#418 Resa Lewiss MD: Building a Career with Both Hands — Part Two

Hi everyone! Welcome to our show, Chief Change Officer. I'm Vizchen, your ambitious human host. Our show is a modernist community for change, for aggressive, in organizational and human transformation from around the world. Today's guest is Dr. Riza Lewis, emergency medicine physician, educator, and co-author of the book titled Micro Skills. She's also a first guest in medicine. Dr. Lewis, near early on, she didn't want to be boxed in by gender roles. She chose a specialty where she could sing fast, move freely, and lead in real time. Over the past 25 years, she's worked in trauma-based, taught ultrasound across the world, and trained others to stay calm when the room is anything but. In this two-part series, we talked about what drew her to emergency medicine, how confidence is built through protecting and preparation, and how it's more practiced behaviors, i.e. micro-skills, can shift how we show up under pressure, in life and in career. Let's get into it. When I first came through the book, my immediate reaction was ambitious, and I mean that in a good way. This show is all about making change ambitiously. I've been dying to ask you this. Why combined so many different scenarios and skills into one book? You've covered communication, networking, managing up, effortlessly, and anything. Each of those could easily be his own short book. But you decided to go comprehensive. What was your thinking behind it? The true motivation behind not only those articles, but then what became the book was to make it easier for other people. I gave them a copy of what I call the workplace playbook. If we were to make a sports reference, teams will get a playbook. And I certainly felt along the way that I did not get a copy of that playbook. And I thought all these, the example I just gave about letters of reference, if someone had just told me that, it would have saved me a few years of learning and being less efficient. And allow me to be more efficient, because I was less efficient until I learned that pearl, that lesson, that this is the way the workplace works. And so the motivation was to create a book that would help people in their careers. And not just doctors and not just women, but truly everybody. And you have highlighted that we started the book with three truths. Number one, we want the reader to think of time as a currency. Time can only be spent. You can't put it in a savings account for later, and you cannot get a refund. And that even ties back to the story I shared about the patient that died right at the beginning of the shift in front of me. Time was going. I had seven more hours. I had to keep going. And in the emergency department, we do a lot of task switching. When one thing's done, one patient gets discharged, one cut is sewn, next, next, next. That we're always pivoting. And so time is always being spent. And so we want the reader to be very intentional about how they're spending their time, and with whom they're spending their time. And the how is also what motivated the book to be a very efficient, practical, useful read. So sure you can read it, cover to cover, and you're right, it is chock full of content. But also it can be a toolkit that you can jump in and jump out of. And so that's why we wrote a very granular table of contents. So people will be like, I need to learn about running a meeting. Oh, okay, page 258 running a meeting. And we specifically wanted it to be readable. And when you're publishing a book and to make it publish a bowl, you have to somehow make the argument that it's different from all the other books. Someone that interviewed us on a podcast was like, I have a lot of these books on my shelf, and I've read a lot of them. Why should I read your book? Why is your book different? And it's a fair question because if all of us are any of us that have traveled in airports or train stations, when we go to the book shop, there's always that table of business self-help books. And this is different in that. If you've ever had the experience of picking up a book, and it's put out there as a book for everybody, but you read it and you're like, this doesn't relate to me or my experience. So this all there's not speaking to me. We wanted to write a book that made no assumptions about where someone is coming from. They're upbringing, they're financial resources, they're network, they're pedigree. No assumptions. We want to tell you these secrets, these tips, the plays in the playbook. Time is currency, it can only be spent. Number two, the world is not equal. We all have different start lines and start at different places. But by learning these micro skills, we can fill in gaps. So hopefully we all get to the same endpoint in terms of navigating and being successful in the workplace. And number three, we truly believe learning is limitless. If only it is accessible. And then speaking to accessibility means, do people have time to learn, to read a book, to watch an online video, to have a conversation with a subject matter expert? Do people have the money to pay for this education these resources? Do they go home and do they have what is called the second shift where they take care of children or elderly parents or pets? Trying to make no assumptions. So we wanted to write an efficient read that would give people access to that learning. There are so many chapters in your book. We won't have time to go deep into all of them. But this one I really want to highlight, which is polished communication. If world in the ER, traveled the world, taught across cultures. You've seen firsthand how core communication is to be a human. But today, let's be frank, people barely write, which text. And with AI, some do even bother writing at all. No real thinking, no real analysis. In a chapter on polished communication, what would you say are three key pieces of advice you would give to someone early in the career? Things they can do to really nurture in the strengthens the communication skills in today's world? So as you point out, we wrote a chapter called Micro Skills for polished communication. And audience members may say, gosh, what did they possibly write? And I will highlight as you asked a few and truly like all of them are helpful. And when we've had readers who are mid career and late career, they said, oh, I didn't think I was going to learn anything from this book. But they really point to the polished communication chapter as where they really learned specifically with email. So I'll start with email. We all think we know how to email because literally we've been doing it for years. It's a part of every industry. And you've noted, and this has been published on that younger generations don't like email. However, many people feel that email is not going away anytime soon. So we specifically talk about writing emails that people actually read because people decide whether or not to read an email within 10 seconds. And if it's a long email that's chunky and just like long paragraphs, they're less likely to read it. So we give specific advice on creating a title that you're actually telling what the email is about in the title of the email. We go into the use of tools, the two line, the CC line, which stands for carbon copy. And a favorite is the BC, the blind carbon copy. And a lot of us either avoid it because we're not sure what to do with it. Or we've been taught unfortunately to use it in a malevolent manner. In other words, to get someone trouble to create a paper trail. And we basically really feel that the BCC should not be used nefariously, that the BCC can work towards having positive communication and actually creating health for yourself. So for example, say I have to keep track of a communication. And I want to make sure I follow up a week from when I send it. When I send, for example, I send an email to you and I want to make sure I follow up, then I can BCC myself. And then a copy of that email will go right to the top of my inbox when I send my email to you. That's one example. Another example is say we're at the same company. And someone in our department gets a promotion. If you put the whole email list to the department, congratulations, Vince got a promotion. Then everybody is going to want to respond. Congratulations. Congratulations. Next thing you know we have 5,200 emails that everybody is getting to their inbox, which isn't really necessary. So what I can do is say I'm making the announcement of your promotion. I can put you in the two line. And the email list of our department in the BCC. And I can say everybody congratulate Vince. She got promoted. And then all the congratulations go back to you and me. And so you can see all the colleagues that are congratulating you. But all those colleagues don't get the 5,200 emails. There's just the final way. And this is something that relates to you and to me. We were introduced thanks to a mutual friend. So it's very simple. If you want to introduce or create and grow the network of someone in your network, say I'm going to introduce you to my friend. Tom Smith. Dear Tom, please meet Vince. Please take the conversation from here. You or Tom can reply. Thank you, Risa. I placed you in BCC. Dear Vince, when's a good time that you and I can meet? It would be wonderful to have a conversation. So then everybody knows that I have seen that this loop was closed. I don't continue to get emails as you and Tom communicate. But also it's not hidden from you that I have seen the message. Because that's a big thing. We talk about say. Say I'm going to BCU. We actually think you should tell the person receiving the email. Dear Tom, I've spoken with Vince from the C's in BCC and you and I are going to connect first. And then you can connect with her. In other words, he knows everybody knows there's no hiding because he can't see you when I've placed you in BCC. As you were talking, I kept thinking this isn't just about email etiquette. I've learned this the heartway in corporate life. Yes, there are technical things like CCC or BCC someone. But underneath that, there's an art to it. It's about respect. It's about knowing when to involve someone. When to close the loop. When not to overwhelm people with too much noise. And when silence can actually feel like exclusion. It's not just about the email. It's about how we treat people. And the more I listen to you, the more I realize. Sootful communication is relationship management. I really like that you described it as being respectful. Someone else has said that a lot of the book is about how to be kind to yourself and others. But just to close the loop on what you just shared, I have worked in places where the supervisor wanted to be CCEED on everything and be part of that dialogue. And other times where in adding the supervisor, people felt like they were being publicly embarrassed. And the person did not want to be CCEED on everything. And so I think that goes back to the Polish communication. How you communicate if you're working on a team should be discussed with the team and how everybody wants to approach this as a team communication. You are absolutely right. Some bosses want to be CCEED on everything. Even small things. Others get annoyed if you copy them too much. It's not always about the email content. It's about how it's perceived. And that's where the politics come in. Honestly, in my corporate days, I was exhausted not by the work, but by the constant calculation, such as, who do I send this to? Who do I copy? If I get it wrong, even unintentionally, it could be used against me. So it's more than just communication. It's reputation management. It shapes how people see you, how much they trust you. And that ties directly into the next point I wanted to ask you about, which is networking. I don't mean just adding people on LinkedIn. I mean real connection. When I talk to guests on the show. How do I build enough trust? Quickly enough so we can have a meaningful conversation. What's your take on that kind of relationship building? So we have a specific chapter on micro skills for networking. And we, first of all, it's important, I think, to share that each micro skill about which we speak. We start with a story, like an actual vignette that my co-author and I have had the experience within the workplace. And then that illustrates the micro skill we're teaching. We then say why the skill is important because we don't want people to just take our word for it. They have to, the reader has to think, okay, this is important. This could help me be better at work. Then we actually have what we think is a very important of a why the skill is hard, because what's easy for someone to learn and incorporate into their functioning is more difficult for someone else based on some of those other factors about culture, upbringing, personality, preferences, all these things. And then fourth, we have the critical actions where we literally break down the how to and circling back to how this book is different from other business health books. We literally tell the reader how to because I remember reading a finance book that said go start just make a budget. And I that task was so overwhelming and so paralyzing that I never made a budget. And finally, I actually found a finance book that literally walked me step by step how to manage and organize my finances that would felt very empowering. So our goal is to break things down into small micro skills, small, fundamental units, behaviors to help the reader gain the skill. So networking is huge and can be intimidating and people like like shy. So we actually just first of all talk about its importance in terms of developing your own expertise, but also in terms of creating healthy teams. And in terms of growing how you maybe find your next opportunity, a lot of this is through networking and the snowballing effect of networking, for example, Chris here and I met, he suggested I reach out to you. Now we're speaking in conversation. That's part of the snowballing effect of even we advise in that chapter of every time you meet with someone who is a mentor or someone who with whom you're connected say, hey, is there someone that you would suggest that I reach out to based on my question about this or what you're talking about. So I'm going to ask you a question about this or based on the expertise that I'm looking to bump on that one highlight specific that I really like because this is the part that I really learned personally and then have written about is networking for introverts. Many workplaces are very much built for extroverts and networking events are built for extroverts. We have highlighted ways that the introvert can actually reserve and keep their energy and not get dreamed at networking events and we talk about deciding you don't have to stay for the full extent of the networking event. You can actually go there, decide that you are going to meet three new people, exchange contact information and ask them is it okay if I follow up tomorrow or sometime next week and then you've grown your network but basically had like a tangible goal in mind and then once you achieve that goal, you can leave the event. There's other things I talk about academic medicine conferences, they're often at large hotels and they're one of the ways to conserve your energy is don't stay at the big conference hotel where there's going to be a lot of noise and sort of social overload. Stay at a nearby hotel that's quieter that allows you an easy escape or say there's someone that you really want to meet. Try to make an arrangement ahead of time to meet up with them at the event but actually from the event go for a walk have a walking meeting and return back to the event. So there are many ways to design networking experiences if you identify as an introvert that doesn't feel draining overwhelming or something that you really just detest because really it can be very enjoyable and it really is part of being healthy in your professional life. The tips you shared especially for introverts really hit home. I'm actually an introvert too. I can look like an extrovert at events or on a podcast but I've learned to manage my energy and focus it on the conversations that matter. That's my way of practicing self care and that's what sets your book apart. Most business books die trick into strategy. You start with self care and I think that's the foundation of everything. If we don't care for ourselves enough we can't effectively lead or connect well with others. So I love to hear more about that. Why did you choose to begin your book with self care? What do you want readers to take from that first chapter? I love what you just shared and to your point just because someone is an introvert does not mean that they are shy or socially awkward or socially inept. In fact they often go hand in hand and I'm very similar to you. I don't mind being in a room of strangers introducing myself meeting people but where we recharge and what are the sort of social and networking designs that give us the most energy. So our chapter one is micro skills for self care and we were very intentional in making that our chapter one because we really believe that everything starts with the self. And the better you are in terms of yourself, your health and we'll talk about what health means, the better team member you are, the better you're able to produce a high quality product. Whether that product is patient care, whether that product is a policy paper, whether that product is bringing something to market. I think everybody understands this concept of the better work product. And we felt it was very important because of everything that everybody's been reading about in terms of work out, burnout, moral injury. And there is a crisis in medicine, there's a crisis in epidemic in emergency medicine, but it is not just health care. This concept of burnout and moral injury is across many industries. And so the question is why and part of it is we know that we are not as powerful as these organizations, these companies, these industries. However, we strongly feel that we can have individual agency. So part of making micro skills for self care, our chapter one was to teach about it, talk about it, but also to inspire the reader to realize their individual agency. And going back to the health part, we don't just talk about physical health. We talk about mental health, emotional health, social health, financial health, civic health. Health is the key to everything in life. Without our health, our personal and professional lives are very challenging. And so for example, in that chapter one, we talk about sleep and we talk about deliberate rest. And I'll talk about the difference, but what I think I wanted to make sure emphasizes, we did this because it's not taught, it's not modeled, it's not loud. Certainly in medicine. And in fact, it's often rewarded if you're quote strong and you don't need to sleep or you stay up for 48 hours. Now, think goodness, duty hours and rules have changed. That's no longer legal because it really isn't safe. It's not safe for patients and it's not safe for the healthcare worker, the position in this case to be doing such things is that we tell these stories that at the time they're funny, not funny. For example, many physician colleagues we've seen walk around the emergency department working their shift while having an IV poll in their arm walking around with the poll, getting their medicine. For example, to try to abate a migraine headache or because they've been, they have food poisoning and they're trying to rehydrate themselves. I tell the story of like when driving home after an overnight shift and having not slept, hoping that I don't have to stop at a red light. Or when I lived in Manhattan, I wouldn't sit down on the subway because I would miss my stop and wake up in Queens. And the environments aren't necessarily set up to take care of ourselves or teachers how to take care of ourselves. But we strongly feel that we need to prioritize taking care of ourselves. And so like you, we talked a bit about sleep. I actually didn't realize and appreciate and believe. And so I started reading the science and also feeling the difference of when I really started paying attention to taking care of my sleep. And sleep, we absolutely need it for our health. It is actually a detoxing time for our brain. It gives our guts a rest. Sleep is exquisitely important for health also in terms of like quarters, all levels, etc. And the more you're able to stick to a sleeping pattern and get a healthy amount of sleep, everybody it varies a little bit what everybody needs. But the science or what's been published to date has been seven to nine hours, they say, whoever they are. That kind of restful, intentional sleep is really important for our health, for our mind, body functioning and to be productive at work. Another microscope we talk about in that chapter, something called deliberate rest. In the education world, they talk a lot about deliberate practice, which is actually actively applying the skills and the educational methods that you learn. And so similar to deliberate practice and working intentionally, deliberate rest is literally deliberately resting. So that can mean making sure you get your intentional sleep. It can mean taking a nap. It can mean exercising. Deliberate rest is also like having a social meal with friends who care about you, who you care about. It means reading a book not because it's going to help you be better at work, but reading it for pleasure. These sort of things that take us away from our work, the more we do deliberate rest, when we actually sit down, we're even more efficient with our deliberate practice with getting the work done. Yes, I've started putting some of these ideas into practice. Today, for example, I stepped out for work, not because I needed groceries, but because I needed fresh air and a mental brick. Sleep is still a work in progress, but I'm committed to building a more sustainable routine this year, going to bed earlier, waking up earlier. So I can stay sharp and energized with all the plans I have in mind. Before we close, is there anything you would like to add or emphasize as a final takeaway for the audience? I truly subscribe to what you're putting out into the world about we are the chief change officers of our lives. And I think that we all have the ability to do many things. And yes, I'm a physician and also I'm an educator and also I'm an author and also I'm a podcaster. And all these things are not siloed off. They're actually overlap. And the more we pursue the things that bring us joy and satisfaction, the better we are with the hats that we wear in all areas. And I think similar to writing about something that's not in healthcare, is what we learn from our fields, from our professional lives, is applicable to many people. And it's more generalizable than we would ever imagine. And also for anybody that's ever had that large project, that overwhelming goal, that habit that they'd like to incorporate, but that it just seems like too big and too undoable. I absolutely think that everything can be broken down into small intentional step by steps that are additive, that translate to other things. And it basically like we can do these big things by just breaking them down into small digestible steps. And that's the end for our two part series on Dr. Risa Lewis. Risa showed us that what stays with you isn't just knowledge. It's what you have practiced, reflected on, and done with intention. Whether it's treating patients, teaching ultrasound, or taking the garbage out, instead of clearing the table. What matters is showing up on your own terms. Thank you so much for joining us today. If you like what you heard, don't forget, subscribe to our show, leave us top rated reviews, check out our website, and follow me on social media. On this channel, you're ambitious human host. Until next time, take care.