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Pediatric hematology-oncology physician and co-founder of Pink Coat, MD Tammie Chang discusses the article “Unhooking from the ego in medicine.” Tammie shares her personal journey through depression and clinical burnout, explaining how these challenges forced her to disconnect from a professional identity rooted in ego and achievement. She describes the neurological shift from a left-brain focus on analysis to a right-brain focus on intuition and interconnectedness. By choosing to show up as a loving presence in the exam room, Tammie found that she could complete her work with more joy and less exhaustion. This transformation allowed her to move away from being an automaton of productivity and toward a state of equanimity. Her experience suggests that physicians can find peace even amidst global uncertainty by reclaiming their true selves. True healing begins when we prioritize human connection over the need to always be right.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome back Tammie Chang. She is a pediatric hematology-oncology physician and co-founder of Pink Coat, MD. Today’s KevinMD article is “Unhooking from the ego in medicine.” Tammie, as we have been talking about offline, it has been many years since we have last spoken.

Tammie Chang: I know it is good to be back. Thanks for having me.

Kevin Pho: All right, so tell us about your latest article, “Unhooking from the ego in medicine.” Why did you decide to write it and share it on KevinMD?

Tammie Chang: Oh, well, I was so glad and so privileged to get to share it with you and your readers. To me, your readers and our readers are our colleagues. They are our friends and our peers. I disappeared for about three years, which is why I haven’t been on your podcast or been doing much speaking or writing. I actually had a very hard time. Part of my story from before was that I had been doing this work and I had been in the wellness officer role for several years. But before that, what got me into this whole space and the mental health space was experiencing severe burnout, depression, and suicidal thoughts. Ultimately, I became a big advocate for well-being.

I advocated for addressing burnout in health care, making changes, and reducing and removing the stigma from mental health for us in medicine because it is pervasive. It is the reality of the work we do. So that became really my passion and my “why” for a very long time. Yet even in spite of all that, and learning so many skills and becoming a coach, I actually had a really hard time the last three years. I was again burned out, suicidal, and severely depressed. That is why I disappeared. It is interesting how even when we are doing this work that is so deeply passion-driven, purpose-driven, and fun, it can still burn us out too if we bring a certain level of intensity to it.

We bring ourselves into whatever we do. That level of intensity and drive is common among physicians. We are all so driven, striving, high-achieving, exceptional, and really talented. We can do a lot of things, and yet we can really hurt ourselves in the process too. So that was why I wrote this essay.

Kevin Pho: You were a chief wellness officer and a coach. You talked about burnout, but you burned out yourself. Then you had that period for three years. Tell us what you have learned during that time away.

Tammie Chang: That is really what I write about in that brief, reflective essay. It is really about figuring out who we are and who we really are separate from all the identities that we put on ourselves in work and in life, especially for us as physicians. At least for me, I won’t speak for everyone else, but I am so achievement-driven. Since I was three years old, I have been achieving. I had the Asian family, immigrant parents, and all of it. Bringing that intensity to even that kind of work really became who I was and what my identity was. When things were not going well, which is inevitable in any kind of work, especially that kind of work, it then meant I was not OK.

It really became a period where I had two more breakdowns essentially. I am sharing this very openly with people around me because I think it is important for us to realize that it is not like once we have had this big awakening and we are doing better that we have got it and we are good forever. Actually, we are still learning and being humbled by life every single day and every year. What I learned honestly was how to unhook from myself in a way from all the things that I thought I needed to be, or that were honestly driven by my ego.

Kevin Pho: So you mentioned that you had to essentially unhook yourself from a particular identity that you were so familiar with for who knows how long. How difficult was that for you? What was that process like?

Tammie Chang: I actually think it took having complete breakdowns. That is how dramatic it had to be and what I had to go through. Honestly, it is why I wrote this, because I know other people are struggling in similar ways, and I don’t want anyone to have to go through a complete breakdown to find peace. We don’t have to completely get to the point where we think we are going to hurt ourselves again. That is where I got, and I had to take a leave of absence again even though I had all these skills. I don’t want that for anyone. I don’t want anyone to feel they have to get to that point ever to find the joy and the peace that I truly have. I have a freedom now that I have never had in my life. I want others to be able to glimpse that or to know it is possible out there.

Kevin Pho: So, without getting into too much detail, you had the skills to deal with burnout. You coached it, you talked about it, and you were a chief wellness officer. In your particular situation, why didn’t those skills work?

Tammie Chang: Honestly, I have actually been learning a lot about the neuroscience and the neuropsychology of how we experience life as human beings, not just physicians. I think it is so clear that, especially in the Western world, and especially in medicine, we live on the left side of our brains. That side is all about strategy, achievement, ego, fear, anxiety, production, productivity, and striving. We live in that, and it is almost like that left side of our brain is so hypertrophied that we don’t tap into the right side.

The right side is the only part of our brain that helps us understand that we are interconnected as human beings. It actually has no sense of self or ego. I wrote about that in the article because it has been transformational for me. Learning that our ego and sense of “me,” like Tammie Chang or whatever, is only limited to the left side of our brain was eye-opening. If we can intentionally strengthen and tap into that right side, that is actually where we can find peace. This is based on the work of Jill Bolte Taylor. Maybe some of your listeners have heard of her. She was super famous. She did the very first ever viral TED Talk in 2008.

Kevin Pho: She was a Harvard neuroscientist who had a full left-sided stroke when she was 37.

Tammie Chang: “My Stroke of Insight.” She has become a dear friend and mentor. I feel like it is the universe that brought her into my life. Because of her work, that has been what has transformed my experience of the world. It is something that I openly want to share with everyone else because it is true. Peace is really, truly just a thought away, and we can access that at any moment in time.

Kevin Pho: So tell us some of the things that you did to proverbially access the right side of your brain. What were some things that you did?

Tammie Chang: I think we hear so much about meditation, mindfulness, prayer practices, and our spiritual connection. That is all the right frontal cortex. So that actually was my transformation. It was really leaning into it because it felt natural and it felt right, but I didn’t understand the science behind it. I think what is so powerful about the neuroscience work is what Jill Bolte Taylor calls “whole brain living.” We can access that quadrant of our brain at any moment by intentionally strengthening it. Just like monks who meditate every single day, when you look at functional MRIs of their brains, they are lit up all over, but especially strong on the right side.

Whereas if you look at us in the Western world working like dogs, we are just all on the left side. I literally intentionally practice that every single day, every morning. That really became, and it still is, a routine of mine today.

Kevin Pho: So tell us about that routine. So every morning you would meditate and reflect. Tell us what that is like.

Tammie Chang: It is actually the first thing I do when I get up. Now every morning I get up really early, definitely by 6:00 a.m. just so it is quiet. There is nothing else going on, and I don’t have to work yet. I go into a special room that I have really made for my space. I meditate and I definitely do guided ones. I am not advanced enough to do it by myself, and I actually find it really peaceful. It is a nice routine. I do the same few meditations and it is only for maybe five or ten minutes, sometimes less if I am short on time, and then I will do some breathing exercises.

Then if I have time, I will do a little journaling. I literally do the Five Minute Journal, so it is super easy. It doesn’t even take five minutes. If anyone has ever heard of the Five Minute Journal, it is by Intelligent Change. It is like 30 bucks on Amazon and it literally asks: “What are the three things I am grateful for today? What are the three things that would make today great?” The next line is: “My intention for today is X.” It literally takes me two minutes to fill that out. Then at night, I do the same routine going to bed. It involves stopping, slowing down, and reflecting on the three things I learned today and what the highlights of today were. It just helps ground us in the space of not always going and achieving constantly.

Kevin Pho: You recently had a dear friend of mine, Dr. Roxanne Elmi, on your podcast.

Tammie Chang: Yes. She is a good friend. We have been friends since residency. We are in Pink Coat together. I love her work. I think that is also what we need so much of right now.

Kevin Pho: How much of a change was it in your professional life and in your job? Did it make a huge difference in terms of where you were and where you are now regarding this whole unhooking thing?

Tammie Chang: Yes. I actually think it was this process of unhooking, which has really been over the last three years for me, that has allowed me to step down from the wellness officer role this month. I am able to let go because I know it is not for me, and I am actually going back to part-time. I will be a pediatric nocturnist, actually.

Kevin Pho: Oh, nice.

Tammie Chang: Because I really enjoy it, and it is fun. Then I have all this time and energy to devote to things that bring me joy in a very different, free way. Had I not gone through this, honestly, I don’t think I would have known how to step down from a big leadership role. They were actually talking about expanding the role. And here I am choosing to go. It is not for me. It is definitely for someone else. But I think it is just knowing myself more than anything else and knowing who I really am.

I wrote about it in the article. When all that stuff stripped away, I was back to asking who I was without all that, and who I was when I was a kid. I kept coming back to when I was 18 years old going into college and medical school. They are so young, full of hope, and so bright. It made me think about who that was, and that is how I feel about other people. It is asking who you were before life, medicine, and work broke your spirit. So I went back to that for myself and came to realize that I don’t want big titles and I don’t need a lot of money. That is not what is important to me in this life. So it really shifted my whole life perspective, and I am so grateful for that.

Kevin Pho: That identity is so critical. I have talked to so many other physicians about what their identity should be, how to choose their identity, and whether the identity is imposed on them. That is really one of the keys, I think, in terms of breaking out of those doldrums of burnout. For those other physicians who are listening and maybe in a similar position to where you were, tell us if there are some pieces of advice that you could share with them. Perhaps they feel stuck or feel constrained by a certain identity that they are not happy with. Where can they even start? What are some things they can do?

Tammie Chang: I saw an article coming out from you about not calling medicine a calling. I think so much about how we all not only survive but thrive in the midst of all the craziness and the reality of health care in this country and the way it is evolving rapidly. We are all part of corporate medicine, the vast majority of us now, which means we have very little autonomy. I also think a lot about all the difficulties in the world and our society right now. We are like a microcosm of the macro. Ultimately, what I want for each of us is to figure out how to be OK. This is a hard time in our world, and I don’t think it is going to get better very quickly.

So ask yourself what you can control. What is within your control today and right now to be OK? No matter where you are, no matter where you are working, and no matter what your work situation or family situation is, you have that capacity within you. You just have to slow down and be quiet, because that is the only way we can actually get in touch with that part of ourselves. Start there and realize that we are so much more than our job, our title of being a physician, or even being a parent or wife. I look at all these identities and ask who you are without all that, because you still are incredibly valuable and a beautiful human being without any of it. Just remember that inherent goodness is in every single one of us, and we have the capacity to be OK.

Kevin Pho: Sometimes I find that mindset is a little bit incongruent with current medical culture. When you decided to step down, not take that expanded chief wellness officer role, and go part-time, what were some of the reactions of your immediate colleagues? Did they understand why you were doing what you were doing?

Tammie Chang: You know, I have been surprised because I share why I am doing it very openly. I tell everyone that yes, this work is so important to me, and stepping down allows me to do the things I truly feel called to do out in the world. To me, that is what I have to do right now. When I frame it that way, people understand. I have also had people say that it is unusual for someone to want to promote you and for you to say you don’t want that. Even five years ago, I would have taken that job. Even three years ago, I would have leapt at it because that is what I thought I wanted and what was right for me. But I know now so well that that is not right for me.

Kevin Pho: We are talking to Tammie Chang. She is a pediatric hematology-oncology physician and co-founder of Pink Coat, MD. Today’s KevinMD article is “Unhooking from the ego in medicine.” Tammie, we will end with some take-home messages that you want to leave with the KevinMD audience.

Tammie Chang: I think I said the same take-home message in the past. It is to trust in yourself and in who you really are. You are going to be OK, and you can be OK no matter what.

Kevin Pho: Tammie, as always, thank you so much for sharing your story, time, and insight. Thanks again for coming back on the show.

Tammie Chang: Thank you. Thanks for having me, Kevin. Thank you for everything you do.