Transcript:

Dr. JB: Hi, everyone. Welcome back to the Hope4Med podcast. I’m your host, Dr. JB, and today’s featured guest is Dr. Nerissa Bauer. She is a Behavioral Pediatrician, CEO of Let’s Talk Kids Health, and creator of Teach Me ADHD. She is passionate about helping families become competent in navigating the road ahead after a diagnosis of ADHD. She left academia due to burnout in December 2018 and found her way back to serving families in a way that aligns with her passion and her purpose. Welcome to the show.

Dr. Nerissa Bauer: Oh, my goodness, I am so excited to be here. Thank you so much.

Dr. JB: I’m very excited to have you as one of our featured guests today. So, let’s start from the beginning, shall we?

Dr. Nerissa Bauer: Yes.

Dr. JB: Can you share with my audience, your origin story?

Dr. Nerissa Bauer: Oh, my goodness. So, I’m a behavioral pediatrician by training. And you know, when you go to medical school, you think I’m going to go and learn to be a doctor so I can help people. And even before I went to medical school, I knew I needed to work with kids. I actually started college as an elementary education major. But life happens and I fell in love with psychology. I knew I had a thing for science, so melded all those things, and I knew pediatrics was it. So, got into medical school, got into residency, and then realized during residency training, I really loved helping kids who think and learn differently. So, that’s how I became a behavioral pediatrician.

After that, I went into fellowship for research, because at the time I was training – and I’m going to date myself here – is when Columbine happened. And then shortly after that, Santee happened which was in San Diego, and I was seeing kids with nonspecific symptoms, realized quickly that I needed to do something about this. I got a grant. I wanted to give out gun locks, but couldn’t give out gun locks, nobody wanted to tell me they had guns in their home. I realize I needed to figure out public health influences, hence another fellowship to learn more, and to get my Master’s in Public Health.

Very quickly, while I was there, I started a foster care clinic and realized at the time, I didn’t really know how to support families. I didn’t have kids of my own, and people were like, “You’re a pediatrician, shouldn’t you know how to do this?” However, as you know, kids in the foster care system have a lot of behavioral and mental health issues. Sometimes medication is warranted. But more often than not, it wasn’t. Families needed that support. So, I was like, “Oh, my goodness, I don’t know what to do.” And I luckily found an eventual mentor, Carolyn Webster-Stratton, who developed the Incredible Years. She graciously invited me to sit in her parenting group.

And then through that experience, invited me to also watch all the videotapes and meet with her leaders. And so not only was I learning content by going through it, but learning how she was thinking and how to make this work – the group therapy part of it. And realized very quickly, as I finished the program as the only person to date who has gone through the program without kids. Because at the time, I didn’t have any.

I realized, as a pediatrician, that we are not taught those skills in this way. It’s do one, see one, teach one, right? And it wasn’t very systematic. So, with her permission, when I got my first faculty position at Indiana University, started a behavior clinic, running the developmental-behavioral pedes rotation, decided I needed to help bring this curriculum into residency training in a systematic way. And so I adapted it, worked with her, and then really fell in love with just trying to make my mission to help pediatricians feel comfortable dealing with behavior problems, how to identify, and then how to incorporate this in a more holistic approach to talking to families about behavior.

And then fast forward to helping a lot of kids with ADHD. And it’s one of the most common neurobehavioral conditions that we see. And COVID happened and realized I had the skills to help. So, I’m going to leave it at that for now. But I have this passion for helping kids and families who think and learn a little bit differently. And how I got here, it’s like, I didn’t know I would be doing what I’m doing now. But life has a funny way of working out.

Dr. JB: Isn’t that so true?

Dr. Nerissa Bauer: Yeah, it really is. And as a physician, we think, “Gosh, I’m only a doctor.” Only a doctor, right? But when I got into burnout very quickly, I was like, “Oh, my gosh, what am I going to do after this? What can I do? I’m only a doctor.”

Dr. JB: Yeah, So, let’s explore that a little bit more. What do you mean, when you got into burnout? What was happening?

Dr. Nerissa Bauer: Yeah. So, I was very happy in the first part of my career. And I credit a lot of my life experiences to who I am today. It just got to the point where, as I was moving further into my career, I was promoted to Associate Professor, I was in academia for 13 years at Indiana University. I didn’t realize until later that I was burned out. And I was in this faculty position where the expectation was I’d have to write a grant every cycle. I would write grants related to helping general pediatricians identify and intervene in behavioral issues in primary care. So, totally my jam, totally what I wanted to do.

But when grants don’t hit, it’s really hard. Because I fell in love with the idea, several months of writing this awesome plan and how I’m going to do it, only to find out it didn’t hit. And then, as you know, in academia, if your time isn’t covered, you’re either asked to go back and do more clinical time or put on different committees, which means meetings with to-do. But the expectation is still to write grants.

So, over time, I was writing grants on the weekends, at night. And to the point where my kids were like, “Mom, you’re not taking your laptop with us, we’re going on vacation.” And so I’d hear things like that. But it wasn’t until two of my family members got ill, one being my husband and needed emergency surgery, which then, kind of domino effect of me taking on my job, my kids, my two dogs, and getting him to and from places, and then my dad who lives elsewhere, was in the ICU for a couple of days. Just a bunch of stuff happening.

And it made me stop and realize, okay, what is the universe trying to tell me here? I just can’t take any more. And then it was like, the universe was trying to say, “Okay, you are not happy.” And I realized, too, with things that happened with the people that I love, life is too short and I’m not happy. I need to refocus on what it is I need. And it was at that moment that I realized, wow, I really haven’t been happy in my job for a while. You get into that rut of just the same thing over and over again, get the kids to school, go to work, do this, do that, come home, work late into the night, go to sleep and wake up. And you don’t really notice until something happens. I mean, at least that was for me. I had a wake-up call, I really feel like the universe was trying to tell me something and it made me reconsider what I wanted to do.

Because at that point, I was just struggling to stay above water. And I didn’t realize it. But as I started getting this nagging feeling of, “Whoa, something is not right. I don’t feel the same when I’m going to work.” I started realizing that I was moody. I was getting more frustrated and irritated with my co-workers or just my to-do list that just seemed to be growing and I just wasn’t happy.

Dr. JB: And so when you started realizing that, how long did it take you to make a transition?

Dr. Nerissa Bauer: Well, so it was a good six, seven months of me helping get our family back in order, at least to where I felt like I could breathe. But as my husband got better, and my dad got better, everything slowly got better. But we started talking, me and my husband, about how I was feeling. And at that point, he had already left his job a couple of years ago. So, he came at it from the standpoint of, “You did a lot for our family and got us through, I know that we’re going to be okay. Because I was able to leave and landed on my feet. Let’s do that for you.”

And when he said that, I literally started crying. I had no idea that that was even possible. I mean, even though I’d seen him do it, I didn’t realize how much I needed that life raft at that moment. And it was a gift. And I will say this out loud, I fully acknowledge that I was in a very different position than maybe other friends of mine who felt burnt out and couldn’t leave because they were the main breadwinner, they had to figure out insurance, there were just so many other considerations. But we were in the position where I could just leave and all of a sudden, I was like, “Wow, I could just leave.”

And when we talked about this, we laid out, okay, so how are we going to do this? What are the things that I need to do to line up things, and then put this plan into motion? I started with learning the higher ups and then slowly it trickled down. But it took, I would say, it was like three months from when I made the conscious decision to and then when I fully left. But it felt like an eternity, keeping that private and going through the motions, going to the meetings, knowing that I was going to be wanting to leave or will be leaving, and feeling like, “Why am I just here?” I feel so ashamed that I’m leading my colleagues on not letting them know, but it was this weird period where I knew this, and I couldn’t tell anybody yet.

But when I did, I’ll tell you what happened. People were like, “Oh, my gosh, where are you going?” They assumed I was going to go to another academic institution. And I was like, “I’m not going anywhere.” They’re like, “What? What are you doing?” I’m like, “I have no idea. I’ve been burned out. I have no idea. I need time to just stop and figure out, is it the research? Is it clinical? Is it like everything? Is it patient care? What is it? I just need to get out.” And some people are like, okay, and then some people were like, “Tell me how you’re doing this because I want to know.”

Dr. JB: So, you left without necessarily plan B, it was just, “I just need a sabbatical to figure it out”

Dr. Nerissa Bauer: Yeah, I know. It was weird. And I was doing a lot of reading, maybe trying to find a bridge job just to get out. And that’s what my husband did when he left his job initially. But for me, again, we were in this place where he was good. He was better. He was making good money. Gosh, we’re physicians, we were not going to struggle, we just had to rein in our expenses and change the way we lived for a little bit, but it was doable. And again, it was weird. I just got out and I started volunteering at my kid’s school. And I was going to Costco in the middle of the day. And I was looking around, this is so strange. I’ve never had this experience before.

But then I got really itchy. I loved the time of just getting back to taking care of myself, getting good sleep, and being with the kids. But I just felt like I needed something else too. So, after about four months, I was like, “Well, I could go back and be a doctor. I know how to do that.” So, I started a private practice and then still had some time to figure out what else. And so, I took that time, because I also was very scared of getting burnt out again.

Dr. JB: So, you mentioned your husband was a doctor?

Dr. Nerissa Bauer: Yes. He got out.

Dr. JB: So, can we talk a little bit more about that and what happened with him and what made him decide to leave?

Dr. Nerissa Bauer: Oh, his story is a little bit different from mine. He is med-peds trained and we both went into academia at the same time. He was working as a Service Chief Pedes Hospitalist here in town. He’s a great clinician, he loved teaching, he got so many accolades, and then the opportunity to become a Section Chief came up and everybody’s like, “You should do it. You should do it.” And he did. They did a national search, they interviewed, and then he got the job. And it was great for a while, but he quickly realized that he really wanted to be a clinician, he didn’t want to do the administrative stuff. But it was such a demanding job. I think the people that were in that position before him, four or five years and that was probably it. And he reached that for lots of different reasons. And that’s his story to tell.

But he just was like, “Okay, I just need to pivot.” And so he did. The interesting thing is he took a job with Anthem and started working there doing some med utilization reviews, and he got to work from home, not working holidays, not weekends, no call. It was weird, but awesome. To the point where my daughter, she was young at the time, she was like, “Mommy, daddy does it this way when we go to bed.” I’m like, “Oh, Daddy has a way? Oh, my gosh” Because daddy is home now, he can put you to sleep. So, that was just an amazing experience for our family to re-acclimate, to see what was possible, again.

Dr. JB: And when your husband transitioned out of working in health care, at that point in your career, you were…?

Dr. Nerissa Bauer: I was fine. I was good. I was still really happy and still doing great. I’m thankful that it happened this way because it was staggered. Because I don’t know what it would have been, if we were both feeling the same thing at the same time.

Dr. JB: Yeah, that’s amazing. So, then you took four months off. Then you opened up your private practice. And you’re like, “Mm, what else?”

Dr. Nerissa Bauer: Yeah, exactly. I knew given the work that I do, and this goes for everybody who does their own field in medicine. There are just things about it. I love the kids, I’m such an empath. I feel so much. And with behavioral medicine, there’s not a quick fix. Oftentimes, there are so many different stressors and risk factors, things that you can’t control, family circumstances, all of these different things, and trauma. But I want to support these families in so many different ways. But sometimes it felt like, oh my gosh, I can’t, I just need to sit with them and know that I’m here with them on this journey.

I can’t send them to surgery to get something taken out. I can’t give them medicine and make it just go away. I mean, yes, for ADHD, maybe sometimes, but no. So, I just knew that doing one-on-one patient care with this type of work, I probably couldn’t do it five days a week. But I loved connecting with families. So, I started thinking about different things. Obviously, I told you I was trained in the parent training work. So, in my private practice, in addition to one-on-one, I also started offering parent training groups, which is so needed.

But then COVID happened and then all of that went away because I couldn’t safely get families together in the small conference room we had at the office. Luckily, I was able to transition my private clients to tele-health. I did that for 18 months straight, especially for behavioral health, I don’t need to look into their ears necessarily or do things. So, I was able to transition luckily, to tele-health pretty seamlessly. But a couple of things happened. So, during the pandemic, as everybody knows, we were all just trying to figure out what was happening, what was life going to be like, and juggling, home, work, and everything in our houses.

And parents were struggling, I mean, my own clients, and then seeing the things on social media, I knew I couldn’t do the parent training groups. So, one day I was just sitting there thinking, how am I going to continue to support these families? I came up with the idea of a book club. I just ran it by one friend, she goes, “Oh, that’s a great idea.” So, I just announced… I already at this point had a Facebook page and was slowly starting to interact and dabble in that space. But I just said, “Hey, I’m going to be reading this book for the coming month. Anybody wants to read along? Great, let me know, get the book and let’s talk.”

So, I made it this cute thing where you can read along in your pajamas, no one will care, no one will know. Answer questions whenever you want. Because I just knew that with parenting, there’s not a one size fits all approach. Certainly, a lot of the work you do in groups is to help them learn the principles, but then how to generalize and apply them in their circumstance. So, the parenting book club seems pretty easy reading books, and you’re like, oh, wow, that’s great. But then it doesn’t work. So, I wanted to offer something like that in that form, and so I offered it on Facebook.

I still wasn’t quite sure what that was going to be. I just started doing that. And then January of last year, came up with this idea, again, just like, here’s an idea, because I’m an extrovert, and I missed my friends, and with social media, anybody can put anything out there. And so I knew that there was so much misinformation. And I knew, especially with pediatric behavioral health, there was so much to say so much stigma. So, I again, called up a couple of my friends say, “Hey, would you be willing to talk to me because I miss you. But it would be amazing if we could do this live and broadcast it out to everybody, and share information that people need to hear about.”

And so that started the Let’s Talk Kids Health Live show that I’ve been doing weekly since then. And then lastly, in October of 2020, as remote learning was in full swing in schools, we’re now at least figuring out that they needed to do some format of remote learning because schools couldn’t reopen. Kids were struggling for lots of different reasons in that capacity. And I was just like, “Oh, wait, I can help these families, I can help them understand what ADHD is, what it isn’t. But bringing together my skills of positive parenting, working with kids, and developing this program, which now I call Teach Me ADHD, which is the only class of its kind where kids with ADHD and their parents take it together with other families.

So, it’s a zoom class. And yes, I know, parents were like, “No, not zoom. We are zoomed out.” But I’m like, “How else am I going to get to you guys? We can’t get together.” So, I knew it had to be fun, and engaging. I made it a detective theme, the All Deeds Help Detective Agency. I put together a supply box. Parents and kids become detectives, they adopt code names. And then I develop family missions and deeds that we work on week to week. And then parents have to take pictures of the evidence and send it to headquarters for feedback.

And all of these are crafted to help kids and parents on board together about what ADHD is and what it isn’t. Work on executive functioning skills, and set in motion systems for home and school so kids thrive. But because kids and parents do it together, they’re so eager to talk to each other and connect. And so I’ve come up with these fun things. And now I’ve done it so many… I’m in the middle of selling right now, but I’ve helped like 60 some families from eight different states and it’s growing. And I just love it. And I’ll tell you that, right now, did I know I was going to be doing this when I left academia? Heck, no, I did not know.

But in the end, my grants were really about helping families, helping pediatricians identify kids early, and infusing this positive parenting behavioral health into strengthening parent/child relationships. And I am so grateful that COVID happened to help me push me outside of my comfort zone and make me think outside the box. Because there is this gap, there is this need, I was seeing it and I was like, okay, I’m going to go for it. And it’s been amazing. It really has been.

Dr. JB: And you did it and it’s just so creative. I was just following along, yeah, detective in the headquarters. It reminded me of Inspector Gadget, you know?

Dr. Nerissa Bauer: Yes. And who doesn’t like maps? I mean, I wish I could show you it right now, it’s over there. But I was like, I got to make a map. Kids like maps. So, it’s this map of missions one through eight, and parents and kids have their own top-secret mission and all of these different things. It’s just been so fun. And when I to put it together… I’m going to just tell you one quick story. I put it together and I’m like, “Okay, I think it’s going to be like, six to eight weeks.” And at this point, I had run groups before for parents. But I’m like, six to eight weeks, I think this is what it’s going to be. But to try it out, I need at least three or four families.

So, I just made a flyer and put it out on social media, I’m like, “Okay, I need some families.” I tell you, within a week, I had seven families that were like, “Oh my gosh, we’re so in. Whatever it is, sign us up.” To me. I was like, “This is so strange.” Because in academia, when you’re writing grants, you need to know exactly to the penny, what you’re going to spend your money on, and a five-year plan. And here, I was being loosey-goosey saying, “Well, I think it’s going to be this, I think it’s going to be six to eight. Here are the possible topics. I think it’s going to be an hour.” And parents are like, “Yes, we need this. Thank you.” And I’m like, “Okay, I’m going to do it.”

And I just have not regretted any moment since. And it’s just like, these are the people I want to help. And here they are saying, “Yes, help us, we are willing and able.” And that was what I needed to just remind me that, even though I’m only a doctor, I’ve had experiences along the way, which really culminated in the time being right for me to be the one to create this awesome thing out of nothing, and to see the transformations the families have and the connections they’re having. It’s just so heartwarming. And to me, that’s why I do what I do. In the end, that’s why I wanted to get those grants. That’s why I wanted to help these families. That’s why I do the patient care that I do. I want to help these families, and I get to be part of this journey. And they’re happy they’re doing it. And kids are embracing the fact that they have ADHD, and they have tools in their toolbox now. It’s really amazing.

Dr. JB: That’s absolutely amazing.

Dr. Nerissa Bauer: I’m sorry, I’m so excited whenever I talk about it, because it’s so fun, it’s so fun.

Dr. JB: No, because it is, and you’re just so creative. It’s just like, how did you even come up with this idea? And you came up with this idea and it aligns so perfectly with your values, with what you really wanted to do? And without any red tape.

Dr. Nerissa Bauer: I know. I didn’t have to get permission. I didn’t have to wait for some funding agency, I just did it. And that was what really exciting about entrepreneurship, but also scary at the same time. Because being who I am today, I didn’t know anything about business. Even when I started my private practice, I was like, “What is an LLC? What is this? What do I have to do?” So, we don’t get that training in med school. And I don’t think we do a good job at showing physicians what the options are for us. But I think so many of our colleagues have been burnt out from the pandemic, just being on the front line and dealing with misinformation.

And it’s been really hard to see some of my really great friends and colleagues across the nation just wanting to leave medicine, not having hope anymore, and then not sure what to do. So, I’m so grateful that you’re doing this because I think it just highlights the fact that we all went into medicine for our own reasons to help people. And there are lots of ways that we can help people. It just doesn’t have to be the one way.

Dr. JB: And you’re not just a doctor.

Dr. Nerissa Bauer: Not just a doctor. I know. And I told you I wanted to be an elementary education teacher when I first started. It feels almost a little bit like, here I am designing worksheets and things like that. Well, guess what? I’m going to tell you a secret, I just formally got diagnosed with ADHD myself a month ago. And I think partly that’s why I get how to do this because my brain thinks and learns a little bit differently too. I feel like I have a way that I like to think through things. And it’s really helped me be able to connect with the families and the kids in that way. And when I told a couple of my now friends who’ve taken the course, and they were physicians themselves, and they did it with their kids, I told them, oh, my gosh, I got tested. And guess what? I have ADHD moderate. And they’re like, “Oh, yeah, I totally could tell.”

Dr. JB: What made you get tested?

Dr. Nerissa Bauer: Yeah, well, so two things. One, my son needed to get testing because we’re noticing he has a behavioral… I was like, oh, my gosh, you are not turning in assignments, having to help a lot more. Did you check this? Did you do that? Like all that scaffolding we do. But really, when I left academia, I had no idea how much that structure was so needed, those deadlines, and those meetings, that was the structure that I needed to get through my day. And when that went away, it was like, oh, where are my keys? Or, oh, my gosh, I’m supposed to be doing what? Like, bills, did I pay that bill? I don’t know. So, those things started becoming way magnified. And I just was trying to feel like, oh, maybe I need some help.

But when I tell the kids, I don’t tell them right away. But I usually tell them six weeks into the eight-week course. Guess what? I have ADHD, too. They’re like, “What? And I’m like, “Yeah.” I want these kids so much to just realize that they have a gift, it’s not a disability, it’s their ability, it’s their unique ability, and they can learn to love themselves and reach for the stars and just know that they might have to work a little differently than other people or creatively, but they can do it. And to not let having ADHD stop you. But so many of these kids as you know, who have ADHD, oftentimes hear so much negative feedback, like, “Don’t do this. Why are you doing this? Why do you forget this again? Can’t you sit still? Stop doing that.

And so a lot of these kids internalize those feelings of like, “I’m no good. I’m always the one getting in trouble. No one likes me. I am a failure.” That inner voice is so amplified. And so my goal with this course is really, to help them understand what it is so they’re not scared. They’re not embarrassed. They learn tools, and learned systems, and learn how to talk about it with their parents, their doctors, and their team. And they learn that ADHD is my superpower. I just love this work. I just feel so good about what I’m doing now. I’m reaching the families that need it, and I’m doing it on my terms, and in my way.

Dr. JB: Yeah. I love it. This story completely blew me away.

Dr. Nerissa Bauer: Oh, thank you. It’s been a ride.

Dr. JB: Yes, especially with what you said about when we go through our training, we don’t get taught about business. All these things that I’m doing I learned them from Google and read some books to be able to do it. And so, there’s such a steep learning curve, because now you’re not in your same field, you are in a whole different field right now. But we’re not just doctors. And so there are a lot of new skills that we can learn, develop and nurture that can merge with the skill set that we have as physicians and do something even more amazing and still get the care that we intended to. But we can combine the skills that we got as a physician or working in health care along with these new skills to really create something amazing and still be able to be effective with people or with patients. Because that’s what we do every day is we talk to people, it’s our job to connect with people, and really just try to make things better for people.

Dr. Nerissa Bauer: Yes, absolutely. If you can learn how to intubate somebody and code, someone, you can do hard things. This is different, but it’s learnable. And sometimes when I was in this space of, “Gosh, do I put it out there? What if people don’t like it? Or what if it’s a great idea, but nobody else wants it?” It’s scary to put yourself out there in a different way. But if you don’t try, you will never know. And it worked out, it worked out for me and it just was meant to be.

Dr. JB: Well, if my listener wants to find out more about what you’re doing, how can they do so?

Dr. Nerissa Bauer: Thank you. So, my website is www.letstalkkidshealth.org  – altogether. And it has everything on there from my private practice, my book club, my live show, and my courses. And so that’s where you’ll want to go. Please reach out to me if you have any questions about anything, not just what I offer, but just like my journey, and how I did it. Because I’m always happy to help because I’ve been there. And I know that sometimes it can be really scary, but sometimes just having someone to talk through things like “Oh my gosh, how did you do this? How did you do that?” And hearing that there’s hope out there, there is not one path, there are so many paths. But we need to just remember, we’re not just doctors, we can do real things to help our families. And that’s where the fun is. I think.

Dr. JB: Okay, so in closing, do you have any pearls of wisdom you’d like to leave my listener?

Dr. Nerissa Bauer: Yes. So, if you’re feeling burnt out, depressed, or hopeless, that is your cue to just know it’s going to be okay, you need to ask for help. Sometimes, as doctors, we want to appear that we can do everything and anything. But we’re also human too. And again, I’m a big advocate for this because I work in the mental health space. If you’re a parent, kids can feel it when you’re not functioning at your best. And it really behooves everybody if you can get help for that. There is help, there is no shame in it and there is a supportive community that wants to see you succeed. So, take care of yourself, and then give yourself permission too, to think about what else you can do because anything is possible