In this episode of The Scalpel and Sword, Dr. Lee Sharma welcomes Dr. Jess Bunin to explore how self-awareness builds trust in healthcare leadership. They discuss recognizing blind spots, embracing vulnerability, learning from mistakes, receiving feedback, and creating psychologically safe teams. Discover practical ways to strengthen relationships, improve communication, and lead with greater empathy and accountability.
What if building trust in healthcare starts with understanding how others actually experience us?
In this episode, Dr. Lee Sharma welcomes Dr. Jess Bunin to discuss her book, Self-Awareness and Trust: Leading Healthcare Teams from the Inside Out. Together, they explore why self-awareness is more complex than reflection alone, how blind spots influence leadership, and why honest feedback from others is essential to understanding our impact.
Dr. Bunin explains how vulnerability, self-compassion, and accountability can transform workplace relationships. Through stories from medical education, military leadership, and clinical practice, she illustrates how admitting mistakes, recognizing others' contributions, and acting on feedback strengthen trust. The conversation also examines shame-informed mentorship, positive reinforcement, and the importance of restoring relationships rather than simply resolving conflicts. Listeners will discover practical ways to build trust, encourage psychological safety, and become more effective leaders at every level of healthcare.
Three Actionable Takeaways:
About the Show:
Behind every procedure, every patient encounter, lies an untold story of conflict and negotiation. Scalpel and Sword, hosted by Dr. Lee Sharma—physician, mediator, and guide—invites listeners into the unseen battles and breakthroughs of modern medicine. With real conversations, human stories, and practical tools, this podcast empowers physicians to reclaim their voices, sharpen their skills, and wield their healing power with both precision and purpose.
About the Guest:
Dr. Jess Bunin is a physician, educator, executive leader, and retired U.S. Army colonel whose career spans medicine, military leadership, education, and organizational leadership. Her book, Self-Awareness and Trust: Leading Healthcare Teams from the Inside Out, explores how understanding our own behaviors, biases, and blind spots can improve communication, strengthen trust, and transform healthcare teams. Her work emphasizes vulnerability, self-compassion, constructive feedback, and relationship-centered leadership.
Connect with Dr. Jess Beutin
About the Host:
Dr. Lee Sharma is a gynecologist based in Auburn, AL, with over 30 years of clinical experience. She holds a Master’s in Conflict Resolution and is passionate about helping colleagues navigate workplace challenges and thrive through open conversations and practical tools.
[00:00:00] Hello, my peaceful warriors, and welcome to the Scalpel and Sword podcast. I'm your host, Dr. Lee Sharma, physician and conflict analyst. So we talk constantly about trust in healthcare. We want patients to trust us. We want clinicians to trust administrators. We want teams to trust their leaders and leaders to trust their teams.
When trust breaks down, we hold retreats, we develop initiatives, we rewrite mission statements, we talk about culture. But what if trust starts somewhere much smaller? What if it starts with one person asking a profoundly uncomfortable question? How do other people actually experience me? How do I think I show up?
Not what kind of leader I intend to be. What happens to the people around me when I enter the room? Do they [00:01:00] speak more freely? Do they not speak at all? Can they challenge me? Do my behaviors match the values I say I hold? And when they don't, am I self-aware enough to recognize it? Because perhaps before we can build trust between people, we have to understand the person that we're actually bringing into every interaction, ourselves.
And today we're talking about the inside work of leadership: self-awareness and trust. So I gotta tell you guys, I've been very excited for this episode today because we are welcoming back to the podcast one of my favorite people, Dr. Jess Bunin. I'm so excited to talk about this conversation because she's written a book about something we don't talk about nearly enough in healthcare leadership, the internal work required to lead other people.
Dr. Bunin is a physician, an educator, [00:02:00] executive leader, and a retired US Army colonel whose career has spanned medicine, military leadership, education, and organizational leadership. Her new book, Self-Awareness and Trust: Leading Healthcare Teams from the Inside Out, examines the relationship between understanding ourselves and our ability to build the kind of trust that allows teams to function, communicate, and lead effectively.
And I love the phrase from the inside out. Jess, welcome back. Thanks, Lee. I'm thrilled to be here, and I'm really looking forward to the conversation you've literally spent decades doing this. You were a West Point graduate. You had tours in the military. you've been in situations that are very high stakes, from the ICU to the battlefield.
So before we kind of get into it, Why self-awareness and trust? Why these two ideas? great question. So part [00:03:00] of what went into this book for me was the concept of we're not doing a good job of communicating to others across difference, and I was trying to really understand what that was about.
And as I dug into that, as a dean of community, as a dean of diversity, equity, and inclusion, I was pulled into a lot of these situations where there was conflict. And invariably, the individuals involved in the conflict didn't mean to be. They just didn't understand how they were impacting each other and what was happening along the steps of the way.
And once they were made aware of that, or once the individual across the room could explain how it was impacting them and why, it was like a whole different conversation. But the individuals didn't understand who they were, what they were feeling, and how that was impacting the person across from them, and it changed everything [00:04:00] to
open up that floodgate .
And so that's the part where the self-awareness comes in for me. I think across the board, I have yet to find a study that proves that this is not true. Physicians say self-awareness is so important. If you ask them on a scale of one to 10 how important it is, they will say nine to 10 invariably. And then we do assessments of self-awareness, and we do assessments of self-perception of competence and invariably they're on the far end, meaning they're at the, like, zero to five range of this thing that they said was so important.
So something's wrong here. Something's happening with how we think it's important and how we're portraying ourselves to others and how we understand how we are affecting those around us, and that deserves some time and energy, and it deserves to be dug into. And that's where I wanted to start the book is we cannot have meaningful conversations, we cannot move systems [00:05:00] forward if we don't understand our role in the system.
And understanding our role means understanding who we are and how we impact others I love that. I love that so much on so many levels. I think it's one of those terms, we talk about self-awareness. I think one of the things we talk about, when people say, "Yes, on a scale of nine to 10 we need this," but it's really nonexistent.
And I'd love to know what you think about this. It's sort of a deceptively simple term. It seems like that would be a relatively easy thing to get ahold of in terms of being self-aware, and a lot of us may even classify ourselves, as you said, as being self-aware. So what is so challenging for us, especially as physicians and leaders, in terms of pursuing a path of self-awareness?
where do we get hung up? Yeah, I don't think that it's actually a simple term. I think there are so many factors that go into it that we are unaware of or that make us uncomfortable to think about, and so we don't [00:06:00] do it. And I think that's part of it. The other part that I think is a defining factor in how good we are at this is we have been told to be self-aware we need to spend more time reflecting.
And so individuals will journal and reflect and meditate and spend all this time alone trying to understand themselves better. And when they do that, they understand how they impact themselves. They understand how they are feeling inside. But their blind spots are growing through this process instead of shrinking, and we need someone else in, at least one person, involved in this process if we're truly going to gain the self-awareness.
And when I'm talking about the self-awareness, I don't mean I know how to soothe myself. I'm talking about how do I affect the world around me? How can I make a difference? How do others experience [00:07:00] me on a day-to-day basis? That's the part where we need help, because by definition we can't do it alone.
And this is like the heart of narcissism. It's the heart of imposter syndrome. we don't understand how others see us. As sort of a funny story, when I was an intern, I had switched over from being a psychiatry intern to a combined internal medicine and psychiatry intern. Mm-hmm. I was a mess and terrified all the time.
I was constantly waiting for someone to say, you don't belong here. You don't know what you're doing." And one day on a psychiatry rotation, one of the psychologists who had been there forever walked up to me in the middle of the hallway and he stood in front of me and he said, "You're not pulling the wool over anyone's eyes."
And I got like terrified. And he said, "You know exactly what you're doing, and you're doing just fine And it was like exactly what I needed to hear in that moment because I was so unaware [00:08:00] of the fact that others thought I was doing okay or that I was carrying my own weight and wasn't leaning on others too much.
And it just took him saying that one phrase to me for me to believe in myself enough
to keep going forward.
Oh,
that's beautiful. And I think it's so interesting because in that moment that person knew that was something that you needed to have your awareness raised to. Yeah. That you needed somebody to open your eyes to that.
And I love how you talk about blind spots as you're talking about building this process of self-awareness, which is actually a very complex process, and I'm really glad you said that. because I think on some level we think it should be easy for us to become self-aware- Yeah ... and it's truly not.
And as we sort of are engaging with these blind spots, we actually are able to not only address them, but we can see how they play into conflict. I did last year as part of a health policy fellowship a 360, leadership assessment I had never done this before, where you have to give out these questionnaires or email them to, your [00:09:00] direct reports and your superiors and all this kind of stuff.
So I sent these out to people, but part of my world is martial arts, and my two lead instructors are my children. So I also gave this 360 to my, at that point, 27 and 26-year-old son and daughter. So when we had our executive coaching session with our small group and they put our results up on the little slide projector so I could see, I knew who was what.
I knew exactly who were my employees. I knew which ones were my children. And so they're going through this with me, and what was really interesting is some of the stuff that I thought that I was good at, I was like, "Oh, I think I'm really good at X." My children were like, "Yeah, she's not so great at that."
Now you wanna get humbled? Have your children call you out on your blind spots. That's how you get humbled. And after it was all over, I don't think I ever said to them, "Hey, I saw you called me out on that." What I did is I made a conscious effort to work on those things. When I was with them, I was like, "I want to [00:10:00] get better."
And I think this is one of the things about the people, like the person who called you out in the hall and gave you that wonderful boost up That sometimes as people open up our blind spots, we don't really maybe need to tell them, "Hey, thanks for blowing up that blind spot." Right. But what we can do as a measure of thanks is be actionable and intentional about working on it.
Yes. Yeah, I couldn't agree more. And the interesting thing about this is all of these skills, you're not born with them. you're not born understanding how you impact the people around you, right? Right. This is all stuff that we can work on. And so when I'm talking about self-awareness, I'm talking about every stage of it.
I'm talking about reflecting with the help of others. I'm talking about understanding when you need to take a step back, whether that's a step back for a minute or an hour or a day or a year, but understanding when that happens. I'm talking about understanding how to have some self-compassion and when you need that, and understanding [00:11:00] how the grace you give others you don't give to yourself, and you're not aware of that in real time until someone points it out.
And then our, like you were talking about up front, the importance of understanding our biases and how they're affecting our behavior. 'Cause in general, our behaviors are often the opposite of what we say we believe, which is the worst possible situation. Mm-hmm. So we have to understand our biases. And then the last part of it for me, which I think really goes into scenarios where we're stressed, and in the military we're under chronic stress, in medicine we're under chronic stress, and then there's these acute bursts, and we have to know what our values are when we're not stressed so that when these bursts of stress come through, we can stick by our values.
We can know what it means to live by them in hard times because we've solidified them and decide what's [00:12:00] non-negotiable when we're not stressed. And so all of that to me is self-awareness, and none of that are insights you're born with. They're insights you need to work on and you need to work on with others This is awesome.
Okay, so one of the things you just talked about I really wanna talk about because I do think this is such a common thing, the idea that we have values that we hold that we may or may not be conscious of. This might be the low voice of a peer or a parent that's sort of playing as a record in the back of our heads that we maybe unconsciously don't realize are dictating our actions, but we've never spent time actually trying to understand them.
Yeah. But then it manifests when we are under, like you said, this burst of stress, this very, very difficult situation, and these things start coming out, and it's like where the heck did that come from? Yeah. I have no idea why I said that. And then of course after it's over, we have guilt and shame that we carry around with us because we had this outburst and [00:13:00] we don't understand
Why did that come out of my mouth? I have no idea. And then we walk around with the guilt and shame. But what I would love, and I would love to know what you think about this, is that as people are in this little phase of guilt and shame when they've had this, how do we move away from the guilt and shame?
Because guilt and shame is not a productive place to be- No ... at all. And when you talk about having this, being able to exercise the grace, I have been thinking about a phrase all day today of letting myself off the hook. I have had that in my head all day today, and as I have tried to let myself off the hook, I have been trying to be conscious of letting other people off the hook.
Because once I started to look at, like you said, oh my gosh, I really don't let myself off the hook very often when it comes to a lot of things. But the thing that's bad about that is I manifest that on other people. Yeah. Yeah. So I have to see it myself, and a lot of times unfortunately it is conflict and those shame interactions that make us step back Can we [00:14:00] have these interactions and instead of rolling into shame and doubt, and shame and fear, can we roll from those experience into a pursuit of self-awareness?
Yeah. Only if we are willing to be vulnerable with others. That's what's required. That is the bottom line for this. So I am a huge Brene Brown fan. early in my career when I was reading a lot of her work, she always says, "Shame cannot survive the light." I love that. And I thought this was fascinating, and I applied this so much to various times in my life where I was in a shame cycle, and it just kept getting more and more painful and worse and worse until I opened my mouth and told someone about it.
Yeah. And then they say, "You know what? That exact same thing happened to me, and I felt shame. But then this is how I got better, and I bet we can get you past this really easily too." But it requires you being [00:15:00] willing to say it out loud to someone else. So you have to be willing to be vulnerable with someone else, and you have to have someone that you really trust enough to be vulnerable with, and then that person has to have the strength to be honest with you.
Not tell you what you wanna hear, but be honest with you. And that's the key to overcoming this guilt, shame, perfectionism cycle that we let ourselves fall into. And the interesting part of what you described a moment ago is letting yourself off the hook allows you to let others off the hook. that is exactly the self-compassion cycle, right?
We build some self-awareness, we know that we have to be kinder to our own selves, and then we get more confident as we are kinder to ourselves, and it does allow us to have more empathy for others. And then this starts this beautiful, good cycle. Like I think in medicine we talk a lot about bad spirals, Mm-hmm
in critical care. we talk about the [00:16:00] triad of death. You know? Like there's a lot of badness that spirals down. But this is a great spiral where if we can be kinder to ourselves, we develop more insight, we develop more compassion, we have more empathy for others, and that feeds itself. We all start feeling better about each other, and we're all more willing to share our shame with others around us, to let it go away, to let it melt away.
'Cause as soon as we feel it and don't share it, it just grows. and makes us feel terrible about ourselves. Yeah. We have to share it with someone for it to go away. Absolutely. And I think that's one of the things that, in medicine, like we tend to be so siloed. We tend to be very lone wolf, unfortunately.
I think this is one of the ways in which we've seen that really negatively impact medicine as a community, is that we have kept ourselves locked in these little closets, and we don't have a chance to shine the light. We don't have a chance to let other people in. And so we just sit in our little closet with our shame, and like you [00:17:00] said, it grows and grows and grows and grows.
Yeah. And then it sort of explodes out against ourselves, against our patients, against our staff, against our colleagues, and it starts to, have this awful ripple effect. So yes, we wanna break that cycle. Yeah. We wanna break that cycle, but it's like, come in and sit with me in my little closet.
And you know, I don't wanna sit in here by myself. I wanna come in here, and I wanna tell you, and then you, all of a sudden someone tells you, "Hey. No, no, no. It's okay. I've been through this too. I had this happen too." And all of a sudden it's like, "Okay, I'm not the only person on the planet that's done this.
Okay. Now I can talk about it, now I can learn from it." One of the things that you mentioned as part of building this beautiful self-awareness is inviting other people into this process. How do we go about finding people to help us build a self-awareness? I was very blessed to have this 360 experience, but not every physician's gonna be able to access something like that.
So how would somebody start building this team, if you will? Yeah. Well, I talk about one of the key factors of [00:18:00] developing trust or becoming trustworthy, however we wanna look at that, is extending trust to others first, and that means revealing parts of yourself. And I didn't realize how powerful this was, until I got comfortable enough to do that.
And how that started for me, I was gay in the military for years. I was gay before Don't Ask, Don't Tell, during Don't Ask, Don't Tell, after Don't Ask, Don't Tell. Yeah ... but when Don't Ask, Don't Tell was first repealed, people were afraid that it was gonna come back, and so people were afraid that it was gonna get ripped from under our feet, and anything that we shared was gonna get us kicked out of the military the next day.
Yeah ... so we were still really scared, but I decided I had enough rank. I was in a comfortable enough position where I could be the person that could start sharing how I felt with others and what was important to me with others. And so I was doing a presentation one day where I was asking people to create a slide deck for a mentorship program, and I showed my slide, [00:19:00] and my slide had pictures of my wife and I.
It had my research interests. It had my professional interests. It had that I loved critical care, but also psychiatry. Like, all these things about me, and I didn't even really think about the fact that I had put this picture of my wife and I on this. But about a week later, someone grabbed me from their office and pulled me and said, "I have to tell you something."
And I'm like, What is it?" Yeah. I didn't know him very well. Nothing. And he said, "You know, I have to tell you that because I saw your slide last week, I went home and proposed to my partner." We've been together for a decade, and it never occurred to me that I could be in the military and be married to my partner until I saw your slide.
So it was that little bit of being willing to put it out there from me that allowed him to then be vulnerable with me. So when people see you do it, that's the key, and then it starts a cycle. And then once you know that you're willing [00:20:00] to share something, people are then gonna come to you, and it just forms these relationships in our work environments for these things that we've felt like for years
we can't talk about ,
right?
We think, "Ooh, not appropriate for the work environment." But if we aren't revealing parts of ourselves that are so important to who we are in our work environment, then we can't be there for each other fully like we need to in medicine. And I think we really, right now more than ever, need each other. We really need each other.
And so we have to be willing to share our vulnerabilities, especially as we get higher in rank, be willing to share more and more. And when I say rank, I'm not talking military rank, I'm talking academic rank. I'm talking, professional positions, hierarchical rank, in any environment.
As we get more comfortable and more established, we have more leeway to share more with less risk. And so it becomes incumbent upon our leaders to [00:21:00] be willing to do That's beautiful. I mean, I was gonna cry. Just the fact that you shared that slide changed that person's life. Yeah. The way that you opened the door for that person is so cool.
And then Him telling me that then changed how I taught and presented. Like, I made a point in every presentation I gave that year to mention something about my wife or something about my living situation or some mistake that I made so that someone else in the crowd would be more comfortable, and that was a huge learning point for me too I love this and I think this is really important.
I think this is important as part of what you're offering us in your book, but I also think this is important as educators, and I really wanna drill down on this. When I have medical students, and I just thought about it as you were talking. When I have medical students, one of the things I always tell them is, "As you are rotating with other faculty, one of the things that I'm going to do that might be [00:22:00] different from other faculty is I'm going to share with you a lot of the mistakes that I've made in my career, a lot of the things that I've screwed up on, a lot of the things I had to learn from and I had to learn from the hard way."
And one of the reasons I'm doing this is I realized as someone who's being educated as a medical student resident, a lot of times when I was on service with other attendings, I got highlight reels. They would tell me the cool stuff that they'd done, which don't get me wrong, I love hearing about your hero moments.
Yeah. I do. I love hearing those stories. Those stories are great. They make you wanna run through a brick wall. That's fantastic. But maybe those aren't gonna be the moments that I'm gonna learn from. And more than that, as an educator, as I'm teaching you, I do want you to trust me. I do want you to feel like that I'm invested in your education.
So a lot of what I would do with them is like, "Let me tell you this mistake that I made. Let me tell you this. Let me tell you... Oh, let me t- oh, here's a patient that I did this on." And one of them actually said, it's like, "You're probably the first person that's ever said that you're intentionally telling me the [00:23:00] stupid stuff that you've done."
It's like, because I had to learn to be intentional about it. and I think as you do self-reflect and realize that all
I'm telling my little medical students is all the
good stuff I've done, that's great for me, but that's not doing anything for them, and it's not certainly building that relationship.
And I always say that one of the things I value in terms of investing that way is that my medical students even from five and six years ago will still text me, will still, "Hey, this happened. Hey, I did this. Hey, just wanna let you know." How do you build that relationship? Like you said, you build it by being vulnerable.
How do we become vulnerable? It takes that step of courage to maybe let the mask drop, let the persona drop, and actually be who we are intentionally. That's hard. Yeah. It's really hard. this past year, one of my colleagues and Dr. Gail Ciariello, we wrote an article about shame-informed mentorship, and it is exactly what you're talking about.
So we talked [00:24:00] about, you know, what makes our learners prone to shame experiences? Are there previous life experiences? Are there previous, things that have happened to them in the learning environment or before that, that are gonna make them prone to shame? And then what are we looking for when we see their shame spirals?
How can we become aware of it? And for women, that tends to be saying, "Ooh, I should have done this. I should have done that. I should be different. I should be better. I should be as good as her. I should be as good as him." those sorts of things start coming out. And for men, they tend to get angry or silent.
And so again, like we know gender is a spectrum, it's not absolute at all. it tends to be more of a masculine trait to when I feel ashamed, I'm gonna lash out at someone else or I'm gonna completely withdraw. And so as mentors, we have to look for those responses so we can break it down, and then-
so we can help them navigate that shame response by doing exactly what you're saying, which [00:25:00] is s- tell them when we made this mistake. So we talk about maintaining a CV of failures so that we have this list in front of us so when someone comes to us and says, "I just almost did a chest tube on the wrong side," I can say, "Well, you know what?
When I was a fellow, my attending had to run in the room and point out to me that I was on the wrong side of the chest." and I can honestly say that to them because I have this list of things that have made life difficult for me, that have caused shame spirals in me. Why should they have to feel alone in that?
It just isn't right for them to have to feel that way. So that's a big part of it for me, is how do we, create these scenarios where we can show people that they are indeed not alone. We all make mistakes. Which again comes back to this idea of self-compassion. One of the beautiful tenets to me that has helped me the most of self-compassion is this idea of a common shared humanity, meaning we [00:26:00] all make these mistakes I'm not unique because I messed up.
we all do it, but we don't think other
people do it because they don't talk about it.
That's it. It's not something that as you're cruising through the doctor's lounge someone's gonna say, "Oh, let me tell you what I did wrong today." You're not gonna do that. But you build a community or you build a very close-knit group of people.
I have my two or three colleagues that I can text. I'm like, "Okay, I gotta tell you what I did." And one of the good things about having people like that, like you said, is I trust them to tell me if I did something wrong, if I really royally messed up, and it's "Yeah, that's what you did."
And sometimes it is me saying, "I know that I did not do this well. I know that I made this mistake. This is how I'm going to learn from it. This is how I'm being accountable to it, is I'm telling you this is what I did." And then the person who you're sitting there talking with going, "I love you. I still love you.
It's fine. You're still a good human. [00:27:00] It's gonna be okay, and you will learn from this." And sometimes that's the only thing you need somebody to say to you, is they give you a big hug and go, "You're still okay." Yeah. "You're not a bad person." Sometimes that's all that person needs to hear. Yeah. Sometimes that's all I wanna hear, is like, "You're not a bad person.
You really are okay." Yeah. Yeah. And I think that's, again, how I'm building trust with an individual. People that I trust the most with my life and my career and having that level of vulnerability, and I'm really glad you said that, were relationships that I had to reach out and trust that person first, that I had to really drop my guard first, which is really hard to do.
But then the payoff of doing it that first time, and then you feel the love and you feel that response, I think we got into last time talking about psychological safety. Ever since I think we first had that conversation, I have had more and more people really delving into this topic, and this goes hand-in-hand with exactly what you're talking about in the book Yeah.
Yeah. [00:28:00] Yeah. It's completely true. and I was thinking about that as you were talking about I have... Someone has to point it out to me or I have to admit that I made a mistake, and then I have to be willing to take accountability. And- ... I think the nice thing about this is what makes it so simple for others to trust us and to be willing to give us feedback, is just one time we have to prove to them that we did something with their feedback, right?
We have to ask them for it, and then be ready to accept it when they give it to us. But then show them how we changed our behavior, just one time. It was worth their risk to tell us because we changed something as a result of it. So the more often we can show people that, great. But it only takes one time for someone to say, "Huh, I can trust them.
I can give them feedback. They want it, and they're gonna change their behavior because of it." Yes. And I do love that you said that because this is one of those things that transcends rank and hierarchy. the ability to receive feedback [00:29:00] in such a way and then demonstrate actionability builds relationships.
I'm gonna tell the story. I'm gonna tell it really fast. At Parkland, It's not just an ER. There's a GYN ER, psych, general surgery, medicine. So they're all called the pits, and each pit has a pit boss, which is generally the residents in charge.
Sounds terrifying, by the way.
oh my gosh. it is trial by fire, 110%, 'cause you're a second-year resident. You never know what's walking through that door. it's a fun time. There was a charge nurse in the GYN ER named Wilma. Wilma had been a charge down there for 20 years. Wilma should've been a doctor. Wilma knew more about medicine than most of the residents who were running around down there.
Wilma could sit at the front desk, and I'm not making this up, she could diagnose ectopic pregnancy sitting at the front desk. She would see them and she, "Ectopic. Ectopic." So I'm down there, I'm the pit boss, and she elbows me and she says, "Lee." "Yeah, Wilma?" "Ectopic." And I look up and I see this patient.
She's sort of hunched over and she's [00:30:00] like... So I run out there. We get her into triage. Sure enough, she's got a belly full of blood. We get her up to the operating room. She does fine. and by the way, after that Wilma told me everything.
Wilma made me look good. Any time something needed to be done, Wilma's like, "Hey, Lee, do that," I would stop what I was doing and I would go do it because Wilma always took care of me, and as a result the patients always got taken care of. I was down there for something else and I saw her do that to somebody else.
One of my co-residents, she said, "Hey Doc, that patient has blank." And that doc said, "Oh, okay, Wilma, I'll get to it." And went back to work. And I was like, ' cause I saw it happen from my very eyes, that Wilma was reaching out to her, and rather than taking her up on it, recognizing her wisdom and running with it and taking care of the patient, that she didn't act on it.
And I'm willing to bet that Wilma never probably said anything to this doctor ever again. Because- she made that one overture, and rather than the person acting on it, she [00:31:00] kinda just brushed it off. and maybe she brushed it off because she thought Wilma was just a nurse, which again, is this dumbest thing you could do.
But when you're telling that story, and then you actually have something, it's like any other disease process. You can read about it in a book, but then you see it in real time, and when you see it in real time, you never forget it. Yeah. Well, and then if we take that one step further and say, well, what if now that resident who did that goes back a week later and says, "Wilma, you told me about that patient, and I didn't listen, and you were right.
And I'm sorry. I'm gonna listen to you every time from now on," it would've fixed it. Just one time she had to say it, and it would've moved on. Yeah. It's so funny, as you were talking about all that, what was going through my mind, so my equivalent of an ectopic pregnancy is a GI bleed. Mm-hmm. And so many times there are patients who are pooping red blood, and the resident or another physician will say, "Oh my God, it's a lower GI bleed."
and their nurse will say, "Nope. This is just a brisk upper." And they're right every time. But we have to learn [00:32:00] to listen to them, and it's the same exact thing. There's doctors who listen and doctors who don't, and those nurses are always gonna seek out the ones who do. Because it's too high risk- Yeah
to tell a doctor they're wrong, for a nurse. It's too high risk to tell a doctor over and over again that they need something or do something. They're gonna think they're crying wolf or something of the sort. So once that happens one time, they don't listen one time, they're not gonna keep doing it.
Exactly. And then you've not built that trust. You've not built that self-awareness of the humility that you need to be able to say, "Everybody on this planet is here to teach me. I just gotta listen." that's hard to do unless you walk that talk. That's very hard to do. I was talking about my kids doing my 360 eval.
So one of the things I actually had to learn from that is that I'm not great with that with my kids. So when my kids would give me a directive, like my daughter would say to me when I'm in public places, "You're not really good at spatially awareness in public places. Sometimes you back up without looking."
And so we were in an [00:33:00] airport, I think we were getting coffee. And I actually was with her, and I kinda stopped, and I kinda looked around and was like, "Okay, I'm gonna take a step back so you have space for your coffee." And she went, "Mom!" I'm like, "What?" And she's like, "You're spatially aware." And I was like, "Well, you've been telling me to do it."
And she's like, "Yeah, but you listened." it's something as tiny as that- Yeah ... that we actually use, and then that relationship, guess what? The next time she's gonna tell me something, and I'm very blessed to have kids that are much smarter than I am, so I have a lot to learn from them. But that's just one little penny, one little piece of investment that I'm putting into that relationship that I know is gonna compound and pay off.
Yeah. You're putting one more marble in the trust jar. Yep, 100%. we're all sort of leaders in one way or another, but we don't always think of ourselves that way. And so part of building self-awareness is realizing that we are leading wherever we [00:34:00] go and wherever we are in that hierarchy, and that's medical student up to attending.
That's child up to parent. that's front desk up to physician in the office. I mean, that exists everywhere. So how do we help people build the self-awareness to understand that whether or not they think they're leaders, they're acting as one? Well, I'm gonna take that one step further, which is a lot of times some of our more senior physicians need to be reminded that they're also followers at any given time.
And I think honestly, that begins with basic education. When we start teaching people about leadership- Mm-hmm ... we give them these terms or these philosophies or these theories of leadership which just may not be helpful. We need to give them real-life examples of what it means and what it looks like, and we need to point it out when they're doing it, right?[00:35:00]
Just like I needed my attending to say to me, "You're not pulling the wool over anyone's eyes," sometimes we just need to tell a resident one time, "You did a great job of leading on rounds today, and let me tell you why." Yeah. We do, a good job in medicine, I think, of being aware of when people do something wrong and giving them feedback.
We're not as good at seeing when they're doing something right and pointing that out, and that's what it takes to prove to someone that they're leading in these scenarios. "Wow, you just had a great interaction with that patient, and I believe you led them to change their behavior because you listened to them so well.
Like, that was a great interaction." Right? Now they know they're leading their patients. Or, "You led rounds beautifully today." now they're a leader on rounds, right? Like, they need to hear it from other people and understand the behaviors that made that come true. The same as if we want them to fix behaviors, we need to give them specific feedback [00:36:00] on that.
Like, what are the behaviors that didn't work out in that scenario? So we do it a lot with the constructive feedback in medicine. We don't do a great job with the keep doing this because this is what I see when I think of a leader. You just did that Wow I think even if we do that in clinical care sometimes, we don't think of it on a leadership basis.
I'm so glad you said that, and I think this is even a bigger deal in when we look at sort of the different generations in terms of the different age groups that are in healthcare. Because I look at, like my age group, I'm super old, and when I was going through my medical education, basically if you didn't get yelled at you were doing okay.
if you got a page that it was like, "Oh, okay, I'm about to get screamed at," that was the only reinforcement you got. You didn't really get positive or yes, you did well. And I think our generation grew up that way, so this was sort of our positive feedback was no feedback.
Yep. Which is not great, but that was sort of our process. The younger [00:37:00] medical students and residents coming through now, their expectations are much different. They do want that positive feedback. they don't want unearned positive feedback, but when they're doing something well they want to know, what did I do well?
What can I do better? my niece is a third-year medical student and she's on her OBGYN rotation, and she texted me, it's like, "I'm getting no feedback, I'm getting no feedback, I don't know what I'm doing." And I was like, "Okay." So I said, "Call me. Let's go through this." And so we went through. I was like, "What do you have tomorrow?"
"I have these surgeries." "Fantastic. This is how we're gonna prep." And by the end of that day she's blowing up my phone, "It was great. She said I did great. I'm so happy." But it really was in real time being able to see how much that meant to her. Yeah. And probably all she did the entire day was suction and hold retractors.
But she did it well, and that positive feedback got her more invested in that educational process. Yeah. So I think what your point is so important, and it's even more important as we have older attendings teaching younger
students. [00:38:00] Being able to provide
that positivity. Yeah. So one challenge I'm gonna give you towards that is that- Don't we all want that?
Like, we're saying younger generations need it or want it more. Yep. But look, I'm like- Yeah ... just the thought of you getting some positive feedback sort of made you giddy, right? Like, we all want that and need that to- Yes ... truly become our best selves. So I think that's a huge part of it. But it also reminded me of, the saying, and I don't know where it came from or who I first heard it from, but the phrase of, "If you think that the next generation needs to suffer how you suffered because you turned out okay, you did not indeed turn out okay."
You're not good. It didn't work for
You if you feel like you need to shame someone else, or torture someone else, or not give them the positive reinforcement. Oh, that's brilliant, and I'm so glad you said that because I think that is something we all need to hear.
We all need to receive that, that just because that was how you grew up does not mean that was the right way to grow up. [00:39:00] And, like you said, we all live for the lollipop. We love that. we want that. you can't find me any physician at any stage in their career that's like, "Hey, dude.
High five. That was awesome. That was a great case. I loved how you talked to that patient." You're gonna get a smile out of them. They're gonna go- Yeah ... home and they're gonna be happy. They're gonna be in the car thumping the steering wheel with their thumbs and singing along because you said something nice about that.
So- Yeah ... I'm glad you said that. I think that's so true. Yeah. And to push that one level further, I have a box on top of the shelving unit behind me that is ... a red velvet box, and inside- ... the red velvet box is every nice note I've ever gotten from anyone in my medical career. And when I'm having a bad day, I'll dig back in there to find it.
like, I always tell my students or my mentees to keep a warm and fuzzies file in their email file to any time they get something positive, like just stick it in there 'cause you're gonna need it on a bad day. or have a box, on top for any cards or notes or thank yous you get [00:40:00] along the way, or congratulations or great job, whatever it might be, keeping those sorts of things handy, 'cause it makes such a difference to remember that you do things right when you feel like, I really messed up."
I love that. I have also a box on my shelf where I keep all of those notes, and is, it's lovely to look at back, go back and look at that- Yeah ... and go, "Okay, that's good. All right." I think that, I'm so glad you do that, and that is such great advice. so I wanna end with something. I wanna give people something really practical.
Of course, we want them to get the book, 'cause the book is awesome, so we really want them to do that. These are big concepts. These are big things we're talking about in terms of building this process of self-awareness, which leads us to building relationships with trust. So we've had a lot of great things we've talked about, but if I wanna do one thing, I wanna do one thing tomorrow that's going to sort of move me along on this journey of building my self-awareness and helping me build trust into my relationships, [00:41:00] what's one thing I could do tomorrow?
Yeah. So I'm not sure this is gonna happen to you tomorrow, but the next time this happens I'm gonna ask you to do this thing. Okay. So you feel something's off with someone that you're working with, whatever that reason might be. You had some conflict at work, you feel like you're embarrassed because you did something a little wrong, or they're embarrassed 'cause they did something a little wrong, like whatever it is.
Instead of just directly diving into that and creating more conflict, saying, "What do I need to restore our relationship right now?" And asking yourself that, what's gonna restore the relationship? And then asking them, "How do I restore the trust between us right now 'cause it's important to me?" Yeah.
And going into things with this restorative mindset, so not how am I gonna get through this moment- But how am I gonna optimize our relationship? How am I gonna optimize our communication moving forward? So that's that idea of not only [00:42:00] do we wanna think about how do I get through this moment, but how do I restore things to where I want them to be?
How do I optimize the
relationship with the person in front of me ?
That is so beautiful. I love that, and I'm so glad you said that. 'Cause I think especially conflict in medicine with physicians, we like things settled, we like things cured, we like patients post-operative doing well, we like patients extubated and off a vent.
We like those things, and we tend to carry that to conflict as well- Yeah ... that we want it resolved. And so rather than actually investing and trying to bring restoration into that relationship, which prioritizes the relationship over the conflict, that's always what we want. We might rush to close it.
We might rush to go, "Hey dude, we good?" What if we're not good? Yeah. What if I don't have a chance to tell you? 'Cause If I have a conflict with somebody and I go, "Hey, we good?" And you don't have a chance to really tell, it's like, "No, we're not good. I still [00:43:00] feel like there's so much that happened that I wanna talk with you about.
We have a ways to go before I feel restored." But we don't give ourselves a chance to feel that. Like you said at the very beginning, that self-awareness and self-compassion starts with us before we can extend it to somebody else. So if we're not asking ourselves how to restore the relationship, we're very
unlikely to ask that of somebody else .
Yeah. For sure. For sure. And in medicine, in hierarchical scenarios, we do tend to have more retributive or rehabilitative mindsets. Sort of exactly what you said, like, we wanna solve the problem, punish the person, move on. We wanna fix the problem, give them some anger management and move on.
We're not thinking about who are all the people impacted and how do we restore these relationships, and I think that's where the money is. 100%. So Jess, where can people buy your book? Yeah. So my book is available on Amazon and through the American Association for Physician Leadership. But I'm gonna make [00:44:00] it easy, which is that you can just go to my website, which is www.jessbunanmd.com, and go to the book page, and it's all available there.
It'll tell you all about the book. You can find some resources. there is a worksheet about self-awareness so people can do some of this reflection and talk to some friends about it to gain some insight. Cool. There's, quizzes, there's all sorts of things that you can find on that book page. So I'm gonna direct people there.
Fantastic, and we will put that link in the show notes as well so people can go and buy the book. Jess, thank you so much for being here. I'm so excited you came back, especially to celebrate your book launch with us. This is really wonderful, and the work that you're doing with the book and with All Levels Leadership, just so grateful for what you're doing.
Yeah. Back at you, Leigh. you're doing amazing work in conflict resolution, and it's really fun to see. Thank you. For all of our peaceful warriors who have joined us today on The Scalpel and Sword, [00:45:00] thank you so much for being here. If this episode resonated with you, share it with a colleague, share it with a friend.
Definitely check out Jess's book, and until next time, be at peace