How mentors changed this physician’s life [PODCAST]

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“Dr. Good’s willing intervention and active interest in my development kept me in medical school and led me to become an academic anesthesiologist. When his career took a turn toward administration, his mentor, Dr. J. S. Gravenstein, took over. He convinced me to stay at the University of Florida, and a couple of years later, when I mentioned a need for a good introductory anesthesia textbook geared to medical students, he suggested we co-write one. So we did. Writing Essential Anesthesia: From Science to Practice together was an incredible journey. Not just through selecting topics and writing and choosing diagrams and writing and working with publishers and proofs and reviews, but through his innumerable stories about the evolution of anesthesia during his career and the story of his remarkable life. But that’s a topic for another article, or a full-length book, or series, on its own. Sadly, Dr. J. S. Gravenstein did not live to see the publication of the 2nd Edition of our book. Instead, two of his sons wrote it with me. But Dr. Gravenstein made me into the educator I became.”

Tammy Euliano is an anesthesiologist and author of Fatal Intent.

She shares her story and discusses her KevinMD article, “The inestimable value of a mentor.”

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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 Tammy Euliano. She is an anesthesiologist and an author, and she wrote the KevinMD article “The inestimable value of a mentor.” Tammy, welcome to the show.

Tammy Euliano: Thank you very much. Happy to be here.

Kevin Pho: So again, the article in a little bit, but first off, can you share your story and journey to where you are today?

Tammy Euliano: It’s actually part of the article, but I am a UF lifer. I went to undergrad, medical school, residency, and fellowship, and joined the faculty right after graduation. During that time, I had some ups and downs as far as my life goals, and I considered quitting medical school on a number of occasions, as probably a lot of your listeners considered at some point. I’m glad in the end that I stuck it out, and largely because of great mentorship, I was able to achieve goals that continued to evolve over the course of my career.

Mostly I do obstetric anesthesia now. I was a residency program director for five years and ran a medical student clerkship, and I was sort of headed down that academic administrative path when I realized that was not where my skills lay. I wrote an introductory textbook to anesthesia with one of my mentors, and as we finished that, he said, “Let’s do something else together.” And so we started writing a fiction book. He passed away before we made much progress, but that became my encore career. So now that I’ve made full professor, I’ve sort of wrapped up my research, and now I’m 60 percent clinical, and with the rest of it, I’m launching a career as a fiction writer.

Kevin Pho: Tell me, from your lens as an anesthesiologist, what are some of the challenges today facing your profession?

Tammy Euliano: Just getting there is a challenge. I do a lot of mentoring of undergraduates who are trying to get into medical school, and our ability to choose the right people is not that good. We end up picking some people who aren’t really cut out for medicine, and some people who I think would be fabulous physicians aren’t blessed with the opportunity.

And then now residency selection. Well, medical school itself has changed dramatically, at least here at UF. Even before the pandemic, largely the students were watching class online, so the camaraderie of classmates sort of suffering together through medical school is quite different than when I came through. Other than on their rotations, there really isn’t that sense of working together. We have some nice ways, little groups that we get them into, but I was the head of one of those little groups of eight students, and they didn’t even know some of their classmates, which was remarkable to me.

And then now, to get into residency, it’s a real challenge for program directors, now that the majority of schools are pass/fail, and now next year even USMLE Step 1 will be pass/fail. So it becomes extraordinarily difficult, from our side, to tell who’s going to succeed, and from their side, to stand out. So it really is evolving.

And then once you get to anesthesia, there’s the political stuff between extenders and physicians, and different politics in various states and with the VA system. I’m not involved in any of that, but I read about it. And then there are drug shortages, and people dictating how we do things in ways that aren’t necessarily the best for our patients, which I think faces every specialty.

So it’s interesting and scary at times, but it is so worth it when you get to take care of a sick patient and successfully get them through an operation, or you take care of a young mom and she has a successful, relatively pain-free delivery. It’s still a very worthwhile profession.

Kevin Pho: For those in medical school considering a career in anesthesia, what are some of the character traits that you look out for in order for them to be successful as an anesthesiologist?

Tammy Euliano: Several things. One is a love of physiology. That’s what we do; it’s a live physiology lab all day, every day. So a desire to understand the tenets and be able to apply them in real time. The ability to stay calm in a storm. And then you have to gain the patient’s trust in a very short period of time, right when you meet them.

And then you have to be able to really work on your own, largely. There’s not a lot of, there is a team, yourself and the extenders or the residents, but you don’t do rounds with eight other medicine residents or anything like that. It’s very much working on your own with the surgical team.

And then it takes a lot of reading, because you have to know every area of medicine. You have to be able to read the pre-op, remember all those medical diseases, and know what the surgeons are doing. So it’s very broad, because it’s everything from pediatrics to geriatrics to pregnant women, and then the specialties; I do obstetrics. There are other specialties, but it’s really a great field.

I think it’s under-recognized, because we don’t show up on ER or Grey’s Anatomy with any frequency, but we really do have a major role in the medical care system. And I encourage medical students to check us out, because you may not even have a required rotation. So when you’re on your surgery rotation, spend some time up with the anesthesiologists and ask about what they do. We do a lot of fun stuff.

Kevin Pho: So let’s transition now to your KevinMD article, where you talk about the value of mentorship and how mentorship affected your own life. Now, for those who didn’t read that article, can you just walk my audience through it and share a story of why you decided to write it?

Tammy Euliano: Mentorship is a very big word right now, and there are lots of politics about it, but I’ve had a very grassroots mentorship. I found my own mentors and was very blessed to find people who were willing to mentor me, and when one moved on, I found another one. When you find the right person who is willing to support your goals and encourage you and guide you and check in with you on a regular basis and tell you when you’re going in the wrong direction, it’s just immeasurably valuable.

So when I was in medical school, and not sure it was really what I wanted to do, and thought about dropping out, I was just so lucky that my attending at the time said, “You know, before you sign that paper, why don’t you meet this person?” He introduced me to Mike Good, who was at the time inventing the first human patient simulator, and that catered to my engineering interest. And so I started working on the project.

And it seems sort of silly that someone who’s struggling in medical school would then spend all of her time not studying for medical school, but it gave me an outlet, something that really fascinated me, and it kept me in school and kept me fascinated through residency. It gave me something to do my fellowship on, which was the simulator. And then Dr. J. S. Gravenstein, who some of your listeners may remember, started our department. He then took me under his wing for teaching and writing our textbook. And now I’m finding mentors in writing, which is just such an important thing.

So I encourage people to try to find somebody. It doesn’t have to be the same sex. They probably should be older than you and more experienced than you and have an interest; you don’t want to force somebody into it. It’s got to be a two-way relationship, and it takes time, and it can’t be all you taking. You need to be a good listener and accept their advice and follow through. When they say, “Read this article and let’s talk about it,” if you don’t do that, they’re going to assume you’re not actually all that interested in mentorship. So it definitely takes effort on both sides.

Kevin Pho: So I want to elaborate more in terms of that fit in the mentor and mentee relationship. For those premedical students, medical students, or even young physicians who are looking for mentors, what are some of the characteristics that define whether that particular mentor is a good fit for them?

Tammy Euliano: Ideally, they would have similar values, which is hard to tell from an external view of their CV or anything, but they don’t have to be in the field you’re planning to go into. And I discourage undergrads from choosing a field, because they just don’t know enough to pick at that stage. So it’s anyone who is willing to invest the time and who seems to have a similar life that you want.

So if you want to be a parent who’s really involved with your kids and has quite a life outside, then probably the neurosurgeon down the street is not going to be your best mentor, because they’re not going to necessarily see the world the same way that you do. Not that neurosurgeons can’t have a life, but on average, they are going to be way more invested in their career than maybe their kids’ soccer games on a weekly basis. I hope I’m not offending any neurosurgeons there.

And that happened to me. I had a great relationship with one of our surgeons, but when he never wanted to leave the hospital, and was disappointed when cases got canceled at 7:00 p.m., I realized that was probably not going to be the best mentoring relationship, because I was going to disappoint him with my desire to actually spend time with my husband.

So you do have to find somebody, and it’s OK to try out a couple of relationships and decide that that’s probably not the right fit and try another one. We’re not going to be offended if you decide that you would prefer a different mentor. It’s supposed to be helpful, not stressful.

Kevin Pho: Let’s say you’re a medical student looking for a mentor. What’s the exact process of going about finding one? Do you just kind of cold contact people? Are there any resources within medical schools that can help with that matching process?

Tammy Euliano: I’m sure it depends on the medical school. We have a system here where there’s a secretary assigned to help medical students find people to shadow, both medical students and undergrads, and from the shadowing relationship, you can sort of grow from there, if you see professors that you kind of bond with. Research projects: I’ve ended up mentoring several students who started out as students under me for research projects. And that’s a great way to show your interest and then foster a deeper relationship.

Kevin Pho: We’re talking to Tammy Euliano. She’s an anesthesiologist, and she wrote the KevinMD article “The inestimable value of a mentor.” Tammy, I want to talk more about your burgeoning writing career. So tell me about that transition from anesthesiology into being a published author.

Tammy Euliano: It was humbling. You’ve written all these textbooks and medical articles, and I do a lot of editing of personal statements and things, and I thought I pretty much knew how to write. And then I sat down with a blank page and went, “I have no idea how to begin.” So I read a bunch of articles, and I read a bunch of books, and took some classes. I had the idea already for the book, as far as I wanted it to be about end of life and the decisions related to terminal care, without being too morbid. And so it just sort of evolved over a very significant number of years, with lots of edits and rewrites and starting over.

It’s fascinating to me that there are so many other fields that are just as detailed as medicine; they’re just different. So writing has at least as many textbooks as anesthesia does, or any field of medicine, and it takes just as much training and work and advice as being a good physician. So I’ve learned a ton. I’ve met some amazing people, and I’m proud of what we ended up with.

So it was a multiyear process and lots of rejection, which was not something I was used to. I mean, certainly I’d get papers rejected, but I’d get them accepted somewhere else. I knew if I worked hard enough I would get where I wanted to be, and I got my patents and my grants and things. But with writing, you could write forever and maybe never get published. But then there are some avenues to start with.

And so eventually I found a publisher, and Fatal Intent was the result. It took another year after that. And now the sequel is about to go to the publisher for release next year. And of course, it’s featuring an anesthesiologist as the main character. It’s about time we got a little bit of decent press in the public fiction arena.

Kevin Pho: And as you mentioned, your book is titled Fatal Intent. It’s a novel. Now, for those physicians who are interested in becoming published authors, what are some actionable tips that you could share from your own experience?

Tammy Euliano: Read widely, and do more than just read for fun. It’s very easy to get invested in the story and not pay attention to the mechanics of it, and I still have trouble with that. But try to think about: What’s the point of view? How did they create this scene? You know, the actual how it works. Read some craft books on fiction.

And then, I was not given this advice until pretty late, but try starting with a short story. It’s so much more manageable, but it has the same character arcs and plot that have to fit together. It’s also much easier to get those published, and they’re bite-size.

And then what really helped me was going to some writer conferences. So once you figure out your genre, go to a conference where people who write that are there, and you can meet them and talk to them and create some friendships. I went to ThrillerFest, which is in New York City, and on the back of my book are a bunch of blurbs from Tess Gerritsen and Kathy Reichs, and it’s all because I met them at ThrillerFest. They’re just the most gracious people, but if I hadn’t spoken to them in person, I don’t think I would have been able to generate the blurbs. And it’s also just so inspiring to meet those people and hear their stories.

Just like in medicine, you’ve got to work on your craft, and there’s maybe a little more creativity to it than most of what we do in medicine. And if you want to write nonfiction, then obviously that’s a little bit different road, but the principles are the same. You have to put one word after another, and then you have to erase a few and put some more words in there.

Kevin Pho: And my final question: What are some of your take-home messages that you want to leave with the KevinMD audience?

Tammy Euliano: The first one is find a mentor, or many mentors. You can have a mentor for being a parent, you can have a mentor for your spiritual life, and you can have a mentor for your work life. But taking advice, accepting advice (you don’t have to accept everything), having someone you can discuss your issues with and whose advice you value is, I think, huge, because we don’t have to all reinvent the wheel. We can learn from others’ mistakes. It’s just like M&M conferences during medical school; it’s useful to see how other people have solved problems.

And then, just a general parenting thing: I tell all the medical students to plan to take one child out at a time on a date, if you have more than one child, and that has been just huge for me. My kids are all grown now, and they still talk about “mommy days,” when I would take an afternoon off and just take one of them out to get ice cream or read a book.

And then, if you do have a passion, look for a passion outside of your primary field. During training probably isn’t the right time to do it, but further along, it’s nice to have something else to have an encore career with that isn’t necessarily 100 percent linked to being a doctor. Mine happens to be writing, but art, travel, anything, but something that recharges your battery outside of the hospital.

Kevin Pho: Tammy, thank you so much for sharing your time and insight, and thanks again for being on the show.

Tammy Euliano: Thank you.

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