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“We all knew this pandemic was going to change how we practiced medicine, but I, personally, was not prepared for how much it would challenge the ‘work-life balance’ that I have spent years carefully maneuvering. Female physicians are often hesitant to express individual needs for fear of being viewed as “weak.” I’m finding freedom in removing the stigma of weakness and shame from my own concept of vulnerability. It can unite and connect us, giving us strength and empowerment in a time when so much seems beyond our control.”
Erica Gillette is a family physician.
She shares her story and discusses her KevinMD article, “Vulnerability gives us strength in a time when so much seems beyond our control.”
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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.
Transcript
Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we have Erica Gillette. She’s a family physician, and she wrote the KevinMD article “Vulnerability gives us strength in a time when so much seems beyond our control.” Erica, welcome to the show.
Erica Gillette: Hi, thanks for having me.
Kevin Pho: So we’ll get into your article in a little bit, but first off, can you share your story and your journey to where you are today?
Erica Gillette: Sure. It’s kind of a full-circle kind of journey. I grew up in rural Kentucky, in a little, little town called Round Hill. However, if you know anything about Kentucky, everything outside of Louisville is referred to by county, so I’m actually from Edmonson County. As soon as I graduated high school, I ran really hard away, and I went to the University of Kentucky for undergrad, where I wanted to be a physical therapist, actually. I never even went to the doctor as a kid, and I didn’t know that females could be doctors.
And so somewhere around the time I was supposed to graduate undergrad and start applying to physical therapy school, I started to get a calling. That’s about the best thing I know to refer to it as. I kind of wasn’t really sure that I wanted to be a physician, but I certainly had a calling to be a rural family medicine physician. So I applied to medical school, and I went to Indiana University School of Medicine in Indianapolis, and then I stayed around in Indiana and attended residency.
After that, I kind of wanted to serve the underserved in rural communities, so I’ve been to Missouri and South Dakota, Kansas. And eventually I decided I wanted to teach as well as practice, and I made it full circle back home. Right now I am a faculty physician at a family medicine residency in Glasgow, Kentucky, which is about 30 minutes from my hometown.
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Kevin Pho: And can you tell us a little bit about your practice, and perhaps how the pandemic is affecting rural America?
Erica Gillette: So obviously I’m doing faculty teaching in a family medicine program, so I still kind of do a lot of full-scope medicine. I still round at the hospital, and I teach residents. So how the pandemic affected that, I guess, is pretty severe. You know, we did have medical students who came in and out pretty frequently, and that stopped pretty abruptly. But we had to adapt really quickly, and I really think a lot of minds put together all at once made it a lot more seamless. It was amazing how quickly we adapted and how quickly everybody jumped on board to telehealth visits.
And I really feel like we really had to relearn how to teach, and we really had to relearn how to serve our patients and how to serve our community, especially in the beginning, when so much was unknown. Doing Zoom meetings has become the norm, and for a while we were even teaching remotely, as far as didactics and lectures went. So it’s been different.
Kevin Pho: Tell us how the pandemic is affecting the patients that you’re seeing in the clinic.
Erica Gillette: You know, I can only speak for where I am, which is in a rural area. At first, I think everybody was really appreciative that we were offering telehealth visits and they could still get care. And then, I think Kentucky locked down pretty fast and pretty hard, and we started to reopen somewhere at the end of May, a little bit. And at first patients were really excited to come back, but as our numbers rise, there’s some more fear. I think there’s a lot of fear about our resources. We don’t have a lot of ICU beds. We don’t have ECMO anywhere near us; we have to send out to Louisville or Nashville for that. We don’t have a lot of specialists; we do have to ship out for things like that.
At the same time, we have a lot of other resources at our disposal. We kind of rely on each other as a community to take care of one another. It’s been a lot easier, I think, to lock down than it may have been in other places. We don’t live in apartments, generally; we live in houses, so we have yards and gardens and a lot of sharing of resources, because we all know each other. We’re all neighbors. Being a rural physician, also, I get a lot of phone calls and texts from people about how things are going on as well, so that was the difference in being back home.
Kevin Pho: Well, let’s get to your KevinMD article, “Vulnerability gives us strength in a time when so much seems beyond our control.” Now, for those of my audience who haven’t read your article, can you walk my audience through it and perhaps share the story of why you decided to write it?
Erica Gillette: The article came as almost a cathartic piece. I think early on in the pandemic, so much was unknown. There was a lot of fear and anxiety that came from social media. There were a lot of pretty vivid images, pretty vivid stories. We didn’t get hit like New York did, obviously; in fact, we’re just now starting to kind of hit our surge. But we still changed rapidly. The schools shut down. I’m the mother of three biological children. I have stepchildren as well now, but, you know, I was homeschooling while I was trying to adapt to all those changes at work. I was out scrounging for toilet paper like everybody else. I was wearing all these different hats, and, you know, they’re all hats I’ve worn before, but never at the same time, all the time.
And I felt, secretly, like a failure. I felt like I was failing at my job as a physician. I felt like I was failing at my job as a mother. I felt like I just wasn’t doing enough, or good enough, no matter what arena I was in. I had a lot of shame and a lot of guilt, I guess, for just not being able to be perfect at everything. I’d always prided myself on being able to achieve a decent balance of that work, home life, and mom balance. I had the first two kids in medical school and the third one in residency, so I’ve been doing it for a while. And all at once it felt like that scale had tipped over, and everything was chaos, and I just didn’t know how to balance it anymore. I was kind of feeling very unsure about myself in all those roles. I kind of kept it in, and I didn’t want to admit how I felt, because I felt like if I admitted that I was struggling, that was a sign of weakness.
As you probably know, my colleague and I actually wrote, initially, a two-piece article, where we both kind of wrote journal entries from a day in each of our lives and submitted them. What we found when we read each other’s journal articles was that we really weren’t. Even though her story was different, there were a lot of similarities, and we had a lot of similarities in the fact that we were struggling to admit that we were struggling, and that there was strength in admitting and being vulnerable, and reaching out to one another, and offering support to one another as well as ourselves. And in order to be authentic, we had to accept our imperfections and accept vulnerability, and then rely on one another and our colleagues, and open that door for conversation.
Kevin Pho: Now, during this podcast I’ve interviewed so many physician parents who are really struggling with that balance between homeschooling and practice, and really what the future of the pandemic brings. Are there any tips that you can share with the other physicians listening to this podcast, to perhaps help them through a similar situation to yours?
Erica Gillette: We’re all in this together, just staying in there. I think I’ve had a lot. That’s probably the question I get asked the most by other parents, not just other physician parents: “What am I supposed to do? Do I send my kid back to school? Do I not send my kid back to school? What are you doing for homeschooling?” I think for everybody the situation is going to be different, and the right answer, well, the best answer is going to be different for everyone. You do your best right now. We’re not all teachers, but our kids see us, and they see us trying, and they see the effort we put in. And I really applaud the teachers out there for all the effort they put in and all the support they’ve got behind us. I really just hope everybody’s kids don’t drive them nuts.
Kevin Pho: So we’re talking in the third week of August. What’s the situation with schools in the upcoming fall in your area?
Erica Gillette: So the governor of Kentucky just a few days ago released a recommendation that schools not go back to in-person instruction until after September the 28th. A lot of them are going to go ahead and start some virtual instruction, just to start burning some time off the clock before then. There are a couple that are going to go ahead and start some in-person sessions. I think most of them have abided by that; they’re going to start on the 28th.
The schools have been pretty, pretty rapid, just like everywhere else, about trying to do as much as they could to support their teachers, as much as they could to support their students, trying to supply laptops and whatnot for children who didn’t have them. It’s rapidly changing. Like I said, that just came through the other day, and all the schools adjusted and, you know, changed their plans again. It’s pretty fluid.
Kevin Pho: I’m sure a lot of parents are asking you for your opinion about sending kids back to school. So what kind of advice are you giving them?
Erica Gillette: I think everyone has to assess their own personal home situation and do what’s best for their family and for their children. And maybe even what’s best for one of your children may not be what’s best for all of your children, if you have multiple children. And you’ve got to encourage your child to make the most of whatever decision it is you make, and stand behind them, and support them the best that you can, and get support for yourself. I mean, this is another area where you aren’t necessarily the best teacher or instructor. You may not be great at math, or social studies, or whatever. I mean, reach out and ask for help from other families, from other friends, from other teachers, because that’s a lot to take on at home.
Kevin Pho: We’re talking to Erica Gillette. She’s a family physician, and she wrote the KevinMD article “Vulnerability gives us strength in a time when so much seems beyond our control.” Erica, is there something that you know now that you wish you knew back before the pandemic started?
Erica Gillette: I wish I had been more forgiving of myself. I wish I had known to give myself a little bit more grace as I walked through the steps. Basically, I almost feel like sometimes we walk through the stages of grief throughout the pandemic, and to give myself grace to go through them, and to be human, and to process them, just like everyone else out there. I really, really wish I had started doing what I started more recently doing, and that’s trying to find a lot of joy in every step as it comes, in, you know, the new norms of every day. It kind of changes, but there’s still a lot of joy, and a lot of fun, and a lot of great in the world. And it took me a little bit, I think, before I could see that and accept it and go in search of it.
Kevin Pho: And my final question: From the perspective of a rural family physician, do you have a take-home message that you want to share with the KevinMD audience?
Erica Gillette: I think sometimes family medicine, you know, we call it the jack of all trades. There are a lot of expectations or perceptions of what family medicine is, and as someone who teaches it, I’ve always said the beauty of family medicine is it can be almost about anything you want it to be. We’re all out there doing different things. Some of us are in the outpatient facility, some of us are rounding on inpatients, some family medicine doctors still practice OB. We’re still in the heart of America, out there in, you know, the rural communities, the cities. We’re all over. And, you know, hang tough, stay in there, and keep trying.
Also know that people are going to come to you. You’re going to be one of their resources for answers and for questioning, and you don’t always have to have them, but it’s good to have a discussion with other people. And it’s a great place to be, to feel like you have a place where your opinion or your insight can be heard. We have a lot of influence on others, and that can be a good thing and a bad thing. So just proceed with caution, and love, and grace.
Kevin Pho: Well, thank you so much for sharing your story and your insights, and once again, thank you so much for being on the show.
Erica Gillette: Thank you.
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