A lot of times we get it backwards. We think we're irreplaceable, you know, at work, and we really aren't. I was always putting everybody above myself, and I've realized now that I cannot be the doctor or the leader I want to really be unless I take care of myself first. Being on this leave, taking care of myself right now and modeling that that's okay, and be an even better leader when I return, that's more powerful. Welcome to Digital Voices, where healthcare and life science leaders explore the real work behind transformation. This podcast is about people, leadership, and the conversations that move healthcare forward. Now your host, Ed Marks. Hey, it's Ed, and welcome to another edition of Digital Voices. I am with Dr. Jenna Taglienti. Jenna, welcome to Digital Voices. Hi, thank you for having me. I've been really looking forward to this particular episode because I think it's going to be really helpful to every one of our listeners and subscribers. And it's really based on an article that you wrote for JAMA called Time is Finite. And so we're going to break into that a little bit. But Jenna, this would not be Digital Voices if I didn't ask you, what are the songs on your playlist? What kind of music do you like to listen to? I listen to probably all sorts, you know, the gamut. And including whatever my kids want to listen to in the car. You know, I've been listening to Ordinary by Alex Warren. And I think one of the lines in it is pretty powerful for me right now. And that is, he mentions like turning the mundane into a masterpiece. And I kind of feel that right now with just really trying to live in each moment. And then I also have fun songs like Carry On by Fine. I think that's just really uplifting and upbeat and catchy right now for me. And that's sort of where I'm at. That's great. And I failed to mention that you're the psychiatry residency training director at Mather Hospital, part of Northwell. And you love to write. And you're just a cool person. Thank you. I don't feel that cool, but thank you. I appreciate it. So we've already sort of gave a hint of what we're going to talk about, and it sort of came out in some of your answers on the playlist. But what's your life message or mantra? What are words that you live by? Yeah, and it's probably changed a little bit recently because I've been able to put things into perspective. But I think really it's just living with purpose, which is easier said than done, but fully being in the moment. And for myself, it's medicine is really important, but you can't give up the pieces of yourself that make you, you. Yeah. I love that. We're going to, we're going to break down into it. So before we get to your story, tell us a little bit about like who you are, where'd you grow up? You know, what was your life like? Sure. Yeah. So I grew up in Oklahoma in a pretty small town there. My mom was a nurse and my dad an engineer. So I, you know, was kind of around the medical world with my mom would bring home stories from the hospital, of course. And then my dad was more like analytical and structured. But I think I carry kind of both of those mindsets when I see the world and how I navigate it. And, you know, when I was younger, my sister was diagnosed with a neurological condition, syringomyelia, and required brain surgery when she was about like six years old. So I saw my parents travel all over the country consulting with different neurosurgeons, and they took me along. It was a huge learning experience and it had a big impact on how I view the medical world, the respect I have for it, the hierarchy and how you could challenge the hierarchy. And I saw my mom in particular as a nurse doing that and advocating. And I think that stayed with me. So that hasn't changed. And then I moved to Buffalo, New York, which was a culture shock at the age of 13. Um, so I, I lived there for a while, did my medical school training there. Um, and then I met my husband in medical school. He's also a doctor. He's an ER doctor. And we, um, we moved here for residency. So he, we matched at the same hospital, Stony Brook University. And we've lived here ever since. I have three kids. Uh, they're amazing, 13, nine years old and a seven year old. and I am a psychiatrist, and I run a residency training program. Yeah, that's so cool. I have to ask you, do you guys watch The Pit? We do. Yes, I really like that show. I need to catch up. I have like two episodes I have to watch right now. Especially when there's an ED doc involved, but obviously they bring in not enough is what I'm told. They don't bring the psychiatrist in enough into the program. We know a little bit about your background now, about why you chose healthcare as a career and why psychiatry? How did that come about? Yeah, I just, I think that I've always been interested in humans, right? Like that human connection, but on a deeper level, I always wanted to dive deeper. I always felt it was very rewarding to get to the inner thoughts of somebody and what they're struggling with. And I felt like psychiatry was the field that you could connect with somebody on such a deep level. I was drawn to it. I was actually thinking like along the psych lines in undergrad when I took my first psychology 101 course. And I was like, wow, this is incredible. And I kind of kept with that. And when I went to medical school, I sort of thought like psychiatry would be my place. And that is where I landed. Yeah, that's super cool. So for those who don't know, what's it like to be a residency training director? It is great. It is one of the most rewarding jobs, really. Like you can have an impact on future generations of doctors. I think that is incredible work. And it could be challenging, very, very challenging at the same time. And it's probably I've heard other people equated and I have to agree. Like, I didn't understand what they said at first, but they said this is like middle management, completely middle management. Right. You get told what to do and then you've got to execute it and like make it seem like it's your idea or you're part of it, even if you maybe don't agree or you have to sell it to the people. So I get that now I was told that years ago when I finally get it There is no other job I can imagine being happy with This is this is what I was meant to do I love being a program director. No, that's cool. Yeah. And you get to influence the next generation of psychiatrists and, and medicine. That's so cool. So cool. Was there a person in your journey that helped you see who you could be? There is, there's a lot. I think it takes a village and you as a person have to actually open your mind enough to listen, especially with maybe some really tough feedback at times. But there is one person in particular who is at our institution, and she was one of my main mentors when I first took the job as program director. And she was the one that got me through my first really difficult year when I didn't know what I was doing at all. And I, you know, thought that I had to be this person that wasn't really me. I just I was afraid to make a mistake. And so I think that put up this like force field where people didn't really see me as a person. They didn't know if they could trust me. And it led to some challenging situations. But I was able to learn a lot from it. And she's an incredible mentor, Dr. Zatilla. And she works at Northwell. I think anyone of substance has had someone help them to get there. So let's sort of transition into how we got connected, which was through the JAMA article. But let me start with this. Was there a pivotal moment in life that fundamentally changed your trajectory? One that actually changed my trajectory was probably after that first year of being a program director. The learning experience was, I mean, the learning curve was super steep. And what I learned, you know, I had to hear some really hard feedback, but actually opened my mind to listen to it and actually grow from it. And that changed my trajectory because it changed my entire outlook on the way people lead. What is effective leadership? What does it mean to do this job? Am I any good at it? Should I keep going? All of those questions, like, maybe I should just quit. This is like not working out. Um, but, uh, no, because I did have fabulous mentors. They saw something in me and somebody told me this, just be yourself. Like you're a, you're a likable person. If they just see you and see yourself, let people in a little bit more. And that was a huge life lesson. It did change my trajectory. I changed completely the way I was, I was leading. So you had another major life moment and that you wrote about in this JAMA article, Time is Finite. So can you share a little bit about the backstory and then we'll get into some of the learnings and the sharing? Yeah. So I'm still pretty early in this whole medical journey and the shock and all of that. Like I'm still in it. But I'll tell you, back in November, it was the day before Thanksgiving, bang. I went to the hospital with the worst pain I've ever had. And I thought it was a kidney stone, not that I've had them before. But I figured like everyone says that's the worst pain in your life. So I keep going. I'm like, work me up for a kidney stone. This typical doctor, like I think of diagnosing myself and, and they listened to me, they did work me up for a kidney stone. But it turned out on the CAT scan of the abdomen that they did, it caught my right lower lobe of my long. And I was lucky about that because that's what showed the tumor there and why it was causing such pain was it infected the, like the plural space there. So that was causing intense pain at the moment. And all I remember, like, I just was like, I need to get home. I'm hosting Thanksgiving. Just give, like, patch me up, get me something to get through this and then we'll figure it out later. So I actually did that. And I think they listened and discharged me because I'm a doctor. so like you know I have to learn how to be a better patient but um then I had the surgery in January and my doctors were very very sure that it was not cancer I was more worried about the surgery and the recovery and and all of that and um so it was about two weeks later and I was like I think these results should be in so I was checking the portal casually and when I opened it I was in shock. I just remember like sitting there and I'm like, I had no carcinoma. It says, I don't know carcinoma. My husband's like, what? Like that's cancer. What? So I just give him the laptop because I'm in shock, information overload. I didn't even want to know anything else in that moment. I didn't want to see any other information. So I handed that off to him to navigate. He's the one who contacted my doctor and got everything explained and helped me, helped me over those next couple of weeks while I was just completely blindsided. And then I was started getting ready to hear a little bit more pieces of information and understand things a bit better after that. Yeah. And where are you today in that journey? Yeah. So I just finished four rounds of chemo. Last week was my last round. And I'm hoping that we're good. You know, I think you learn, you live kind of scan to scan a little bit. So I have another scan tomorrow. I have a PET scan tomorrow. So hopefully that's all good. And then I have to do immune infusions for a year. I'm hoping I'll get back to work in July. I don't know what that exactly is going to look like when I return. So it's that balance. It's not falling into the same old, same old when I go back. Yeah. And I don't know what your faith orientation is, but I just want to call out to my audience that everyone prays for you. Oh, thank you. For complete healing. So that's cool. So you got this moment of clarity going through this process, and that's really what you wrote about. So tell us about that process of getting to that clarity and sharing sort of the thesis, you know, of time is infinite. I actually had to go back to my original thoughts and everything to just even remind myself where it came from in the first place. In that moment, I was really just trying to figure some things out. Like, you know, there's always stuff at work that I bring home and I think it over and think it over and just, you know, second guess myself. And it takes away actually experiencing those small moments with the kids. But I just thought that, oh, what will this like answer in this quick email? Well, that's not a big deal right now. I'll just do that real quick and off my plate. But in reality, I was doing it chronically and it was taking away from really living and experiencing those small moments. I just remember sitting in the living room. I was still recovering. I think I had just had my first round of chemo and I got to see for myself how everybody stepped in, took over my job, did it well. And I grateful for that And they still doing it really well I very very happy for my team But like I look at my kids and my husband and my family and I like well they wouldn adapt the next day Like if I was gone, it's just that it came to me and I just felt like I just felt it in my soul. Yeah. It's like the meaning of my work to quote you, meaning of my work is profound, but meaning of presence at home is irreplaceable. Because a lot of times we get it backwards. we think we're irreplaceable, you know, at work and we really aren't, especially if we're a good leader like yourself. And, uh, but we, we definitely are irreplaceable at home. So that was, that was a great, a great quote and, and something that I really took from, from your writing because everyone is afflicted with what you just described in some way, shape, or form, where we try to separate work in life and oftentimes work wins. And so you had this moment of clarity, but it came with a diagnosis. How might someone who's listening, who doesn't have a diagnosis, like a big wake-up call like you've had, kind of achieve that same clarity? Obviously, we hope that they listen and they take to heart what you're sharing and what you've written. But any other words of advice, Like, how do you make it stick or how without going through the trauma? I know, I know. And I think, I think it can stick. I think it can for people without a diagnosis. I hope it can. You have to just not forget yourself in the process. It's such a slow, you know, it seeps in and medicine. I mean, it's, it has, like I said, it has profound meaning, but it can seep in over time and take control of your whole being when there's so many other parts of life that make you you as a human. And it's important to live that. I think people need to put themselves first, especially doctors and healthcare providers put themselves first. We always are taught patient first, patient first. And I agree, the patient's got to be like, you know, first or maybe tied with you, maybe tied with you. I don't know. But I was always putting everybody above myself, the patients, the residents, the job. And I've realized now that I cannot be the doctor or the leader I want to really be unless I take care of myself first. I had a colleague, a hospital president, he's now a professor at BYU, who wrote a book that was kind of controversial at the time, but it was called Patients Come Second. And because it was the same premise, you know, you have to take care of yourself and your people, your nurses, your doctors, those sort of things, and then they will take better care of the patient. So we're actually bettering patient care and taking care of our patients or our residents by taking care of ourselves first. What other pieces of advice might you have for achieving this clarity? Again, you know, you've had this profound situation happen in your life and some people have and can relate. But for those that can't, like any other sort of tips that you might offer, maybe it's from your psychiatry profession or otherwise, that might help people just connect and stay grounded with true purpose. I've been thinking about it a lot and I have some thoughts. I think that there are some systemic issues in health care that prevent some of these things that are really needed to have that clarity and have that perspective. I've been thinking about sabbaticals for doctors. The thing is, I don't think the doctors are going to take it. So it's almost like I was talking to my dad and I'm like, do we do forced sabbaticals? So how does that work? Because I was basically, not that this is a sabbatical, this has been really hard, but I was forced to do this. I was forced to pause. And that was not a choice I would have made for myself. And I think the clarity really came with that and the ability to finally have a second to breathe and think and reflect has been really valuable. And I think all doctors and health care providers in general should have that opportunity. Without it burdening their colleagues, though, the way the system is set up now is if you take off, you take a sick day, vacation, your colleagues are having to carry your work and their work. And it's like burdening another person. So you always have that in the back of your head. And you're trying to, like, do your own health, but you're burdening someone. And so it's like that push and pull is real. And I wish it wasn't quite like that. Yeah, that's a great idea, these sabbaticals, but with the support for remaining staff, as you mentioned. Another thing I was just thinking about is sort of forced PTO, right? Because we're all type A. Like many physicians, that's just how the culture and administrators like myself, we're also their type A. We're very driven and we're almost proud of the fact that we didn't take all of our PTO and, you know, because we're such, you know, dedicated professionals, but yet it can lead to some bad outcomes, you know, especially on the home front. And so if you're forced to take PTO, that's just a practical thing, I think, that organizations could do and make sure that you take PTO. And if possible, you know, turn off. And I don't know why it wouldn't be impossible is turn off your feed of your email because, you know, we'll go take our forced PTO, but that will still be on email trying to run things. I will go into my story, but I have a similar story. And I would be in the hospital bed, you know, doing email because, you know, what would happen if I don't, you know, keep. Yep. Same with me. I was in labor multiple times with three kids and I was texting and emailing from my hospital bed. Yep. Yeah. Yeah. Yeah. Yeah. It's crazy. So there's definitely things. And then for the for those of who are watching and listening, you know, we're many of them are in leadership position. We should we should also sort of take care of our our our the people that we serve with. So you as a residency director, is that going to change or impact how you sort of run things or train? Yeah, that's a great question because I'm obviously reflecting on this a lot and trying to think ahead. Luckily, I was always really into wellness and preached wellness, and I encouraged my residents to take off. And we have these things called like wellness days where they get these, you know, a certain number where they could take off and go to their medical appointments. You know, that comes with some challenges because maybe people don't take them because they're afraid they're going to burden their co-residents. So that's another issue. But I think the part that was missing that I'm going to do a much better job is modeling it myself. So I was great with preaching and telling the residents what to do but I wasn doing it for myself And that part of leadership You have to model it And I think just being on this leave taking care of myself right now and modeling that that okay and I going to come back and be an even better leader when I return, that's more powerful for residents. And you're spot on about the modeling because no matter what policies you might have, people aren't going to follow it if they don't see their leader living it. So yeah, I would feel guilty if our CEO, he never took PTO. And so we didn't want to be that one C-suite member around the table, you know, absent. And it spoke, it was never said out loud, but man, that's the way we all acted as a result. So that's really good advice. Speaking to the next gen of clinical leaders, so not just your psychiatry residents, but anyone. What would you share in terms of, hey, how you should approach your career? I think you should approach it with purpose and intention and stay true to yourself, whatever that may be. There's no right or wrong playbook here. everybody has to figure out for themselves what is meaningful for them, both in life and in medicine, and make sure that they have all of that. Jenna, has there been any tools or anything that has shaped or formed you in terms of finding that purpose? You talked about being true to self and finding purpose. Is there anything practically you might offer people? Because it sounds really good theoretically. yeah no i mean it's yeah it's vague when i say it like that but to get into the nitty-gritty for example i still don't call myself a writer that's difficult that is something foreign to me all right so i just by accident realized i could write during this time you don't know what talents or what is hiding beneath the surface. If you don't have the time to think, like you have not a spare moment. We get caught up in just the day-to-day and getting through the day-to-day. What this has showed me is the chance to reflect and think is valuable. And it helped me, it's helping me get through this. That's my coping skill. I learned how to write. But I would say other people probably have other hidden talents like music or, you know, something else that gives them joy and helps them through difficult moments. And it's important not to give that up. I had no idea that I could write until now. This was just something new. I'm figuring it out. No, that's awesome. Hey, let's end on a kind of a fun thing, but can be practical. Something your parents made you do as a kid, where you rolled your eyes, probably like your kids do to you now. But now as an adult, you're like, man, I'm glad my parents made me do that. There's great things that like, you know, in the moment you're just you do you roll your eyes and then but you years later, you kind of like you figure it out that that actually made a difference. Um, there, my mom always taught me that if you get, um, like a bad grade or something like in, in school that you always go up to the teacher and just kind of get, ask them about it or ask them like why or what you could do better or how you can improve. And I just was like horrified, doing this as a child. But it taught me something because when I did, the teachers, they offered to stay after school or meet them before school for extra help. And it just shows that you can ask for help. I think that's what has been ingrained in me is you can ask for help. And that was taught at an early age. Yeah, that's a good one. Wow, Jeb, this has been amazing. We talked about a lot of different things. We talked about some of the music that you mentioned and it's kind of interesting how it's just all sort of flowed into the common theme of our entire discussion today. But I think one of them was about mundane, turning the mundane into a masterpiece. And then just the whole concept in terms of your life message of living with purpose and always be in the moment, obviously heavily informed by what you would share later with your cancer situation. We talk about growing up in Oklahoma and then ultimately Buffalo, where you then went to medical school and you married the love of your life that you met there and have three children. And you chose psychiatry, obviously, as a specialty to better understand people. And you do watch The Pit with your husband, who's an ED doc. And so that was kind of fun. And then we talked a lot about your JAMA article, Time is Infinite, and sort of how you came to the conclusions that you did and how important it is to put yourself first. Don't think you're replaceable at work. You are replaceable, but you're not replaceable at home. I mean, that's a big thesis. So it's really important to give your time, your energy, your mindshare to the home. At the same time, you love your work and you're very professional, but the home comes first. And so that was really good. And then we talked about some of the things that you could do definitely by modeling it to others and then talking about incorporating sabbaticals and also taking PTO. So do you take your time off when you get it? So different ways of helping others achieve that. And then, you know, taking the time to think and that's how you find your purpose. Because if you're so busy, you can't find your purpose. But if you take time to think and you might find new skills out of that, like writing or, or yeah, playing an instrument or Something like that. So we, and then how you learned from your parents also to ask questions and ask for help. So how important that is. So we talked about a lot of different things today, Jenna. I'm going to leave the last word to you. What did we miss or anything you want to double down on? Sure. I think we hit all the high points about wellness and what it means. And there's still a lot to learn there. And I don't think anybody has all the answers at the moment. But one thing I did want to say is about specifically about lung cancer is that we need to figure out a way to screen people who aren't smokers and develop guidelines there. And we need more research into that area so that people like me could could possibly get screened and maybe it's caught earlier. Yeah. Jenna, I appreciate it. Again, as we all sign off, we all say a prayer for you and for 100% clean sheet healing. And thank you for being our guest on Digital Voices. Thank you. Thank you for listening to Digital Voices. We hope today's conversation sparked ideas, reflection, and connection. 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