Episode 171 (audio)
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[00:00:00] This is the Drive Time Debrief, episode 171.
Hey guys. Welcome back to the podcast. I'm Amanda. I'm Laura. And I'm Kendra, and today you're in luck because we have a special guest, Dr. Marcy Gadda. She's an emergency physician with over 20 years of experience. She brings special insights that we haven't heard before since [00:01:00] she serves the Navajo Nation through the Indian Health Service in Gallup, New Mexico.
She's absolutely incredible. She is one of our favorite clients. They're all our favorite clients, but she's really, really special and we're honored to have her here today. Thank you so much for coming on the show and sharing your story.
Marcy, thank you so much for inviting me. I'm very honored that you asked me to be on your podcast, so thank you.
So to begin, why don't you introduce yourself to our listeners and what was the main thing that drew you to working for IHS?
Well, I can tell you a little bit about myself. My background's a little bit different. I didn't grow up in the United States. I was born here. I'm a US citizen, but I grew up in Asia as a minority and went to Europe for a while. Graduated from high school in Italy and came over to the University of Pennsylvania to do my undergraduate degree.
Did that, did an English literature degree. Kind of worked various odd jobs for several years. Decided it [00:02:00] was time to get serious and go back to med school. I went to Temple Med in Philadelphia, and while I was in med school took a month or a rotation at San Carlos Indian Reservation in Arizona, and while I was there, I thought, wow, this seems familiar.
I'm a minority. People around me don't speak English. The culture and language is completely foreign. This feels pretty good. So for me, I think that was the glimmer of recognition that first drew me to the original Native American people and I kind of sparked an interest in working with this population.
I ended up doing residency also in Pennsylvania, and as soon as I was finished with residency, came out to the Southwest to interview here in different locations. The place that resonated with me was Gallup, New Mexico. I met some really great international like-minded people here, and I joined the [00:03:00] IHS system and I lasted there about two years before I went to Albuquerque, worked for a for-profit system, worked for a not-for-profit system. But what I really liked was working in rural remote areas. So the last organization I worked with had satellite hospitals, critical access hospitals around the state. So I always made it a point to add the critical access hospital shifts into my routine. I really didn't enjoy working in the city so much, but I loved being single coverage in these small remote areas.
I was missing my rural medicine experience and I thought, well, let me go back to Gallup. And so I've been back here—this is year four that I've been back here—and I'm really glad I did come back because things have changed quite a bit. I've had some great opportunities that I didn't anticipate, one of which is I was offered the opportunity to learn acupuncture, [00:04:00] which is a traditional Chinese medicine modality. As part of my work with Indian Health, there was an organization offering scholarships for any Indian Health Service physician that wanted to—could apply. So I applied and I learned acupuncture and Indian Health Service was very supportive of that.
I was able to kind of log hours for the hours that I spent learning acupuncture, and now I run an acupuncture clinic one day a week within the family medicine clinic in addition to my emergency medicine shifts. I have a waiting list of over a hundred people waiting to come into acupuncture because they love it so much. It really merges with the traditional Navajo way of medicine. They do a lot of ceremonies. I'm not really privy to it. The Navajo folks are not very open and forthcoming with their culture. They come from a really difficult place, and so they're not always forthcoming. As an IHS employee working with this group, you're never really an insider. You know, you gotta realize you're an outsider. [00:05:00] You're not Native American. You can go and you can help them out, and you can provide medical services and listen to their stories and kind of do what you can for them. And so I really get a lot of satisfaction out of it. They're a really delightful group to work with.
My burnout story started before the acupuncture when I was working a lot of shifts in the ER here in Gallup, away from home, which I did establish a home eventually when I was living in Albuquerque.
I didn't realize what was happening until I talked to Amanda the first time and I realized that I was just on edge. I just didn't think there was anything that would help me. My mind was going in not healthy directions. My friend Safi Uba, who worked at Indian Health, told me about you guys.
So the first time I talked to Amanda, I was amazed how fast you were able to identify the problem, and once I realized that my self-talk was the problem, I was able to change it and to modify it and to slow it down.
I had just gone down this hole in my mind, like what have I done? I had a lot of regret. I was kicking myself for picking emergency medicine to begin with, thinking [00:06:00] here I am at this age, how can I possibly continue this field? I hate it now. It's really hard and I don't really want to be witnessing human tragedy every day.
Like, what? What have I done? And once Amanda and I talked the very first time and she challenged some of my thoughts, I was opened up to the realization that maybe my thoughts aren't really true, you know, so a lot of the things that you guys talk about on your podcast and in wellness really started to resonate and kind of think of things differently, reframe them, and just open myself up to the idea that what I'm doing is a choice I'm making. It's not that I have to do this. It's not that I can't go part-time, 50% if I don't want to. I'm doing what I need to do for myself and my family.
And I'm really trying to make the most of it and enjoy it as much as I can. You know, I don't think I'll do this forever, but now I have some other thoughts about what I might want to do when I'm finally finished with emergency medicine. I have a new [00:07:00] acupuncture skill that's really valuable that people love.
Like my patients just love coming in and getting their treatments. And I feel that it benefits them. I can be a healer in a different way than just working in the emergency room, you know, seeing patient after patient trying to fix everyone's problem. I've been able to kind of sit back a little bit and relax a little more than I did before.
Yeah, I'm not a type A anymore. I'm a type A minus slash B plus.
Yeah, we love the B plus. You too can be a type B plus—maybe the B. Come on. Jump on the bandwagon. It's tons of fun here.
Yeah, it's more fun.
Yeah, it's super fun. Marcy, that's amazing.
And I think that's what's amazing about having a coach is like, we were talking about this actually just before we got on this podcast, but just about like you come in the ER, you check in and you're like, I don't know what's happening, but my belly hurts. Or our patients are like, I have a headache, or I have chest pain. [00:08:00] You know, they don't come in and say, I am having a dissection, or I have a ruptured appendix. You know, like, they're not giving you the diagnosis. And I feel like people come to coaching and they don't know how to show up, but you just say like, hey, this hurts. I'm feeling—my thoughts, my this, my that. And so what's so fabulous about coaching is you're talking to another ER doc that was like, oh yeah, like for real.
I was there last week or yesterday or whatever. And then you just start to realize like you said, it didn't serve you anymore. You were like, why am I even doing this? And started questioning like there's no facts to back up these thoughts. And then they're not even true.
Yeah, I felt better immediately. I really had low hopes for how anyone could help me. I had seen a counselor during COVID. It really wasn't helpful much at all. I think the fact that you all have done emergency medicine and you've been doing it for quite a while, it gives you some credibility and gives you greater insight into [00:09:00] what we go through and what our life experience is. And so it's just a different perspective and really helpful, and I think you've put so much time and energy into learning and exploring different facets of mental health and burnout.
It's really helpful. Like to go into your Wellness 911 program, be able to get something valuable from the modules each time. You know, I listen to your Drive Time Debrief and I have a lot of driving back and forth to Albuquerque, you know, so I'm very happy and grateful that you have formed this coaching platform and I think it is very helpful.
I know it's helped me.
So what hesitations or doubts did you have before joining the program? Were you at all skeptical?
Yeah, I just didn't think anything would help. I just didn't have any hope that there was anything out there that would be helpful because I had tried a counselor. And [00:10:00] you know, he just didn't get it, you know, he just didn't understand what the life is like, you know, people outside medicine don't really see what it's like, you know, to be inside the system. So I just had kind of low expectations. I thought nothing will really help but I'll try this because it's there and Safi says it's good, and so I'll try it.
Thank you. Shout out to Safi! We love our Safi. We love her. Yes.
Yeah. Yes. We coach docs from all different specialties and some non-ER docs are like, well, would it really work for me? And we say to that, well, we talk to non-ER docs all the time. And yes, yes, it works.
Really just being in the culture of medicine gives us a shared experience and it really does [00:11:00] help to talk to someone else who knows exactly what you're talking about. Just like a returning war veteran. Those guys and women all want to speak to other returned veterans. They don't want to talk to a random therapist who doesn't know their experience.
It's kind of similar for us.
So what specific shifts or breakthroughs did you experience during your coaching?
I think the realization that the thoughts were making the problem, not the external facts, but the actual thoughts and interpretation of the experience was the problem. And that's something I can control.
I can't control the external, you know, the building I work in—yeah, just from the 1950s. I can't control that. I can't control how other people behave. I can't—there's a lot I can't control, but I can control my reaction to things that are happening and try to make my life better and, you know, do what I can do. Try to provide great patient care within the constraints of the system. [00:12:00]
So that's kind of what I've learned from coaching. Yeah. That's been helpful.
Yeah. Not to say that there are not problems in the workplace. There definitely are. Doctors love control. We just, that's kind of how we get to where we are and so all of us try to control things that aren't in our control.
And you're exactly right. That really creates a lot of discontent, unhappiness, and burnout for us. So yeah, that's a realization. I had that realization, and it's transformational. And I, you know, if you were to just tell me, well, your thoughts are causing the problem, I even now just hearing that it's like there's part of my brain that's like, no, that's not—it's not, don't, you know, all this other stuff.
But once you get some practice at really examining the thoughts and deciding which ones to keep and which to release, it does make such a huge difference.
Do you remember any one pivotal moment or insight that changed everything for you? Or was that the thing? [00:13:00]
That was it. Just realizing I was doing this to myself. It was my own negative self-talk that was making me miserable. It wasn't the external factors. I mean, the external factors are challenging, but they weren't the thing that was driving me into the ground and making me feel miserable on, you know, even on shift, off shift, I was just miserable and resentful and wishing I could switch right away and do some other kind of work and this kind of thing.
And I could have, you know, I thought about becoming a baker or going to work at Trader Joe's, you know, had all those thoughts.
Yeah, the Trader Joe's people are happy. They get to wear Hawaiian shirts, you know what I mean?
Yeah. But I'm glad I didn't do that. I'm glad I stayed and kind of worked through with you guys and was able to come out the other end with an appreciation for what we do.
Again, I feel like ultimately we do a lot of good, we make a lot of important diagnoses and are able to direct patients to the best possible outcome, which may not be our desired outcome of [00:14:00] you know, thriving in the world and living a long time. But the best outcome for them, and sometimes the best you can do is just make them feel better.
Is there any other way you would describe how your life or practice are different now as a result of coaching?
I think I just try to appreciate being in the moment. I try not to just rush through my shifts so I can do something else, which I was doing for several years. You know, I would go to work because I had to do that in order to go to the rest of my life. And now I'm trying to really engage with my work life as well and try to make the days as pleasant as possible, even though an ER is never a pleasant place for anybody.
Especially patients—most of us don't really want to be there.
Make it as good of a shift as it could be. You know, make it as pleasant as possible, and I just try to remember that when I have doubts, but keeping my mind open that, you know, change is part of life. And if things were to change and move and I needed to do something different for survival or whatever it might be, or, you know, I could be open to that. [00:15:00]
What I hear in that is that even if you were to move to a new position or a new job, what you've developed is the ability to create your own happiness and joy and to take care of yourself rather than waiting for a system to change.
That's exactly right. Yeah. No system is perfect and the systems aren't set up for our wellbeing. They're set up to perpetuate themselves in most cases. So I, number one, take care of myself. I do exercise every morning. I do yoga every morning and almost every day I go for a walk outside. And that could just be around my neighborhood. If I'm home in the mountains, I'll go on a trail. If I'm here in Gallup, there are lots of beautiful hikes here.
And the nice thing about New Mexico is we have more than 300 sunny days a year. So every day is beautiful here.
I love that. Good for you, Marcy. And can I just say that I think that is what's going to take the change. People like you, docs like you, Marcy, that are actually standing up and doing the work at work. [00:16:00]
I can tell you before I did coaching, I was miserable at work. I was lashing out. I was complaining a lot. I didn't think I could continue that way. But now I'm pretty happy at work. I show up, I take my breaks. I don't lash out anymore. I try to be pleasant, you know, as much as possible. And so it's definitely made a huge change.
So you work for IHS, which is a government position and it turns out, we've mentioned this earlier in the podcast that I've stopped calling it control freaks. I am a control enthusiast. A lot of us in medicine are, but there's something special about working in medicine within the government that you had to face a whole lot. You face a lot more challenges that go directly in the face of control enthusiasm. So I'm wondering—you know, this is not a political discussion whatsoever, but people working within the government had a pretty tumultuous early year. And so do you think that coaching made a difference for you at all going through this? [00:17:00]
That's a good question. I think it probably did because yeah, you just have to kind of not own what's happening around you. You have to respond and adapt, but it's not something you're generating, you know? And I think the coaching helped me see it in that way instead of taking things personally or being upset about the way things are going. You know, trying to reframe, you know, like there's no perfect system. I think with my personal experience of having worked in various environments has given me that perspective. Just realizing there's no perfect job anywhere. They all come with drawbacks.
There's no one perfect setting where you could work and be happy every single day. And same with the federal environment, you know, different leadership comes and goes and I've seen it happen over time and you just have to kind of adapt to the leadership du jour, you know, and then that leadership will be different next year or in five years or in 10 years, you know, you can't hold onto any one thing that tightly. [00:18:00]
Yeah. And I feel like even as physicians, we all have lots of options. I'm just really hopeful that we can continue to take care of this particular community because I think we're like a life-saving force that's helping these [people]. From a health perspective, we're doing our best to provide good services for them. So my concern there is more, not for myself, but for my patients, and hoping that they continue to get the care that they need 'cause they're a very worthy population. They've been through a lot.
Yeah, this is a little bit of a full circle moment for me because I actually remember that first call with you, and I remember the transformation that you had in just 30 minutes, and I remember getting off the phone and telling at our next meeting, Kendra and Laura, like I think, I know we're going to have Marcy on the podcast one day.
That's funny.
Because I also have felt, for whatever reason I was in my own mental prison about my own autonomy over the—I felt so stuck before in my career and that like things were happening to me rather than [00:19:00] happening for me or like that, I really felt stuck. Absolutely stuck. But then when we went through it together, there are so many amazing things about where you work, including, I was lucky enough to have met many of your colleagues. And let me tell you about the quality of your colleagues. They are incredible humans.
I know why you love working there. That, and you guys all have such a heart for your mission. It's just really inspiring and yeah, we talked about you could totally leave, but it turns out when given all of the options, there's a reason why you're there. There's so many great things about where you are and it can be true that there are a lot of challenges and there can be a lot of incredible things about where you are.
So anyway, I was just reflecting on that. Like, I knew this would happen. One day you were going to be here and we were going to be talking to you because it was so amazing.
Well, what surprised you the most about the coaching experience? [00:20:00]
I think the speed of the change. Just from going to no hope at all, and oh, I'm going to go work at Trader Joe's, you know, to like, oh, maybe I need to challenge these thoughts I'm having and reassess. And I mean, I didn't think I'd feel better after a half hour.
I thought it would—could take years, you know, years of struggle and it wasn't that hard, you know, it was just kind of a really quick transformation.
That's cool. What would you say to somebody who's on the fence? Because we're a skeptical group, turns out. What would you say?
I would say give it a try. If you're burned out, ready to switch fields, ready to get out of medicine—you know, it's taken you a long time to acquire those skills. Maybe there's a way that you can stay in it and do what you need to do to try and figure it out because you are valuable. You can do a lot of good for people, and by leaving you're taking that away from yourself and your future patients, possible patients and communities. [00:21:00]
So I would say do what you need to do, and coaching for me has helped and I would say just give it a shot. And maybe it'll work. Maybe you'll be able to stay in it for a while and really help people out.
Or if you're certain it's time to go and you need to know how to transition out. We help people do that too.
Yeah, yeah. That's probably a misconception that we're trying to force people to stay. We are not, we just want you to do... Yeah. Like if you're ready to set up your acupuncture business—oh, that will be happening.
Me too. I mean, that helps people in a different way. That's my retirement plan now.
Yeah. I love that. It's something that I have that I can help people with. So cool.
Is there anything we forgot to ask or anything that you'd like to add before we close out?
I would just say remember to refill your own cup. That's number one.
Remember to do what you need to do to feel good, be healthy, be strong. And then you can worry about helping others, you know, help yourself out first and figure out real ways to do that. Everybody's different. So what works for me might not work for someone else.
Love it. Yeah. Wow. [00:22:00]
Thank you so much, Marcy. I so appreciate that last comment because it's true. And thank you for being brave to come on here and share with the world.
Yeah. Thank you. So thank you very much.
Yeah, thanks. And we hope this podcast has helped you. Please, please, please give us a five-star rating. Leave us a review because just like Marcy said today, we all need to start doing something. That way we can be an example for the next generation coming up. So if you have any experiences that you want to talk about or if this episode resonated with you, email us at [email protected]. Don't forget to follow us on all the socials. We put up great content.
So go to Insta right now or Facebook and follow us. And we want to tell you about our next free webinar. It's coming up June 26th at 7:00 PM Central Time. It's called The Five Steps to Freedom from Burnout. You know, we're honoring that 4th of July holiday and the Fast Five Freddy Fireworks stand. So scroll down in the show notes and find the link to register today.
So until next time, you are whole. You are [00:23:00] a gift to medicine and the work you do matters.
