S7E13: Polarizing Views and Collaborative Solutions in Medicine

Austen: Oh, yeah. Sorry. From the top. Sorry, everybody. First, I forgot to turn on my mic. Now I can't even remember how to open up an episode. It's going great.

Well, welcome to "Bundle of Hers." For those listening today, my name is Austen, and I'm one of the hosts of the podcast. Today, I'm going to be joined by two of my friends and classmates, Anna and Jade, and we are going to be talking about navigating polarized systems that should be founded on collaboration. Kind of a mouthful of a topic, but really just talking about what we do when things get really divisive when they probably shouldn't be.

Just as a disclaimer before we start anything, we are going to have a conversation today that reflects our own personal opinions and views, not the views of the institution that we belong to, the University of Utah School of Medicine. So just so everyone knows, we're just talking about our own personal thoughts and feelings, not the feelings and thoughts of the institution to which we belong.

But before we jump into the topic, I'm going to turn the time over to Anna and Jade so they can introduce themselves and talk about what's important to them so you, the listeners, can understand who's talking to you.

So, Anna, if you want to go first.

Anna: Hi, my name is Anna. I'm a medical student. There's not that much interesting to say about me.

Austen: Not true. Not true at all.

Anna: I identify as a lesbian woman. I like to hang out with my cats, and that is about all you would need to know about me.

Austen: In addition to that, Anna is one of the smartest people I have ever met in my entire life, and she is hilarious. Well, thank you, Anna, for being on the podcast. I'm excited to hear what you have to say.

Jade, if you want to introduce yourself, that would be awesome.

Jade: Sure. So my name is Jade. I am also a medical student. I think that's probably the most important thing to know about me right now. I grew up as an Asian-American, so that's kind of a fun fact. And I love all things outdoors.

Austen: Jade is probably the sportiest person that I've ever encountered. We were hanging out, what was it, on Friday? And she was like, "Yeah, I just ran a half marathon." And we're like, "Oh, you signed up for a half marathon?" She's like, "No. Just for fun."

And then at that moment, my jaw was on the floor, because I was like, "Dang, to just wake up and be like, 'I want to run 13.1 miles for fun,' I could never." But congratulations to Jade.

Jade: Thank you.

Austen: Well, like I mentioned before, I kind of wanted to talk to you both about how you navigate kind of divisive environments and situations. I feel like you two are two of my close friends, and you guys are very different. I feel like have very different approaches to navigating division and sticking up for your beliefs and values and advocate for other people, but I think that you both approach it so well.

And so I'm excited that we have this time together. And hopefully this podcast comes at a meaningful time for people. I feel like election season is so weird because everything becomes so divisive and polarized. I have been thinking a lot about division within society as a whole.

And politically, I think that there are so many parallels that we can draw from polarization in society to polarization within the medical system, be it amongst physicians who are practicing, or medical students, or medical education.

And so I kind of want to dive in and ask you about the dynamics of our class, of what you guys see going on. I think we have a cool class, I like our class, but from my perspective, I feel like there is sometimes division, and that can sometimes lead to contention.

I kind of just want to get your guys' opinions and ideas of what's going on and how you think that affects productivity and feelings of collegiality in our class.

Jade, if you want to go first.

Jade: I would love to. I find this topic really interesting just because I thought about it a lot, too, especially with some of the unique discussions we get to take part in or we had during the past two years in classes and in lectures.

I think back to our first week in medical school, and I think sometime during that week, we were told that the class we had was one of the most diverse classes to enter into the school of medicine, which was a really good thing and I really find that to be a really big step forward.

And it was interesting going through classes to then start to feel like there was just one right way to think about things, and it didn't really make sense in my mind. If we had so much diversity, so much diversity in thought, and just the type of people we were and where we came from and our background, how was it possible for us to all be thinking the same way about certain topics?

To kind of backtrack, I think our class is amazing. I've had lots of discussions within and outside of classroom settings of where we could talk about what we thought and have a discussion in a non-judgmental way. And I think that's been really amazing.

Austen: No, that's definitely awesome. I agree. I feel like I had a different reaction when they were like, "This is the most diverse class." I was like, "For real?" I was so confused. But I think that is something to give us hope that there will be diversity of thought and experience and perspective, and hopefully that'll continue as the years pass.

I like you bringing up how that diversity should be the foundation of respectful discussion. And I think that'll only help other people kind of broaden perspectives and stuff like that. And so I like you mentioning that.

L-O-L at us having very different reactions, but I think, yeah, it's hopeful overall to know that the class is getting more diverse and hopefully reflecting the more diverse society which we live in. Maybe not so much in our state, but in the country as a whole.

Jade: Yeah, I just . . . Sorry, can I add one more thing really quick?

Austen: Of course.

Jade: Just what you were saying of when you were taken aback when they said that, I think a lot of diversity also comes through patterns of thought and behavior, right? And sometimes those are things that we can't really see right off the bat.

I think that's maybe where we're seeing a lot with politics and elections and things like that. What are my classmates thinking about this same thing? And I think that's where it's kind of fun to learn about and hear.

Austen: Definitely. Anna, what are your thoughts about diversity in our class and division?

Anna: I think Jade has an optimistic outlook that is very refreshing, especially about the class, to hear it's the most diverse class ever and be like, "Yeah, that's awesome," instead of looking around and being like, "Yeah, whatever." I think I shared Austen's reaction to that sentiment a little bit more.

And I think your point about diversity of thought is not something that you can necessarily measure. One of my personal problems with diversity, and this is a vulnerable moment, but I feel like I tend to see people's visible appearance or their identities that they have or that they mention, and then I tend to attribute a pattern of thought to them based on who they interact with, things based on their physical nature, instead of really engaging in conversation with them.

I feel like that's where I wish I could be a little bit more like Jade, who is interested in being like, "Yeah, I would love to talk about how we think differently."

I feel like part of my own problem is I've been hurt by other people's various opinions of me and my lifestyle choices. And so I tend to put up a barrier in that regard. I think our class has really helped me to kind of break that down because when you inevitably talk to people, like Jade is saying, you learn that people do have more diversity of thought than you would think based on maybe the not-so-diverse demographics of the class, if that makes sense.

Austen: That definitely makes sense. You mentioned something that is so important and I think that a lot of people can relate to, is when you find out an identity that someone has, whether that be a physical identity for some people, or an identity that they share openly that might not be physical but definitely affects their life in many different ways, I think a lot of people's kind of gut reaction is to then be like, "Okay. So you feel X, Y, and Z about topic one, two, and three."

I think it's hard when we make those decisions or we have those assumptions based off of past experiences. Especially if you have lived experiences where you've been burned in the past by someone who has those identities, I think it makes sense to be like, "Well, you're going to think this way about me, so we're going to keep it rolling."

First of all, thank you for that vulnerable moment. But then also, I think that makes sense. I feel like everyone does that to some degree. I think a lot of that is protective, right? I mean, you want to make sure that you are maintaining your peace, that you are creating a space where you feel comfortable, where those around you feel comfortable.

And sometimes you really do have to just be like, "I don't want to start a fight today, so I'm just not going to hang out with you, Joe Blue, over there." You've just got to maintain boundaries to make sure that you're in a good place and that the other people around you are in a good place.

So often in medical school or in our future professions, we won't really get the option to just be like, "I can't talk to you right now." When we're in a learning environment, that's one thing. In the classroom, you can kind of just disengage and be like, "Whatever. You have your whack ideas. I'm just going to settle in myself and just astral-project while everyone is having a conversation."

But when we are on a hospital team or when we are treating patients, so much of medicine is collaborative, and so much of that collaboration happens between people and teams who do not see eye to eye. But that's something that we kind of just have to lean into sometimes, even though we don't really want to, which is frustrating, but hopefully an opportunity for us to kind of explore how we do that.

I was on an elective a couple weeks ago for a specialty that will remain nameless, because I don't know what the rules are about calling out different specialties, and it was interesting to hear them talk about different specialties.

You think, "As an individual, I'm allowed to have these opinions, and other people can have their opinions. I might not want to hang out with them, but it's whatever." But then when you get to a professional sphere, it kind of changes.

So I was listening to professionals be like, "Well, we are radiology and Joe Schmoe in cards think this. Obviously, he doesn't know as much," or whatever. And it was interesting to see them operate in a professional setting that way.

I feel like if I'm an expert in one field, I can't discount an expert in their own field just because we view things differently. And so it was just kind of surprising to me to see it, honestly. You think everyone on a treatment team gets along always and everyone sees eye to eye, but that's not always the case.

And so I think that med school and medical education gives us the opportunity to kind of practice collaborating with people that we don't want to collaborate with. And sometimes that won't always be the case, it can't happen, but it's interesting that this is something that's perpetuated in the profession.

That kind of moves into why this conversation is important, at least in my opinion. I would love to get your guys' thoughts on this as well. I just feel like division inhibits collaboration. There's so much division that is generated by us and we think that there are differences, but then there's also real division that exists.

And I feel like no matter the cause of the division, it can really mess things up, and it can prevent us from growing as individuals and learning. It can prevent us from accomplishing goals, whether that be personal goals or patient-centered goals. And so I feel like it is such an obstacle that needs to be overcome within the medical field.

Jade, I'm going to popcorn this back to you, but what are your thoughts? Because I feel like you're really good at collaborating with people that you do not get along with. I feel like you're really good at giving opposing opinions and people who hold those opposing opinions space and room. So I want to get your thoughts on that, collaborating with people that you do not necessarily agree with and you might even really disagree with.

Jade: Sure. I think a lot of the things that go through my head first is respect. I want to start and end every conversation with respect to the individual, because I think regardless of our opinions and our thoughts, when it comes down to it, we're all citizens of the earth. And I think that bears in its place the type of respect that everyone should be treated with.

I'm not saying that I'm perfect at this, but I always try to see things from their point of view. It changes depending on whether we're talking about a specialty or between med students or things like that. But I think everyone has their own background that influences their opinion towards something, and I think those are really important to consider when I have a discussion with someone.

For example, one of the things that was kind of hard for me going through med school was learning that the way that I learned was not the same as the way that perhaps 70% of the class learned.

And it was weird to be hearing all of these thoughts and things from classmates saying, "Oh, this is how I study, and this is the best way to do it," for whatever reason. It was hard for me to try that and then just have it not work. It was like, "Why is this one way that's supposed to be foolproof not working?"

I kind of wish, looking back on it, that we had even just in the learning a little bit more collaboration. But at the same time, I can listen to someone and I can respect them, and I can listen to their opinions, but if they aren't willing to listen to my opinions and put themselves in my shoes or see things from my perspective, that collaboration is very difficult.

Austen: Definitely. I feel like collaboration, just like you said, is so dependent on mutual respect and, at the very least, mutual intent to understand or intent to listen. So thank you for mentioning that.

Anna, what are your thoughts about division and collaborating with people who you don't agree with?

Anna: Yeah, I think this topic is really difficult. And I think the biggest struggle I have with it is I do a lot of that. I come into the conversation thinking I am right. I'm holding to my opinion, and I feel like I can listen to your opinion and try, but at the end of the day, I will always come back to I think I'm right. And that is obviously not a great place to start collaboration from.

It's kind of twofold in things that are political or religious and these really deep-rooted beliefs. You have to come to a conversation knowing you're not going to change their opinion and they're not going to change yours.

And so it helps me to recognize, "Yeah, I'm really stubborn in this thought," to reflect that back, and be like, "Well, they're probably really stubborn in their thought." And so if we can have a productive conversation built on respect, like Jade was saying, then that's fine. But if not, then that's kind of where you can be like, "Maybe this isn't a great conversation to be having."

But as far as collaboration on a team in medicine, working, and maybe you have a different opinion about something, that is where it's really harmful to come to the docket with, "I know I'm right and I'm just waiting to prove you wrong," because it totally closes the door to any sort of potential that they might be right.

And so, in that case, I think it takes a lot of practice and humility to be like, "I'm going to not even think about what I think is right for a second so I can truly evaluate what the other person is saying."

I think doing that allows you to reason even within yourself. Maybe they're not even going to listen to what your ideas are, it might not be a mutual respect thing, but you can at least be like, "Well, I know that I've evaluated without letting my own opinion or ego get in the way."

Austen: I love that. I feel like that is, just like you said, something that takes so much practice. For a lot of people, you go into a conversation, especially if it's a heated conversation where there are very deeply held beliefs that are diametrically opposed, I think human nature, a lot of times, we're just like, "Well, I'm right, and it doesn't matter what you say because I know what I think is true." I think it's so hard to get out of that mindset.

But just like you said, as soon as that takes over, you eliminate the possibility that they could be right, that they could bring options, they could bring viable solutions to whatever problem is in front of you. And so I like how you mentioned that.

I, right now, am a sucker for sweetie pie Pete Buttigieg. I don't know what it is about that man. I love him so much. We already did the disclosure. This is a personal belief, not one for the school, but I just think he's so great.

He was on a late-night show with someone. But he said, "What is the point of a conversation if you're not speaking to people who don't already agree with you?" But it can be hard.

I like how both of you kind of acknowledged that and gave good solutions for it. It's not just like, "I'm going to spit my opinions at you. You're going to spit them at me," but, "Hopefully we can talk about this like an adult. And even if my opinion isn't changed, maybe there's something I can kind of learn from you, or I can take from what you said and kind of use it in a way that's helpful and productive."

Jade, are you raising your hand?

Anna: Yeah. I just wanted to add something. I guess I didn't have to raise my hand. I just didn't want to interrupt you and your beautiful thoughts.

When you were talking about finding a solution, I think one thing that's important, too, is to keep in mind what the purpose of that conversation is, right? If we already have the same views, why are we having a conversation? I agree with that. I think conversations are there for us to enhance our perspectives and to see things a little bit differently.

Collaboration happens a lot better when we do have a unified purpose. Going into healthcare, this is kind of easier, not 100% easy, but we remember the patient. What are we trying to do to help this patient? And I think if our purpose is unified, then maybe the way we help this patient . . . maybe there are multiple ways to help this patient. But as long as the patient is helped, does it really matter what specific way it takes?

And I think that's one thing that's kind of, I don't know, something that I think about a lot. When conflict or contention arises, it's like, "What actually matters in this case?"

Austen: That's an interesting thought. Sometimes we think that the road to a solution is what matters most, when maybe it's the destination. The solution is what is most important. But our own personal feelings kind of make us think that we have to take our road to get there. So I like that. Thank you for mentioning that, Jade.

I'm going to kind of switch gears a little bit. We've been talking about collaboration, which is important, and I love an action item, so I'm glad that we've talked about this. But I feel like collaboration, while that's the goal, sometimes we do need to kind of advocate. We need to take a stand and be like, "You know what? Even though I respect you, we don't see eye to eye on this. And this is kind of what I'm thinking about."

And so I want to kind of get your thoughts about how you balance collaboration with being an advocate. Anna, I want to get your thoughts on this, because you are bold and fierce, and honestly, that's probably one of the things I admire most about you.

Anna: You are too sweet. It's a double-edged sword, because you can be too fierce and too bold.

Austen: Never.

Anna: I think this is a really difficult thing. And I feel like in medicine especially, it's a difficult thing because there are a lot of hierarchical power dynamics. It's a lot easier to be bold and advocate for yourself amongst peers, in my personal opinion, than it is with your superior.

I think what you're saying is just that it takes practice to gather this balance of respect for other people's opinions. Personally, I think when it crosses over the line of making assumptions about other people's identities or making remarks that are inappropriate is when I feel like it's warranted to stand up for yourself and say, "Hey, I disagree about that."

And as long as you approach it in a way that's respectful, I think the other party is a lot more willing to listen to you, as opposed to just being like, "Hey, that is racist and sexist and homophobic," and then they're like, "Yeah, yeah, yeah, whatever."

I feel like it's saying, "Hey, that hurt my feelings," or, "Hey, I think that could be misconstrued. I'm not sure if that's what you were meaning," and always give them the benefit of the doubt that they probably weren't meaning to hurt anyone's feelings.

Sometimes people say things without thinking, and so giving them the benefit of the doubt, but not being afraid to say, "Hey, that affected me in X way."

With superiors, that's a whole different story. But with peers, I feel like that's kind of the approach I would take.

Austen: I like that. What would you say for people who might be conflict-averse? How would you encourage them or what instruction would you give to someone who might be conflict-averse who maybe wants to be a better advocate for themselves or others in very divisive situations?

Anna: That's a very thoughtful question. It depends, but my advice would be, for me, sometimes it's easier to think about someone else. If someone's being mean to me, sometimes I'm like, "I can just take it." But picture someone's remarks being targeted at a really close friend or someone you care a lot about, and it might be easier for you to have the courage to stand up for them.

I think being a little conflict-averse already sets you up for success because you're not going to be as brash and rude in your addressing of the conflict. And so take that skill, that you're averse to conflict, and then put behind it some love for the party that might be being offended in the situation or one that might need an advocate.

It can be helpful to practice, "I'm going to stand up for this person." Sometimes I find that's easier than standing up for myself, and then it trickles over, and then you can get too confident.

Austen: I think that is super helpful. I feel like so often being conflict-averse is seen as a weakness. It's seen as, "Well, I'm meek and I can't talk to people, and I get nervous when I say what's on my mind," but I like how you framed it as a strength.

Ultimately, everyone's going to have a different approach to how they become an advocate. And so I like how even something that we perceive as a weakness of sorts or something that we're working on can be kind of the springboard for our personal growth and development, and the springboard for us becoming fierce advocates and allies for those around us. I love that perspective. So cool.

Jade, what are your thoughts about being an advocate in divisive situations or environments?

Jade: Well, I think I definitely am very conflict-averse. I don't think I have as much confidence as Anna in just calling someone out, and I wish I had a little bit more. But one thing that I found helpful is, like I said at the beginning, I try to choose to not be offended. If anything was headed my way, I always choose to try to not be offended.

And like Anna was saying, if it was something that was said to someone that I really cared about, I think it is easier to say something and to stand up for them.

The way that I found to be super helpful, which I don't know if it's the correct way, but I tend to ask questions. And I think being a student it's a lot easier to say, "Hey, I don't understand why you said whatever or why you did whatever it may have been. Could you explain to me how this is important or how this matters?"

I've found a lot of times when I have brought that up, there comes a point where the person I was talking to will say, "Oh, yeah. Well, maybe that could have been a little different."

In a way, it might not be as direct, but it, I think, puts a different perspective and a different thought into that other person's mind that hopefully does a little bit good in the future.

Austen: Yeah, I'm sure that it would. I like the approach of having a call-in. So often people think, or at least I think, that to be a good advocate, I have to call people out, and that's not always the case.

I like the approach that you offered, that we can ask for clarification, ask someone else to be like, "Well, what did you mean by that?" and then that gives them the opportunity to reflect and be like, "Well, damn. What did I mean by that? Why did I say that? Should I have said that?"

And so I like that approach. I like both of your guys' approaches, I feel like. This has been really helpful for me and super enlightening, and I'm sure it will be for the people who are listening.

If you can have collaboration in incredibly divisive environments and communities, I feel like what I have learned is that we can be both an advocate for ourselves while still maintaining respect for the people that have opposing views to us. We still have the opportunity to collaborate.

We don't need to always collaborate, though, and I think that's something to remember. Sometimes we have to draw very real lines in the sand and be like, "For my safety, for my sanity, this isn't going to work. I'm just kind of going to minimize interaction with you."

But when that isn't an option, when we have to interact with people professionally or in whatever capacity, it's nice to know that there are options that exist. We can try to listen without preparing for some sort of verbal battle, and we can call people in, in different ways, whether that's asking them to reflect on what they said and clarifying it for the group, or thinking about the people that we love, the people that we want to do justice, and speaking up for them in situations that call for it.

So thank you, ladies, for joining me. This has been great for me. I hope you've had fun. I've had a ball.

With that, I guess we'll do a quick sign-off. Thank you so much for joining us on "Bundle of Hers." This has been Austen, one of the regular hosts, joined by my guests, Anna and Jade.

Just a reminder, you can listen to us wherever you podcast. We have new episodes released every other week, so join us in two weeks for a new episode.

Thanks. Bye, guys.