty six, So that's generally as
young as you can be.
Speaker 1: Oh right, twenty two would be straight out of undergraduat Yeah,
so after medical school, very very yeah. Yeah, and so
and in your experience, were most of your colleagues in
the same age cohort or did you see a mix? Okay, okay, yeah.
And so of course going into a hospital where you
have young physicians who are attending, but also like people
in their sixties who are your attending physicians, maybe even older,
and working with that kind of spread of wisdom and knowledge,
and some people who are much better at keeping very
up to date with the latest, most cutting edge research,
and some people who have just so much institutional knowledge
and so much of the sort of art of medicine.
That must have been quite interesting to observe.
Speaker 2: Oh yeah, I think I had. I had a lot
of clinician too, you know, some have passed away now,
but who had Yeah, who had been involved in, you know,
discovering different antibiotics or different treatments for you know, cardiac disease,
and so that that was really inspiring. And many of
them had like trained pre you know, computers, that kind
of thing, and so had a very different approach and
had great physical examination skills. Yeah.
Speaker 1: Yeah, Oh, there's just there's so much to learn, Like
how how did you cope with the potential overwhelmed the
potential anciet of course, the questioning, you know, the self
efficacy as you were going through your training and you know,
being challenged sometimes, Like I think there is an experience
that I've had people described to me where let's say
they were the valedictorian of their high school, or they
were in the top ten percentage of their class, and
then when they made that transition from you know, academic
training to practical training, when real life kind of hit
them in the face, they were like, Okay, I don't
know nearly as much as I thought I knew, and
I need to really take a deep breath and find
my find that balance I guess between humility but also
self efficacy and the strength to keep going when you
really do start to question yourself.
Speaker 2: Yeah. I think, I mean, I definitely think that there's
some you know, the learning curve is so steep, especially
during your intern year, but I remember also feeling like
there was a lot of like kind of life learning
curve happening at that time also where I needed to
learn how to talk to someone who's like, you know,
sun had just been diagnosed with cancer or you know,
different types of scenarios that I really had no experience
with because I was twenty six. And so I think
that that part is interesting to think about, Like you're
trying to learn like all the names of the antibiotics,
but you're also trying to learn like how do I
like communicate in like a supportive way and in a
sensitive approach. Yeah.
Speaker 1: Yeah, Oh, it's so interesting, Like just the breadth and
the depth that is necessary. And do you find as
a hospitalist, you know, as somebody who's who focuses on
internal medicine, that there is just so much more breadth
right like you will you have these specialists who know
a whole lot about very specific pathologies, are very specific treatments,
and you have to know, you know, as much as
you can know about a lot of different stuff.
Speaker 2: Yeah, and that's the part I think you really need
to like hopefully have a good sense of the kind
of what when you when you don't know where you
don't know, you know, like trying to get to the
edge of your understanding, and I I mean I have
a great relationship with like our consultants, so you know,
I feel like sometimes when things seem like out of
my scope, having the consultants there has been really useful.
But I definitely I mean, now, you know, now it's
like becoming more and more common to kind of console AI,
which is like a whole new realm. Whereas for the past,
you know, for most of my practice, it you've you'll
look in like you know, you'd look in pub med
or you would look in up to date to see what,
you know, what the expert guidelines are. But now more
and more it will be open evidence, which is like
an AI platform.
Speaker 1: Yeah. I actually just like had some trainings yesterday on
the AI that we have in our hospital and kind
of the conversations around it. It being such a useful tool,
but it not being a you know, clinical decision making tool.
Speaker 2: Yeah.
Speaker 1: And I think that's the important point here is that like, yes,
we are seeing more and more increases in sort of
technological advancements, but like, ultimately healthcare is delivered by people.
You know, we can be informed by technology, and we
can use robots and all sorts of cool technology to
aid in UH in sort of sort of treatment approaches.
But people not only do they want to be treated
by people, they have to be treated by people. It's
about human connection at the end of the day, isn't it.
Speaker 2: Yeah, I think, I mean yeah, And I think that
that's going to become more and more important as like
AI becomes like more integrated into the different systems that
we're using, like for writing your notes and you know,
answering like answering chatbots, answering questions in the portal.
Speaker 1: Yeah. Yeah, oh, and that's that's always you know, it's
it's wonderful that there are so many resources available to
so many patients now, and I I always get sad
when I realized that a patient either wasn't aware of
those resources or wasn't like, you know, able to really
utilize them the way that they they could and did
feel disconnected because there's so much kind of I don't know,
there's so much technological UH work on how to help
people be more connected to and to get the care
that they need. You know, you're in a like a
major metropolitan area in Texas. How do you think that
that differs the hospital experience from I mean Texas is
a great state as a I guess a metaphor for
this from sort of rural health care, because there's still
so many individuals who are served either by rural hospitals
or more and more we're seeing that they're closing down
and they just don't have access to like, for example,
level one trauma center within hundreds of miles.
Speaker 2: Yeah, I take care of a lot of patients who
previously would have been taken care of at a hospital
that was between Austin and Houston, but that it was
a rural hospital that closed, and so now it's you know,
they they end up in Austin and they live almost
two hours away, and it's really tricky. I at our
hospital as conferences, I met a rural hospitalist who works
I think like in northern Minnesota, and yeah, his job
is very different than mine. He does a lot more
like I think. He said he sometimes will have to
do like minor surgeries, which is very different than what
I do. But here it's like a rural access hospital.
So that was really interesting and yeah, I think, and
then there's also I think in a lot of rural
praises now they're doing a lot more like Teley hospitalists
and Telly Ice you and that's incredibly controversial.
Speaker 1: Hmm oh interesting, Telly ic you. Yeah. I was like,
it's one thing if we're always call it dialo doc like,
it's one thing if you're talking about, hey, I have
a UTI, like I do not want to drive two
hours to get a prescription. I'm going to do, you know,
a zoom meeting with a healthcare provider and describe my
symptoms and do all of that. It's a It's another
thing to be like intubated without people in person. I mean,
I'm sure there are some people in person, but without
expert care managing that, you know, managing the remotely, that
can be pretty scary. Yeah, and a lot.
Speaker 2: Of pressure on the bedside staff.
Speaker 1: Yeah yeah, yeah, who maybe doesn't have uh that expertise
or that training. Yeah, that's that's right. I mean I
can imagine that, you know, as the landscape changes, there
are going to be some some pain points along the way,
and hopefully we don't learn a lot of these lessons
the hardest way possible, because of course, in healthcare the
stakes are high, aren't they. Yeah.
Speaker 2: Yeah, And I think I think that in in that
was like a big part of intern year is like
either making a mistake or thinking that maybe you had
made a mistake and not really knowing, uh, and trying
to like figure out how to like how to live
with that and how to learn from it. I think
that that facing that was like a big challenge.
Speaker 1: Yeah, yeah, I can imagine. So you know, this is
not your Is this your first full length publication? It's not,
is it?
Speaker 2: No? This is my third book. The first one was
a collection of Motherhood comics, and then the second one's
a picture book because when with the Motherhood Comics collection,
I got a lot of messages and emails from people
saying that their kids were reading the Motherhood comics, and
I thought, oh, I'll make a picture book. But now
I am getting a lot of pictures of children reading
the medical one, which I guess is okay. I mean,
you know, see one do intention has some heavy topics
in it, but I guess it's okay if they're you know,
I think that the sense and like the you know,
the reading and library world, is that if someone's interested
in something, then maybe they should read it.
Speaker 1: So yeah, that they'll seek it out anyway, And and
you know, there's something interesting too about a picture Book
because uh or Disney movies. I think they operate the
same way, Like there are levels of depth of understanding,
and so even though there's heavy topics, one of the
drawings in the book are are you know, potentially traumatizing drawings.
And so maybe you see something and you have questions
for your parents or you you want to learn a
little bit more about it. I mean, I won't go
off on this tangent because we don't have time. But
one of the things that I remember learning, you know,
when reading IRV Yallam and some of his writing about
existential psychotherapy and especially about concepts of death, is that
we don't give kids enough to credit for their how
sophisticated their understandings of death actually are just from your
exposure to the world, And so often we do them
a disservice by shielding them in a way to try
and like, yeah, of course, maintain their innocence. There's certain
things kids aren't ready to understand. But when we just
straight up ask them, what do you think, well, what
do you think happens? What do you think that word means?
I think a lot of people are really surprised by
by how much the narrative that they have developed based
on their sort of cognitive level, is is a really
meaningful and realistic one for where they are. So I
could imagine a kid reading your book would take from
it what they can and maybe there's certain things that
are more sophisticated or above their head, but but that's okay.
Speaker 2: Yeah. Yeah, I've gotten a bunch, you know, from friends
whose kids have read the book. They've sent me sweet
quotes that were the kids, you know, the ones who
are children of doctors, have said, oh, I didn't realize
that you you know, you did this in the anatomy lab,
and you know I have Another friend's daughter has read
it twice and I said, I saw her and I said, oh,
I didn't realize you were interested in medicine. And she's
ten and she said, I'm not. I'm going to be
a physicist. Okay, But yeah, so that's that's been on
expect Oh.
Speaker 1: I love that. And of course we all know the
power of representation, right that, like little girls, for example,
are never going to see themselves as doctors when they
grow up. If they don't see women doctors, they just
like you have to see the representation to kind of
approximate it and to know that it's it's feasible for
you as well. And so what a wonderful way to
show that representation in the intentionality of your doctors where
you have, or just of all the healthcare professionals where
you have, you know, people of different ethnicities, people of
different genders, people of different body shapes and sizes. Like
it's just it's a very important thing to do.
Speaker 2: Yeah, And I you know, when I was embarking on this,
like as a pre med I had a lot of
I always thought like, oh, I'll probably end up like
having kids, and I was very curious like what the
doctor life looked like in particular because I just had
not known any doctor mothers, and I really wanted like
a visual of like how how does that feel and
how does it look? And so definitely wanted to have
a little bit of that kind of at the end,
you know, for people who are thinking that they, you know,
want to have that kind of life.
Speaker 1: The doctor mom. I love that, Yeah, the representation of
not just a doctor mom at the end, but also
the pregnant doctor, which I think is an important representation,
like my my primary care just to I think she
actually just finally returned for maternity leave, but definitely before
she left for maternal leave, she was real pregnant the
last time I saw her, and I was like, Oh,
this is just so lovely to see and for it
to be normalized, it's necessary, you know, like moms are
people too. Moms are doctors to and doctors are moms to.
Speaker 2: I am. I felt like my first pregnancy that was
like one of my more beautiful times of being a
doctor because I had patients like it was kind of
like I had you know, it wasn't a medical problem,
but it was like I had something for them to
discuss with me, and you know, they would I would
be trying to talk to them about, you know, their
antibiotic regimen or something, and they would be like, well,
you need to sit down.
Speaker 1: How are you feeling.
Speaker 2: Do you think it's a pool?
Speaker 1: Yeah?
Speaker 2: And I thought that was wonderful because it was like
this brief period where the you know, the like there's
such an imbalance in the relationship and it was this
brief moment where it was like tilted a little bit
and such a like a pleasant way, and I you know,
some people would ask if they could touch my belly
and it was like sure, like, you know, I don't
have any issues with that, so I didn't have any
kind of like disturbing experiences. It was like a very
positive pregnancy.
Speaker 1: That's good to hear, and you're right, like it's not
a quote unquote medical condition. Although manage care. Maybe it's
not even so much managed care. It's more like our labor,
like our department of labor that treats it like one.
Like a lot of people have taken medical leave for
pregnant Like what that is insanity? Yeah, disability, Like are
you kidding me? But along that same line, you know,
there is a kind of empathic power there that I
think patients also experience when they have a provider who
has like an obvious I don't know, like a dex
calm on their arm, or like a provider who's in
a wheelchair, or a provider who clearly has you know,
both the provider and the patient relationship with the healthcare system, definitely,
there's a lot of empathy there when you know, when
you've been to the er, when you have to see
a specialist, when you yourself have experienced the system, you're
going to be more conscientious of the fear and the
frustrations that the patient has navigating that same system.
Speaker 2: Yeah, I definitely, I mean yeah, because I was like
twenty six and then like by the time I was,
you know, graduating, I was still very young. I think
having that experience, even though it was not like a
bad diagnosis or it's still yeah, like having to navigate
all of the the you know, the healthcare and then
the birth. You know, the birth couldn't have been any
smoother or you know, like it was a very easy berth,
but it still felt, you know, so terrifying, and like
the clinical aspects of it felt just like very destabilizing.
And so I think I feel like that was definitely
helpful for my like later practice of medicine.
Speaker 1: Yeah, I guess that's that's you know, if there was
something that comes up for me that I'd like to
close with, but of course, if there's anything that comes
up for you, I'd like to touch on them as well.
But it's sort of you know, I worked for many,
many years outside of this field. I worked as a
science journalist and you know, television host for fifteen years
before I went back to school. I started as a
licensed psychologist in my early forties, and so I'm coming
into it with a lot of life experience, with a
lot of you know, and I'm working in a cancer setting.
I'm doing a lot of palliative work, a lot of
end of life work, and I feel like a lot
of that stuff prepared me in a way, and of
course my exposure to the experiences of my patients continues
to help me grow. I don't know what it would
have been like to have been doing this at twenty
six and in my forties. And I'm curious from you,
you know, as you continue down this path, as you
continue to age in this role, what are some of
the differences that you've noticed between being a young doctor
and being, you know, a more seasoned attending physician.
Speaker 2: Yeah, well, I think I definitely think that how more
life experiences. I mean, we you know, I remember in
med school because I was twenty two, but we had
some people who were, you know, had taken a couple
years off to teach or do something else. And I
remember at the time, every thought, oh my god, they're
twenty six and they're just starting medical school. How that
is that's so irresponsible? Yeah, so old, how can they
do that? And we even had one forty year old
who was starting med school and we were like, how
could that be allowed? And now when I think about
it now that I'm in my forties, I think, you know,
I mean, sometimes it's nice, like, you know, there's the
med students. I just met a bunch of twenty two
year old med students yesterday and they were so optimistic
and energetic and that was lovely, and so sometimes that
can be really wonderful to have that energy. Yeah, and
so I think everybody's like bringing different skill sets to
the table. And you know, we recently had one of
our med students a few years ago was in her
forties and now she's like a wonderful palliative care doctor
in the community and it's great to have her. And
so I think, you know, I feel like right now
in healthcare there's like a place for everybody if you're
interested in like you know, but definitely I think now
in my forties, especially having kids now, you know, sometimes
I'll see like an eight year old guy named Floyd,
and I'll think, oh my gosh, like eighty one years ago,
someone was like, I'm going to name this baby Floyd,
you know, and it's just like this is I think
that makes it feel a little bit different now, and
especially when I see, you know, because I'm taking care
of adults. So sometimes I'll take care of patients, adults
with Down syndrome or other adults who have different types
of cognitive limitations, and their parents will be there, and
so it's I think it's just like the parenting journey
has brought like a different lens also.
Speaker 1: But yeah, so it's not even just age. It's also
being a mom and having that kind of relationship in
your life that you didn't have when you were twenty
six or twenty four.
Speaker 2: Yeah. Well yeah, Now if I have a patient who is,
you know, in the hospital, a kidney infection or something,
and she tells me that she has like a three
year old at home, I'm like, oh my goodness, Like,
you know, just relaxed. I know you're here for a
medical thing, but like I know, you're also probably really tired,
and like, I hope you just get to watch some
TV and like take it easy.
Speaker 1: Oh that's hilarious. Yeah, well, gosh, Grace, I'm curious if
there's anything that we didn't touch on that you were
hoping to share, you know, something you would be remiss
and not sharing with with the listeners.
Speaker 2: Anything that I missed, I think, well, one thing that
this is hasn't come up in a while, but sometimes
people feel like comics are infantilizing or and so I think,
you know, there have been a lot of great graphic
novels and graphic memoirs over the years, but and I
think in other cultures comics for adults are kind of
more normalized. But yeah, this is definitely meant to be
a book for adults, and it deals with dark topics,
and but it is meant to feel kind of easy
to read, easy to get into. It's you know, you
could read these types of books like in a couple
of hours, so they're very fast, but hopefully like bring
some humor and then also some interesting thoughts.
Speaker 1: Oh yeah, I love that. Gosh, Well, everybody, the book
is See One, Do One Teach One The Art of
Becoming a Doctor, a graphic memoir by doctor Grace Ferris Grace,
thank you so much for being here with us today.
Thanks Cara.
Speaker 2: This is a fun convert station.
Speaker 1: Definitely, yeah, so fun, And everybody listening, thank you for
coming back week after week. I'm really looking forward to
the next time we all get together to talk, nerdy,