EP 17: Overcoming Imposter Syndrome

In this episode of the Hope4Med podcast, we have an in-depth conversation with PA Daryle Blackstock who shares his story of overcoming imposter syndrome throughout his journey as a healthcare professional.

[00:00:00] Dr. JB: Ever wish for a safe place to have conversations that need to be had? A place where you could say the things that need to be said? Well, welcome to Hope4Med. This is Hope4Med, med. New day for med, med. For us, by us, and just for us. This is Hope4Med, med. This is Hope4Med, med. New day for med, med. For us, by us, and just for us. This is Hope4Med, med.

[00:00:38] Hi, everyone. Welcome back to the Hope4Med podcast with me, Dr. JB, as your host. Today, we have a special guest, his name is PA Daryle Blackstock, he is a distinguished fellow of the American Academy of Physician Assistants and is a certified clinical transplant coordinator. He currently serves as a director of clinical transplant operations at New York Presbyterian Hospital, Columbia University Medical Center, Morgan Stanley Children’s Hospital, and Weill Cornell Medical College, and in his spare time, he is completing his PhD in public health. Welcome to the show, PA Blackstock.

[00:01:18] PA Blackstock: That is wonderful, thank you so much. I’m still laughing at “it in my spare time.” Thank you so much. I’m excited to be here and to speak with you and all of your listeners. Thank you.

[00:01:30] Dr. JB: All right. So, tell me what made you decide to become a physician assistant in the first place?

[00:01:37] PA Blackstock: You know, I have a family full of medical providers. My mom was in nursing school when I was born, so I always say I have 30 plus, if not more, unofficial godmothers who are in the nursing profession. And I got bit by the bug, you know, just watching her work, watching her enthusiasm– she trained as a midwife– you know, reading her textbooks and just realized that I had a passion for medicine and helping folks. And through my own medical journey interacting with PAs and learning about the profession from high school or grade school, maybe even earlier, I said, wow, this is an interesting profession and I was just drawn to what it is that they do and the lifestyle, and being able to work in multiple specialties, and be able to have that freedom. And I, the more I researched, the more I fell in love, and I said, yeah, this is, this is it, this is for me. And that’s what drew me into the profession. And, you know, just being able to connect with the patients and being able to sit at the bedside translating and making sure that they understand everything that’s coming at them, and allowing me not just to be a physician assistant, but to be an advocate, patient advocate, if you will.

[00:02:52] Dr. JB: That’s awesome. And so when you finished your PA training, what did you do? What was your first specialty?

[00:03:01] PA Blackstock: So, I loved orthopedics and so I started my, my first job was in orthopedics, but of course, coming out of school with loans and really getting the taste of a paycheck, I found myself, you know, working per diem in different areas of the hospital, including– so, you know, orthopedics is in OR and in clinic, but then on my off days, I would find myself working in the emergency room, seeing the ortho patients that came in, and as part of our jobs, even though we were orthopedic surgery, we covered general surgery, so I was picking up a lot of skills in and out of the OR, and it was great. And after that, I got a job working in trauma and critical care at a major medical center and due to circumstances, we ended up covering more than just trauma/critical care and, and included transplant, and it was a major transplant center at that time and I got bit by the transplant bug. You know, it’s more than just surgery, it’s more than just medicine, it’s more than just getting these patients pre-op. You really shared in the excitement and the enthusiasm of playing a role in this gift of life process, you know? To know that someone who died was, or alive, gave up their organs to help save someone else. It was just a beautiful thing. And from there– I, I know I’m, I’m giving you the whole spiel here– but then I went on to become a transplant coordinator and worked on the outpatient side and helped to make those calls at nighttime to say, listen, we have an organ for you. And it’s just been a wonderful journey in the field of transplant as a PA.

[00:04:38] Dr. JB: Wow. That is quite a journey. And this was over how many years?

[00:04:43] PA Blackstock: So I graduated in 1997 from the Bronx Lebanon PA program after graduating from Rutgers, I did my undergraduate first and then completed the PA training after. So, it’s been since 1997.

[00:04:58] Dr. JB: Wow. Yeah. And that’s definitely one of the benefits of being a physician assistant, because you started out in ortho and then you went to emergency medicine and then you went to transplant. Can you imagine, as a doc, if I wanted to do that? I’d have to go back to residency, two or three times.

[00:05:19] PA Blackstock: Right, absolutely. And that’s the beauty, that’s the beauty of our profession. And, and just to talk about the PA profession, we, uh, during COVID here in New York city– you know, just shout out to all of the healthcare providers around the world– and, and I’ll speak specifically about the PAs here, uh, in the city of course, which, you know, we made up a team of great, great providers and healthcare personnel. We were able to take, you know, come from the specialties that we work in and function in other areas, we were able to flex to meet the need of our patients, the needs of our patients. So yes, that’s the beauty of having PAs and being a PA.

[00:06:00] Dr. JB: Yeah. And not only did you have all this experience working in, in these different specialties, but you’ve also been getting a lot of leadership experience, leadership exposure, and now you’re the director.

[00:06:14] PA Blackstock: Yes. Yes, absolutely. And it’s multifold, in my current leadership role, I am able to effect change that really, that impacts our patients. I’m able to help fine tune our operations to get the best possible outcome.

[00:06:34] Dr. JB: And so how did you get involved with leadership?

[00:06:38] PA Blackstock: Yeah, so it’s interesting. So I started, I came back to NYP after my stint as a, a clinical transplant coordinator, and I worked on the lung transplant team, which was just a phenomenal experience, as the first PA on that service. And we grew from a PA of one, which was myself and we were up to six or seven PA’s on that specific service and I became the senior PA on that team. And my experience as the clinical transplant coordinator and as a senior PA really gave me some of that administrative feel. And going through as a senior PA, going through the training courses, I really enjoyed, I am a talent development buff, shout out to the NYP talent development team, I just love their courses, and any opportunity I get, I look to advance myself and my training and my knowledge. And applying those leadership skills and what I’ve learned to the development of my team, and then after that, I became the chief PA for transplant services at NYP and the Children’s Hospital training. And with that came more training, more development, and more training and development of my team members, and encouraging them to go back to school and putting myself back in school so that we could advance our self professionally, personally, and as a, as a profession. And so it’s just been, it’s been wonderful. And shortly before COVID hit New York, March 8th, I started my new role as the director of clinical transplant operations. And again, just, just the wealth of knowledge, experience, it’s, it’s just been phenomenal to apply what I bring to the table as a physician assistant and having the clinical transplant coordinator experience, bringing that experience to the table and really, again, helping to just affect all the services that we offer.

[00:08:33] Dr. JB: How was that for you? You’re this new brand-new director of the clinical transplant operations, and then bam COVID strikes.

[00:08:43] PA Blackstock: Yes, I can laugh now, but I–

[00:08:45] Dr. JB: But you weren’t laughing then.

[00:08:47] PA Blackstock: I was not laughing then. It was a whirlwind, right? Quickly, so I, I’ll tell you that I went into survival mode. In an emergency, so through college, I was an EMT, emergency medical technician, and I automatically went into what I was trained in. Airway, breathing, circulation. Now I know, I know my CPR folks are saying, “no it’s CAB!” Compression, Airway, Breathing. Just please give me this license NYP, or whoever’s listening, just give me this license or allow me this ABC. But I went into, I really went into survival mode and I prioritized what is important and I use that core training to say, okay, we are in crisis. Okay. What do we do? Let’s go back to the basics. And that’s what I did. And part of the basics was ensuring communication was followed and early in the crisis, we all experienced this, we didn’t know what to do. Things were happening. We weren’t sure of the information that we were getting. And so, my job was to say, hey, we know what we’re doing, let’s get back to basics. This is a virus, let’s wash our hands, let’s distance, let’s wear our masks. Let’s go back to the basics. So sticking to the basics is what got me through and ensuring great communication with our team members internally and externally, that’s what I relied on. So it’s only, now that we’re through the, what I hope to be the worst part of the storm, it’s only, now that I actually sit back and reflect on what we all went through and what I went through.

[00:10:26] Dr. JB: Interesting. One question I have from this is for a patient who had COVID, like died as a complication of COVID, were they eligible to donate their organs?

[00:10:40] PA Blackstock: No. No, they weren’t. And because COVID what, we weren’t sure, right? Of the transmitting of diseases, specifically COVID, and we do know that we don’t want to transmit diseases from donor to recipient, so we did not accept COVID organs.

[00:11:02] Dr. JB: Yeah. Especially if you’re going to be a recipient of a transplant and then a transplanted organ, and you’re going to have to be on immunosuppressive agents.

[00:11:12] PA Blackstock: Correct. Exactly. Exactly. And then, and then transplant, the goal of transplant, we look at that. We screen the donors carefully, same with any blood transfusions. The last thing that we want to do is cause further harm to the recipient or to the patient. Cause no harm, right? And so, yeah, so we really screen donors for any kind of diseases, and COVID is definitely one. It was so new and it still is relatively new, and we’re still learning so much about COVID and, and the after effects.

[00:11:42] Dr. JB: Interesting. And so more questions, is it if they ever had COVID they’re not candidates to donate or if it’s an active infection, or do you guys try to tease apart the two?

[00:11:55] PA Blackstock: Interestingly, so great question. Great question. So this answer is very, very complex. So if we know that a patient or a potential donor has COVID, then we will not, that’s an, that’s a rule out. They would not be able to donate. Folks, actually, what we’re learning is that there are a lot of people who had COVID and did not have symptoms, and they have antibodies to COVID. And then there’s some folks who have the classic symptoms of COVID, but yet they’re antibody negative. And so, can we really answer if someone had COVID, would they be a donor? If they have active COVID, no. If they have signs of COVID, no, they wouldn’t be. But from what we’re learning now, it looks like we may have missed quite a bit of people who actually had COVID and it just didn’t show up on the detection tests that we were using. So very complex answer. So we will, if we know someone had COVID and they’re still having symptoms, then no. If they have active COVID, no. But if they had COVID in the past and they are having no symptoms and it’s years out and they’re fine, they could potentially be a donor. So the verdict is still out on that.

[00:13:12] Dr. JB: Did you say years out?

[00:13:14] PA Blackstock: Yes, years. I mean, if they were, I mean, like I’m thinking of a living donor, I apologize, a living donor.

[00:13:22] Dr. JB: Well, no, no, but still, but I’m still thinking about years. We’re still in the midst of it, so it’s going to be a while before these people would be able to be donors, it seems.

[00:13:31] PA Blackstock: You’re right. You’re absolutely right. And part of my dissertation, my doctorate work is looking at COVID infections and how it affects patients who had preexisting pulmonary conditions. And I can tell you that the data is so rich, it’s just, there’s a lot of information that’s surfacing now. And, and you’re right, we’re in the midst of it, we’re in the thick of it, and data will still continue to come out so it’s going to definitely affect how we practice and how we consider and who we consider donors in the future.

[00:14:02] Dr. JB: I think that the ability to be flexible and the ability to change is key. And we’ve, and we’ve been doing that with COVID, right? Before we, when COVID first started, the person’s hypoxic, they get tubed right away. And then, as time has gone on, we realized, oh, maybe that’s not the best thing to do, and then let’s go ahead and give them high flow, BIPAP, let’s prone them, let’s do whatever we can to minimize intubations. And so that flexibility and the ability to change direction was definitely a good lesson and something that I think that the healthcare system in general will really be able to benefit from moving forward.

[00:14:49] PA Blackstock: I couldn’t agree more. That, that was a great example of real world data, right? We had always been looking at how do we get information and react to it much faster or sooner than putting it through a study and looking at it and perseverating and collecting more data and doing this. We were, we were unfortunately forced to adapt to this ever-changing presentation of this virus and we had to use real-world data, minus the studies, you know, as prolonged studies, because we were up against, this was a battle, we were up against an enemy, this viral enemy that really kept us on our toes and we didn’t have a choice, but to adapt to an ever-changing presentation. Before, you’re right, they would come in and fevers, typical symptoms of the flu, some infiltrate in the, in the lungs based on an x-ray, and we’re like, okay, we can change it. And then it changed to, I have this wicked headache, joint pain, atypical signs and symptoms and presentations, and then we would say, wait a minute, is this COVID-related? And sure enough, it was. And so we had to change on the drop of a dime, how we addressed them and really fought this virus.

[00:16:09] Dr. JB: Yep. And so, you spend your days being the director of the clinical transplant operations for a major academic hospital system. And then on your spare time, you are pursuing your PhD.

[00:16:26] PA Blackstock: I love that, I still chuckle at that. That’s great. It, it’s true. So in all fairness, it’s days and nights as a director, it’s, it’s truly a labor of love. Transplant is one of those fields that, when you’re in it, you’re in it, because you’re in this battle with our patients. Really it’s, we’re, we’re in it with them. And the PhD thing came about, I’ll tell you, I had always wanted to pursue a doctorate because I just, I wanted to learn more and I wanted to take it to that terminal degree, if you will. And I’ve always loved, uh, public health. I earned a Master’s in public health and environmental/occupational health and safety, and just loved it. And I knew that I wanted to study more about environmental occupational health and, and had been researching programs, and one night, I said, you know, Daryle, if you really want to do this, you got to do this. So, I woke up that night, got out of bed and YouTube the GRE and YouTube different programs and said, yes, this is it. And that’s where it began. So it’s been five years. Of course, 2020 was a wash because of the pandemic, but I finished my courses, passed my milestone exams and, and now it’s at the dissertation phase. So it’s, it’s funny, I’ve never in my lifetime thought that I would be looking forward to doing my dissertation work, but I now embrace that work. I now embrace that research because when it’s dealing with a pandemic, something that affected all of our lives, and I’m learning more and I’m contributing more to the science, and it’s like, you bite the dog that bit you, right? COVID put us through it and I have to turn that into a positive experience. I have to turn that negativity that we all went through into a positive experience. And, and being a man of color, I know what COVID did to black, brown, and marginalized communities. And again, using my particular stance on the job and in my research, I make sure that we address disparities, and what did this look like for society as a whole, and then those who are at risk. And so I’m, I’m taking, you know, I have to take some power back from this negative experience. And that’s what’s getting me through it. So, yeah, so it really is a labor of love. Shout out to this 15-minute crew, FMC, I’m going to have them definitely listen to this, but that’s how we keep each other going. These are classmates who are all in their, in the doctoral phase and those who just graduated, shout out and congratulations to the crew. But we committed to doing 15 minutes a night minimum, each night, just to keep that momentum going. And normally that 15 minutes turns into an hour, two hours worth of work, and so we encourage each other. So yes, it’s, I still chuckle “in my spare time,” but yes, I dedicate some spare time towards this.

[00:19:21] Dr. JB: I’m sure your family is super proud of you.

[00:19:25] PA Blackstock: They, uh, I love my family, just, just blessed to have a great family system. We’re originally from Jamaica and we’re here in the U.S., England, or Canada, all over, and just shout out to them. And this work is of, our great, my great grandmother really, she planted the seed in all of us that education is super important and the family, we take education very, very seriously. Congratulations to the new grads in the family. They’re amazing, amazing young people, but education is extremely important to us because once you have it in your mind, no one can take it away from you.

[00:20:04] Dr. JB: That’s right. That’s absolutely right. I guess, during these, these periods where you’re going through PA school and even when you were working in these various environments that we talked about, did you ever feel like you had it all together? Like you always knew exactly what you’re going to do, the next steps, et cetera?

[00:20:25] PA Blackstock: No, Dr. JB, I think you are– am I just laughing because you’re hitting all the right questions? Great question. Absolutely not, no. No. I’ll tell you, there’s talk about the insecurities that come in here, like, do I belong here? What am I doing here? Did you make a mistake and accept me into this program? Do I, am I supposed to be… No, I wish, I wish I could tell you that I had it all together and I was super confident, but absolutely not. No.

[00:20:54] Dr. JB: And so oftentimes there’s a word that we use to describe these feelings called imposter syndrome. Did you ever experience that yourself?

[00:21:05] PA Blackstock: Yes, imposter syndrome, absolutely. So interestingly here, the PA professor we, we had some seminars on this and, Damien who’s completing his doctorate, shout out to him, he led us through the imposter syndrome. And in talking about that, and I’ll tell you, quite, quite a few of us were like, wait a minute, I suffer from that syndrome. Absolutely. Where, first off, in the academic hall, there aren’t too many people that look like us, right? Who are, who were melanated and in a position of authority and wielding that stethoscope to make a clinical decision, there aren’t too many of us. So right then and there you feel, oh, well, okay, little isolating here. You know, people are kind, people are nice, but it would still be, it would be better to see a more diverse community of healthcare workers and providers. The studies show that the patients actually benefit from having a diverse clinical team treating for them. Right? And when you’re the only one, you’re isolated. And when you’re isolated, it’s like do I belong here? Why am I here? And then you find yourself, at least I found myself, working harder, studying harder after my clinical shift was over as a new graduate and, not just a new graduate, throughout my PA career. Reading, learning, picking up articles, joining associations, listening to CMEs, earning that additional certification, just to say, hey, you know what? I belong here. If you have any doubt, look at my certification, look at my pedigree. And also as a reminder to myself that, you know, Daryle, you passed that exam, you earned that designation. Yes, I belong here. So those are the things that I have done to combat imposter syndrome, and definitely, I definitely suffer from it.

[00:22:51] Dr. JB: Suffer, as in still?

[00:22:54] PA Blackstock: Not, now that I’m, now that it’s been put out there, and now that I know what it is and that I definitely suffer from it, yes. But not to the same extent. It’s, this is what it is, it’s imposter syndrome. Do I belong here? Yes, I belong here, so I’m able to say yes. And I say suffer in the present tense because yes, it is still a part of me. But I’m recognizing it and I’m saying to myself, I belong at this table. I belong here in this position. I belong in this school. And so I always have to acknowledge its presence, address it, and so this way it doesn’t show its ugly head and takeover. Absolutely.

[00:23:41] Dr. JB: Yeah. I think a couple of things that you mentioned should it be highlighted. Number one, imposter syndrome. It’s something that everyone experiences, and I don’t think that’s necessarily related to race. I do feel like regardless of your background, the vast majority of healthcare professionals, and even other fields, experience that. ” Was this a mistake?” Or, especially when you’re starting something and everything is so brand new and it’s so hard and it’s so much information, just feels so overwhelming and you feel like you can’t do it. That’s one thing, However, what I don’t believe that a lot of, that everyone experiences is the, the pressure to prove themselves, that they belong there. To prove themselves by going out and getting extra certifications or extra degrees and whatever to say, yeah, I do belong here. Look at this long list of all of these accomplishments that I’ve done, and to constantly have to bring that up and list out all of the things that you’ve done to show that you belong at the table.

[00:24:52] PA Blackstock: That’s a great point and you are right. And, and in addition to that, I don’t know if others experience the isolation of being the one and only.

[00:25:04] Dr. JB: The token.

[00:25:06] PA Blackstock: The token, right? The, the shiny token, the well-deserved token, you know? And that adds to that pressure. And some of that, like definitely I, I let folks know, or at least in my titles or signatures, my, my credentials, it’s there. And sometimes it’s good for me to look at and again, address that imposter syndrome that still lurks within to say no, no, listen, you’re here. You, you deserve to be here. And can I, so I know you’re interviewing me, but I’d love to hear your take on that. Have you ever experienced any of this imposter syndrome?

[00:25:46] Dr. JB: Have I ever experienced the imposter syndrome? Uh, who are you kidding? Of course! Of course, because it’s universal. I mean, come on, let’s just say it as it is. Of course, it’s always that “fake it ’til you make it.” That was my motto, fake it ’til you make it. Yeah. And of course, I can’t hide the fact that I am also a black female in this field, and so, even to this day, I don’t necessarily experience the imposter syndrome to such an extent like I did when I first started, when I was fresh, like medical school, residency, the first several years of residency. But there’s still challenges, and like you mentioned, in terms of race and having to, prove yourself and what not. Even in front of the patients, it’s not even in front of the patients, I get it from the patients where I walk into a room and they asked me what school I went to. What do you mean what school I went to? Then I’ll tell them, I went to Duke University for medical school. “Oh, that’s a good school.” Yeah. That’s one of the realities of living and working in this country that you go through as a black, or as a minority. I won’t even say black, I’ll say as a minority, that’s definitely something you experience. But in terms of imposter syndrome, yes. And I think that, quite frankly, it has to do with when you’re just not sure of what you’re doing but you don’t want to let people know that you’re not sure, that you’re a newbie.

[00:27:32] And reflecting on it, I think, and this is what I tell the students that I work with, I said, when you’re a student, your job is to learn. You don’t have to pretend like you know, everything ’cause we already know you don’t know, so don’t pretend. Have your freedom to ask the questions. Because there’s some point in your career where you’re going to be expected to actually know these things, and if you never asked the questions or did the research when you were a trainee, then that is going to be more difficult to admit, “I don’t know.” But it’s never wrong to say you don’t know, if you don’t know, you don’t know. But definitely when you’re training ’cause that’s where you get the imposter syndrome the most. It’s when you first start training, you get your acceptance letter, you’re excited and you have day 1 and you’re like, oh my goodness, I have no idea what’s going on. Your teacher asks if you have any questions, nobody raises their hand, it’s not because everybody knows the answer, it’s not because nobody has questions, but it’s just nobody wants to be that one. But then, what I’ve noticed and you can tell me if you’ve ever experienced this, I’ve worked with people throughout my training where they were that one, and it was so freeing. They would just freely ask whatever question they want, and it was just so freeing. And you would think that because they’re doing that, then I could do that too, but I wouldn’t.

[00:28:47] PA Blackstock: That’s right. I would think, and I’ve definitely seen that, I would be in awe and amazement just to say, wow, how do they, the questions that you’re asking, I’m thinking I need to read this. I need to sneak off to the bathroom or go and look this up, find one of these books and look it up. And they’re like, hey, you know, I don’t understand this, that, and the other. And I’ll tell you, that’s influenced my freedom to say, hey, you know what, you need to go ahead and ask these questions. Why not?

[00:29:15] Dr. JB: Yes. Yes. Because you should. And it’s so freeing not to have that burden of “I’m supposed to know this.” No you’re not. No you’re not. And the worst thing they can say is go research it. Okay.

[00:29:29] PA Blackstock: So, you know what I still do though? I admit, I will still quickly look at Google or look at one of these, just to understand what either the acronym stands for or whatever it is, and just say, okay, look, I know, and then I’ll throw out the full name, and just to say, but could you explain so and so? I still do that, just so that I’m not coming from a place of absolute “I don’t know what you’re talking about,” but just to say, I have a little idea, I’m not that bad, you know? Teach me, please. I’ll learn.

[00:30:08] Dr. JB: This field of medicine, we’re always going to be learners. And I think that’s one thing that will be really freeing once we all realize that we all have something to contribute that’s different, and you may know something that I have no idea about, and I may know something that you have no idea about and together collectively we can teach each other and grow. We don’t have to make the other person feel bad. We’re all in this together, and we can really help uplift each other instead of tear each other down.

[00:30:37] PA Blackstock: Well said, and, and if, if one thing, you know, we’ve learned quite a bit from COVID, but COVID forced us to work together. COVID forced us to tear down these walls, these silos that kept us separate, you know, and, and this is true of those of us in the healthcare field, we had to work together. Because we all came from a place of “we don’t know how to battle this.” So we have to collectively work to battle, put our knowledge together, and that’s how we got through this. Right? We got through this, or we’re getting through this, or we’re keeping it at bay or keeping it more controlled, because we’re working as a community. We look at the COVID vaccine initiatives and, , and just for record, I, I do, I,I’ve taken the vaccine and I do encourage it, but of course, I’m, I’m not saying you have to do it, but we’re looking at, we have to work as a community and we have to treat the entire community to get through this, this pandemic. And so what do I mean by that? COVID just didn’t affect a certain group, of course it affected certain groups worse than others, but it affected the entire world. And this was a global pandemic, and this is still very much a global crisis. So we can’t just treat this one little pocket and not pay attention to that. We have to address this as a global community. And we had to acknowledge, yeah, you know what? We don’t know what’s going on here. We were at our most vulnerable. And when we realized, just to address this, when we realized that, okay, so you don’t know this yet? I don’t know this, but I do know this, Hey, I know this. We have to work together. It’s the same thing. And this is how we’re finally getting this under some kind of control. It’s because we acknowledge that, Hey, you know what, uh, I don’t know what’s going on, help. Well, I can do that. Okay. I can do that, and let’s work together. And so you’re right. You’re absolutely right. And that’s the lesson that we should all learn, drop the insecurities. For those of us suffering from imposter syndrome, acknowledge it, but just know that you belong because you might not know everything, but there’s something that you know that you can contribute. And it’s one of those, it’s one of those lessons that Oprah teaches us, right? This is a lesson that we should all take with us. It’s that, yeah. I might not know everything, but I do know something I can contribute and we need each other to survive.

[00:32:56] Dr. JB: That’s right. And it’s hard. It’s hard to drop the imposter syndrome because it just makes you so vulnerable. I think that it’s like a safety blanket because if you stay quiet, nobody’s gonna know, and so, we’ll all be wrapped in our little safety blanket cocoon, and not really be able to just have that freedom of, of truly connecting with each other on a deeper level. So I acknowledge that it’s hard. It’s not something that like, oh, you just, just drop it. Like I tell my patients, stop smoking cold turkey. That’s the most successful way to do it, just stop. You just have to put your toes in the vulnerability pond. It’s a little cold, but when you put your whole entire body in there, when you jump in, it’s going to be so refreshing. Be vulnerable.

[00:33:47] PA Blackstock: Yes. Yes, absolutely right. And that’s what it is. And that’s exactly what it is, to be vulnerable, to be comfortable enough to be vulnerable. And once you, like you said, it’s liberating once you start to admit and you can admit to others, hey, could you show me this? Or could you teach me this, please? I’m not familiar with this. And then you get that knowledge, and when you begin to just keep, you’re amassing that knowledge because you were vulnerable enough to say, Hey, you know what? I don’t know this, I need extra help in this. It’s a learning process. It’s like, that imposter syndrome can really, it can really limit your experience and it could really limit what you learn because, you know, me slipping away to read a book just to refresh myself on something, whereas I could have stood there and got the knowledge from an expert in the field, who would have taught me the same material, but in his or her own way, I missed out on that. And when I started to, like you said, jump into that water, I was able to learn so much from different people. There are 10,000 ways to skin a cat and, you know, in medicine, medicine is very much a science as well as an art. You practice medicine. And it’s, it’s artistry. There, there are prescribed studies that we’ll, of course, go by ethically and everything, but there are so many different ways to interact with the patient, to talk to patients, to make the diagnosis, to, to treat and to follow up on treatment, and to just play in this orchestra of so many talented folks. And if you’re sitting in your little cocoon, wrapped up in your imposter blanket– I’ve never heard imposter syndrome sound so nice by the way, Dr. JB, great job on that, I promise I won’t, I won’t fall for, I won’t become comfortable in that cocoon– but, but if you’re wrapped up then you won’t play in that symphony, and you won’t play with these masterful people, and so you’re right, we have to shed that. We have to shed that imposter syndrome.

[00:35:42] Dr. JB: Because that’s how you blossom, really. You bloom, I mean, you might get there eventually, it’s just gonna take a lot longer, cause you’re going into that bathroom or that closet, and teaching it yourself then, and then reading another thing, and another thing, and another thing, meanwhile you can just–

[00:36:01] PA Blackstock: So, you know, for your listeners, for your great listeners, anyone listening, what kind of advice– I just thought about this and I’ll throw that, throw this question out there too as I pose it to myself– what kind of advice would I offer to someone out there who doesn’t suffer from imposter syndrome and, and may recognize someone that does, I would encourage you to make yourself available and say, listen, this is, present what you know, this is what I’m good at, or do you know this? And be willing to teach, be willing to share knowledge. And, and if you, and don’t be offensive, don’t be aggressive, just really come from a genuine place of, listen, I know this material, I can teach it to you. What do you know? You can teach me. And what that does is you put people, when you make yourself vulnerable as someone who’s the expert in the field or as the teacher say, you know what? Thank you, I didn’t know that, that’s very interesting. Once you allow yourself to come from a vulnerable place as a teacher and say, “listen, this is what I’m going teach, but I’m going to learn from you,” it creates a much better conversation, much better flow, much better flow of information. And so let me throw that question out there too. What could we share with your listeners, those who don’t suffer from imposter syndrome, or they may have gotten over it, or they’re dealing with it, like, like I am, how do we help those who we recognize are suffering from imposter syndrome? What can we do to help them overcome, overcome this?

[00:37:32] Dr. JB: So I think we all can benefit from practicing saying these three words: “I don’t know.” I don’t know. That’s the hardest thing for a healthcare professional to say, say it to colleague, say it in front of a patient, oh my goodness. But it’s true, you may not know. I don’t know. I don’t know everything. And I say what it is that I do know, and then I will say, I do not know the answer to the question that you are asking me.

[00:38:05] PA Blackstock: Yes.

[00:38:06] Dr. JB: There’s no beating around the bush, there’s no making up something without ever addressing the question. It’s just being straightforward and saying, I really don’t know the answer to your question.

[00:38:16] PA Blackstock: And to that credit, to get to that point, it’s taken me a while to admit to that, to a patient, to their family members, “I don’t know.” But guess what? Somebody does and I’ll get you that answer. And it’s taken me– that’s just great advice, “I don’t know.” And be honest, don’t lie. Don’t fidget. Don’t try to make things up because people can see right through and you’re going to lose their trust. Those are great words. You’re right. You’re absolutely right. Why is it so hard for us?

[00:38:50] Dr. JB: Because we’re supposed to know. Right? , you’re trained to be the person who knows all the answers, that’s why they come to you, you’re supposed to know the answers. And so, that’s the air that you’re supposed to exude, is “yes, I am PA so-and-so, I am doctor so-and-so, and I can answer any question you throw at me.” people feel like that they’ll be seen as less than if they say, “I don’t know,” but in reality, you’ll be seen as less than if you lie or if you really don’t know and you pretend to know, then you lose trust. And losing somebody’s trust, it’s hard to regain.

[00:39:30] PA Blackstock: That’s right. That’s right. And, and even just as being a patient and having my provider or healthcare practitioner and anyone on the team stand there and just make things up, you can tell, and I would never want to be that person. So you’re right, those three words, being able to admit that and to say them out loud.

[00:39:53] Dr. JB: Yeah, out loud. I don’t know.

[00:39:58] PA Blackstock: Right. Right. And create, and creating an environment where it’s allowed to say, “I don’t know.”

[00:40:05] Dr. JB: That’s important. Yeah, because we’re always learning. That goes back to what we were talking about earlier. We’re always learning. And so “I don’t know this today” doesn’t mean I won’t know it tomorrow, but today, I don’t know. And then they have to go back home, I have to go and research it, maybe I’ll get back to you.

[00:40:21] PA Blackstock: That’s right. And then thinking about that, some of the best physicians, surgeons, colleagues, providers, practitioners, that I’ve, that I’ve ever come across and that I’ve had the pleasure of working with, and these folks are experts in their field, respective fields, they’ve all, I’ve seen them be vulnerable with patients, sitting at the, at the bedside. Saying, “you know, listen, we don’t know what’s happening, I don’t know what’s happening to you right now, but this is what we’re doing to try to figure this out, this is what my best guess is, and we need to figure this out and we’re going to figure this out together.” And I’ve seen that bond with the patient and the provider and the team, and they’re like, “you know what, thank you for being honest with me.” And we’re able to give a plan and we’re able to come back and say, we’re going to figure this out together. I don’t know what’s happening to you right now. And, and that’s where the magic happens, you know? And that’s where you say, listen, I need you as a patient to, to, you know, you’re part of this team. You’re the central person here. And your job is to tell us if what we’re doing is working, how are you feeling? If it’s not working, give us that feedback. And this is how we’re going to work on this together. And it’s all back to the imposter syndrome. If you are trying to, if you’re caught in that, you’re going to rob yourself of that true experience, of that true artistry, you’re going to limit how much medicine you truly practice.

[00:41:45] Dr. JB: That’s right. That’s completely right. I agree with you 100% in terms of medicine is both an art and a science. There’s a saying that I live by, that says, medicine is both an art and a science, if you don’t master the science, you’re incompetent, but if you don’t master the art, you’re a monster.

[00:42:11] PA Blackstock: Wow. Wow. Wow. That’s, that is so deep. That is so deep and true.

[00:42:19] Dr. JB: So that saying will be on some t-shirts coming around.

[00:42:24] PA Blackstock: I might add that to my dissertation. That’s excellent.

[00:42:31] Dr. JB: Yeah. But, that’s so true. So with that being said, like you can say, “I don’t know,” and there’s nothing wrong with saying, “I don’t know,” and then you learn about it. You ask questions, you do your research or whatnot, but you make yourself vulnerable. If there’s somebody there that is an expert in that subject area that you don’t know, take advantage of their expertise. Then you can supplement whatever they tell you by doing your own reading and whatnot later, but that’s a wonderful opportunity to really connect with somebody and really get all your questions answered.

[00:43:01] PA Blackstock: That’s right. And it’s a way to pay respect to somebody who is an expert, who spent the time to become an expert in that field. That’s the greatest compliment, is to have that person teach you and practice their art and share their knowledge, and impart what they know. That, that’s what I would think, that’s the greatest form of respect. So pay that respect and don’t rob yourself of learning– you know, textbooks can give you one thing, teaching yourself is one way, but there’s so many different ways to learn. And then you form that connection and you have that interpersonal, you build a community. What we talked about earlier, we can’t do this by ourself.

[00:43:39] Dr. JB: Never, never ever. And so, that’s one takeaway, let’s do away with this imposter syndrome. If you got accepted into XYZ school, you got accepted by your own merit. You didn’t take somebody else’s identity. If you did, if you steal somebody else’s identity, then maybe–

[00:43:58] PA Blackstock: That’s a different podcast, Dr. JB.

[00:44:08] And I’m proud to say that I will not be a part of that one, but I’ll definitely tune in!

[00:44:16] Dr. JB: But if this is your work, this is your sweat and tears, so you deserve to be there regardless of your racial background, sex, anything, you deserve to be there. All right? So you’re there, and then once you’re there, learn all that you can. And then you get accepted to your residency program, that’s all you again, you deserve to be there. Be vulnerable, learn. You’re a learner. And then throughout your career, throughout medicine, we don’t work in a silo. We work with other specialists, other specialties, and learn from them, strive to learn at least one new thing every day by being vulnerable and asking questions that you don’t know the answers to.

[00:44:57] PA Blackstock: Right. And to our medical education institutions, medical school, PA schools, nursing and nurse practitioner programs, everything, really, I challenge, I challenge all of you that are listening to really work to have a diversified class. You know, diversity, the richness of information that comes from having a ethnically, racially diverse program, it’s bar none. Nothing can compare to that, because the students in your program will benefit from sharing knowledge, both personally and professionally, and then you’re going to, you’re going to be putting out people who are going to be able to meet the needs of a diverse population. And that’s what we really and truly need. And, you know, through the recent protests and experiences that we’ve gone through globally and, and the push to acknowledge race and ally-ship and overcoming those barriers, I want that to continue because it’s the right thing to do. It’s the right thing to do for society to build a community and to continue to address these global issues that, that, you know, unfortunately, COVID was just the first that we, that we’ve seen in long time, it’s going to continue. And so this is extremely important, it all ties in, it all ties into, into everything. So, so again, to those folks who are at the helm and making these decisions, when they put together these programs and these classes, I really would love for you to take a look at your program and what you’ve put together, and I think that you should wear a badge of honor if you’ve succeeded in putting together a brilliant class that is diverse. That’s, that is the mark of excellence and getting them through that program.

[00:46:52] Dr. JB: Giving them the support, once they’re in there. We’re not trying to weed anybody out, that whole weeding-out process took place before you got into health professional school. Once you get into health professional school and beyond, the goal is to give your students as much support as is needed to make sure they are successful.

[00:47:14] PA Blackstock: That is right. That is absolutely right. And, and recognize that your folks, I mean, everybody’s going to go through that, that imposter syndrome. You are absolutely right, that is not just specific to folks of color, but do recognize that if you have folks of color, they’re dealing with other things, including isolation, other things that’s going to accentuate and even prolong that imposter syndrome. So please, definitely do something. Give them that support, identify it, acknowledge it.

[00:47:43] Dr. JB: Acknowledge it. I wonder, if you had a class your intern year, it’s not called intern year in medical school or PA school, your first year, your first year in school, and it highlights the whole imposter syndrome, and then has everybody in the class stand up and say, I’m an imposter! Just get it out, then leave it at the door, leave it in your seat, class dismissed. How freeing would that be? Just scream it out, just let it go.

[00:48:18] PA Blackstock: I might do that with the next class I teach, just go out in the middle of the field and just say, “imposter!” Leave it right there. I love that.

[00:48:24] Dr. JB: Yeah, I think that would be really freeing. So we are reaching the end of this podcast and our time together, and I just had a last minute question. If you had any final words for my listener, what would you say?

[00:48:45] PA Blackstock: Wow, that’s a great question. You know, life is not promised, go out, live your life and contribute positively to society. Just know that your actions, you matter, your actions matter, your words matter, and I really, I’d like you to just, I’d like to encourage you just to practice kindness. One act of kindness, you know, saying hello, helping somebody, allowing somebody to go in front of you, just taking a breather, just knowing that people are really going through times of stress, again, this COVID thing, we can’t stop talking about it because it’s, this is the biggest thing that happened to most of us in our lifetime, lifetime as a community. Just be more understanding and be kind, and it’s okay to be kind and, in small acts. Smile. If you’re in Starbucks, listen, pay for a drink behind you. You know, just something, let’s, let’s just encourage kindness.

[00:49:47] Dr. JB: Yeah, who says a doc can’t rap? D O C T O R J B. The greatest doctor to ever touch the mic. The greatest podcast ever broadcasted or prerecorded. Come learn some, each one, teach one. I’m done.


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