Newsletter #5

  Your Weekly Dose of Positive Medicine 

“Emotion, which is suffering, ceases to be suffering as soon as we have a clear picture of it”

– Benedict Spinoza

Given all the many challenges in the world, how about some good news?  

Emotional intelligence, or EI, can help—both in your personal professional life.  Studies indicate that EI can help with both burnout, and with wellness. Dan Goleman is the author of Emotional Intelligence: Why it can Matter More than IQ, and Primal Leadership: Unleashing the Power of Emotional Intelligence. Dan and I recently collaborated for an article on this very topic in Harvard Business Review (HBR). The article, titled “How Healthcare workers can help themselves,” contains many practical tips specifically tailored for stressed healthcare workers in the coronavirus era.

So what is emotional intelligence? It’s simple and intuitive structure is one of its strengths:  four quadrants comprised of self-awareness, self-management, social awareness and relationship management.  Described by Salovey and Mayer in 1990, it has subsequently been shown to be a key driver of leadership success.

Self-awareness is our attunement to our emotions and their impact on others. It can be influenced by reflective practices such as journaling, 360s and other forms of feedback.  

Self-management is our ability to navigate our emotions, especially ones commonly found to be problematic such as anger and frustration. Skills in self-calming aid this quadrant.

Social awareness comprises what is commonly known as empathy. Physicians are typically strong in this quadrant but may have less skills bringing empathy to themselves and may struggle in the area of self-care. 

Relationship management is how we interact with and influence others and manage the supportive or stressful bonds of our relationships.

As with many things in life, simple does not mean easy.  There is a seemingly infinite depth in this four quadrant model. Insights about self and others, and skills in navigating these relationships, can be continually deepened and applied to enhance one’s behavior and experiences.

Increased flourishing is possible; there is definitely hope, even amidst the heavy challenges in our world. EI skills can be built, and they can help. Engage with a mentor, colleague, or coach for added support. The benefits are many—both for you, and for all the lives you touch.

Now on to this week’s ideas…but first a brief note – given the feedback from our readers, please see our new physician spotlight section at the end of this newsletter. This allows us to highlight the work of physicians and medical students making a difference in the world.

This week, we are featuring Michael Federle, MD who is Professor Emeritus of Radiology at Stanford University School of Medicine. Over his career, Dr. Federle has had a tremendous impact on thousands of residents, radiologists, and physician colleagues. His commitment to education, research and collaborative clinical care has been instrumental in advancing the fields of radiology, surgery, and transplant medicine. 



“Everybody experiences painful emotions. From anxiety and grief to shame and disappointment, emotional suffering is both universal and unavoidable.

And yet, how we respond to emotional suffering varies dramatically from person to person. For many people, emotional pain triggers a cascade of negative thoughts, self-defeating behavior, and increasingly painful emotions. While others seem to bounce back almost immediately from emotional pain.

The difference is this:
Emotional resilient people are able to experience profound levels of emotional pain without being consumed by it.”


In this terrific article, psychologist Nick Wignall outlines 5 habits that we can cultivate to improve our ability to manage difficult feelings and emotions. Contrary to what may seem like a superpower, this emotional resilience is a learned behavior available to all of us. We just need some guidance. Here it is.


2.  3 Foolproof Ways to Build Resilience During the Coronavirus Pandemic: The Three Marks of Existence

“Pain and suffering are part of the lot of all human beings, and probably all living beings. This probably does not come as a surprise. When you consider your life thus far, have you experienced suffering and difficulty? I suspect that you have. With the pandemic, certainly, there is, suffering aplenty. So, you know that difficulty and challenge are a fact of life. But do you still find yourself railing against the difficulties that life presents you? 

Or thinking something like “This really isn’t fair“ or “Why do I have to struggle in this way when others don’t?” or “Why do all these bad things keep happening to me?” Perhaps, with all the comparisons that Facebook and other forms of social media so readily offer us, “Why is their life or marriage or family so perfect when mine is a shambles?” 

Mindfulness expert and physician coach Gail Gazelle discusses how physicians can use 3 key tenets of Buddhism to improve our emotional well-being especially during this time of uncertainty and stress. Awareness that suffering and difficulty occur for all of us, that change is a part of life, and that human beings tend to bring a great deal of ego to everything they experience can fundamentally alter our relationship to suffering and ultimately increase our happiness. 


3.  I transitioned to a non-clinical career. What did that mean?

“Over the past 16 years, I’ve watched the continuous decline in autonomy and decision-making abilities for doctors in clinical practice.  I’ve heard from doctors who tell me their children don’t know them, their spouses don’t like them and that they have a hard time getting out of bed each day because they don’t look forward to living.  Many of these doctors are probably clinically depressed.  Some are suicidal.  Many just long to be doctors and take care of patients in an environment where they can flex their intellectual muscles, have more than ten minutes with a patient, and leave the hospital or clinic before 8 p.m. in the evening without bringing home two hours of charting work.  It hurts me to hear their stories, but I know there’s hope for every one of them.”


In this KevinMD article, Michelle Mudge-Riley shares her journey to a non-clinical career well before it was popular. Given how this transition positively impacted her personal and professional life, she has spent the last decade helping other physicians make similar transitions. 


Physicians Helping Physicians Spotlight

Michael P. Federle, MD 

Professor Emeritus of Radiology, Stanford University School of Medicine

1. Can you tell us a little about your career path and what led you to your current role?

Following a fellowship in Abdominal Imaging at UCSF, I joined the UCSF faculty in 1979 working at San Francisco General Hospital.  It was an exciting and challenging time to work at SFGH, where we pioneered the concept of the dedicated urban trauma center, under the leadership of Don Trunkey, the Chief of Surgery.  We were the 1st to report the value of CT in evaluation of trauma, and published a book and numerous articles on this subject. Along with great colleagues, like Brooke Jeffrey, we helped define the role of CT in evaluation of numerous infectious and inflammatory processes, which helped to revolutionize medical and surgical care of patients, essentially eliminating the concept of “exploratory laparotomy”, for instance. We also encountered a new phenomenon of young gay men and IV drug users developing aggressive, previously rare infections and malignancies, and SFGH became a pioneer in determining the etiology, spread, and treatment of what would become known as AIDS/HIV.  We played our part in reporting the imaging manifestations of the epidemic in articles and books. 

In 1989 I moved the the University of Pittsburgh Medical Center (UPMC) as Chair of Radiology.  Under the leadership of Tom Starzl, the “Father of Transplantation” UPMC became the largest transplant center in the world and trained many of the 2nd generation of the surgeons, who developed transplant centers throughout the world.  Again, we contributed to understanding the diagnostic imaging and interventional aspects of transplantation through many articles, books and lectures around the world.  Looking back on almost 50 years in medicine, I have been brought to tears watching or reading about the pioneering work of my non-radiologist colleagues who dealt with incredible challenges and even physical danger in revolutionizing the care of patients, and feel proud and professionally fulfilled in having played a small part in supporting their work. 

Throughout my career in Radiology administration, I never lost my primary focus on Radiology education, and under the inspired leadership of Ric Harnsberger, helped to found Amirsys, a company focused on delivering comprehensive training and decision-support to radiologists in training and practice.  While eventually being bought by Elsevier Publishing, Amirsys became one of the the most widely-used sources of Radiology education in the world. 

In 2008 I received an offer from long-time friends and former colleagues to return to the West Coast as Chief of Radiology Education at Stanford, a position I maintained until retiring from clinical work earlier this year.

2. Given the state of mental health in medicine, how can physicians (trained as lone wolves in a culture that often pits us against each other) form a cohesive community that can help to support each other?

Frankly, I could never understand why some physicians seem to be threatened by having to share credit with others for any success or recognition they may be seeking.  I have always sought to associate with as many highly-motivated and accomplished colleagues as possible, believing and experiencing that we could achieve much more by working together than by seeking individual glory. The most professionally satisfying highlights of my career were all initiated or highly supported by others.  If radiologists wish to truly impact patient care, it is essential to work with and educate/be educated by non-radiologists.

3. What do you enjoy most about the work you do? What are you most excited about now?

I have truly loved being a radiologist; I love the detective work of establishing a precise diagnosis, routinely drawing upon clinical and laboratory findings to refine the differential diagnosis. Again, interacting with “clinicians” has been a major source of satisfaction throughout my career. Then, I thoroughly enjoy sharing any acquired knowledge or wisdom with as many people as possible.

4. What do you wish you had known as a young physician?

I believe that having great mentors as a young physician, such as Alex Margulis, Al Moss and Hank Goldberg, helped me to avoid many pitfalls.  The screw-ups, however, are all mine!

Registration now open for the 2020 Virtual Conference

Two Quick Things Before You Go…

As physicians, now more than ever, we desperately need to do a better job of supporting each other.  If you are struggling with the current demands of medicine, please know that a FREE confidential formalized peer support for physicians by physicians is finally in place. Contact Physicians Confidential


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